# Storytelling as narrative health promotion in community psychiatry: a quasi-experimental study

## TL;DR

A storytelling intervention in a community psychiatric rehabilitation program improved life satisfaction among participants over four months.

## Contribution

This study demonstrates the feasibility and effectiveness of storytelling as a novel health promotion tool in community psychiatry.

## Key findings

- Life satisfaction significantly increased among participants after four months of storytelling sessions.
- Participants rated the stories as highly interesting and comprehensible, with a strong positive correlation between these ratings.
- Psychological variables like self-efficacy and sense of coherence showed improving trends, though not statistically significant.

## Abstract

Community-based psychiatric rehabilitation (CBPR) helps patients reintegrate into society while enabling them to live autonomously in supportive environments. CBPR uses multi-modal approach to address patients’ needs in health, education, livelihood, empowerment and social functioning. In addition to pharmacotherapy, other interventions such as metacognitive training, lifestyle interventions, psychoeducation, arts therapy may be used to improve functioning and quality of life. Storytelling as a new intervention was implemented in a community-based rehabilitation setting with patients with mental health issues to test its feasibility and potential to improve life satisfaction.

Stories presenting difficult lives and complicated relationships were narrated and discussed in eight storytelling sessions for members of a civil organization involved in psychiatric rehabilitation in four months. Acceptability was tested by following participation rate and feedback with scales after each session. Demographic as well as mental health data including sense of coherence, distress, self-efficacy, and life satisfaction were investigated by standard scales before the first and after the last session.

Participation ranged from 31 to 49% compared to all persons present at the setting. Participants (mean age: 53.41 ± 12.23 years, 63% females) found the stories highly interesting (mean: 8.93 ± 1.62) and comprehensible (8.67 ± 1.9) on a 1–10 scale though the means of individual sessions somewhat varied. Significant positive correlation was found between the stories being interesting and comprehensible (Spearman’s rho = 0.656) but significant negative correlation was found between story length and comprehension (Spearman’s rho=-0.183). Based on the responses from participants who completed the questionnaires before and after the intervention, life satisfaction significantly increased. Psychological variables such as self-efficacy, sense of coherence, pathological distress showed improving tendency without reaching significance. Pre-intervention data showed significant positive correlation between self-efficacy and sense of coherence (Pearson’s r = 0.659). Psychological distress was negatively related to both self-efficacy (Pearson’s r=-0.728) and sense of coherence (Pearson’s r=-0.825).

Storytelling as a means for promoting health proved to be feasible in a group of rehabilitated patients with mental disorders. Their life satisfaction significantly improved in four months. Carefully selected stories narrated and discussed in group settings may result in the gradual shift of participants’ perspectives leading to improved life satisfaction.

The online version contains supplementary material available at 10.1186/s12888-025-06816-1.