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by Meredith Jones, M.A., and Michelle Robbins
Broth, Ph.D.
Because of the ignorance and stigma which still sadly surrounds
HIV, children born with the human immunodeficiency
virus (HIV) experience additional psychosocial stressors beyond those
commonly associated with other childhood illnesses. They often live
with real and perceived rejection from others, accompanied by the burden
of secrecy and a sense of shame. Thus, when Camp High Five — a camp for children ages six to sixteen
living with HIV — was given a grant by the H.E.R.O. for Children
Foundation (www.heroforchildren.org) to enhance HIV-infected children's
emotional competence during their week-long summer camp experience,
the primary aim was to create an intervention that would target the
burden of living with a shameful secret. Given our psychological training,
we decided to implement a modified form of narrative therapy tailored
toward the camp environment, the cultural background and mixed literacy
skills of the campers, and the therapeutic goal of giving voice to the
unspeakable. To our delight, the intervention worked better than expected,
and the youth created poignant stories. As we discovered, modified narrative
therapy is a viable, worthwhile endeavor to include in a camp aimed,
at least in part, toward enhancing the emotional life of children and
teenagers. In this article, we provide a rationale and how-to guide
for using narrative techniques in a summer camp for youth living with
HIV, with the hopes that other camps and campers may similarly benefit.
Why Tell Stories
In order to fulfill our therapeutic goals and also
work within the camp parameters for time and space,
we decided to use a modified form of narrative
therapy. Narrative therapists believe that stories
(i.e., narratives) shape individuals' identities.
In particular, the way in which people tell stories
about their lives reflects their inner world and
conveys what they think about themselves and their
experiences. For example, one's story
may reflect a sense of hope and resilience in the
face of stress. In contrast, one's
story may reflect inaccurate beliefs, a tendency
to view situations from a negative vantage point,
and themes such as "everyone
I care for betrays me." Narrative
therapy is also helpful for increasing self-esteem
and self-worth by asking an individual to voice
the complex and intricate series of events that
comprise his or her life and to focus on how problems
are viewed, dealt with, and resolved.
Our modified
version of narrative therapy involved creating
a third-person narrative, a story not about our campers' lives
directly, but rather about someone "like you, someone
who could be in this cabin." We believed that creating a story about a character
like them would allow access to the personal experiences
and inner worlds of our campers more so than direct
questioning of their own lives. Although traditional
narrative therapy would ask for non-fictional stories
from an individual person, we decided for two reasons to use the group
process so that each cabin would generate one fictional story. First,
we wanted to take advantage of the camp dynamics and the bonding of
cabin mates to work together toward a common goal of storytelling. Furthermore,
the time constraints of camp would not permit us to adequately listen
to, analyze, give feedback on, and reconstruct each camper's
narrative. Second, we believed that some campers
might be reluctant to share personal information
about themselves or their experiences in a direct
format and that they might be more willing to disclose meaningful information
if they could do so under the guise of a character.
The Process
We generated
excitement among the campers with the notion that
they would be authors of their stories, which would
be "published" in
book form. We encouraged them to illustrate their
stories as well. We planned to use our grant funding
to print and bind the stories such that each camper
would have his or her own cabin's
book. As authors, we hoped that the campers would
feel that their voices deserved to be heard, that
their stories were worth telling, and that they
would be free to share their stories with other people in their lives
as they chose. We hoped that the stories would reflect some of the
problems they experience in their own lives and that the book would
be a tangible product to represent their connection to each other,
to camp, and to their accomplishments. In addition, we believed that
knowing they would be getting their own book might be rewarding in
itself to help them engage in the narrative story-telling process.
Getting Started
We met with each group of campers in their own cabins
to create a safe place for them to disclose personal
information and ideas. We had two facilitators — a
psychologist and a clinical psychology graduate
student — at each
session. We brought a laptop computer with us in
order to type in verbatim the campers' words and
ideas. After working with several cabins, we found
that the process was best facilitated when one of us led
the group discussion and one of us took notes on
the discussion on the laptop. We introduced the
idea that each cabin would author its own book and that each camper
would have a copy of their own book to take home; we stipulated that
sharing the book after camp was each campers' individual choice, and
that deciding to not share the book was perfectly acceptable. We then
explained that the main character of the book should be a person
similar to the campers in each cabin. So, in a
cabin of fifteen- and sixteen-year-old girls, the
main character should be a fifteen- or sixteenyear-
old girl.
Next,
we asked each group to describe the character using
questions such as: What is her name? Where does she live, and who does
she live with? What does she do for fun? What is she good at? What is
hard for her? Who are her friends? How does she do at school? What kind
of music does she listen to? Typically, the campers used aspects of
themselves when describing their character. For example, one camper
who wore an Atlanta Braves T-shirt contributed that his cabin's
character liked to watch baseball. By using aspects
of themselves to create the character, the campers
were both identifying with the fictional character
and blending themselves into one person, which strengthened their cabin's group.
Almost all of the campers enjoyed this aspect of
the narrative process; they seemed proud and happy
to share information that defined their character
to create something with their group. In addition, this aspect of the
narrative process allowed campers to learn more about their peers — when
one camper contributed that her character likes
to eat Chinese food, another camper said "Ew! You
really like to eat that?" By
the end of the ten or so minutes it took to describe
the character, most of the campers were eager to
continue the narrative process.
Developing the
Story Once the campers had established many of
their character's attributes, we told each group that although they
had the ability to create any kind of story that
they wanted, their story must include one component — that
their character has a secret. We told the campers
that they had to decide, as authors, if they would
like the book to explicitly state what the secret
was or if they would rather not share the specifics
of the secret. We then asked the campers to describe what happens when
people keep secrets, including both the good and bad things about keeping
secrets. Campers typically gave responses that secrets were good because
they ensured privacy and security but that secrets were bad because
they were a burden and may make you feel like you are lying to someone
if you do not tell them the absolute truth. We asked the campers to
think about how the character felt keeping his or her secret, how people
in general feel when a secret is kept. What does it feel like to keep
a secret? Is it uncomfortable? Can it make you angry or frustrated?
Are people hurt?
Once we had established that there are many different
facets to keeping secrets, we told the campers
that every story has a plotline and that they needed to generate one
for their story. If a group had difficulties in creating a plotline,
we asked them to talk about what their character was like before the
secret, what did he or she enjoy, and what was his or her life like
overall. As we talked about the secret and the evolving plotline, we
continued to ask questions about how the character manages her secret:
How does the character think about the secret? What might the character's
family think about the secret? What might the character's friends
think about the secret? Does the character change
his personality, behaviors, or opinions because
of the secret? Is it alright to change in response
to a secret, and what might the consequences of those changes be? Discussing
the many implications of keeping a secret was a way to talk to the campers
about managing emotions. Through the cover of their character, many
of the campers talked about how difficult it is to keep secrets but
that it is sometimes a necessary part of life. Such a conversation enhanced
the campers' thinking about emotions,
ability to discuss emotions, and capacity to identify
emotions correctly.
As the campers generated a
plotline and a manner for their character to manage
his or her secret, we asked the campers if there were other ways to
cope with the secret and what the positives and negatives of these options
were. Generating several different alternatives for the character to
pursue was a form of problem-solving in which both the campers and the
character in the story engaged. Through our discussions with the groups,
we were able to problemsolve by weighing the pros, cons, and likely
outcomes of each scenario for the character to manage her secret. The
purpose of problem-solving was to role-model critical thinking and analysis
skills to the campers, in addition to helping them see that there may
be numerous ways to confront problems. Although many groups were able
to generate interesting plotlines on their own, if they had difficulty,
we asked, "What happens to the character over time? What happens to
the secret?"
We were
surprised by the depth and content of the campers'
stories. Having never done narrative work at our
camp before, we were not sure what to expect and whether the campers
would be able to take the book-writing project
seriously. Some of the secrets generated by the
cabins included teenage pregnancy, childhood cancer
and HIV, and living without HIV in a family of
HIV-positive parents and siblings. Perhaps the most moving story was
created by a cabin of eleven- to twelve-year-old boys who wrote a story
about a family's mother passing away from AIDS and a young son needing
to "man
up" and become the provider for the family. All the stories were
powerful because we could see various aspects of
the campers' experiences
in the narratives. Aside from the secrets chosen,
themes interwoven throughout the narratives also
included loss, poverty, violence, social isolation,
and resilience.
At the end of our first meeting, each cabin had generated
the majority of their story. We then left paper,
markers, and colored pencils with each cabin so that the campers could
create illustrations for their books. Younger children tended to create
many drawings for their books, while the older campers selected not
to create any illustrations. Before leaving, we asked each cabin about
how their experience with writing a story had been so far, and whether
there were any difficulties. Campers tended to give feedback that was
very positive, indicating that they enjoyed the experience and were
excited to see their books.
Finishing Up
We returned to each cabin for
a second onehour period to generate a conclusion
for the story (if not already completed), collect
the illustrations, re-read the story back to the campers, and discuss
what they thought of their book-writing activity. Again, we brought
a laptop to allow us to take notes on what the campers wanted to put
in their story. To help generate conclusions for the stories, we asked
the campers, "Does the character handle the secret differently in the
future? Why or why not? Did the character learn anything about keeping
secrets?" We also asked the campers to think about what would happen
to the character's secret and if the character's
view of the secret changed over time. In many cases,
the campers decided that their character should
resolve problems associated with the secret by
disclosing the secret to a trusted friend, family member, or therapist.
When campers chose to have their character disclose the secret to someone
else, we talked extensively about how to approach someone if an issue
was bothering you, how you might ask for help, and what words you could
use to convey a problem and the distress it has caused.
Once each cabin
had finished creating their story, we read our
notes for the story back to the campers out loud. This reading became
an editing process, in that some cabins decided to change parts of their
story, use different words to change the meaning of certain sections,
and extend dialogue or descriptions. When the entire cabin agreed that
the story was complete, we talked about what illustrations the campers
would like their books to have and when we could collect the illustrations.
We also verified how each camper wanted his or her name to appear on
the book as an author (e.g., first and last name, first initial and
last name, etc.). We concluded the book-writing process by talking to
the campers about what it was like to be authors, especially about topics
with which many of them had had experience. We asked questions about
how their view of secrets changed, if they would do anything differently
in the future to handle a secret, and what they liked best about the
narrative experience. Overall, we received positive feedback from the
campers with whom we worked; they both enjoyed the creative process
of writing the story and were eager to see their books. After we met
with each cabin twice, we converted the notes we took using the laptop
computer into stories, used a scanner to add the campers' illustrations
to the stories, and formatted the books accordingly.
The editing process took longer than planned, and
then the books were printed and bound. We distributed the majority of
the books to the campers at camp the following summer.
A Powerful Process
As our first attempt, this story-writing experience
at a camp for HIV-infected and affected youth went
beyond our expectations. We were pleasantly surprised to learn that
the narrative therapy process was enjoyable for them. What was most
amazing was the campers' contributions to the
group creative process; many cabins thoroughly discussed issues
related to sexual activity, drug use, violence,
values, pregnancy, friendships, family, and life choices. Such topics
are often difficult to bring up and openly discuss with the campers
with whom we interact in other settings (e.g., the medical clinic).
We feel that creating a fictional character and story about that character
was a useful way to improve problem-solving, emotion identification
and regulation, and social skills in our campers. In addition, because
each camper eventually received a copy of his or her book, it is our
hope that some of the campers might refer to the story or recall the
narrative-writing experience in times of trouble or distress to think
about ways to solve problems and make themselves feel better. Overall,
we believe that the narrativewriting experience was a powerful process
that adequately allowed us to achieve the goals that we wanted to reach.
For those who would like to replicate this process, we encourage the
use of some structure (i.e., giving campers a theme
on which to base their story) to balance the freedom
of the writing process. Key components of our success included having
return campers who had a history of feeling safe and supported at Camp
High Five, choosing a theme that targeted our audience (i.e., keeping
secrets), and using an oral narrative-writing experience rather than
a written one (e.g., many of our campers with HIV have learning disabilities).
We were impressed by the campers' generally
serious approach to this project; most wanted to
produce a book of which they could be proud. As a result, we felt that
the experience was not only enjoyable but also therapeutic. It is our
hope that as our campers continue to grow, they will be able to use
some of the techniques they learned through story-writing to help them
manage future difficult times in their lives.
Originally published in the 2009 March/April
issue of Camping Magazine.
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