John Launer is lead for educational innovation in primary care for Health Education England in London, honorary associate clinical professor of primary care at University College London, honorary lifetime consultant at the Tavistock Clinic, associate editor of the Postgraduate Medical Journal, faculty member at ISTUD Business School in Milan and founding president of the Association of Narrative Practice in Healthcare. Professor Launer was the originator, with Caroline Lindsey, of Conversations Inviting Change (CIC). His most recent books are Reflective Practice in Medicine and Multiprofessional Healthcare (2022), Narrative-Based Practice in Health and Social Care: Conversations Inviting Change (2018), How Not To Be A Doctor: And Other Essays (2018).
What is the name of your organization/association/society/research group?
Association for Narrative Practice in Health Care in the United Kingdom (ANPH) www.anph.org.
What is its story and history?
The Association was founded in 2016 to support narrative practice in health and social care, particularly to promote the model of practice “Conversations Inviting Change” (CIC) www.conversationsinvitingchange.com.
This approach to teaching narrative practice was developed at the Tavistock Clinic in London by Dr John Launer and Dr Caroline Lindsey. It was taught there from 1995 to around 2010, as well as in workshops and conferences around the UK and internationally. During that time, it became an established approach to teaching interactional skills to doctors and other health professionals in London. After 2010 most of its activity was relocated to the training organisation Health Education England.
In 2016 a group of health professionals and educators teaching CIC decided there was a need for a professional association to support teachers and learners of narrative practice and offer accreditation to everyone trained to teach the approach.
What is its mission and its philosophy?
According to the website of ANPH: We believe that doctors, nurses and other professionals who can listen to people’s stories and show genuine curiosity about them become more effective healers and can produce better medical outcomes.
The Association of Narrative Practice in Healthcare promotes an understanding of narrative ideas and skills among the medical and allied professions. While drawing on the academic field of narrative studies, our emphasis is primarily on practice. We are dedicated to encouraging more attentive and skilful conversations not only with patients but in training, peer supervision, teamwork, management and leadership.
The Association of Narrative Practice in Healthcare is open to doctors, medical students, nurses, health visitors, dentists, health service managers, medical and health educators, psychologists, and to any health and social care professionals or those in training who are interested in applying narrative skills and ideas in health care.
How is it framed today?
There are currently around 25 trained teachers of CIC who are members of ANPH and around 75 other members who support and attend its activities live or online. The Association has a committee consisting of honorary president, co-chairs, secretary, membership and events secretaries and other members. We hold meetings five or six times a year lasting half a day with presenters on topics related to narrative practice and opportunities for peer supervision in small groups. ANPH also supports a wide range of projects as listed below.
What are the main ongoing projects?
Activities undertaken by ANPH members include:
- Live and remote training courses and workshops in narrative practice for health care around the UK.
- Live and remote presentations and workshops at conferences and meetings internationally, including Europe, North America, Australia and Japan
- An online one-year part time training for health professionals to become accredited trainers of CIC
- Publications (books and articles), webinars, podcasts
- Collaboration with other organisations including EUNAMES, Narrative Medicine International and narrative medicine societies in other countries to promote narrative practice
What plans for the future?
We aim to increase the number of courses and workshops for different health care organisations in the UK and internationally, and to train a larger number of accredited trainers of CIC in order to deliver this.
We are keen to develop our international links with organisations supporting narrative medicine and narrative practice around the world.
We are currently in discussions with a university medical school in the east of England to establish a collaboration that would allow us to draw on their infrastructure for administrative support, promotion, and research.
Where did the organization/association/society/group find resistances or difficulties. (i.e. shortage of HCP, time pressure, EBM dogma…)?
The main difficulty over the years has been in organisational and political changes which have led to fluctuations in funding for courses. These factors led to our relocation from the Tavistock Clinic to Health Educational England, the wish to set up ANPH as an independent organisation, and our current discussions with a medical school to explore a permanent base.
Our other main challenge has been the need to negotiate contracts to deliver training with multiple different commissioners in the public sector (including university departments, professional colleges etc). This is largely done by members themselves. It requires a lot of input of time as well as persuading commissioners that the courses and workshops are relevant to health professionals and the needs of patients.
We face very little hostility or resistance, but more often the objection that there is no space on the curriculum for teaching narrative approaches, or people believing that the pressures of everyday work will make it too hard for health care professionals to apply these.
Our main mission is to persuade everyone that narrative practice makes life easier for practitioners and enhances health care for patients.