Empathic impacts of adolescent-focused storytelling interventions: A protocol for a scoping review

doi:10.21203/rs.3.pex-1908/v1

Method Article

Empathic impacts of adolescent-focused storytelling interventions: A protocol for a scoping review

https://doi.org/10.21203/rs.3.pex-1908/v1

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Adolescence represents an important, transitional period for social and emotional development, which contributes to conceptualisations of the self-story or narrative identity. Storytelling is a mechanism that contributes to identity formation and is intrinsically connected to social and emotional learning due to its relational context. Social and emotional learning programs are well-documented in the literature regarding their effectiveness. However, findings that are specific to empathy outcomes from interventions that center storytelling are not well established. This review aims to contribute to the research by providing a scoping review of key findings for empathic outcomes of storytelling interventions for adolescents. This scoping review will follow the Joanna Briggs Institute (JBI) framework for scoping reviews, and the research stages as defined by Arkey and O’Malley, and Levac and colleagues. A formal search strategy will run across seven databases, including ASSIA, Eric (EBSCO), ERIC (ProQuest), PsycINFO, PsycArticles, and Scopus. This search will be supplemented with hand-searching in Google Scholar, and grey literature will be identified using ProQuest Dissertations & Theses. Studies (published in English) from 1997 onwards will be included based on the following criteria: 1) An adolescent population (10-24 years old), 2) Storytelling interventions or narrative exchanges are the intervention of study, 3) Empathy is the key outcome. Studies will be excluded if they are published before 1997, written in languages other than English, focus on other interventions, populations, and outcomes other than empathy. The selection process will be presented in a narrative format and a PRISMA flow diagram. Results will be reported using the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA-ScR). Ultimately, the validity and effectiveness of storytelling interventions for promoting empathy will be synthesised.

Health humanities

Psychology

Sociology

Storytelling Interventions

Empathy

Adolescents

Scoping Review

Rationale

Storytelling is universal and fundamental to human expression. It is a way for individuals to make sense of their experiences (2, 3). Storytelling becomes a central aspect of building identity, allowing individuals to organise their autobiographical narrative (4, 5). There is a vast literature on how the internalised self-story shapes identity formation, especially in late adolescents (2). Authors call this process narrative identity, which can be defined as the mechanism in which people are placed in their culture and unifies past, present and the foreseeing future, providing meaningful connections between the life events (3). Moen (6) argues that in order to be a narrative, a story needs to organise events in a significant way for the narrator and their audience.

Storytelling is also a more recent focus of interest in Psychology and neurosciences (7), while several studies have investigated the impact of narrative on health (8). For example, Pennebaker and Seagal (9) describe considerable mental and physical benefits of writing personal experiences in an emotional way. Narratives are also intertwined with the development of language, the reason why the research is broader in the educational context (10). Reviews of literature on storytelling cover a vast range of fields. It can be approached in the form of digital storytelling as an educational tool (11-13) or as a mental health tool (14). It can be a research method used especially with minority groups, as indigenous peoples (15, 16) or migrants and refugees (17). It is also used as a research tool and intervention on public health (18), as a pedagogical tool in the development of language skills (19), and even as a communication strategy for corporations (20).

Another approach that uses storytelling as an essential element is peace-making circles and the restorative practice framework (21). The restorative tool develops from a diverse range of traditional cultures and religions, where harmful acts are understood to be collectively addressed in the search for repair (22). It usually is based on a circle, where offenders and victims participate in the problem-solving and a facilitator guides them through a set of questions that welcome all different perspectives. Nevertheless, the circles can be preventive and aimed at strengthening communities (23).

As the narrative identity is always built in a relational context, storytelling is intrinsically connected to social and emotional learning (SEL). SEL can be defined as the cognitive, affect, and behaviour skills that enable one to deal effectively with intrapersonal and interpersonal challenges. They include the dimensions of self-awareness, self-management, social awareness, relationship skills, and responsible decision-making (24). Recently, numerous studies have been developed mapping the benefits of school-based interventions designed to facilitate SEL in children and adolescents (25). There is evidence in the literature (26, 27) that universal school-based programs, for example, contribute to enhancing SEL competencies. There is a growing recognition of the importance of fostering empathy in education, alongside academic achievement. In addition, promoting social and emotional well-being has been considered crucial to promoting mental health among children and adolescents (28).

Social awareness is a key SEL dimension involved in storytelling and narrative identity. It is related to being aware of the culture, beliefs, and feelings of the people and world around them (29). As part of social awareness, empathy is a crucial SEL skill, where one can feel what others feel (emotional or affective response towards a stimulus emotion) while recognising that the source of emotion is not one's own (cognitive capacity of perspective-taking) (30). Although empathy's multidimensional concept can overlap with other meanings such as perspective-taking, social cognition, theory of mind and emotional contagion (31), research has shown the importance of empathy in different aspects of an individual or societal experience. Empathy can strengthen social bonds. It is a trigger for caring about others' well-being and, therefore, a driver of prosocial behaviour (32). It has also shown it is a malleable trait that can be improved with time and according to the circumstances (33).

Studies have shown that empathy can be fostered through interventions, for instance, the perspective-taking strategy (34). In this case, participants temporarily suppress their own perspectives and embrace someone else's after listening or reading a story (35). This is the basis of storytelling, and previous research has shown that storytelling is positively related to empathy (36, 37).

Adolescence is a crucial developmental stage for defining identity and establishing connections with peers (38). The complexity of personal narratives tends to increase during this period, and storytelling can be a powerful instrument to develop self-awareness and social connectedness. However, although there is a body of evidence on the effectiveness of SEL programs in adolescence, data specific to empathic outcomes from interventions focused on storytelling with adolescents is not well established in the literature. As such, a scoping review will be conducted to map the research previously conducted in the field and will maintain a focus on empathic outcomes.

Review Aims and Objectives

Our preliminary search in the databases PsycInfo, Scopus, Annual Reviews and Cochrane Libraries, on 16 August 2021, retrieved no existing literature review on the topic. Given the small number of studies published up to date, a scoping review was chosen to summarise the literature to maximise the possibilities of reaching relevant articles. Following Arksey and O'Malley's framework (2005), this scoping review aims to identify all relevant quantitative and qualitative literature in the area of storytelling with adolescents.

The objectives of the review are: (a) to map the storytelling interventions applied to adolescents, (b) to summarise how empathy is conceptualised in the context of engaging in a storytelling programme, (c) to summarise how empathy is operationalised in the context of engaging in a storytelling programme, (d) to summarise the evidence of empathy outcomes following participation in a storytelling programme.

Methods

Study design

This scoping review will establish a summary of the up-to-date literature on the empathic outcomes of storytelling programmes. The study follows the Joanna Briggs Institute (JBI) framework for scoping reviews (39) and the stages defined by Arksey and O'Malley (40) and Levac, Colquhoun, and O'Brien (41): identify the research question, identify relevant studies, study selection, chart the data, and collate, summarise, and report results.

Research questions

The primary research question for this scoping review is "What are the key findings concerning the relationship between storytelling interventions and empathy with adolescents?". The following sub-questions will guide the data charting in accordance with the objectives of the review:

1. What are the different story exchange/ storytelling interventions applied with a young population?

2. What are the empathy outcomes reported following participation in a storytelling programme?

3. How is empathy conceptualised and operationalised in the context of the storytelling?

4. What is the effectiveness of storytelling interventions in promoting empathy as reported by the literature?

Information Sources

Given the limited number of publications in the field, a wide range of databases will be searched. The search will be run in the following databases: ASSIA, ERIC (Ebsco), ERIC (ProQuest), PsycINFO, PsycArticles and Scopus. The references of the articles retrieved will be searched for additional papers to be screened and included. Grey literature will be searched through ProQuest Dissertations & Theses A&I to identify unpublished studies relevant to this review.

The search will be limited from 1997 to 2021 to provide an up-to-date review of the topic. The year 1997 was chosen because this was the publication year of the first book to conceptualise social-emotional learning, the Advancement of Social and Emotional Learning (CASEL) framework (42).

The search strategy will involve keywords related to the main concepts (storytelling and empathy) and the population (adolescents) (Table 1). A preliminary search will be carried out in two databases (PsycInfo and Scopus), following JBI scoping review guidelines. It is important to note that the search strategy format (e.g., truncation) will be adapted to each databases formatting guidelines.

Search terms to be used in the database searches (*Key Concepts):

1. Population: *Adolescents, Adolescen*, Teen*, Youth, "Young pe*"

2. Intervention: *Storytelling, Narration, Narrative, "Narrative intervention", "Narrative based intervention", "Story-based intervention", "Peer support"

3. Outcomes: Empath*, Compassion, “Social and emotional development”, “Social and emotional learning”, “Cognitive empathy”, “Affective empathy”, “Cognitive-affective empathy”, “Perspective taking”

Eligibility of Studies

Considering that a scoping review is iterative in its study selection (39, 41), some future changes may be made in the inclusion/exclusion criteria. All modifications and rationale will be described in the final review paper.

Inclusion criteria

a) Studies where storytelling interventions or similar programs, such as story exchange, and narration, are the main focus of the research.

b) Studies where empathy fostering is a central outcome of storytelling interventions.

c) Studies that have adolescents as the population of interest. According to the World Health Organization (28), adolescents are defined as being between 10 and 24 years of age.

d) Articles published in English.

e) Peer-reviewed publications, books, book chapters, conference papers, or grey literature, including reports from relevant NGOs, national and regional educational organisations, government bodies, and unpublished dissertations and thesis.

f) Qualitative, quantitative, mixed-methods, literature reviews and meta-analyses.

Exclusion criteria

a) Studies where storytelling interventions are not central to the research.

b) Studies that do not report outcomes related to empathy.

c) Studies that focus on other populations rather than young people.

d) Editorials, commentaries, and opinion pieces.

e) Publications from before 1997.

f) Articles published in languages other than English.

Study selection

Search results will be added to EndNote software for references management and duplicate removal. Articles will first be screened for eligibility by titles and abstracts by one reviewer. Then, a second independent reviewer will screen half of the retrieves for accuracy. Studies that meet the inclusion criteria will then be examined in full-text by the first reviewer and fifty per cent redone by the second reviewer. Finally, disagreements will be resolved by a third reviewer, as recommended by Peters, Marnie (39).

The study selection process will be presented in a narrative format and a PRISMA flow diagram (43), with the reasons for exclusion described in the review paper.

Data extraction

A data extraction form will be pre-piloted using a random selection of articles. Two reviewers will independently enter into the form, and a third review will resolve disagreements. Data extracted will include:

a) Publication data: authors, year, title, journal.

b) Country of origin.

c) Context of intervention (e.g. schools, community, health institutions).

d) Study method: quantitative, qualitative, mixed-method, review.

e) Sample size.

f) Participants: age, gender, education level, ethnicity, nationality.

g) Study aims and objectives.

h) Description of storytelling intervention.

i) Empathy outcomes: What were the described outcomes? How were they operationalised? What measures were used?

j) Main findings.

k) Evidence of suitability of the storytelling as a tool to promote empathy.

Results

The results of this review will be reported using the Preferred Reporting Items for Systematic reviews and Meta-Analysis extension for Scoping Reviews (PRISMA-ScR) (43).

The narrative synthesis of the results will address the primary research question, i.e., describe a summary of the available literature on storytelling interventions with adolescents. The quality of the studies will not be assessed. The findings will be organised according to the aims of this review, identifying common denominators in the application of storytelling as a tool to develop empathy. We will summarise how empathy is conceptualised and operationalised as outcomes of storytelling interventions. Ultimately, the data collated will synthesise the validity and effectiveness of storytelling interventions in promoting empathy

Discussion

Given the lack of literature review studies conducted on storytelling interventions with adolescents, this review aims to be the first scoping review to summarise the literature on the topic. We aim to describe the types of storytelling interventions mainly used with adolescents, report the empathy skills presented as outcomes of such interventions, conceptualise these outcomes, and summarise how these skills are measured in the studies. As doing this, we seek evidence of the effectiveness of programs developed to foster empathy.

The results from this scoping review will be published in a peer-reviewed paper to provide an updated description of the available research in the field. In addition, the findings of this review will potentially inform future research into the effectiveness of storytelling interventions and point to the gaps in knowledge.

Limitations

This review has potential limitations as some studies may not be published or available in the databases used. Nevertheless, the search terms were carefully defined to cover most of the available literature and a strategy designed to find relevant grey literature. Another possible limitation is missing studies published before the year 1997. However, our preliminary searches indicate that the majority of articles on this topic were published in the last decade. One final limitation is the lack of scope to include papers published in languages other than English in the review unless otherwise translated and published in English.

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Empathic impacts of adolescent-focused storytelling interventions: A protocol for a scoping review

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