Graduation project at CSM, UAL
Developed and tested at Bemerton social housing estate, Islington, and the Bromley-by-Bow centre
“This process has shown me that my health is manageable. You can do something about it. When I used to think about it, it would seem too much, too difficult to try and balance it all; what can I really do about it? But seeing it visualised I realise that it’s okay, actually I can do this.”
Health as a personal story
Health Chronicles is a unique methodology that uses storytelling and self reflection to turn health into a comprehensive personal story. It provides a holistic approach: utilising narrative instead of medical equipment. During engaging sessions people discover what their health means to them and how it relates to their daily life. They uncover what their aspirations are, and how these motivate them to take positive steps towards a healthier life. This process leads to a greater sense of control and ownership over your health and wellbeing, and creates a deeper understanding of the holistic and multi-disciplinary approach that is needed to improving your health.
Examples of Health Chronicles from people with long term multiple health conditions
While health is a personal matter, health care is often impersonal. People may lack a sense of control over their health, particularly in a context where illness is commonly treated with medication. The relationship between daily life and physical and psychological health is often overlooked; GP consultations are brief and focused on physical matters. The factors that cause the health issues in the first place are not focused upon, which means that the symptoms will most likely return.
“Many patients do not understand their own illness. They just trust the GP and the medication they get and they want it to be over as soon as possible.” General Practitioner
“Doctors will say, ‘do this if you feel like this, do that if you feel like that.’ But with Health Chronicles you’ve got something to work on for yourself. I can decide; ‘now I’ll work on this area, now on that area’. I can do one bit at the time, rather than everything at once because it’s too much to handle. You have to break it down and then it won’t be so scary.”
The listener guides the participant through the process of telling their health story. Starting from the medical issue, the story is expanded to explore how and when this ailment started, how it affects them and how else it relates to their lifestyle and environment. 6 lifestyle themes help as a guidance: Home, Work, Leisure, Relationships, Personal and Money.
The listener will create an ‘illustrative map’. This map is a visual and holistic representation of their health experience.
The participant reflects on their story, to understand their health situation. This process gives them the opportunity to discover connections and find the things that get in the way of them leading a healthier life.
In this active and engaging session, the participant maps out what their ideal health story could look like. Taking the emerging lifestyle themes from their current story, the participant will explore what their ideal scenario would be. By focusing on their aspirations they can see becoming healthier as an enabler to do the things they care about.
We have completed a Health Chronicles pilot at the Bromley-by-Bow centre in East London. Currently it is being implemented in Walworth, South London, as part of a whole-systems approach to tackling multiple long-term conditions in the area and improve residents' quality of life. We are modelling Health Chronicles as a holistic way of care assessment that bridges the gap between health and community organisations. Read more about this on the Guy's & St. Thomas' charity website.
“This makes me think I’m not going mad, it’s all there. It’s emotional. Nobody has ever asked me these things. Not even in CBT. They just focus on one thing. Never look at it holistically." Participant
“This makes it more real. I love it. I’d like to show it to the neurologist, to the whole medical team. To social services. So that they finally understand what it feels like. I’ll show it to my family, my friends. I need copies that I can use for my campaigning to raise awareness of the illness. Others can get so much out of this as well, I want to hand them out everywhere.” Participant
"I have nothing like this, that sums up my whole journey. It’s been all in my head. This is a hard copy. It shows that it hasn’t all been wasted years. I found this an extremely rewarding experience." Participant
“It explains so much background information which I can really use to understand the patient better and be of better help to them. It gives me more insight than I would have ever found out through only talking to the patient.” General Practitioner