The notion that one can do RCTs of narrative techniques is an interesting
one.  I did a commentary on the JAMA paper which Charlotte refers to. I
don't think I had the last word on the topic but the authors of the JAMA
paper emailed me and said my assessment had been fair.  At one stage we were
planning to work towards a bigger trial along the lines of what they did,
but I think everyone got cold feet.  Not sure still whether this line of
research is epistemologically sound!  Any commments?  Here's the url of my
editorial.
http://www.bmj.com/cgi/content/full/319/7205/270


Trisha Greenhalgh
Professor of Primary Health Care
University College London
Room 410, Holborn Union Building
Highgate Hill, London N19 3UA
Tel 00 44 20 7288 3246
Fax 00 44 20 7281 8004
[log in to unmask]

-----Original Message-----
From: Researching and evaluating the use of narrative in health and
related fields [mailto:[log in to unmask]]On
Behalf Of C&F Charlotte Burck
Sent: 12 November 2001 09:42
To: [log in to unmask]
Subject: Re: Using the time between between consultations


Dear Judith
I wanted to respond to your idea about asking people to write, and
wondered if you know about the research in the USA on the effect of
writing on symptom reduction.
JAMA (1999) Effects of writing about stressful experiences on symptom
reduction in patients with asthma or rheumatoid arthritis. Journal of
the American Medical Association 281: 1304-1309. They have shown that
asking patients to write about stressful events in their lives, not
necessarily about their illness / pain, had an effect on their immune
systems.
This technique of asking people to write has also been incorporated into
work with families that struggle with chronic illness, and there is a
good article called:
Chronic Illness: Trauma, Language, and Writing: Breaking the Silence. by
Peggy Penn. Family Process. Vol 40. No 1 2001, which offers ideas about
narrative, listening and the use of writing which could be applicable in
a consultation process - this article pays attention to the relational
aspects of managing pain and illness, ie the effects on everyone in the
family.
Charlotte Burck
Family Therapist

-----Original Message-----
From: Judith Norman [mailto:[log in to unmask]]
Sent: 10 November 2001 11:30
To: [log in to unmask]
Subject: Using the time between between consultations


"Using the time between consultations" sounds as though it has huge
potential.
So far my experience has been that many people need to be handed a
specific
sheet of paper with some sort of written question/s posed on it and
space for
them to write their response. Seems very directive but gives more likely
response
than a verbal request. Not sure why - ?They think I don't seriously mean
the
request otherwise? ?They forget?

Am planning to introduce patient-held notes for the Pain Clinic but
would like
ideas from anyone. Thought of starting small, and evolving as I get the
feel
of it. Have certainly reaped rich pickings from the material received on
my
initial Pain Clinic Questionnaire which they mail back before the first
consultation.
Saves a huge amount of beating about the bush asking the wrong questions
on
the day.

What sort of things would you be asking people to mull over in between
consultations
Nigel? Examples always inspire me.
Judith