The Tree of Life narrative approach was co-developed by Ncazelo Ncube (REPSSI) and David Denborough (Dulwich Centre Foundation) to assist colleagues who work with children affected by HIV/AIDS in southern Africa. This approach has proved so successful and popular that it is now being used with children, young people, and adults in a wide range of countries across Africa, and also in Australia, Brazil, Canada, Russia, Nepal, the USA, and elsewhere. This collection is home to a growing body of research, evidence and practice relating to the Tree of Life as a therapeutic approach. 

The Tree of Life

Stubbs, K (2022). A Qualitative Exploration of Facilitators’ Experiences of Using the Tree of Life Methodology within Global Community Contexts.


The Tree of Life methodology (ToL) is a Collective Narrative Practice developed to support communities to respond to collective hardships and trauma from a place of strength. In seeking more culturally-appropriate, localised, community-centred approaches towards global mental health provision, ToL has great potential. However, whilst there is a growing knowledge base regarding ToL, there is a sparsity of empirical literature. In particular, little is known about what leads practitioners to use ToL and how they experience the possibilities of its use in community contexts, both important knowledge(s) to support the understanding, deconstruction, improvement and future uptake of the methodology. Using semi-structured interviews, this inquiry sought the experiences of 19 practitioners, who work(ed) across 16 different countries using ToL in community contexts. The inquiry aimed, specifically, to understand the personal and professional impact of this work, the opportunities and challenges afforded by ToL, whether the practice differs from other practices, and what leads people to use ToL within community contexts. A Reflexive Thematic Analysis of the conversations with practitioners constructed three main themes: ‘Encountering Possibility’, ‘A Contrasting Way of Being and Doing’, and ‘Shared Humanity’. Eleven respective sub-themes were constructed, and together the analysis told a story that practitioners experience the methodology as one of ‘possibility’, different to other approaches in the way practitioners are able to work and be alongside others, sharing their stories in an authentic way and contributing to a joint humanity that leads to both connection and action. Implications for practitioners, the continued use of ToL, clinical psychology and the wider context were outlined. A critical appraisal and several possibilities for future inquiry were presented.


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Nigar G. Khawaja, Kate Murray, and Shaheeda Sadeed (2022). Tree of Life: Acceptability and feasibility with older Bosnian women of refugee background


There is a growing awareness that mental health issues of culturally and linguistically diverse individuals from refugee backgrounds can benefit from therapeutic intervention to promote wellbeing. However, there are numerous barriers to services for these populations. There is increasing recognition that culturally sensitive and safe therapeutic and counselling models are needed, particularly for people less likely to engage with mental health services. Consequently, researchers have begun exploring psychosocial approaches, such as Tree of Life, a relatively new narrative-based intervention which uses creative and expressive tools to enhance personal strengths and resilience. This study used a qualitative methodology to assess the acceptability and feasibility of Tree of Life in a community setting with older Bosnian women from refugee backgrounds. Five women with a mean age of 72 years attended a 6-week intervention. They provided feedback at the end of each session and participated in a focus group after the intervention. Three participants were also interviewed following the intervention. Facilitators documented their observations and any issues with the intervention process. Qualitative data revealed Tree of Life as an acceptable and feasible intervention for this population and suitable for further testing. Further, participants reported that they found the approach beneficial. Implications and future directions are discussed.


Sophie Parham, Jeyda Ibrahim, Kate Foxwell (2019)


Some suggest the ethos of the Tree of Life (ToL) group aligns with the concept of “personal-recovery” promoted in mental health policy. Thus, it is claimed that the group could be a useful approach within UK mental health services. This review collated 14 papers to explore whether existing literature regarding the ToL group supports this assertion. The papers were synthesized using the thematic analysis method and three broad themes were identified, which support the argument for its utility within services. These were recovery-aligned themes, the inclusivity of the model, and group processes relevant to mental health contexts. The papers are critically appraised, key concerns regarding the wider literature discussed, and clinical implications summarized.

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Agata Vitale, Nigar G. Khawaja and Judy Ryde (2019)


The current study aimed to understand the experiences of refugee women living with HIV as they participated in the Tree of Life (ToL), a group-based narrative technique. A qualitative case study methodology was used. Five African refugee women took part in the study. The ToL consisted of seven two-hourly sessions conducted on weekly basis. Further, participants completed a feedback form after each session, and they were individually interviewed on completion of the ToL. The researchers kept detailed field notes. The data indicated that participants were motivated to attend the intervention in order to overcome their psychological distress, isolation and negative thoughts associated with their situation. Participants found the intervention beneficial. In a safe and supportive setting, and through the art making process, they were able to reflect on their painful past and current issues associated with their migratory stressors and with living with HIV. They identified personal strengths and qualities that enabled them to cope and build their resilience. The art making process and the discussion of the tree empowered them to re-author their life narratives. Finally, they related to each other and they developed a sense of connectedness. The findings indicate the Tree of Life as a promising technique for use with refugees living with HIV. Implications and future directions are discussed.

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Schweitzer, Robert, Vromans, Lyn, Ranke, Grace, & Griffin, Jane


The Tree of Life group program is a narrative-based expressive arts intervention, designed to target the psychological difficulties faced by young people from refugee backgrounds. This study utilised a case study methodology to investigate the experience of a single adolescent from a Liberian background resettled in Australia, who participated in a manualised version of the Tree of Life program. The case study aimed to identify the underlying therapeutic processes that enabled the participant to adopt a preferred self-narrative. The participant was observed to demonstrate positive gains as a result of program participation. Five therapeutic factors were identified as particularly salient to the program’s success: the exploration of alternative stories of self; the fostering of group cohesion; the provision of corrective emotional experiences; the experience of outsider witnesses; and the instillation of hope. These factors were discussed in relation to working with young people from refugee backgrounds. Recommendations for future implementation of the Tree of Life program are provided.