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CHAPTER 15: NARRATIVE THERAPY. Theories of Counseling and Psychotherapy Third Edition By Nancy L. Murdock Prepared by Marcy Stites. Case Study. “Kennedy family”. Highlights of Narrative Therapy (NT). Life is a process of storytelling
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CHAPTER 15:NARRATIVE THERAPY Theories of Counseling and Psychotherapy Third Edition By Nancy L. Murdock Prepared by Marcy Stites
Case Study “Kennedy family”
Highlights of Narrative Therapy (NT) Life is a process of storytelling Social constructivist approach – no objective social reality only constructed by social interactions and processes Distinct social activism Michael White and David Epston Narrative Means to Therapeutic Ends (1990) Social workers by training Biting the Hand that Starves You (2007) www.dulwichentre.com.au/ or www.narrativeapproaches.com/ www.anzift.com
“narrative therapy questions pathologising practices” Dulwich Centre website
Basic Philosophy Social constructivist – no objective social reality Constructed by social processes, interaction with others Analysis of Social Power (Foucault) Power determines truths Power and knowledge are inseparable Therapy is a form of social control Emphasizes health and strengths
Human Motivation The tendency to create meaning
Central Constructs Stories: human life is a series of stories “according to plot” Dominant and alternate (hidden) stories Created through interactions with others Cultural discourse (dominant discourse) – culturally-based “truths” that influence our lives Problem-saturated – brings them to counseling Thinness (few) and Thickness (elaborate and rich): qualities of the stories Unique Outcomes: not part of the dominant but are exceptions Preferred story
Theory of Person and Development Don’t have much use for tradition, stage-oriented theories of development Focuses on client’s unique trajectory through life, cultural context, and his/her personal understanding of the current situation Some recent application of Vygotsky Multiversioned or multistoried – multiple selves
Health and Dysfunction Dysfunction is stories by which living doesn’t sufficiently represent their life experiences Ongoing conflict Not being appreciated Continual lack of trust Fear and love (Doan, 1998) Healthy: “preferred narrative”
Nature of Therapy Client tells story, therapist listens, and two of them bring meaning Assessment: do not use formal assessment Assessment is a continuous process to understanding the client’s stories Cultural and other contexts A thorough exploration of the problem Overview of the therapeutic atmosphere Collaborative, utilizing the client’s language Roles of client and counselor Counselor: collaborator or consultant Clients: the true experts Both are “investigative reporters” Goals: new and satisfying stories for their clients Deconstruct problem-saturated stories and re-author narratives that support preferred outcomes
Process of Therapy Five stages (Vromans and Schweitzer (2010) Stages are overlapping and thought of as principles as much as rigidly sequenced phases Establishing relationship Eliciting problem stores Deconstructing dominant stories Embracing preferred stories Living enriched stories
Process of Therapy (cont.) Three stages of NT (Beels, 2001) Through listening to the story of the problem, recast as an affliction of the client Alternatives to the problem are explored, and alternate story is created through focusing on unique outcomes – preferred story (re-authoring, re-storying, or re-membering) Build a support group to help the client continue the new story Externalizing: recast the problem as something outside of the client Relative influence questioning Externalizing conversations – four categories Deconstruction: examination of cultural truths in the genesis of the problem Only the beginning of the journey Resistance is plots that don’t easily go away
Techniques Major technique is asking questions – can bring new ways of seeing things Relative influence questioning Landscape of Action and of Consciousness Double listening Visualization – externalize into mental image Outsider witness practices (definitional ceremony) – four areas of inquiry Accountability practices Taking it back practices Written artifacts
Feedback of the Theory Evaluation of the Theory Difficult to read and understand “losing the family” by Minuchin Qualities Postmodern approach Many qualitative studies but some quantitative research supportive of NT Research Support Newness and the difficulty of testing it makes it difficult to give evidence to NT Outcome studies Etchison and Kleist (2000) Vromans & Schweitzer (2011 Weber et al., (2006) Besa (1994) St. James-O’Connor et al. (1997) Smith et al. (1992) Theory-testing Goncalves et al., (2008) Piran and Cormier (2005) Coulehan et al. (1998)
Additional Research on NT Young and Cooper (2008) client reviewed session videotapes in “Narrative Therapy Re-Visiting Project” Keeling and Bermudez (2006) qualitative approach to assess the effects of externalizing problems Knight et al., (2003) Ramey et al., (2009)
Individual and Cultural Diversity “perfect for use with individuals from diverse backgrounds.” The values are consistent with feminist and sexual orientation
Summary Constructivist approach in which counselor and clients collaborate to create new life stories Dysfunction: dominant stories do not fit some aspects of their experiences Goal: deconstruct problem-saturated dominant story and create opportunities more preferred outcomes Questioning is a major technique to assist client to externalize the problem Does not lend well to traditional scientific approaches Issues of cultural and individual diversity seem to be handled well
Conclusion Life is a story of preferred outcomes