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Updated: Jun 8, 2026

Using Visual and Narrative Methods to Achieve Fair Process in Clinical Care
Published on: February 16, 2011
Facades of suffering: clients' photo stories about mental illness
Jan E Sitvast1, Tineke A Abma, Guy A M Widdershoven
1GGNet, Network for Mental Healthcare in the Region Oost Gelderland, Warnsveld, The Netherlands. j.sitvast@ggnet.nl
Abstract:
In this article, photo stories are examined that were the result of working with photography as a therapeutic instrument dealing with suffering in mental health care settings. The purpose is to describe the role of facades in the process of suffering and acceptance. Clients took photographs, talked about them in group meetings, and exhibited them to a broader audience. Their photo stories were analyzed using a mixed-methods model. Data from two narrative approaches (semiotics and hermeneutics) were compared with information from other informants and official records to find discrepancies between the photo story and the real life context. Although facades are usually perceived as an obstacle for personal growth, the visual narratives revealed that facades can function as an alternative to common acceptance strategies, such as facing one's losses and reconciliation. Facades can create a distance between the person and the suffering. We conclude that visual narratives can reveal and foster agency in clients.
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