The Tree Theme Method - An Occupational Therapy Intervention Applied in Outpatient Psychiatric Care

Abstract: Abstract
The Tree Theme Method (TTM), based on occupational therapy, creative activities and life storytelling, implies that the client draws and paints trees representing certain periods in their life. The paintings are used as a starting point for the client to tell their life story with focus on everyday occupations (occupational storytelling) and shaping plans for their future (occupational story making). The intervention comprises of five sessions. The overall aim was to describe and evaluate the TTM as a method for intervention in outpatient psychiatric occupational therapy. Study I was a case study, including five sessions and a follow-up. The study demonstrated the usefulness of the TTM method for understanding a client’s problems and in developing strategies for them to cope with everyday life, and important life themes were identified. Study II was a pre-test – post-test study. Nine occupational therapists recruited 35 clients from general outpatient mental health care units, for the TTM. The findings indicated positive significant changes regarding occupational performance and health-related variables. The high ratings of the therapeutic relationship were found to be related to the changes observed, and the clients’ satisfaction with the TTM was high. Study III investigated clients’ experiences of participation in a TTM intervention. Twenty clients were interviewed. In general the clients felt that the TTM helped them to perceive their lives as coherent, and that they became more able to cope with daily life. Furthermore, the intervention and its meaning were closely related to the development of the client-therapist relationship. Study IV examined occupational therapists’ experiences of using the TTM. In general, the TTM was experienced as a structured method for starting a process and initiating a therapist-client relationship. In order for clients to benefit from the TTM, the occupational therapists found it important to balance the therapeutic frames with flexibility. The occupational therapists thought that they needed personal self-knowledge and a therapeutic attitude in order to motivate the client to take part in the intervention. A good therapeutic relationship was important for initiating a dynamic process, leading to new perspectives in everyday life for the client. Future research should address what happens in a long-term perspective and investigate whether frames and techniques need to be adjusted in order to be feasible in clinical contexts.