The tree of life methodology: a qualitative study of service-users’ and intervention facilitators’ experiences

In many healthcare settings, there is limited consideration for cultural diversity and sensitivity in existing approaches. The Tree of Life Methodology (ToL) offers a solution to this problem. However, investigations on the application of ToL within secure forensic inpatient settings are lacking. The current service evaluation sought to explore service user and staff facilitators’ experiences engaging with the ToL and provide further insight into the methodology’s implementation within this setting (a London-based forensic inpatient unit). Eight participants (two service users and six staff members) took part in semi-structured interviews. Thematic analysis was used to explore their narratives. Both service-users and staff reported enjoying their experience taking part in the group. They perceived the methodology to facilitate the contemplation and rediscovery of parts of their identity/culture in a power-neutral therapeutic environment. The methodology was also perceived to help its partakers build resilience skills and reflect on both their past and future in a positive light; findings which are in line with existing ToL research. ToL encouraged staff to incorporate culture into the treatment of forensic mental health service users and facilitate the provision of person-centered and culturally sensitive care. Our findings highlight the benefits of future use of the ToL within the forensic and other secure settings.