Box 1.

Potential positive therapeutic elements

Time to talk, being respectfully heard

“I think probably they're more likely to see medical students as maybe less judgmental and more on their side than fully qualified doctors, and I know that one patient, she's been sexually abused but she's never told anybody else that before.” (student 9)

Self esteem, validation, and empowerment

“In a way it was quite—not flattering, but it was—it was giving my situation some kind of credence or some kind of, you know, validity, that what I'd been through was, you know, it was worthy enough to go along and talk to students.” (patient 13; episode of acute psychosis and depression)

Development of coherent narrative

“It probably sort of vocalised my thoughts a bit—because I've suffered from it so long, its like the norm to me—I was thinking gosh, they must think this is really, you know, quite bad really. I was seeing it in a fresh way, if you know what I mean, by them asking me questions.” (patient 3; agoraphobia)

New insights

“It was useful to relive the experience, as this reminded me that it was really me that it happened to and it could happen again—going through it with the students reminded me to be careful to not let it happen again and to recognise the signs of when it might be coming on.” (patient 16; eating disorder)

Depth, balance, and understanding in doctor-patient relationship

“It definitely builds a bond. Absolutely. And they've done you a favour, so I feel that the power is slightly over the other way . . . so rather than them being inherently grateful all the time, as some of them are, it sort of changes everything and makes it feel more of an equal relationship.” (general practitioner 8)