Health Literacy

Tools of change: Telling and listening to stories

By Helen Osborne, M.Ed., OTR/L
President of Health Literacy Consulting
On Call Magazine, October 16, 2008

Molly Catron is a lifelong story listener and teller. Growing up, she learned about life from stories that her father and grandfather told. Later, as an analytic chemist, manager, and internal organizational consultant for a manufacturing company, Catron used stories to facilitate change. Now as a performing artist and storytelling coach, Catron helps others appreciate the value of a good tale well told.

Storytelling is certainly not new. But it is something, Catron says, that we’ve overlooked. Our renewed interest may be at least partly due to a problem with the way we communicate. In an age of email, instant messaging, texting, and podcasts, everyone is so focused on communication efficiency that it’s easy to lose sight of communication effectiveness.

Storytelling to effect change

When you tell a good story, you can frame important messages in ways that make them memorable for your listeners. Several years ago, the corporate strategy of the company where Catron worked shifted from one guided primarily by rules to one that relied on teamwork and personal integrity. This shift required new procedures, strategies, and paradigms. Since Catron was a natural teacher who made learning fun, the company asked her to help lead the way.

Catron decided she could use stories to help employees see shades of gray in the way they operated, not just black and white. As an example of how stories can emphasize change, Catron uses a story she tells that focuses on how she changed her own views about what it means to be a manager:

I was determined to fire this guy. While he was a good technician, this man refused to do many of the tasks I asked as we moved toward a team structure. He wouldn’t write a team agenda. He refused to take minutes. And he led team meetings as if they were a joke or comedy routine. His negative behavior had a big influence on others.

Honestly, I thought he was a real pain in the neck. I spoke with him about not meeting expectations and warned that if this doesn’t change, I would write him up for non-team behavior. He could be fired. I asked if he understood and he nodded yes.

About an hour later this man called, asking to talk with me at his work station. He sat slump-shouldered with tears in his eyes. “What you said is really fair. What you want to do is right. But I can’t read or write well enough to do what you want.” This man then explained that in the more than 20 years of working at this company, he always managed to change jobs (sometimes even taking a demotion) so no one would find out. In fact, almost no one knew he couldn’t read – not even his daughters.  

Speaking in a voice that was much too little for a fellow that big, he asked if I could help. Of course I would. I set him up with our employee remedial reading class, bought him a spell checker (the kind that only needs the first few letters of a word), and helped him with the minutes. Once he gained confidence, this man shared his secret with fellow employees, saying “I need your help, not your ridicule.”

He overcame his reading problems and now reads up to par. In fact, he is in charge of maintenance for three buildings and uses a complicated computer program for supply distribution. As a manager, I also am not the same. Now, I always wonder why people behave in certain ways and what else is going on.  

About telling stories

Catron uses the above story to illustrate the principles of leadership. She explains that the story makes it clear that leaders need to understand what drives an employee’s behavior, not just dictate tasks to be done. Leaders also need to take time to find problems that can be solved. The story also emphasizes the fact that teamwork is about empowering employees. The story can do all these things effectively because of the very nature of narrative.

Stories tell the tale of a “hero’s journey.” Catron points out that stories have a beginning, middle, and end. The beginning describes how things usually are. The company in the story expected all employees to participate as team members. In the middle of a story, something happens or changes. Tension is built by telling increasingly important events. In this story, the man refused to write an agenda or take notes, and he treated meetings as a comedy routine. The event that “broke the back” and led to action was his negative influence on others.

The end of a story highlights what changed or resulted from the action that took place in the middle. Catron’s story ends not only with how the man’s life changed, but also with how hers did as well.

Here are some reasons stories work:

  • Stories touch the heart. Catron speaks of the “eighteen inches between a person’s head and heart.” To her, stories present facts within an emotional context. Together, they influence behavior.
  • Stories balance emotions and facts. Catron believes that everyone appreciates good stories, even “androids” who use their heads more than their hearts. While some people need more facts than others, she says that everyone has “emotional byways.” A good story balances both.
  • Stories use images to engage and evoke emotions. Images stay with people. Stories are like pictures or videos, not just words or lists of facts. An example of imagery is the way Catron describes the worker speaking in a “voice much too little for a fellow that big.”

Even though Catron was born into a family of storytellers, she knew she had things to learn. In fact, since she began using stories in the workplace, she’s earned a master’s degree in storytelling. Here are her tips for telling stories well:

  • Use stories deliberately. To move from brief anecdotes to stories with major impact, tellers must structure them. It’s important that there be a beginning, middle, and end, and that storytellers know what it is they want to say. Catron says that storytelling coaches can help people shape their stories into compact and powerful sound bites that get a message across.
  • Collect “pocket stories.” Catron recommends building a collection of short, pithy stories to tell at teachable moments. She suggests jotting down in a notebook or journal reminders of certain stories. Later, you can look back at your notes and expand the stories.
  • Be authentic. Catron talks of a concept developed by the International Storytelling Center that describes two types of stories: “Big ‘S’” stories that are fabricated; and “Little ‘S’” stories built from personal anecdotes. Catron says that too many people think they need the fabricated ones. But this can be a big mistake. In her opinion, people get into trouble when they manufacture big stories to manipulate listeners.  Stories that come from personal real-life experience sound and feel genuine.

About listening to stories

Stories can be just as effective in patient care as they are for organizational change. Telling the right story at the right time can help a patient understand the importance of adherence to a treatment plan or move from a pre contemplative state to a contemplative one during the process of making lifestyle changes. But telling a story isn’t the only way to use them. Getting someone to tell you his or her story can be just as important.

For instance, stories can be another diagnostic tool. In health care, providers often ask patients for their stories. But too often this request is made in ways that merely confirm what the provider is already thinking. As an example, when a provider wants to know more about a patient’s medication problems, he or she might ask, “How many times did you wake at night after you took the medication?” The patient then gives back a directed response, such as “three times.”

But stories can be used more effectively than that. Catron recommends evoking another person’s story without influencing it. This is done by staying neutral, listening for defining moments, and “pulling threads” to get at deeper knowledge.

Replaying the above situation, the provider could ask for information in a more open-ended way, such as, “Tell me about what you did the night you took that medicine.” The patient might respond, “We went out to dinner.” Then the provider can follow up with, “Tell me about that dinner.” To which the patient might respond by giving more information: “Well, I had catfish and 2 glasses of wine.” Certainly, this response adds new information to help diagnose the patient’s problem.

Catron says that when people listen to stories, they do their own processing. So in a sense, people who communicate by telling stories facilitate that processing. The result is that people ultimately decide, “I’ll change me.” And that’s the power of story.

Ways to learn more:

Molly Catron is a performer and storytelling coach. You can learn more by going to her website at


Web sites

Helen Osborne, MEd, OTR/L, is president of Health Literacy Consulting . She received two “Gold 2008 Plain Language awards from NIH for her work on the NCI booklets “Radiation and You” and “Chemotherapy and You.” Her column appeared regularly in On Call. You can contact her by e-mail at

Article reprinted with permission from On Call magazine and published by a division of Boston Globe Media.