Evaluating the effectiveness of a Tree of Life (ToL) intervention on an Older Adult (OA) psychiatric ward

Aims: We explored the feasibility and acceptability of a Tree of Life (ToL) intervention within an Older Adult inpatient mental health ward. The intervention was introduced as an alternative to one-page profiles, with the aim of identifying adaptations required for this population. Methods: Twenty-five service users admitted to an Older Adult inpatient ward between August 2024 and August 2025 participated in up to three individual ToL sessions. A mixed-methods design was used. Wellbeing was rated pre- and post-intervention using a 10-point scale, and experiences of the intervention were explored through Likert-scale and open-ended questionnaires. Quantitative data were analysed descriptively, and qualitative data were analysed using reflexive thematic analysis. Results: Participants reported high levels of acceptability, rating the intervention as useful, supportive, and easy to understand. Recovery-oriented outcomes relating to empowerment, self-understanding, and recognition of strengths were rated positively. A Wilcoxon signed-rank test demonstrated a statistically significant improvement in self-reported wellbeing following the intervention (W=7, p<.05), with median wellbeing scores increasing from 4 to 8. Three themes emerged: Reconnecting with Identity, Meaning, and Strengths; Feeling Seen, Heard, and Emotionally Contained; and The Importance of Flexible Delivery in an Acute Older Adult Setting. Conclusions: The ToL intervention was feasible, acceptable, and associated with improved wellbeing within an Older Adult inpatient setting. Participants described benefits relating to identity, self-reflection, emotional containment, and connection. However, successful implementation required adaptations to meet the cognitive, emotional, and communication needs of older adults.