Narrative medicine

1. Introduction

Version followed: the Columbia University model of narrative medicine as set out by Rita Charon (JAMA 2001; Narrative Medicine: Honoring the Stories of Illness, 2006) and the Columbia faculty textbook The Principles and Practice of Narrative Medicine (Charon, DasGupta, Hermann, Irvine, Marcus, Rivera Colón, Spencer, Spiegel; Oxford University Press, dated 2016 by Columbia and 2017 elsewhere [uncertain on year]), with the classroom methods described in Charon, Hermann and Devlin (2016).

What it is. Narrative medicine is a framework and a training discipline, not a psychotherapy. Rita Charon, an internist with a PhD in English literature, built it at Columbia University in New York, where it is taught in the medical school, in clinician seminars and in a Master of Science programme. It is mainly a way of training clinicians (doctors, nurses, social workers, chaplains, therapists, students) to listen to and represent patients' stories. It was not designed as a treatment that a therapist delivers to a client. This guide is written for a psychotherapist who wants to use its methods in three ways: to sharpen their own listening in sessions; in their own reflective practice and supervision groups; and, as an adaptation, in reading-and-writing work with clients (marked [synthesis] where it goes beyond what the sources describe). [source: Columbia Narrative Medicine book page; Columbia Magazine; Kinross 2014]

Core idea of change. Charon's central term is narrative competence: the ability to recognise, absorb, interpret and act on the stories and predicaments of others. Training in close reading of literature and in reflective writing builds this ability. It is applied to four relationships in care: clinician–patient, clinician–self, clinician–colleagues and clinician–society. [source: JAMA 2001 abstract via library record] Change comes through a movement Charon calls attention → representation → affiliation. The clinician gives full attention to the teller. The clinician then puts what was perceived into words, because, in the 2016 paper's argument, accurate perception depends on representing what was seen, and representation depends on how it is received. This joint work builds affiliation: standing with the patient rather than solving the problem and moving on. [source: Charon, Hermann & Devlin 2016 abstract; ACP Internist 2019; Kinross 2014]

2. Framework

Narrative medicine has no manualised phases, no fixed session count and no criteria for moving between phases. What the sources describe is a set of recurring formats and an order within each one. [source: Columbia Magazine; Proto 2010; Columbia book page] Treat the "phases" below as the order of a single encounter or workshop, not stages of a therapy.

A. Within one clinical encounter (Charon's own practice)

Attention: an open invitation to tell, then uninterrupted, absorbing listening to the content, form, images, silences and tears, in the order the teller offers them. [source: ACP Internist 2019; Kinross 2014]
Representation: writing down what was said (Charon types it during the visit) and noting themes that recur. [source: Kinross 2014]
Co-authoring and affiliation: the patient reads what was written and corrects or adds to it. Patients have added errors to fix as well as childhood trauma, losses, hopes and desires. [source: ACP Internist 2019; Kinross 2014]

Goal of the whole sequence: an account the patient recognises as theirs, and a relationship in which the clinician is "on the patient's side". [source: ACP Internist 2019]

B. Within one training session or workshop (Columbia pedagogy)

Close reading of a short literary or visual text in a group, using a structured set of reading questions.
Brief writing to a prompt linked to the text (Charon notes writing can be as brief as about three minutes).
Optional reading aloud of what was written.
Listeners respond to the writing as a text, using the same close-reading lens. [source: Proto 2010; Charon, Hermann & Devlin 2016 abstract; Ensign blog; Columbia Reading Guide]

Moving on: there are no published criteria. Move from reading to writing once the group has looked closely at the text's form as well as its content. Move to sharing only when there is enough safety and time for it [synthesis].

C. Recurring formats and frequencies reported

Medical students' parallel-chart groups: weekly meetings to read accounts aloud (Columbia, third and fourth years). [source: Columbia Magazine]
Oncology staff parallel-chart groups: voluntary, 6–15 staff, twice a month. [source: Columbia Magazine]
Pediatric oncology narrative seminars: a six-week series. [source: Proto 2010]
Literature reading seminar for clinicians and staff ("Literature at Work: The Robert Braham Seminar"): lunchtime, twice a month, led by English faculty. [source: Columbia Magazine]
Formal training: Columbia lists a Master of Science in Narrative Medicine and an online Certification of Professional Achievement. Their content and length are not drawn on here [uncertain]. [source: Columbia book page links]

Professional frame. Narrative medicine is not a regulated profession. There is no registration, licence or protected title, and no professional body that credentials practitioners in the way HCPC, AATA or BAPT do for the arts therapies. Its methods are used inside your existing professional registration and ethical code. Columbia's MS and online certificate are the institutional training routes; workshop facilitation is best learned there or from trained faculty [source: Columbia book page; synthesis]. Using its writing exercises with clients makes this therapeutic writing, and your own scope of practice, supervision and consent duties apply. If you want to run a writing group as therapy, consider training in therapeutic or expressive writing as well (e.g. via a writing-for-wellbeing or poetry-therapy body in your country) [synthesis].

Materials and physical safety. You need a short text (on paper or screen), pens and paper or devices, a quiet private room and a clock. Physical risks are minimal. The practical risks are emotional (disclosure and distress) and informational (privacy of patient material); see sections 3 and 5 [synthesis].

3. Guiding principles

[source: ACP Internist 2019; Kinross 2014; Proto 2010; Columbia Magazine; JAMA 2001 abstract; Charon, Hermann & Devlin 2016 abstract; Columbia book page; [synthesis] where marked]

Narrative competence is a clinical skill. Treat listening and reading as trainable skills you practise, not a personality trait.
Attention as a gift. Charon speaks of donating "my full attention" (Jefferson Lecture 2018, as quoted in ACP Internist). Put devices away and do not plan your reply while the client speaks.
Listen to form as well as content. Notice the plot, the order of telling, the images, the silences and the tears, not just the facts.
Ask what it is like for them, not how you would feel. Charon calls imagining one's own feelings "self-involved". Ask about the other person's experience instead of projecting your own.
Representation sharpens perception. Putting an encounter into words shows you what you noticed and what you missed. Write briefly and often.
Every word counts. Read the client's words, and your own notes, closely. Word choice, metaphor and what is left out all carry meaning.
The story is co-created. Show your representation to the teller and let them correct it. They have the final say on their own story.
Affiliation over fixing. The aim is to be on the person's side as well as solving the problem.
Four relationships. Reflect on self, colleagues and society as well as the client, because all four shape care.
The ordinary deserves attention. Charon says writing "canonizes the ordinary things we do every day" (Proto 2010). Write about routine sessions, not only dramatic ones.
Many readers see more. Share writing with colleagues because different readers notice different things.
The clinician's feelings shape care. Feelings and memories "influence the care you give" (Columbia Magazine). Name them in the parallel chart so they do not act unseen.
Close reading is the signature method. Start from a text before turning to your own experience. The text gives distance and a shared object to look at.
Respond to writing as writing [synthesis, consistent with the Reading Guide's literary-critical stance]. Comment on observation, perspective, form, voice, mood and movement. Do not judge the writer or diagnose them from the piece.
Privacy of the people in the story [synthesis]. Anything written about a client is de-identified: no names, dates, places or rare details. Keep it separate from the clinical record, store it securely, and share it only in a confidential setting.
Voluntary disclosure and pacing [synthesis]. Writing is private by default and reading aloud is always optional. People choose how much to reveal, and the facilitator keeps the depth of the prompts in step with the group's safety.
Access [synthesis]. Offer texts in large print or audio and allow speaking instead of writing. Choose texts across languages and cultures, keep reading levels plain, and never require spelling or literary polish.

4. Intervention inventory

The first five items come from Charon's clinical practice. Items 6–11 come from the Columbia teaching methods. Item 12 is a client-facing adaptation and is [synthesis] throughout. Example language is illustrative unless it is quoted and cited.

4.1 Open invitation to tell

Purpose / when: opening a first meeting or a new topic. It gives the client control of where the story starts. [source: Kinross 2014]
Steps: (1) Explain briefly why you are asking. (2) Ask one open question about what you should know, in the spirit of Charon's reported question, "What should I know about your situation?" (Kinross 2014). (3) Then stop talking and let the client choose the starting point, order and length.
Example language (illustrative): "Before we get into forms and questions, tell me whatever you think I most need to know about what's going on for you."
Watch for: where the client chooses to begin, what comes first, and what is left out. Working signs: the client talks in their own order and you learn something no form would have asked. If they want structure, give a narrower prompt [synthesis].

4.2 Attentive ("radical") listening

Purpose / when: throughout every session. It is the attention step that the rest depends on. [source: ACP Internist 2019; Kinross 2014]
Steps: (1) Clear distractions and turn toward the speaker. (2) Listen without interrupting or steering. (3) Track the plot, the form (order, pace, genre), the images and metaphors, the silences and the tears. (4) Hold back hypotheses until the story pauses. (5) Only then move to your clinical questions and shared decisions. This is the order Charon describes: listening, then examination and checks, then shared decisions, then documentation (ACP Internist 2019).
Example language (illustrative): "Take your time. I'm not going to interrupt." Later: "You came back twice to the image of the locked door. Can we stay with that?"
Watch for: the urge to rescue or interpret too early. Working signs: the client says more than planned, corrects themselves, or says "I've never said that before." Afterwards you can recall the client's actual words and images, not just a summary [synthesis].

4.3 Perspective check: "what is it like for them?"

Purpose / when: whenever you notice yourself imagining how you would feel. Charon calls that question "self-involved". [source: ACP Internist 2019]
Steps: (1) Notice the self-referencing thought ("if that were me…"). (2) Put it aside. (3) Ask, or wonder aloud, what this experience is like for this person, with their history and their values.
Example language (illustrative): "I don't want to assume I know what this is like. What has it been like for you?"
Watch for: the client correcting your assumption, which counts as success. In supervision, a quick check is to ask whose feelings your notes describe [synthesis].

4.4 Representing the story in writing during the session

Purpose / when: the representation step. Writing helps you see what you heard, and it gives the client something they can check. [source: Kinross 2014; Charon, Hermann & Devlin 2016 abstract]
Steps: (1) Ask permission to write while the client speaks. (2) Write their words as closely as you can, and note themes that recur. (3) Keep your interpretations out of this text or clearly separate. (4) Store it according to your clinical-records rules.
Example language (illustrative): "Would you mind if I type some of what you say as you say it? I'll show it to you at the end so you can fix anything I got wrong."
Watch for: writing pulling your eyes away from the client. Some clients find it alienating, especially those with surveillance or trauma histories. In that case write afterwards instead [synthesis]. Working sign: the client takes interest in the record.

4.5 Shared review and co-authoring of the record

Purpose / when: after 4.4, at the end of a session. It builds affiliation and accuracy. [source: ACP Internist 2019; Kinross 2014]
Steps: (1) Turn the screen or page toward the client. (2) Invite them to read it. (3) Ask them to correct, add to or remove anything. (4) Record their changes, or note where you disagree, according to your records policy. In Charon's practice patients have corrected errors and added trauma, losses, hopes and desires (ACP Internist 2019).
Example language (illustrative): "This is what I've written about what you told me today. What did I miss, or get wrong? Is there anything you'd want added?"
Watch for: clients who feel obliged to approve. Say plainly that changes are welcome. Check what you are legally required to keep in the official note before promising that anything will be deleted [synthesis]. Working sign: the client edits it and then refers back to "our" account.

4.6 Close reading of a text (the close reading drill)

Purpose / when: the signature training method. It trains attention on a shared object at one remove from the participants' own lives. It opens almost every workshop. [source: Columbia book page; Ensign blog, citing Charon 2006 "Close Reading" chapter]
Version: Charon's drill asks about five features in this order: frame (what is included and left out; where and for whom it first appeared), form (genre, structure, narrator, metaphor, allusion, diction), time (how the text handles time), plot (what happens) and desire (what appetite the text arouses or satisfies in the reader, and what that shows about the reader). Josephine Ensign, a narrative medicine teacher at the University of Washington Bothell, describes this order and notes she changes it to suit her own reading. She also uses a "closer" variant that attends to emotion, silence, surprise and metaphor (secondary source).
Steps: (1) Choose a short text of a page or less: a poem, a passage of prose, a painting or a photograph. Ensign, for example, used a Salinger short story and poems by nurses from the anthology Between the Heartbeats. (2) Read it aloud twice, ideally in two different voices [synthesis]. (3) Go through the drill questions one at a time, asking the group to point to the exact words. (4) Name what the text leaves out. (5) Ask what the text made each reader want or feel. (6) Lead into a writing prompt (4.7).
Example language (illustrative): "Before we talk about what it means, what do you notice? Point to the line." "Who is telling this, and from how far away?" "What does the poem not say?"
Watch for: jumping straight to the theme or the moral, or to personal stories. Bring the group back to the words. Choose texts with care: avoid ones that closely mirror a recent death or trauma in the group unless you have chosen them deliberately [synthesis]. Copyright: use texts you have the right to copy, or bring legitimately bought copies, and do not pass around unauthorised copies [synthesis]. Working signs: participants quote exact words and disagree in productive ways.

4.7 Brief writing to a prompt

Purpose / when: straight after close reading. The representation step turns perception into words. [source: Proto 2010; Charon, Hermann & Devlin 2016 abstract; Ensign blog]
Steps: (1) Give one short prompt that comes out of the text, by borrowing its form, image or situation. (2) Set a short time limit; Charon notes useful writing can take about three minutes (Proto 2010). (3) Tell people that spelling, polish and genre do not matter, and that the writing is theirs to keep private. (4) Give a one-minute warning, then stop.
Prompt shapes: Ensign's example asks participants to write about a time emotion made communicating hard, or about caring for someone in that state (Ensign blog). Other illustrative shapes: "Write about a moment when you were not listened to" and "Write from the point of view of the chair in the waiting room" (illustrative).
Example language (illustrative): "You have four minutes. Write whatever comes. No one has to read aloud."
Watch for: prompts that pull too deep for the group's current safety (see 5.3). Use indirect, imaginative or third-person prompts with new groups and distressed participants [synthesis]. Working signs: everyone writes something, and pieces show concrete detail rather than abstraction.

4.8 Reading aloud and responding to writing as a text (the Columbia Reading Guide)

Purpose / when: after writing. It trains clinicians to read one another's writing closely, which Columbia makes central to its teaching and faculty training. [source: Charon, Hermann & Devlin 2016 abstract; Columbia Reading Guide via open textbook]
Version: the Reading Guide for Reflective Writing (Hermann, Charon & Devlin, 2012) gives six lenses for responding to a piece: observation (sensory detail and description), perspective (whose viewpoints appear or are implied), form (genre, metaphor, time structure, allusion, diction), voice (who tells, from what distance, how self-aware), mood (the emotional atmosphere and its effect on the reader) and motion (whether the piece moves and takes the reader somewhere). The guide is paraphrased here, not reproduced. Its categories differ from the five-element drill in 4.6. Use the drill for published texts and the Reading Guide for participants' writing.
Steps: (1) Ask for volunteers to read. Never require anyone to. (2) The writer reads without preamble or apology. (3) Listeners say back specific words or images that stayed with them. (4) Listeners comment through one or two of the six lenses. (5) Keep the comments on the writing, not on the writer's life, feelings or competence [synthesis]. (6) Thank the writer and move on. Do not ask follow-up questions about the events described unless the writer invites them [synthesis].
Example language (illustrative): "What phrase is still with you?" "Whose voice do we hear, and whose is missing?" "Where does the piece move?"
Watch for: praise or critique of craft ("that was brilliant" or "that was weak"), advice-giving, and turning the response into therapy for the writer. Redirect all of these to the text. Working signs: writers say they felt read rather than judged.

4.9 The parallel chart

Purpose / when: a running written account, kept apart from the clinical record, of what the clinical record has no place for: the clinician's own reactions (Charon's example is "I'm angry at this guy"), and the patient's fears, expectations and memories as the clinician experiences them. Students write it during clinical rotations; staff groups use it in high-strain services. [source: Proto 2010; Columbia Magazine]
Steps: (1) After a session that stays with you, write briefly in ordinary language, not clinical language. (2) Include your own feelings and memories. (3) De-identify fully: no name, initials, dates, places or rare details. Change details that don't matter, or write a composite [synthesis]. (4) Keep it physically and digitally separate from the client file, and store it securely [synthesis]. (5) Bring it to a parallel-chart group (4.10) or to supervision. The parallel chart does not replace the clinical record (Proto 2010).
Example language (illustrative, to yourself): "Write the session you couldn't put in the notes."
Watch for: identifiable detail. Check the law where you work on whether personal notes about clients can be subpoenaed or requested by clients [uncertain: jurisdiction-specific; synthesis]. Never use it to vent contempt that then goes unexamined. Working signs: a reaction you named in the chart surfaces in supervision and changes what you do next; in Columbia's student study, participants found it useful both as an emotional outlet and as preparation for talking with patients (Columbia Magazine).

4.10 Parallel-chart and narrative writing groups for staff

Purpose / when: shared reflection for teams. At Columbia these were weekly student groups and voluntary oncology groups of 6–15 staff meeting twice a month to write about fear, loss and mortality. [source: Columbia Magazine; Proto 2010]
Steps: (1) Recruit volunteers; do not make it compulsory [source: Columbia Magazine for oncology; synthesis as a general rule]. (2) Agree ground rules on confidentiality, de-identification, optional reading and no gossip about colleagues [synthesis]. (3) Run each meeting as text → prompt → optional reading → response through the Reading Guide (4.6–4.8), or have members bring parallel-chart entries to read. (4) End with a brief closing round (5.4).
Example language (illustrative): "What we write here stays here. Please change any detail that could identify a patient or a colleague."
Watch for: the group drifting into a complaints meeting or a case conference. Bring it back to the writing. Keep line managers out of the group, or think hard before including them, because their presence affects how openly people write [synthesis].

4.11 Literature seminar for clinicians

Purpose / when: sustained reading together. It builds close-reading skill and sensitivity to many voices. [source: Columbia Magazine; Proto 2010]
Steps: (1) Choose a work or extract per session; the Columbia seminar has read Virginia Woolf and Melville's Billy Budd, and Charon has taught associative, layered contemporary novels (Columbia Magazine; Proto 2010). (2) Co-lead with someone trained in literature where possible. (3) Do a close reading (4.6), then discuss how the reading bears on clinical listening.
Example language (illustrative): "Where in this chapter does the narrator tell the truth 'aslant'? Where do our clients do that?" (Charon's phrase "aslant", Proto 2010).
Watch for: the seminar becoming a lecture. Working sign: participants bring formal observations back into case discussions [synthesis].

4.12 Client-facing adaptation: reading and writing with clients [synthesis]

Purpose / when: individual or group therapy clients who like words and want to tell their illness or life story with you as attentive reader. This is an adaptation and not part of the Columbia model, which trains clinicians. [synthesis]
Steps [synthesis]: (1) Assess suitability, and get consent once you have explained that writing can bring up strong feelings. (2) Offer a short text, or let the client choose one. (3) Read it together closely, asking about form and image before meaning. (4) Invite brief writing, and let the client decide whether to read it to you. (5) Respond to the writing first through the Reading Guide lenses, then explore its meaning in ordinary therapeutic dialogue. (6) Close and ground before the end of the session (5.4). (7) The client keeps the writing. Do not keep copies unless the client agrees, and record only what your notes require.
Example language (illustrative): "You don't need to write well. Let's just see what's on the page and what it notices."
Children and young people [synthesis, except where noted]: use picture books, comics or drawings as texts. Use spoken or dictated stories if writing is hard. Get the child's assent and the consent of a parent or carer. Tell the child before starting about the limits of confidentiality. If a story suggests harm, follow your safeguarding and mandatory-reporting procedures, but do not treat a story as evidence of what happened; it is a narrative, not a disclosure test. A Buenos Aires hospital has used a transparent, colourful umbrella as a private "space of attention" in which children talk more freely (Kinross 2014).
Watch for: writing used to avoid relationship, or flooding (5.3). Do not read client writing diagnostically: narrative medicine offers no validated scoring, and the Reading Guide is a teaching tool, not an assessment instrument [synthesis; no validation data found].

5. Handling problems

The sources describe hardly any of the difficulties below. Everything in this section is [synthesis] unless a source is named.

5.1 Stuck or blank participants

Offer a narrower, more concrete prompt ("one object in the room") or a list form instead of prose. Allow drawing or speaking instead of writing.
In close reading, ask a sensory question ("What can you see in the poem?") before an interpretive one.
If a client stays stuck across sessions, go back to listening (4.1–4.2). The writing may not suit them.

5.2 Resistance and scepticism ("I'm not a writer" or "this is soft")

Present it as clinical skill training. Charon's stated aim is to improve "the ordinary practice of medicine" (Columbia Magazine).
Keep the writing short and private, with no compulsion to share. The oncology groups at Columbia were voluntary (Columbia Magazine).
Start from a text, which feels safer and more intellectual than starting with oneself.

5.3 Overwhelm, flooding and retraumatisation

Screen before groups and client work: recent bereavement, current crisis, active PTSD, dissociation, psychosis or high suicide risk. For these people, offer one-to-one or deferred participation, with gentler prompts.
Pace disclosure: start with texts and third-person or imaginative prompts. Move to first-person prompts about clinical encounters or personal history only once the group is safe. Never prompt for "your worst moment" in an early session.
During distress: stop writing and invite the person to look up and notice the room. Offer a break and water. One facilitator stays with the person while a co-facilitator carries on with the group. Say clearly that stopping is fine.
Risk: if writing or speech discloses suicidal thoughts or self-harm, follow your standard risk assessment and safety-planning procedure that same day. A writing exercise does not suspend clinical duties.
Staff groups: do not let reflective writing stand in for occupational health or trauma support after a critical incident. Signpost to those services.

5.4 Closing safely

Leave 5–10 minutes at the end. Do a closing round of one word or one image. Sometimes read a lighter text to finish. Remind participants of support available between sessions.
Participants decide what to do with their pages: keep them, destroy them, or leave them with the facilitator for destruction.

5.5 Privacy breaches in patient material

If someone reads a piece containing identifying details, stop them gently. Remind the group of the ground rule, and ask everyone not to repeat the detail. Speak to the writer privately afterwards.
Never publish, post or teach from a patient story without the patient's written consent and full de-identification. Some patients will recognise themselves even when disguised. For publication, get consent or use composites, and follow your professional body's code and journal policy.
Shared review of a record (4.5) must follow your records law. Do not let co-authoring erase content you are required to keep.

5.6 Non-adherence (parallel charts not written, groups not attended)

Make entries short (a few minutes) and attach them to an existing routine, such as the end of the working day.
Lower the bar: one sentence counts. Let the group skip a week rather than collapse.
Ask what is getting in the way. Often it is time, fear of exposure or doubts about confidentiality. Fix that before anything else.

5.7 Ruptures

Client feels misrepresented by your written account (4.4–4.5): treat this as the method working. Thank them, revise the text with them, and explore what you missed.
Participant hurt by a response to their writing: name it, return the conversation to the text, restate the norm of responding to the writing, and check in privately.
Clash within a staff group (hierarchy, blame): pause, restate the ground rules, and if needed meet separately. Do not process team conflict in the writing circle.

5.8 Modality-specific difficulties

Using it as therapy without a frame: the Columbia model trains clinicians. If you bring it to clients, make it part of an assessed, consented therapy with clear goals (4.12).
Projection in reading: readers may see their own life in the text. Desire is one of the drill's five elements, so name the reader's response as information about the reader, not about the author or the client (Ensign blog, describing Charon's drill).
Over-literary facilitation: avoid jargon and gatekeeping about canonical texts. Choose texts across cultures, languages and abilities, including oral stories and images.
Access: use large print, audio and screen-reader-friendly files. Allow dictation or a scribe, offer texts in the participant's first language, and keep the room physically accessible. People with low literacy can do close listening to texts read aloud and give spoken responses.
Copyright: bring legitimate copies of texts, and do not distribute scans of copyrighted books in course packs without permission.
Online groups: confirm everyone has privacy, and that no one records or keeps screenshots. Let people write offline and read voluntarily. Have a plan for contacting someone who leaves the call in distress.

Sources

Sources:

Further reading (known from the pages above; full texts not drawn on):

Charon, R. (2001). Narrative medicine: a model for empathy, reflection, profession, and trust. JAMA, 286(15). Abstract seen via library record only.
Charon, R. (2006). Narrative Medicine: Honoring the Stories of Illness. Oxford University Press. Not drawn on here; the "Close Reading" chapter is known via Ensign.
Charon, R., DasGupta, S., Hermann, N., Irvine, C., Marcus, E. R., Rivera Colón, E., Spencer, D., & Spiegel, M. (2016/2017). The Principles and Practice of Narrative Medicine. Oxford University Press. Not drawn on here; contents from the Columbia page.
Charon, R., Hermann, N., & Devlin, M. J. (2016). Close reading and creative writing in clinical education: teaching attention, representation, and affiliation. Academic Medicine, 91(3), 345–350. Abstract only.
Hermann, N., Charon, R., & Devlin, M. (2012). Reading Guide for Reflective Writing, Columbia University. As reproduced in the open textbook above.

Further reading (not drawn on): Charon's "What to do with stories" (Canadian Family Physician, 2007) on PubMed Central; the full text of Charon, Hermann & Devlin 2016; Columbia's public-programming and MS programme pages; a University of Wisconsin narrative medicine groups page. Details that would have come from these are marked [uncertain] or left out.

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