Narrative TherapyClaudia L. Chandler

“There is no greater agony than bearing an untold story inside you.”-Maya Angelou

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C. Chandler 2014

Origins + Background Developed during

the 1990s, largely by Michael David Epston.

Narrative Means to Therapeutic Ends.

Michael Foucault: Poststructuralism

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Theory of Change

‣ Experiential: based on experience and observation, the here and now.

‣ Reclaim, Relieve and Make Meaning of old stories.

‣ Add new substance and new possibilities in Client’s lives.

Narrative Therapy

Critical Thinking Barrage of Information in the world Where is this information coming from?

Reflexive thinking* What is the agenda of the information? What kind of context - history-

power, behind the agenda that is informing the information I’m receiving?

Narrative Therapy

As a Clinician “We have

impositional power that comes with the presumption that we think we know what normalcy might look like.” – Lucy Cotter Narrative Therapy Institute

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Structure of Therapy Time: Usually 60 minutes, although sessions

can last longer if agreed upon by all parties and it would be beneficial.

Length: Can last from one session to several years depending on a variety of factors.

Flexibility: Therapist should negotiate the time of each meeting as therapy progresses to keep it experiential.

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Role of Therapist Care, interest, curiosity, openness. Not-knowing stance. Main task is to help Client’s construct a

story line. Client as Expert when it comes to what

he wants in life. Collaboration.

Narrative Therapy

As a Clinician Should we be suspicious of language

from clients such as: “Codependent” “We have communication problems”

What is the Social Constructionist view of language anyway?

Assessment and Treatment PlanningGenerating Experience vs. Gathering Information

Evaluate their current situation

Name the problems involved

Take a stand in regard to them

Evaluate the usefulness of the

alternative stories

Evaluate their relationship to those problems Tell more satisfying

stories of their relationship

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Therapeutic Techniques No recipe, no set agenda, and no formula This approach is grounded in a philosophical

framework Questions—and more questions: Questions are used as a way to generate

experience rather than to gather information Asking questions can lead to separating

“person” from “problem”, identifying preferred directions, and creating alternative stories to support these directions.

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Therapeutic Techniques Externalization & Deconstruction Externalization is a process of separating

the person from identifying with the problem

Externalizing conversations can lead clients in recognizing times when they have dealt successfully with the problem

Problem-saturated stories are deconstructed (taken apart) before new stories are co-created

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Therapeutic Techniques Search for unique outcomes Successful stories regarding the problem Creating Alternative Stories The assumption is that people can

continually and actively re-author their lives Invite clients to author alternative stories

through “unique outcomes” An appreciative audience helps new stories

to take root

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Therapeutic Techniques Therapists write and send a letter to

clients between sessions regarding their strengths and accomplishments, alternative story, and unique outcomes or exceptions to the problems.

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Narrative Tx Techniques1. Externalization of problem—the problem is

the problem, and is given a name. Family and members not defined by problem

2. Influence of the Problem on each Person3. Influence of the Person on the Problem4. Raising Dilemmas—examine aspects of

problem before need arises5. Predicting Setbacks—they almost

inevitable, best dealt with when anticipated

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Narrative Tx Techniques6. Using Questions

Exceptions-orientedSignificance of exceptions

7. Letters to client families—a form of case note to family, put in transparent/congruent statements

8. Celebrations/certificates—festive, signify victory/achievement, tailored to circumstances by wording, printed and include logo (For achievements in conquest of “Apathy”)

Narrative Therapy

How can we use this with… Addiction Tx? Victims of Abuse and Trauma? Marginalized Cultures and Subcultures? The Homeless Population? Children? Adolescents? The Elderly?

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Summary + Evaluation Contributions Client-as-expert (not knowing position) View people are competent and able to

create solutions and alternative stories Do not support the DSM-IV-TR labeling

system A brief approach, is good for managed care. In general, studies provided preliminary

support for the efficacy

Narrative Therapy

As a Clinician Are your practices congruent with your

integrity as a person?

What does the Clinician Role mean to you?

Are you an expert and what does that mean…really?

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ReferencesGehart, D. (2014). Mastering competencies in family therapy: A practical approach to theories and clinical case documentation (2nd Ed.). Belmont, CA: Brooks/ColeStandish, K. (2014) Lecture 8: Introduction to narrative therapy. Newham College University Centre