Chapter 18: River of life storytelling

Sarah Carmody

 

Learning outcomes

Upon completion of this chapter, you should be able to:

  • Know when to use river of life storytelling in qualitative research.
  • Create instructions and questions to guide the river of life technique.
  • Understand how to facilitate the river of life storytelling technique

 

What is river of life storytelling?

River of life storytelling is a qualitative research technique that invites a person to consider how they might represent a particular experience, journey or event, as if it were a river.1,2 The river is used as a metaphor for the person’s journey. It enables them to consider what their river looks like, choose how it twists and turns, and the features along the river.3,4

This creative technique has a history of use throughout the not-for-profit sector, including youth work, community development, social care, religious organisations and international development. It is applied as an interactive tool for deep reflection on people’s experiences and events.2-7

What does a river of life diagram look like?

While there is no set format for a river of life diagram, several features will likely be included.1,7 An illustration of the river itself, whatever shape that takes, is a central feature of the method, along with features, such as rocks, rapids and waterfalls. Figure 18.1 provides an example river of life diagram.

For more detail about the person’s story, it is good to include information about the specific people, activities and events that occurred, as outlined in Table 18.1. Depending on the purpose of the activity, it might also be helpful to identify the barriers and enablers they experienced.

The additional features along the river might be presented using drawings, text or images. They can also be colour-coded to identify items: in Figure 18.1 items about family and friends are shown in orange boxes, items about crucial events in blue circles, and barriers in black circles. Colour-coding features can make the diagram easy to read and is helpful for analysis.

Completing a river diagram using an online storyboard program enables the participant or the researcher to include drawings, text and sticky notes in different colours, along with relevant images.

Figure 18.1 An example river of life diagram (click to enlarge)

The image shows the journey of a river. Coloured sticky notes represent different elements of the journey. Blue sticky notes are about symptoms and signs of dementia, green sticky notes are tests, purple sticky notes are encounters with the health and social care system. The orange sticky notes are life context information and the black sticky notes are what was hard or challenging. There are quotes throughout the image from the participant.

©Sarah Carmody. Image is not to be reproduced.

How does river of life storytelling work?

The river of life storytelling technique can be used differently, depending on the purpose and audience. The river of life technique has often been conducted in group settings, where each group member draws a river using pens, pencils and paper to represent their journey.2,3 The technique has been adapted to the research setting and can be used on its own or integrated as part of a qualitative interview.

This chapter examines three ways to facilitate the river of life technique in qualitative research.

In-person group activity

The river activity is conducted in person, in a group setting. The facilitator explains the purpose and process of creating a river of life diagram. The group is provided with pens, pencils and paper to create their diagram.3

The group setting enables participants to interact with each other and to share ideas and experiences. The facilitator answers questions, provides prompts and encourages and supports each member of the group to create their river of life diagram, reflecting an experience, journey or event. This type of activity is well suited to people who can more easily attend an in-person venue and who find it comfortable to share with others and design their river in a group setting. For example, a group of women from a local community are invited to explore the effects of the COVID-19 pandemic.1

Individual activity

A participant is invited to create a self-directed river of life diagram; they are provided with the instructions and materials needed to develop the diagram independently.

The self-directed river of life may include sending each participant a pack of materials needed to develop the diagram, including pens, pencils and paper, and a way to provide the researcher with a copy.

The individual river of life approach gives high autonomy and control to the participant. Still, it does involve greater responsibility on the part of the participant, to complete the diagram in their own time and return it to the researcher. A follow-up interview may be conducted with the participant about their river of life activity at a later date. This type of activity is suited to people who are comfortable following the instructions and completing their river diagram independently, particularly for participants across different locations. For example, men across Australia may be invited to reflect on their experience of living with prostate cancer.8

Facilitated interview activity

Through the facilitated interview activity, the river of life is used more subtly and integrated within a semi-structured interview. This approach is effective when the in-person or individual options are not suitable or feasible. It is also useful when there are additional questions the researcher may like to include. Interviews using this approach can be done in person or by video call or phone.

The facilitated activity is well suited for use with communities who find it difficult to complete the river diagram individually. This may include people who do not have English as not their first language, or people less confident in literacy, or people living with a type of cognitive impairment, such as people living with dementia.9

The river of life prompt questions are asked using an interview-style format. The researcher facilitates the river diagram during the interview process or shortly afterwards. For the facilitated interview activity, an online storyboard program can be used to create the diagram based on the guidance and responses discussed during the interview.

The participant is provided with a copy of the river diagram shortly after the interview and asked to check it to ensure that the diagram accurately reflects the conversation and their experience, that they are happy with it and to make any changes or additions.

Conducting river of life storytelling

Once you have decided on the most suitable river of life activity for your purpose, you can begin planning how to conduct your river of life activity.

Design

Begin writing the prompt questions to guide the river of life activity.1 Writing the prompts is especially important for the facilitated interview, where you will generally include the prompt questions within the broader interview questions.

Prompt questions will also be helpful to refer to during the in-person group activity. The prompt questions can be integrated within the river of life instructions for the individual activity.

Example prompt questions are outlined in Table 18.1.2, 3, 5

Next, you need to write up the instructions to provide to participants, including instructions explaining the purpose of the activity and how it works.

Facilitate

Remind participants about the purpose and structure of the river of life activity and ask if they have questions. The activity can be described as a visual way to explore their personal journey, where the river might change, have obstacles and other features.

Start the river of life discussion by exploring the first part of the river, seeking to tease out the different elements and features. Some people will be comfortable discussing and drawing their river without much assistance. Others may need more guidance and prompting. Have the river of life prompts and questions ready to use as needed.

Those completing the activity without a facilitator will rely on having clear instructions and require an easy way to return their completed diagram.

Feedback

Once the river diagram is completed, it is vital to confirm with each person that they are happy with their river and to make any changes they wish to. Seeking feedback is especially important when the researcher creates the river diagram.

Analyse

Content analysis (as described in Chapter 21) can explore key themes within and across the river of life diagrams. They may also inform case studies or triangulate with other methods, including qualitative interviews.

Table 18.1. River of life prompts and questions

Part of the river Prompt questions
The start of the river/ start of the journey Where does the river start, and what does it look like?

Who is at the start of the river?

What does the river look like?

When are there changes in the river (When the situation or perspective changed.)

Does the river have any sudden bends or turns?

Is your river long and winding?

Does the river have a waterfall?

What happens along the river?

Does the river flow fast or slow?

Is the river muddy? Is it clear?

Are there rocks or boulders along the river? (e.g. obstacles and life-altering moments)
The other end of the river What does the other end of your river look like?

Table 18.2. Features of the river

Features of the river This feature may help represent
Pebbles, rocks, boulders Obstacles along the way and the size of the obstacle
Bends in the river Changes that occurred
Rapids, fast-flowing water and/or whirlpools Times along the journey that were particularly difficult
Murky water Confusing and unclear about what was happening
Shallow river Easier to navigate at this point of the journey
Deep river More difficult to navigate at this point of the journey
Calm and/or clear water Times along the journey that were easier and went well
Waterfall Major event, moment or change that occurred<
Family, friends and support people Learning who formed the person’s support network
Specific activities and events Exploring what happened along their journey
Organisations, services, resources and supports along the river Examining what organisations, services and resources the person had access to throughout their journey
Specific barriers or difficulties Identifying what was hard along their journey
Specific enablers and supports Identifying what was helpful along their journey
Other river features Anything else the person would like to include

What are the benefits of the river of life storytelling?

The river of life storytelling technique is a creative approach to engage participants in the research process in a meaningful way. It provides many benefits that differ from other qualitative methods, including:

  • a creative and interactive structure for a participant to reflect on their journey. The process subtly guides the flow of questions and conversation, beginning at the start of the river (a person’s experience) and considering all that happens along the way. Prompt questions enable the person to reflect on their story from start to finish
  • enabling deep reflection about how a person felt throughout their experience by representing different emotions as features of the river, such as rocks, rapids and waterfalls2,10
  • a supportive process to reflect on experiences that may be difficult to revisit10

The three types of river of life activities described in this chapter enable the researcher to cater for differing needs, abilities, time availabilities, accessibility and levels of engagement.1

How long does the river of life storytelling take?

The time to complete a river of life story depends on how it is conducted.3 A facilitated river of life interview usually takes about 60 minutes but will vary according to the number of additional questions in the process and the detail the person provides in sharing their story. It is important to consider a suitable duration for the people involved.

Summary

River of life storytelling is an innovative and meaningful technique that engages people in a creative activity to learn about their experiences. Through the storytelling process, the person reflects on their experience as though it were a river, and a river diagram is created to represent their journey. The chapter described three types of river of life storytelling activities, each with strengths and limitations. The type of river of life activity used will vary depending on your topic, community, location and time available. The river of life technique is beneficial for encouraging deep reflection and exploring a person’s experiences in detail.

References

  1. Howard J. Rivers of Life. Institute for Development Studies. (date unknown). Accessed April 19, 2023. https://opendocs.ids.ac.uk/opendocs/bitstream/handle/20.500.12413/17839/PMs%20handouts%20UoS_Rivers%20of%20Life_finalOD.pdf?sequence=3
  2. With Youth. A River Called Relationships: Catching My Emotions and Needs Visualization. Accessed April 19, 2023. https://www.withyou-th.org/handbook/method/river-of-life-visualization/handout_river_of_life_1st_part.pdf
  3.  Moussa Z. Tips for trainers: rivers of life. Participatory Learning and Action 60: Community-based adaptation to climate. New Mexico Department of Health, Public Health Division; 2009:183-186. Accessed April 19, 2023. https://www.iied.org/g02828
  4. Martinez M, Vasak A, Ibañez A et al. COVID-19 Rivers of Life: Participatory storytelling to improve mental wellness and coping amongst LatinX women. 2022. Accessed April 19, 2023. https://www.texashumanities.org/wp-content/uploads/sites/108/2022/02/Martinez-Monica-COVID-19-Rivers.pdf
  5. The On Being Project. River Of Life Exercise. 2019. Accessed April 19, 2023. https://onbeing.org/wp-content/uploads/2019/05/on-being-river-of-life-exercise.pdf
  6. Catholic Health Association of the United States, Supportive Care Coalition. The River of Life. 2019. Accessed April 19, 2023. https://supportivecarecoalition.org/cultivating-professional-resilience/2019/10/23/the-river-of-life
  7. Kipp B. Using the River of Life as a Tool. Centre for Participatory Research, University of New Mexico. 2017. Accessed April 19, 2023. https://www.youtube.com/watch?v=fxC0ky8EJ5o
  8. Shemesh B, Opie J, Tsiamis E et al. Codesigning a patient support portal with health professionals and men with prostate cancer: an action research study. Health Expect. 2022;25(4):1319-1331. doi:10.1111/hex.13444
  9. Hydén L-C. Storytelling in dementia: embodiment as a resource. Dementia (London). 2013;12(3):359-367. doi:10.1177/1471301213476290
  10. Cummings J. Sharing a traumatic event: the experience of the listener and the storyteller within the dyad. Nurs Res. 2011;60(6):386-92. doi:10.1097/NNR.0b013e3182348823

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Qualitative Research – a practical guide for health and social care researchers and practitioners Copyright © 2023 by Darshini Ayton; Tess Tsindos; Danielle Berkovic is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License, except where otherwise noted.

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