Tree of Life

Maudsley Charity has funded ‘Tree of Life’ workshops for a number of years, promoting recovery and improving the relationships between service users and staff across all acute wards at South London and Maudsley NHS Foundation Trust.

‘Tree of Life’ is a type of narrative therapy that originated in Zimbabwe when counsellors were working in heavily trauma-stricken communities. Instead of asking the affected person to discuss and revisit a problem which can be traumatising in itself, they were asked to talk about the positive aspects of their life first through the metaphor of a tree.

The Charity has recently provided funding to undertake a pilot of Tree of Life across two male and one female medium secure admission wards at River House, Bethlem Royal Hosptial, making it the first time the methodology has been implemented in a forensic setting.

Focusing on the positive

As a therapeutic model, the ‘Tree of Life’ was seen as a potentially effective way of addressing the challenging nature of an in-patient ward as well as engaging an ethnically diverse community. The team at SLaM adapted the idea into a workshop to fit into the busy schedule of this environment and received funding from Maudsley Charity. Following the success of a two year trial the project has now become an official model of care in acute psychology services.

With around 80% of participants coming from BME (black minority ethnic) groups, the workshops have a key focus on culture and heritage.

‘There are three main aims of the project: to promote the recovery approach on the ward, to collaborate with service users who are trained and paid to run the workshops and to develop positive relationships between service users and staff,’ explains Dr Julie Fraser, Senior Clinical Psychologist Clinical, Family and Systemic Psychotherapist.

Breaking down barriers

With the guidance of co-facilitators, they each draw a symbolic tree: the roots are their past, the ground is their present, the trunk is their skills and abilities, the branches are their hopes and dreams and the leaves are the special people in their life.

‘It is a really rewarding and effective way of working together,’ she says. ‘On the wards where individuals have been sectioned, they are often there against their will and may be quite hostile – so there is very much that culture of “them and us”. This therapy is a way of breaking down barriers by getting to know each other and see the person behind the diagnosis or behind the job.’

Once the group has finished drawing, they are asked to share their tree drawings and present one another with a certificate recognising the other person’s skills, strengths, hopes and dreams. The trees are always displayed together in the wards as a ‘forest’ to build a collective sense of strength.

Led by service users

Maggie Hayes is one of the co-facilitators for the workshops and a service user who has first-hand experience of staying in an in-patient ward and the challenges it can bring.

‘The most important thing about the workshop is that service users have the freedom to say as little or as much as they want – and at their pace – something which they are not always able to do,’ says Maggie. ‘It is their story to tell and up to them how much they share, so it is giving them back control.’

Feedback from participants and a real willingness from teams to get involved has been hugely promising for Julie and her team. One service user commented that the therapy has enabled them to see ‘the humanness of people’, and another said it helped them to better accept their relationship with staff members by helping them view the situation as ‘we are the same but we are different’.

‘There is a need for this way of working,’ says Julie. ‘People have attended, they have shown that they liked it and found it valuable, The project embodies the co-production model of working, as every workshop is run by a service user Tree of Life facilitator and a ward psychologist.”

Tree of Life in a forensic mental health setting

In 2019, Maudsley Charity funded a new project that will undertake a pilot of Tree of Life across two male and one female medium secure admission wards at River House, Bethlem Royal Hosptial, making it the first time the methodology has been implemented in a forensic setting.

It will create a pool of trained service user facilitators working directly into ward environments for the first time, using an adapted and extended Tree of Life format. 

Find out more about the Tree of Life project in the short film below