Celebrating Difference: Improving psychological wellbeing in children and young people living with chronic physical illness Barts Health NHS Trust

Children and young people (CYP) living with chronic illness are at increased risk of developing psychological problems, which has a negative impact on their treatment adherence, health outcomes and quality of life. 

This project combined narrative therapy with therapeutic play to promote the psychological wellbeing of CYP living with chronic illness, and their carers, accessing The Royal London Hospital. 

During ‘Health Heroes’ group sessions, patients discussed how they encounter challenges and use their individual strengths and abilities to manage. Participants developed superhero characters (for children) or identity boards (for teenagers), which allowed them to create alternative identities, which were reinforced through performance with the support of Chickenshed Theatre. Carers were also given space to discuss the challenges of caring for CYP with chronic illnesses and to share management strategies.

Seven groups were attended by 47 CYP with a mix of conditions, and their carers. Participants reported that it was incredibly helpful to meet others who understood their experiences. All CYP, carers and referring clinicians said they would recommend the group. 

Preliminary data suggest improvements in experiences of depression and anxiety post-intervention, with some deterioration three months later. CYP and carers self-reported improved psychological wellbeing after the groups, which reduced at follow-up, but was generally improved from pre-intervention. This may suggest a need for sustained therapeutic support.

There were practical hurdles to CYP and their carers attending the groups, and obtaining outcome measures from participants was challenging. 

Although financial constraints mean that the intervention cannot continue in its present form, the Trust has agreed that an on-going support group would benefit patients.

Contact details

For more information about this project, please contact Tara Shea, Team Lead, Play Department, Women’s Centre and Children’s Hospital, The Royal London Hospital or Jennie Robertson, Clinical Psychologist, Paediatric Liaison Team, Women’s Centre and Children’s Hospital, The Royal London Hospital.