Storytelling interventions for families affected by life-threatening illness: A systematic review and Delphi study

Seabrook, Abigail 2024. Storytelling interventions for families affected by life-threatening illness: A systematic review and Delphi study. ClinPsy Thesis, Cardiff University. Item availability restricted.

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Abstract

The present thesis comprises two papers on storytelling interventions for the promotion of psychological wellbeing in families: a systematic review focusing on families affected by life-threatening illness, and an empirical study focusing on families affected by cancer. Paper 1: Systematic Review Life-threatening illness can affect a whole family beyond the diagnosed individual. Family roles, relationships and dynamics can change, which can have a destabilising effect. Although many families adjust to the new normal, some families experience increased psychological distress. Storytelling interventions to promote greater psychological wellbeing in people affected by life-threatening illness have been widely studied, however storytelling interventions that support the family system have received less attention. This review of qualitative studies synthesizes existing literature on storytelling interventions specifically designed for families affected by life-threatening illness. Ten articles were identified according to PRISMA guidelines, with results analysed using thematic synthesis to construct analytical themes, giving insight into the uses, benefits and processes of the interventions. The articles were appraised for quality, ensuring that this was considered when conclusions were drawn. One of the main findings is the ability of storytelling interventions to allow families to “expand outwards” through fostering greater connection, making new meaning and developing the family’s story to be shared and witnessed by themselves and others. The findings from this review support the existing evidence that storytelling can be a tool to promote psychological well-being in families affected by life-threatening illness. The sharing of stories confers benefits on both teller and listener, enabling family members to strengthen bonds through engaging in a creative, enjoyable activity, which moves them towards a more meaningful life, helping them to navigate the challenges of illness together. Paper 2: Empirical Study The second paper builds on the first but narrows the focus to families affected by cancer. This study represents the first stage in the development of a storytelling intervention aimed at families affected by cancer. Like the first study, the literature explores how families face the physical and emotional challenges of a cancer journey, as well as the shifts in roles, responsibilities and relationships. This empirical study employed a two-round Delphi approach to establish consensus and explore diversity of opinion on the key components of a storytelling intervention. The panel of experts was drawn from three groups: professional storytellers, healthcare professionals and people with lived experience of cancer in either themselves or a family member. 15 experts participated in the first round, consisting of a semi-structured interview. The second round consisted of an online survey, with 72 items derived from the interview data. 19 experts took part in the second round, which included both original and additional participants. 91.6% of the items achieved consensus, indicating strong agreement among the experts on the core features of the intervention. Respondents felt that a storytelling intervention should be flexible, employ co-production with participants and provide emotional support alongside medical care. Facilitators should have strong storytelling skills and training to ensure psychological safety, while practical factors like time and resources must be considered. There was less agreement regarding the involvement of family members and online versus face-to-face delivery. The relevance of true-life versus fictional stories was also a subject of disagreement, as was the ability of a storytelling intervention to create a more positive vision of the future for cancer patients and their families. This study offers valuable insights into the components of an effective storytelling intervention, as well as the processes by which storytelling can promote psychological well-being, such as the role of acceptance of difficult thoughts and feelings. The high level of consensus supports the use of the findings to inform the development of storytelling interventions aimed at supporting families affected by cancer. The study highlights the importance of building flexibility into interventions so that they can be tailored to participants’ needs, and the need for the psychological and emotional well-being of families affected by life-threatening illnesses, such as cancer, to be supported by a wider community. Another key takeaway is the importance of facilitators having strong storytelling skills and training to ensure psychological safety. Aspects of the storytelling intervention which did not achieve consensus suggest possible avenues for future research, such as the effectiveness of online or face-to-face delivery methods as well as how different types of story influence emotional engagement, coping, and psychological well-being. Another potential area for research highlighted by the study is the development of consensus measurement in Delphi methodology. Together, these papers highlight the potential of storytelling interventions to support families affected by cancer and other life-threatening illnesses. By fostering connection, shared understanding and the development of coping skills, storytelling can provide a meaningful way for families to navigate the emotional challenges the come with life-threatening illness.

Item Type:	Thesis (DClinPsy)
Date Type:	Completion
Status:	Unpublished
Schools:	Schools > Psychology
Subjects:	B Philosophy. Psychology. Religion > BF Psychology
Date of First Compliant Deposit:	13 March 2025
Last Modified:	20 Mar 2025 16:44
URI:	https://orca.cardiff.ac.uk/id/eprint/176859

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