ORCID
- Alyson Norman: 0000-0002-4332-6049
Abstract
Traumatic brain injury (TBI) brings inevitable and significant changes for family members, yet there is little to relieve their trauma, resolve their grief, or prevent ongoingsuffering. The aim of this qualitative pre-feasibility study was to understand theclinical potential of storytelling for families after TBI using the ‘Life Threads’ approach(LTA). An in-depth inductive qualitative design was adopted within an interpretivist paradigm. Following informed consent, participants took part in an online focusgroup, then engaged with the LTA over four weeks before completing an unstructured, in-person interview. A final focus group explored participants’ reflections on theLTA. A purposive sample of 20 family members began the study, three withdrew afterthe first focus group leaving a final sample size of 17. The analytical approach usedwas Braun and Clarke’s reflexive thematic analysis. Eleven participants reportedtangible benefits from engaging with the LTA, and thirteen described being able totell their story in a way not possible through traditional methods. Four main themeswere identified: ‘Scaling Cliffs with Broken Wings’ and ‘An Entanglement of Wellbeing’ illustrated the evolving and contextual needs of families post-TBI. ‘Hear Me,See Me: The Power of Story’ highlighted how the LTA facilitated voice, agency, andsense-making, while ‘Creating the Conditions for Stories to Be Told’ identified theenabling environment required for such benefits to emerge. The findings suggest thatthe LTA offers a meaningful way for family members to explore, express, and makesense of their experiences following TBI. It supports narrative reconstruction, fostersconnection and agency, and provides a rare opportunity for self-reflection. However implementation must be trauma-informed, paced, and supported by skilled facilitatorscapable of holding space for complex emotional responses.
DOI Link
Publication Date
2026-05-18
Publication Title
British Medical Journal Open
Volume
21
Issue
5
Acceptance Date
2026-04-28
Deposit Date
2026-05-27
Funding
Funding: This project is funded by the National Institute for Health and Care Research (NIHR) under its Research for Patient Benefit (RfPB) Programme (Grant Reference Number NIHR204092). The views expressed are those of the author(s) and not necessarily those of the NIHR or the Department of Health and Social Care. We would like to sincerely thank our PPIE advisory group members: Wal Warmington, Julie Berry, Leroy Jones, John Kennedy and the staff at QMC, Nottingham University Hospitals NHS Trust; Royal Derby Hospital, University Hospitals of Derby and Burton NHS Foundation Trust and Queen Elizabeth Hospital, University Hospitals Birmingham NHS foundation Trust. We are also indebted to the engagement of regional Headway groups and branches in addition to Headway UK, UKABIF, BABICM, Anchor Point, Cygnet and Derbyshire Carers Association. We are particularly grateful to Dr Brandon Smith for ongoing support in the preparation of this manuscript.
Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 International License.
Recommended Citation
Norman, A. (2026) 'Supported storytelling through the ‘Life Threads’ approach for family members after traumatic brain injury: “We've been through all of this trauma, and you're giving me some string?', British Medical Journal Open, 21(5). Available at: 10.1371/journal.pone.0349304
