Narrative therapy

Narrative therapy is a widely accepted approach in the fields of family therapy, counseling psychology, and social work. It is based on the idea that people create and tell stories to make sense of and construct meanings about their experiences, relationships, and lives. The main focus of the therapeutic practice is to explore stories presented by clients in a nonjudgmental way. Stories or aspects of stories that are deemed to be problematic are externalized and, thus, separated from the clients’ identity. Through this practice, values, abilities, insights, and aspirations are used to develop alternative stories and skills to deal with life’s challenges. The therapist’s role is decentered, yet significant.

Overview

Michael White and David Epston developed narrative therapy in the early 1990s, influenced by the work of Salvador Minuchin in structural family therapy, the Milan School’s systemic family therapy model, and interactional family therapies. It is interdisciplinary, informed by research and development in the fields of anthropology and literary and feminist theories.

Narrative therapy holds that a client’s interpretation of an event or experience is influenced by culture, context, and language. Interpretations of an experience, which are sometimes experienced as negative and problematic, affect the client’s thoughts and actions. In therapeutic practice, one of the goals is to redefine the client’s view of the problem, shifting it from being part of his or her identity to being an external challenge that is not a fundamental aspect of identity. Throughout a process of “rich story development,” the therapist engages the client in “externalizing conversations” by asking questions and by modeling language that separates the problem from the client. For example, the therapist might ask “how does this problem affect your motivation?” instead of saying “you’re not motivated.” Clients are encouraged to use similar language as they tell and retell their stories so that multiple possibilities for preferred stories can arise, and their relationship with the problem can change. The therapist’s role is to guide and facilitate the development of rich, multifaceted stories. Over time, as therapeutic exploration enables the re-authoring of preferred stories, the therapist works to connect the client with others who have dealt with similar problems. This allows for both a connection to others with similar experiences and the development of a body of knowledge from an insider’s perspective. Together, client and therapist explore possibilities to engage others in playing a role in the authentication of a client’s re-authored identity, including family and community members. Narrative therapy is widely implemented with a variety of clients, including those dealing with substance abuse; young people with autism spectrum disorders; refugees with PTSD; students with learning disabilities and ADHD, and adults with major depressive disorder. Therapy may take place in an individual or group setting.

More recently, narrative theory has been expanded by Lev S. Vygotsky’s emphasis on language, and by the development of narrative practices with Australian Indigenous communities. In addition, John Stillman has established an evidence-based practice of narrative therapy, a challenging task given that philosophical foundations for this approach oppose those of evidence-based practice. Interestingly, this effort has yielded a Narrative Therapy manual for trauma therapy that may ultimately clarify practice and provide empirical relevance for advances in the field.

Bibliography

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Cashin, Andrew, et al. “The Effectiveness of Narrative Therapy with Young People with Autism.” Journal of Child and Adolescent Psychiatric Nursing 26 (2013): 32–41. PDF file.

Combs, Gene, and Jill Freedman. “Narrative, Post-structuralism, and Social Justice: Current Practices in Narrative Therapy.”Counseling Psychologist 40.7 (2012): 1033–60.

Dulwich Centre and David Denborough. “Dulwich Centre: A Gateway to Narrative Therapy & Community Work. Research, Evidence, and Narrative Practice.” Dulwichcentre.com. Dulwich Centre Foundation, Nov. 2009. Web. 20 July 2013.

Morgan, Alice. What Is Narrative Therapy: An Easy-to-Read Introduction. Dulwich Center, 2000.

"Narrative Therapy." Psychology Today, 13 Oct. 2022, www.psychologytoday.com/us/therapy-types/narrative-therapy. Accessed 30 July 2024.

Ramey, Heather L., Karen Young, and Donato Tarulli. “Scaffolding and Concept Formation in Narrative Therapy: A Qualitative Research Report.” Journal of Systemic Therapies 29.4 (2010): 74–91.

Stacy, James, and Adrian Edwards. “Resisting Loneliness’ Dark Pit: A Narrative Therapy Approach.” Tizard Learning Disability Review 18:1 (2013): 20–27. PDF file.

Stillman, John R., and Christopher R. Erbes. “Speaking Two Languages: A Conversation between Narrative Therapy and Scientific Practices.” Journal of Systemic Therapies 31:1 (2012): 74–88.

White, Michael. Maps of Narrative Practice. Norton, 2007.

White, Michael, and Epston, David. Narrative Means to Therapeutic Ends. Norton, 1990.