The Three-Level Frame: A Framework Statement (Version 0.1)

The Three-Level Frame is a working model for recognizing and responding to the experience of serious illness at three levels: somatic (the body), affective (the feelings), and narrative (what it means for a life). It was built for the people who are actually at the bedside when no specialist is available: aides, nursing assistants, emergency medical technicians, family caregivers, and generalist clinicians. The Frame holds that the body is foundational, that the affective level is the working bridge between bodily signal and reflective meaning, and that once all three levels are present the causal traffic between them runs in both directions. A fourth existential level emerges under certain conditions, end of life being the paradigm case; the Frame marks it rather than forcing it into the base structure. The Frame is applied across three roles (patient, caregiver, practitioner), forming a levels-by-roles grid that organizes curriculum, triage, and skill definition in the author's related work. This statement records the Frame as it stands in November 2026, positions it against adjacent published models, and sets out an evaluation design that others may run. Use of AI: The framework and the positions taken are the author's. The text was drafted with the assistance of an AI language model (Claude, Anthropic) working from the author's frameworks, notes, and direction; the author reviewed, corrected, and approved the final text. Version 0.2 adds this disclosure, the assigned DOIs, and the CC BY-NC-ND 4.0 license statement to the document itself; the framework is unchanged from Version 0.1. Rights: © 2026 Christopher A. Matthews and SkillsHuman, Inc. Released under CC BY-NC-ND 4.0. Use of this document or its contents to train or fine-tune machine-learning systems requires written permission from SkillsHuman, Inc. Commercial licensing inquiries: [email protected]