Embodied Storytelling Research Findings

Rize Foundation provided funding to run a pilot program of Embodied Storytelling at Recovery Cafe Lowell in 2023, and we’re so excited to share the results!

Evaluation of Embodied Storytelling Workshop at the Recovery Cafe

This is an evaluation of a series of workshops facilitated by Meghann Perry of Recovery Revolution at the Recovery Cafe in Lowell, Massachusetts. The Recovery Cafe is a peer-led, drop-in space that supports multiple paths of recovery, including harm reduction. The Recovery Cafe offers a latte hour, a variety of mutual support meetings including veteran’s groups and all-recovery meetings, and group activities ranging from cook-outs to a fishing club. The workshops were held on Thursdays at 11 am and consisted of 5 sessions beginning in February and extending into late March (2/16, 3/2, 3/9, 3/16, 3/23). The workshops and evaluation were funded by a grant from RIZE foundation.

Embodied Storytelling is a series of activities and games that combine established theatre and storytelling practices with the tenets of Recovery Coaching to provide participants with an opportunity for play, creativity, a sense of belonging and community, increased self-awareness, and the ownership and sharing of personal narratives both physically and verbally. In addition, it offers participants the opportunity to develop peer leadership skills in leading games and groups themselves. Exercises include the “clapping game” (where participants “pass” a clap around the room through imitation until synchronization develops), “spectogram” (where participants engage with a statement by distributing themselves across a space to express degrees of agreement), and “sound and motion” (where participants express themselves in sound and movement and their gestures are echoed back to them by the group). These exercises mobilize recognized mechanisms of therapy and mutual aid—such as validation, re-authorizing, externalization, and universalization—in a trauma-informed format safe for trained non-clinicians to utilize.

This evaluation consisted of three parts. The first part was an anonymous survey. From weeks two to five, we administered an adapted version of the Brief Assessment of Recovery Capital (BARC 10) to the group of attendees. We also collected basic demographics (age, race/ethnicity, gender identity), number of workshops attended, housing information, whether the individual identified as being in recovery, time of last use, and substance last used. While maintaining confidentiality, this information allowed us to evaluate attendance, participant retention from one group to the next, and across the series of workshops. The second part of the evaluation was a focus group held with attendees before the final session. This lasted approximately 30 minutes and involved 8 participants. The third part of this evaluation consists of an update about the progress of the group, which continued on its own after the duration of the grant, including qualitative feedback provided by 9 participants.

Demographics and Survey Response

21 participants attended over the course of 5 sessions with the largest session (#2) including 13 participants and the smallest session (#3) including 6 participants. Two-thirds of participants (0.66) attended more than one session and one-third (0.33) attended 3 sessions or more. After session 3, attendance increased and remained stable for the last two sessions.

Participants were diverse in terms of racial/ethnic composition, housing status, last substance used, and length of recovery time. Half of the group identified as Black, Hispanic, or Puerto Rican (10 out of 20 with one participant declining to self-identify). Among the participants who chose to list a housing status, the majority were unhoused or lived in either recovery or transitional housing (11 out of 17). The most common substance that participants reported as last used was heroin or fentanyl (8 participants) and alcohol ranked as second most common substance last used (7 participants). All twenty-one participants identified themselves as being in recovery.

Survey Responses

The survey consisted of an adapted version of BARC 10. BARC 10 is the most widely-used and validated measure of recovery capital (citations).  It focuses on core subjective resources that individuals use to initiate and sustain recovery, including the experience of being part of a community, feeling supported, and engaging emotions. BARC 10 is particularly useful in this type of setting because it measures subjective drivers of a process of positive change that can vary short term, rather than substance use or abstinence, and it does so in a way that does not presuppose the meaning of an individual’s recovery. We also incorporated questions that measured perceptions regarding the utility of tools that participants learned (question 5) and their belief that they will use these tools in other contexts (question 7). Participants responded on a 5 point Likert scale that ranged from strongly disagree (1) to strongly agree (5). Questions are included at the end of this report. We began administering surveys after the second workshop.

Focus Group

The focus group was held at the beginning of session 5 and gave participants the opportunity to reflect on their experience to that point and discuss the feasibility of continuing the group following the end of the grant. Three main themes emerged in the discussion. The first, and most prominent, was simply that the group was fun: a space dedicated each week to something whose sole purpose was creativity, play, and each other. This created a space for conversations that were “serious, but also light hearted.” Several participants described the games as providing a space to “get out of yourself,” “put yourself out there,” “or step out of yourself.”  Participants used this language to talk about the workshops  as a space of release from anxiety, monotony, physical pain, or emotional suffering. But they also used it to describe the workshops as an opportunity to “get out of your comfort zone” and learn new things by taking a leadership role in the activities.

Second, participants stressed the value of the new friendships that they formed during the course of the group. As one member explained: “It’s hard meeting people like you, because some people out in the world judge us … For myself, it’s hard to meet people. With my anxiety, I have a hard time.” Participants also discussed the group as a way of forming deeper connections with themselves through these new friendships. Building trust and getting positive feedback from others were both important elements of the experience that were mentioned by several participants. In response to the question of how to describe what happened in the group to an outsider, another participant brought these different strands together. He saw participants:

“Learning more about themselves. Learning to let go of things. Get out of themselves. Get out of

their heads. Have fun doing it. Learning other skills—that we can give [others], that we are

striving for too. Having a lot of fun, again, having fun doing it. I’m learning more about myself.

Knowing I can strike further. Learning about other people. Making friends…..We can do this

without substances. Don’t need them.”

Third, participants talked about the group as something new and different. Participants described the games, combined with the facilitator’s role as the “team coach,” ”as creating a different kind of “energy” from other recovery activities at the cafe and elsewhere. (No criticism seemed to be intended of these other activities.) This “energy” reflected, in part, the process of actively learning from each other and watching how other group members approached the activities. Learning was not only talking, but fully embodied and engaging. This sense of newness and energy manifested in participants’ excitement to pass on the activities learned. Speaking for her friend and herself, another participant explained her plans to pass on the skills that she learned in the group: “We are going to take home what we learned here and practice at our halfway house with the girls there. It’s set up already—we are excited to show them what we have been doing. 37 of us.”

Follow-Up

As of late September, the group continued to meet regularly on Thursday at 11 with 5-9 people attending steadily. Facilitated on an ongoing basis by two women, the group continues to follow a participatory process around sharing and implementing, soliciting input on scheduling, food menu, and group activities as a whole. Since participants have assumed leadership, the attendance base has expanded to include members of the Recovery Cafe beyond the initial group. Among the most common benefits of participation reported by the group members were the formation of new friendships and increased capacity to cope with the stress, craving, isolation, anxiety, and hopelessness. New group members describe their trepidation at attending the first meeting and the satisfaction that comes from having faced and discussed their trepidation in an affirming, recovery-supportive space.

Conclusion

Although based on limited series with small numbers of participants, this initial data suggests that the use of an embodied narrative approach in a peer-based group has substantial promise. Three findings from the survey data are especially suggestive. First and most obviously, the mean participant response to the modified BARC 10 was consistently high both across questions and across workshops. The average response to all questions was 4.6 out of 5 (except for question 6 which was 4.7 out of 5). The mean participant response for the four workshops was similarly high, increasing from 4.5 in workshop 2 to 4.8 in workshop 5. Second, the consistency of attendance by a group of participants, many of whom were unhoused and/or in early recovery, is notable. Among the participants who chose to describe their housing situation, the majority were unhoused or insecurely housed (11 out of 16, or 0.69) and this group included some of the workshop’s most dedicated attendees. Third, the diversity of the group should be noted, including not only its important racial and ethnic diversity, but also its diversity in terms of housing status, last substance used, and length of time since last use.

Even more notable is the fact that the group continues to meet over 4 months later while adhering to the initial model with limited external support (Recovery Cafe provides the space and a small budget for food). Not only have peer participants assumed group leadership, but they have expanded its membership base to Recovery Cafe members beyond the initial participants. This is suggestive regarding the acceptability of the Embodied Narrative model, its cost effectiveness, and its potential scalability/sustainability. In the past few years, a number of innovative programs have emerged to serve the unhoused, including the medical respite model and street medicine/mental health care. As important as they may be, these programs focus on the unhoused population’s urgent and basic needs, the bottom rungs of “Maslow’s hierarchy.” The peer-led embodied narrative approach is highly unusual in programming for the unhoused population in that it addresses the equally fundamental human needs of play, creativity, and imagination. Additionally, it addresses these needs through capitalizing on the model of a peer-led and facilitated mutual help group, which is now supported by extensive evidence. This combination of an innovative person-centered approach with established evidence-based practice is highly promising and merits future funding support.

—finalized 18 September 2023

Report by Jon Soske, PhD

Associated Researcher, Lifespan Division of Addiction Medicine

Systems of Care Fellow, Center for Complexity, RISD

Survey Questions

Each statement was ranked on a scale of 1 to 5

1. The workshop made me feel part of a community

2. This workshop made me feel supported

3. This workshop taught me ways to play or be creative without the need for using drugs and alcohol

4. This workshop gave me a safe space to take risks

5. I can make use of the tools that I learned in this workshop

6. This workshop gave me a space to engage with my own and other people’s emotions

7. I will use the tools/games/what I learned in this workshop in my community