narrative therapy
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Narrative Therapy Presentation. Advanced Theories Psychotherapy.TRANSCRIPT
Narrative TherapyClaudia L. Chandler
“There is no greater agony than bearing an untold story inside you.”-Maya Angelou
C. Chandler 2014
C. Chandler 2014
Origins + Background Developed during
the 1990s, largely by Michael David Epston.
Narrative Means to Therapeutic Ends.
Michael Foucault: Poststructuralism
C. Chandler 2014
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.
C. Chandler 2014
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.
C. Chandler 2014
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
C. Chandler 2014
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?
C. Chandler 2014
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