Narrative Methods: Talk, Listening and Representation

Abstract

The involvement of the user in decisions about his or her own health and social care has become a key element of the changes encapsulated in the Government's legislation. Listening to the service user and responding to his or her needs is an integral part of that change. Occupational therapy philosophy has always engendered client-centred practice and, therefore, listening to and valuing the voice of the user. Now, more than ever, occupational therapists have to show that this is an integral part of their everyday practice. Narrative is one method that could be used to explore the lived experiences of users of occupational therapy. This study explored the relevant literature about narrative using qualitative methodology. The emerging themes from the data suggest that narrative, in its varied forms, could be a useful tool in clinical and research-based occupational therapy activity. Also, occupational therapists' own approach and reflexivity within the narrative process are key elements in the effectiveness of this technique.

An examination of the pairing between narrative and occupational science

“…Stated differently, narrative is a way of assigning causality and order to the events and circumstances of everyday life (41). Drawing on Kleinman (21) and other researchers in the field of medical anthropology, descriptions of narrative meaning in occupational science literature have often focused on illness narratives, stories that allow individuals to make sense of and explain illnesses to others (10,(45)(46)(47). For example, narrative has been found to serve as a channel through which individuals find meaning in their struggles with bipolar disorder (48,49).…”

“…Drama is created when narrative slopes are either accelerated or altered. In applying this concept to occupation, researchers have sequenced events on a timeline to determine the point in the plot where the narrative slope changes (41,46,90). The Occupational Performance History Interview, a tool used to gather a history of play, work, and self-care performance, has been utilized to examine the ups and downs that occur over the course of psychiatric patients' lives (91) as well as to study key events within the lives of women with chronic pain (88).…”

Satisfaction for quality of life: a comparison of patient and occupational therapist perspectives

“…Studies of physician evaluations of patient quality of life have already been performed in different fields of medicine, such as elderly, chronically ill, or cancer patients, paediatric patients, etc. (4,9,(12)(13)(14).…”

“…Understanding the patient's view seems to be a core value in occupational therapy (OT) (14)(15)(16)(17) and, among others, the client's quality of life seems to be an interesting issue. In the OT context, quality of life has been explored in very different fields, such as Alzheimer's disease, dementia, etc.…”

A quantitative approach to measure occupational therapist–client interactions: a pilot study

“…The nature of occupational therapy, however, is to promote client-centred care-a goal that is inconsistent with the traditional medical model. In particular, the grounding epistemology of occupational therapy has always emphasized clientcentred practice and, therefore, listening to and valuing the voice of the client (4). Clinical encounters involve the occupational therapist and client in the creation of a structure that gives meaning to particular therapeutic actions by placing them within a larger therapeutic story (5).…”