Healing through Story Telling: An Integrated Approach for Children Experiencing Grief and Loss

Article excerpt

For centuries stories have been used to record history, as well as impart meaning and assist understanding within a cultural context. Story telling is an indirect, cross-cultural method of communication which may be employed within the therapeutic setting to assist problem resolution (Fazio, 2008). Many therapeutic approaches use stories and storytelling (Boik & Goodwin, 2000; Clark, Ennevor & Richardson, 1996; Geldard & Geldard, 2001; Ziegler, 1992), and therapists working with children have combined storytelling, story making, play and art to facilitate communication since the 1980s (Hanney & Kozlowska, 2002; Remotigue-Ano, 1980). The use of narrative methods with children with psychosocial and mental health needs has been described as both a strength-oriented, child-centred approach and a collaborative means of respecting children as experts in their own lives (Bennett, 2008; Hanney & Kozlowska, 2002).

Occupational therapists employ stories as a therapeutic medium with diverse populations, assisting adults to resolve anxiety and depression (Gunnarsson, Jansson & Eklund, 2006) and older adults to adjust to devastating injuries (Kivnick, Stoffel & Hanlon, 2003). Using creative media and storytelling to help children address psychosocial issues is endorsed in the occupational therapy literature as a means of supporting children to tell their story of grief and loss, eliciting their interpretration of events (Fazio, 2008) and assisting them to make sense of the experience. Endorsing that approach, Milliken, Goodman, Bazyk and Flynn (2007) cite the truism 'time doesn't heal--actions do'. They describe participation in meaningful occupation as "uniquely capable of being a catalyst in the healing process" (p. 82) and a medium through which occupational therapists empower people "to discover meaning and significance in life" (p. 82).

There are multiple ways in which to use stories with children, including the involvement of a child in constructing a story of his or her own (Fazio, 2008; Jeffreys, 2005). To inform that work, occupational therapists have drawn on the work of counsellors, psychologists and philosophers. In addition, Clark, Ennevor and Richardson's (1996) concepts of occupational storytelling and story making is commonly invoked to explain how people "make sense of their illness and regain control over their occupational lives" (Wright-St. Clair, 2003, p. 48). This approach is often combined with the process of having clients tell their story and envisage possibilities for the future (Gunnarsson et al., 2006; Kivnic et al., 2003).

This paper demonstrates the use of a storied approach to assist children who have experienced emotional trauma. The therapeutic approach described involves the integrated use of sandtray therapy, a peer group and story book creation. An illustrative case example of a girl commencing her healing journey from grief is provided. Emily's story is not based on a single case, but rather extrapolated from the first author's years of practise. While the necessity of a parallel programme for families is briefly discussed, it is not fully explored. The intention of this paper is to present a concise, focused, descriptive approach to change which may prove useful to other therapists working with children.

An occupational approach

The occupational approach we describe has its theoretical roots in narrative or storytelling. Narratives reflect cultural meanings and convey rich personal details. Stories, in particular, have been used as a therapeutic medium "to teach, to comprehend, to influence and to develop self-understanding as well as understanding of our unique social worlds" (Saarni, 1999, p. 20). Narrative therapy is underpinned by a constructivist worldview, which holds that the understandings people form about the world are not fixed; but rather they can be revised as new information becomes available (Geldard & Geldard, 2001). …