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Narrative Therapy and Practice

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Transcript of Narrative Therapy and Practice

Narrative Therapy and Practice
Narrative Therapy Techniques
Construction
of an alternate story
(re-storying)
relative influence questioning
how each family member influenced current negative narrative
integration of externalization and unique outcomes to create new narrative
sense of empowerment and strength
The Story of Narrative Therapy
Founded by Michael White in the 1980's

inspired by the way in which people construe the world
writings of Michel Foucault
developed along with David Epston
social work background
The Story of Narrative Therapy
Family Therapy in the 1970's
shift from master therapist to more collaborative approach
abandoned idea of resistance in treatment
strong listening skills drove approach
Narrative Therapy Techniques
Spreading of "preferred story"
or new narrative
provide an audience
solidifies new narrative to others
Research Findings
mostly qualitative research due to the nature of narrative therapy (emphasis on unique outcomes, personal meaning, and story making)
majority show effectiveness of externalization
Narrative Therapy Techniques
Externalization
separates person from problem
use of externalizing conversations
mapping influence
Search for
unique outcomes
problem-saturated stories
times client resisted the problem
Together these techniques help to
deconstruct
the negative narrative
Ramey et al. (2010) study utilizing White's earlier work
used externalizing conversations White had with 14 year-old boy as template for coding
proved that change is observable within these conversations
narrative therapy sessions can be mapped, observed, and tested
Research Findings
Case Study: Narrative Therapy with R
Demographics
Caucasian Male- 25 years old
Began January 2013
Musician who composes own music, plays 11 instruments, and teaches music in private settings
In recovery for substance abuse since age 17
Currently attends AA meetings
Living with partner for 1 year
Second oldest of 4 brothers
Parents divorced 1997 (age 8)
Physically abused by mother's boyfriend (ages 10-13)
Presenting Problem
wanted to work on alternative ways of handling anxiety and anger because medication is not an option
Assessment
Creation of genogram-
collaborative process
highlighted family strengths
discovered patterns and influences
identified family narrative
Revised Dyadic Adjustment Scale-
assessed current relationship with partner
guided development of goals
Anger Styles Quiz-
process in itself was collaborative and significant moment
demonstrated client's strength and improving sense of self worth
Course of Therapy
Early stage-
premature exploration of R's childhood trauma and abuse (use of external view of self)
externalization of anger and anxiety
discovery of negative narrative ("Am I worth sticking around for?")
began to identify unique outcomes
Deconstruction Stage

exploration of trauma
retelling of significant stories
continued search for unique outcomes
positive re-authoring of childhood stories
challenging truths about past
discussion of blame versus responsibility
suggestion to write letters
use of compositions to explore contributions to original narrative
Later Stage of Therapy
construction of new narrative ("I deserve to be happy")
reinforcing of positive preferred story
use of music/ compositions to spread newly constructed narrative
use of AA as an audience for narrative
Video Clips
Clip #1 (session #3)
Take note of
lack of collaboration
how early in joining process
Clip #2 (2 weeks ago)
Take note of
ability to stick with new narrative
search for unique outcomes
Circulation of Compositions
external representation of work
ability to be spread to family, friends, and community
reinforces new narrative
tool to use in future exploration
Closing Thoughts
"...he was continually developing new ideas to challenge and inspire the field and invite us to think beyond what we already knew." (Beels, 2009)
References
Beels, C. C. (2009). Some historical conditions of narrative work. Family Process, 48(3),
363-378.
Draucker, C. B. (2003). Unique outcomes of women and men who were
abused. Perspectives in Psychiatric Care,39(1), 7-16.
Dulwich Centre Publications. (2004). Narrative therapy and research. International Journal of
Narrative Therapy and Community Work, (2), 29-36.
Dulwich Centre Publications. (2009, November). Narrative therapy. Retrieved from http://
www.dulwichcentre.com.au
Efron, R. T., & Efron, P. S. (2006). Letting go of anger: the eleven most common anger styles &
what to do about them (2nd ed.). Oakland, CA: New Harbinger Publications.
Gaddis, S. (2004). Repositioning traditional research: Centering clients' accounts in the
construction of professional therapy knowledges. International Journal of Narrative Therapy and Community Work, (2), 37-48.
Hahs, A., & Colic, M. (2010). 'Truth-making' in a world of made up stories. Explorations: An E-
Journal of Narrative Practice, (2), 72-77.
Hibel, J., & Polanco, M. (2010). Tuning the ear: Listening in narrative therapy. Journal of
Systemic Therapies,29(1), 51-66.
McGoldrick, M. (2011). The genogram journey: reconnecting with your family (Rev. ed.). New
York: W.W. Norton.
Nichols, M. P. (2013). Family therapy: Concepts and methods. (10th ed., pp. 268-284).
United States of America: Pearson.
Ramey, H., Young, K., & Tarulli, D. (2010). Scaffolding and concept formation in narrative
therapy: A qualitative research report. Journal of Systemic Therapies, 29(4), 74-91.
Silver, E., Williams, A., Worthington, F., & Phillips, N. (1998). Family therapy and soiling: An audit
of externalizing and other approaches. Journal of Family Therapy, 20, 413-422.
Speedy, J., & Payne, M. (2008). Family therapy pioneers. Family Therapy Magazine, 48.
Wallis, J., Burns, J., & Capdevila, R. (2011). What is narrative therapy and what is it not?. Clinical
Psychology and Psychotherapy, 18, 486-497.
White, M., & Epston, D. (1990). Narrative means to therapeutic ends. (pp. 38-76). New York, NY:
W.W. Norton.
White, M. (1997). Challenging the culture of consumption: Rites of passage and communities of
acknowledgement. Dulwich Centre News, (2), 38-47.
Wylie, M. S. (1994). Panning for gold. Family Networker, 41-48.
Case Conceptualization




Anger is from developed negative narrative and pain from childhood
QUESTIONS? COMMENTS?
R is holding onto his traumatic childhood as his own fault
R had no voice as a child
R's partner is critical of him causing R to be resentful and angry
This was followed by a period of addiction which allowed him to "skip over" healing
Full transcript