A service evaluation of a pilot narrative therapy tree of life group in an older adult inpatient service

Aims: This service evaluation investigated the acceptability, feasibility and preliminary outcomes of a narrative therapy Tree of Life (ToL) group within an older adult inpatient Dementia and Frailty (D&F) ward. The group follows a structured, metaphor-based exploration of the ToL, which employs narrative therapy principles to promote discussions and reflection around identity, connection and resilience. Method: Eight service users, aged 56 to 87, attended up to eight one-hour group sessions over four weeks. Data collection followed a mixed-methods design. Psychological wellbeing was measured using the CORE-10 at four time points, and sessional affective responses were collected using a five-point Likert scale (‘Smiley Face’). Post-group qualitative feedback was analysed using a framework approach. Results: A paired-samples t-test and Wilcoxon signed-rank test analysis showed no statistically or clinically significant change in psychological wellbeing following the intervention (t(5)=0.69, p=.52, Wilcoxon p=.65, RCI=3.86). However, descriptive data suggested good acceptability, with high ratings for enjoyment, feeling listened to, and mood, with a mean score for overall enjoyment of 3.08 out of 4. Qualitative feedback highlighted perceived personal benefits, the accessibility of the metaphor, enhanced self-reflection, and the value of shared group experiences. Conclusions: The ToL group was feasible and acceptable within an acute older adult inpatient context and adheres to NHS person-centred, recovery-oriented frameworks. Although measurable symptom change was not observed, findings suggest meaningful personal and relational benefits consistent with person-centred and recovery-oriented practice. Recommendations for service development and future research are discussed.