Date Presented 3/30/2017
This novel qualitative research considers outcomes for 12 participants in the Walking the Labyrinth program at the Southwest Centre for Forensic Mental Health Care. Potential care applications are identified, including the link between mental health care planning and labyrinth participation.
Primary Author and Speaker: Clark Patrick Heard
Contributing Authors: Rev. Stephen Yeo, Jared Scott
PURPOSE: This study considers the research question, What is the meaning and experience associated with participating in the Walking the Labyrinth program for persons with serious and persistent mental illness who reside in a forensic mental health setting? Over the past several decades, labyrinths have enjoyed a renaissance and are often utilized by health care clinicians and spiritual care practitioners to support reflection, stress reduction, and the exploration of personal wellness (Peel, 2004). Labyrinths are used in many settings, including places of worship, hospitals, long-term care facilities, and parks (Zucker & Sharma, 2012). While labyrinths are becoming more prevalent, an understanding of their impact, particularly in the mental health context, is limited.
DESIGN: This qualitative study employed a design consistent with interpretative phenomenological analysis (IPA) to explore the meaning associated with participation in walking a labyrinth for persons residing at a forensic mental health care facility (Smith, Flowers, & Larkin, 2009). In this study, researchers recruited 12 mental health consumers residing at the Southwest Centre for Forensic Mental Health Care in St. Thomas, Ontario. Participants were recruited via direct contact with a Walking the Labyrinth program facilitator. While this enabled something of a convenience sample, research consistent with IPA requires both purposive and homogeneous sampling (Smith et al., 2009). The sample comprised 11 men and one woman, consistent with the gender ratio at the 89-bed facility. The sample ranged in age between 21 and 60 yr, with a mean of 40 and a median of 42. The sample was diagnostically diverse, with schizoaffective disorder, schizophrenia, and delusional disorder representing the majority of primary diagnoses.
METHOD: A standardized interview protocol was used, and the collected data were coded for themes using an editing style of analysis. Three independent coders of varied clinical background independently coded the data. Definitions for each code were developed and overarching themes identified. Following data analysis, the coding scheme was tested for consistency, and final coding agreement was found to be 85.2%. Several methods were employed to establish trustworthiness, including triangulation by analyst and by theory or perspective. Member checking was also used.
RESULTS: Participant responses supported the identification of three themes. The first spoke to labyrinth participation supporting a sense of escape from the day-to-day routines that color and define life in hospital. The second spoke to broader applications of stress reduction. The final theme indicated that walking the labyrinth supported and enabled meaning making. Client participation in this study also supported success experience and personal achievement.
CONCLUSION: Participants indicated that they face many challenges living with serious and persistent mental illness within a forensic mental health setting. They spoke of loss, hopelessness, anomie, and existential pain. Despite this narrative, they also spoke of hope, resilience, accomplishment, meaning, freedom, and autonomy. Compellingly, they spoke of these latter concepts following participation in Walking the Labyrinth. Practically, labyrinths can offer care facilities and treatment teams a relatively low-cost, low-maintenance, and accessible environment that supports individuals in exploring their personal spiritual narratives.
IMPACT STATEMENT: The outcomes of this study identify that labyrinth participation can support consumer meaning making and spirituality in the most difficult circumstances. They identify that experience of the personally sacred is not only possible but also valued by consumers residing within the forensic mental health setting.
References
Peel, J. M. (2004). The labyrinth: An innovative therapeutic tool for problem solving or achieving mental focus. Family Journal, 12, 287–291. https://doi.org/10.1177/1066480704264349
Sandor, M., & Froman, R. (2006). Exploring the effects of walking the labyrinth. Journal of Holistic Nursing, 24, 103–110. https://doi.org/10.1177/0898010105282588
Smith, J. A., Flowers, P., & Larkin, M. (2009). Interpretative phenomenological analysis: Theory, method and research. Thousand Oaks, CA: Sage.
Zucker, D. M., & Sharma, A. (2012). Labyrinth walking in corrections. Journal of Addictions Nursing, 23, 47–54. https://doi.org/10.3109/10884602.2011.645253
