Journal article review: The Tree Theme Method
Gunnarsson AB, Eklund M (2009) The
Tree Theme Method as an intervention in psychosocial occupational
therapy: Client acceptability and outcomes,
reviewed by Dr Katrina Bannigan, Director of
RCOMH
I thought this paper was going to be about a
novel intervention because I had never heard of The Tree Theme
Method. However the intervention was not unfamiliar; it was just
the name that was new to me. When I worked in clinical practice I
had used the intervention (clients paint trees representing certain
periods of their life as a starting point for telling their life
stories; it initiates a process of reflection and interaction as a
means of enabling changes to be made in their daily lives). It was
a technique I had learnt ‘on the job’; a creative exercise with no
specific name. So, for me, this paper demonstrates a really useful
point, i.e. the importance of an intervention being documented and
having clear protocol. Without this there is no consensus about
what the intervention involves which makes it difficult to
evaluate.
Having established that this was an
intervention that I am interested in I was eager to see whether it
was effective or not. As the authors make clear that was not the
point of this paper; it is not a randomised controlled trial. There
was no control group so it was not possible to establish whether
the correlations identified in the study were as a result of The
Tree Theme Method. However, this does not mean the paper is without
value. As was stated in the paper:
“The study of the implementation of The
Tree Theme Method follows a logical continuum of research, starting
with exploratory studies such as qualitative case study
(Gunnarssonet al 2006) followed by studies like
the present study based on quantitative research
methodologies” (Gunnarsson and Eklund 2009: 174)
The aim of this study was to examine the
therapeutic alliance and client satisfaction, in relation to
perceptions of everyday occupations and health related factors,
with clients experiencing The Tree Theme Method intervention.
The results of this paper are promising and
suggest further research would be useful. However, there are a some
methodological points that would need to be considered in designing
future studies, e.g. identifying a representative sample (in this
study they identify that there was a gender imbalance but it is not
clear whether the proportion of diagnostic groups was typical), the
selection of outcome measures (the authors reported reliability and
validity studies but did not indicate whether these were well
conducted), and whether is the use of client satisfaction is an
appropriate outcome measure? (satisfaction has been discredited as
an outcome measure in recent years).
Gunnarsson AB, Eklund M (2009) The Tree Theme
Method as an intervention in psychosocial occupational therapy:
Client acceptability and outcomes. Australian Occupational
Therapy Journal, 56 (3) 167–176. [doi:
10.1111/j.1440-1630.2008.00738.x]