Analysing stories, strengths, externalise problems, deconstruct the negative, reconstruct the positive, therapeutic documents, outsider-witnesses, tree of life, practice approach, references
Three sections follow:
Background Material that provides the context for the topic
A suggested Practice Approach
A list of Supporting Material / References
Feedback welcome!
Background Material
Narrative therapy involves story changing through intensive listening and questioning in a specific manner. Narrative social workers need to be very clear about their own issues, views and experiences to separate them from those of the clients. Great care must be taken to hear and understand the client’s reality, and to individualize each client (Kelley, 2011).
Narrative therapy seeks to be a respectful, non-blaming approach to counselling and community work, which centres people as the experts in their own lives.
It views problems as separate from people and assumes people have many skills, competencies, beliefs, values, commitments and abilities that will assist them to change their relationship with problems in their lives.
Curiosity and a willingness to ask questions to which we genuinely don’t know the answers are important principles of this work.
There are many possible directions that any conversation can take (there is no single correct direction).
The person consulting the therapist plays a significant part in determining the directions that are taken (Morgan, 2000).
Areas of emphasis
Narrative therapy assumes people construct stories throughout life that can both empower and disempower.
We all ‘story’ our lives to make meaning or sense of them. However, we cannot remember all of our lived experience, so we select events that form a dominant story line and forget events that do not fit this dominant story (Kelly, 2011).
The stories we have about our lives are created through linking certain events together in a particular sequence across a time period; then finding a way of explaining or making sense of them. This explanation forms the plot of the story. We give meanings to our experiences constantly as we live our lives (Morgan 2000).
Our lives are multi-storeyed. We all have many stories about our lives and relationships, occurring simultaneously. For example, we have stories about ourselves, our abilities, our struggles, our competencies, our actions, our desires, our relationships, our work, our interests, our conquests, our achievements, our failures. The way we have developed these stories is determined by how we have linked certain events together in a sequence and by the meaning we have attributed to them (Morgan, 2000). It is conceivable that linking events in a different sequence could have resulted in a different story.
Stories can limit people’s views of themselves and others, and can immobilise them from action (Kelley, 2011).
Narrative therapists work with individuals, families and communities to bring about change by analysing ‘problematic stories, i.e., stories that reveal problems that disempower people.
Narrative therapy does not blame the person for the problem but examines the multitude of events, relationships, etc. that may have contributed to the problem, i.e. the story around the person and the problem (Allan, 2009).
Early in their meetings with people, therapists often hear stories about the problem and the meanings that have been reached about them. These meanings, reached in the face of adversity, often consist of what narrative therapists call ‘thin descriptions’. Thin descriptions can be constructed by others (especially those with power) or by the person. Thin descriptions often lead to thin conclusions about people’s identities, e.g. a person described as an ‘attention seeker’ can become an ‘attention seeker’. Thin conclusions disempower people as they are regularly based in terms of weaknesses, disabilities, dysfunctions or inadequacies. Once thin conclusions take hold, it becomes easy for people to gather evidence to support these dominant problem-saturated stories. Any times when the person has escaped the effects of the problem become less visible. Thin conclusions often lead to more thin conclusions (Morgan, 2000).
The aim of narrative therapy is to assist people to break from ‘problem-saturated’ thin descriptions and re-author new, preferred and ‘richly-described’ stories? (Abels & Abels, 2001; Morgan, 2000).
Narrative therapy is a strengths-based approach.
Narrative therapy aims to develop narratable stories of self and circumstances that lead to healthy, strengths-based ways of living. It transforms unhelpful stories, or the inhibiting and self-defeating stories, restoring (or re-storying) them with stories that are strengths-based (Harms 2007).
Narrative therapists externalise people’s problems, i.e. they discuss the problem as an issue in itself rather than something linked to the person.
By the time people turn to therapists for assistance, they have often got to a point where they believe there is something wrong with them, that they or something about them is problematic. The problem has become ‘internalised’ (Abels & Abels, 2001).
By acknowledging that the problem is the issue and revealing the many factors that caused it, the person is led to see the problem is not within him or herself but in the relationship between the person and social structures, or as a product of culture and history (Allan, 2009; Carey & Russell, 2002).
Externalising the problem allows the therapist and person to create distance between the person and the problem. The person is not defined by the problem. Consider the difference in meaning between:
‘Tom’s a worrier’ versus ‘Worry is really following Tom around’
‘Zoe’s depressed’ versus ’A cloud of depression has Zoe staying at home’ (Dulwich Centre, 2022)
Narrative therapists work with the person to deconstruct negative/problem-based stories in order to uncover alternative views reinforcing a person’s strengths.
Therapists recognise that cultural, social and political factors can be enmeshed with the problems people bring to therapy, with power-based relations impacting unknowingly on people. This can lead to people sometimes accepting the distressing and unjust results of these social factors as personal failures, shortcomings or faults (Payne, 2006).
Questions are introduced that help clients assess other ways to view a situation, look for alternative meanings, and find other aspects of their lives, often involving strengths and coping, which may have been lost in the over-focus on problems (Kelly, 2011).
Problems are placed into stories enabling the person to correct self-blame and become aware of how lives are shaped by other, sometimes powerful, factors (Carey & Russell, 2002).
Narrative therapists use these alternative views to reconstruct positive stories that can empower.
By careful uncovering of the various narratives in the stories, therapists and clients identify the empowering and disempowering narratives. Reconstruction involves uncovering or building alternative narratives that recognise the strengths of the client and acknowledge the powerful forces that may impact on the client’s life (O’Connor et al.,2008). Ultimately the person tells a more complete story (Kelly, 2011).
Narrative therapists encourage the client to share these positive stories with others as they live out these new stories.
It is important an audience other that the therapist hears the person’s telling and re-telling of the developing story—friends, relatives, peers, etc. (Payne, 2006).
Other aspects of narrative therapy:
Specific skills used by social workers throughout the narrative therapy process include probes, reflections and summaries together with, most importantly, active listening (Harms, 2007).
While there is no set number of sessions, six or seven are not uncommon, with these spread over a longer time period than every week to give time for clients to try new things (Kelley, 2011).
There are similarities between narrative therapy and other models, e.g. the strengths-based model encourages the client to discern and utilise strengths. The solution-focused approach seeks to build on times the presenting problem was absent or different (Harms, 2007; McFarlane, 2015).
Narrative approaches have been advocated strongly for work in trauma-informed practice, including areas such as dealing with the impacts of adverse childhood experiences, domestic violence, attachment issues, and bullying. (Lonne, 2015). It can be used with individuals, families and communities (Kelley, 2011).
Narrative therapists use several tools as part of therapy (Lonne, 2015; McFarlane, 2015; Payne, 2006):
Therapeutic documents The therapist may introduce written documents, sometimes creating and sometimes encouraging the person to create them. These could include declarations, certificates, handbooks, letters, notes from a session, film, lists, photos. These documents summarize the person’s discoveries and describe the person’s own perceived progress. They could also serve to counter negative documentation that may exist, e.g. hospital files, prison records, and school reports. Fox (2003) provides a number of examples of these documents.
Re-membering Persons can find comfort and support by drawing on memories of significant people who have been lost to them such as relatives and friends who have died or lost touch; strangers who have made an important positive contribution to their life; famous people who have indirectly contributed to the person’s life by examples of courage and integrity.
Rituals and celebrations These mark significant steps of a journey. They are often included at the conclusion of therapy.
Outsider-witnesses An outsider-witness is an invited audience to a therapy conversation – a third party who is invited to listen and acknowledge the preferred stories and identity-claims of the person consulting the therapist. Outsider-witnesses may be family, friends, etc., professionals, or people who have previously experienced similar difficulties. They can attend a one-off meeting or be regularly present. The presence of an outsider-witness means it is much more likely that steps that a person makes in the therapy room can be translated into action in their daily lives (Carey & Russell, 2003).
The tree of life The tree of life is an exercise based on the idea of using the tree as a metaphor to tell stories about one’s life. Participants are invited to think of a tree, its roots, trunk, branches, leaves, etc, and imagine that each part of the Tree represents something about their life (Dulwich Centre, 2009).
Roots: the roots of the tree are a prompt for participants to think about and write on their tree where they come from (village, town, country), their family history (origins, family name, ancestry, extended family), names of people who have taught them the most in life, their favourite place at home, a treasured song or dance.
Ground: the ground is the place for participants to write where they live now and activities they are engaged with in their daily life.
Trunk: the trunk of the tree is an opportunity for participants to write their skills and abilities (i.e. skills of caring, loving, kindness) and what they are good at.
Branches: the branches of the tree are where participants write their hopes, dreams and wishes for the directions of their life
Leaves: the leaves of the tree represent significant people in their lives, who may be alive or may have passed on.
Fruits: the fruits of the tree represent gifts participants have been given, not necessarily material gifts; gifts of being cared for, of being loved, acts of kindness.
Practice Approach
There are no set techniques; treatment varies with the person and situation. The following websites offer courses in narrative therapy:
Dulwich Centre (founded by Michael White, creator of narrative therapy with David Epston): https://dulwichcentre.com.au/
David Epston’s website http://www.narrativeapproaches.com/
Evanston Family Therapy Centre https://www.narrativetherapychicago.com/
There are many directions that a narrative conversation can take. The following is not meant to be prescriptive.
The person tells her story: the ‘problem-saturated’ description
Narrative Therapy begins with a conversation with the person about the things that brought him or her to the therapist. The person is asked to tell their story in their own way. The only questioning might be for clarity if things do not appear to be clear to the therapist. Later, as the person is more relaxed and past the initial anxiety of the meeting, the therapist begins to ask the type of questions which begin to identify the nature of the problem (Abels & Abels, 2001).
Active and empathic listening to what is told and how it is told is the first skill in narrative practice. Other skills include asking open and closed questions (as appropriate), using probes and summarising along the way. It is important the person be allowed to tell all they need to tell, no matter how complex, ambiguous or awful their story (Harms, 2007).
Often, people tell stories that are full of frustration, despair and sadness, with few or no gleams of hope. This is the ‘problem-saturated description’. A problem-saturated description embodies the person’s present ‘dominant story’ of her life. The therapist takes this description seriously, and accepts it, while at the same time assuming that it is not likely to be the whole or only story. Through questioning the therapist obtains a full history of the problem, e.g. the events that led up to it, the thoughts, beliefs and social environment around the events (Payne, 2006).
Naming and externalising problem
When encouraging the person to expand her initial narrative, the therapist invites the person to give a specific name to the problem—a single word or short phrase. Naming encourages focus and precision, enables the person to feel more in control of the problem and gives a precise definition for externalizing the problem (Payne, 2006).
Externalising questions elicit two descriptions: the influence the problem has had and is having on the life of the person; and then the influence the person has had and is having on the life of the problem (Payne, 2006). The Dulwich Centre (2022) suggests an initial discussion of four areas (not necessarily in the order below) will aid therapists to externalise the problem:
1. Characterise the problem in an experience-near way—listen as the person talks about the problem. Questions could include:
“What would you call this kind of problem?”
“What does it remind you of?” “What image comes to mind when you think of it?”
“Could you draw a picture of this problem for me?”
“If this problem were a person who/what would you call him/her?”
2. Connect the problem to its antecedents, effects, links with others, etc. Questions could include:
“Have you ever had to face a challenge of this size before?”
“What effects has the problem had on other people’s lives?”
“Has the problem tried to convince you of things about yourself? Or about others?”
“How has the problem had you acting/talking/thinking/feeling?”
3. Have the person describe their experience of and position on the effects of the problem. Questions could include:
“Would you say these effects are positive or negative? Or both? Or neither?”
“Does it add to your life or subtract from it?”
“Do these effects support your life or the problem’s life?”
4. Locate this experience and position within the person’s wider values. Questions could include:
“How do your values differ from the values the problem holds?”
“What hopes or ambitions is the problem trying to sabotage?”
“What purposes do you have for your life that are under threat here?”
“Did you have some plans for your life that don’t fit with the plans of the black depths?”
This process aims to:
To externalise the problem
To characterise it in ways that make the person the expert on the problem.
To provide a full acknowledgement of the effects of the problem.
To link the problem in time, relationships and context.
To enable the person to position themselves outside and in opposition to the problem.
To locate this position in the wider values of the person’s life.
Deconstructing the problem
Questions that aim to deconstruct the problem include:
“Tell me about a time that you stood up to, said ‘no’ to, or resisted the problem. How was that situation handled differently?”
“Have there been times recently when the problem has not played a role in your life?”
“Can you think of any time in the past when the problem could have played a role in your life, and it did not?”
“Do you remember other times in the past when you have stood up to the problem?”
“How did it feel when you stood up to the problem?”
“How have you been able to keep the problem from getting worse?” (Harms, 2007)
When the person has mentioned aspects of her or his experience, which appear to deny, contradict or modify the dominant problem-saturated story, the therapist invites the person to expand on the circumstances and nature of these unique outcomes, and, by asking questions, focuses attention on how these do not fit with the story-as-told (Payne, 2006).
Reconstruction
Once deconstruction is complete, reconstruction commences. O’Connor et al. (2008) suggest the following steps to facilitate narrative reconstruction:
Uncover the narratives involved, taking care to identify those which are dominant, those which belong to key players, those which are devalued.
Identify the functions of different narratives, including the empowering and disempowering functions.
Validate the narratives (or aspects of narratives) which are performing a positive and empowering function and/or those which are marginalised; externalise the narrative (or aspects of narratives) which work against the interests of or are disempowering of service users. Externalising offers hope that the problem is not part of the client; there is an alternative story.
Uncover or build alternative narratives, retell the story in a new way (re-storying) which is empowering.
Create further social validation by creating an audience for the new narratives.
Ultimately the person tells a richer and more complete story, reconsiders his or her identity, and identifies previously obscured bases for change. It is a knowledge-expanding more than knowledge-changing experience. These are events or outcomes that cannot be explained by the dominant story. People are helped to reconstruct their views of reality by making it broader, not different (Kelley, 2011).
The person is invited to take a position on the problem
Therapy has now reached a turning point. The person can decide to remain dominated by the problem-saturated story (the thin description) or the person can decide to take fully into account the richer re-authored story that has emerged from the discussion with the therapist. Once the story is reconstructed, the person is encouraged to tell others the reconstructed story (Payne, 2006).
Continuing therapy: telling and re-telling towards enrichment of the self-story
Sometimes no further sessions are needed. If therapy continues it aims to facilitate the person’s building on and expanding the richer story the person has begun to narrate about his or her life as it was, as it is and as it might become (Payne, 2006).
Ending therapy
Therapy ends when the person decides that the self-story is rich enough to sustain the person’s future. The final session is a joyful occasions where a ceremony to mark the occasion occurs, such as presenting a certificate (Payne, 2006).
Supporting Material / References
Abels, P., & Abels, S. (2001). Understanding narrative therapy: A guidebook for the social worker. New York: Springer Publishing Company. Retrieved from http://ebookcentral.proquest.com/lib/une/detail.action?docID=423301
Allan, J. (2009). Theorising new developments in critical social work. In J. Allan, L. Briskman, & B. Pease (Eds.), Critical social work (pp. 30-44). Allen & Unwin.
Carey, M., & Russell, S. (2002). Externalising – commonly-asked questions. Retrieved from http://dulwichcentre.com.au/articles-about-narrative-therapy/externalising/
Carey, M., & Russell, S. (2003). Outsider-witness practices: Some answers to commonly asked questions. The International Journal of Narrative Therapy and Community Work, 1, 63-90. Retrieved from https://dulwichcentre.com.au/wp-content/uploads/2015/07/Outsider-witness-practices-1.pdf
Dulwich Centre. (2009). The “tree of life” in a community context. CONTEXT, 105, 50-54. Retrieved from https://dulwichcentre.com.au/wp-content/uploads/2014/01/tree-of-life-community-context.pdf
Dulwich Centre. (2022). What is narrative practice? A free course. Retrieved from https://dulwichcentre.com.au/courses/what-is-narrative-practice-a-free-course/lessons/welcome/
Fox, H. (2003). Using therapeutic documents: A review. The International Journal of Narrative Therapy and Community Work, 4, 26-36. Retrieved from https://dulwichcentre.com.au/wp-content/uploads/2015/07/04Hugh-incl-his-final-changes.pdf
Harms, L. (2007). Working with people: Communication skills for reflective practice. South Melbourne, Australia: Oxford University Press.
Kelley, P. (2011). Narrative theory and social work treatment. In F. Turner (Ed.), Social work treatment: Interlocking theoretical approaches (5th ed.), (pp. 315-326). Oxford, England: Oxford University Press.
McFarlane, F. (2015). What is narrative therapy? Private notes from a lecture at University of New England, Armidale, Australia in the unit HSSW410 – Social Work Interventions - Models and Skills.
Morgan, A. (2000). What is narrative therapy? An easy-to-read introduction. Retrieved from http://dulwichcentre.com.au/what-is-narrative-therapy/
Lonne, B. (2015). Narrative Therapy Practice. Slides from lecture at University of New England, Armidale, Australia in the unit HSSW410 – Social Work Interventions - Models and Skills.
O’Connor, I., Wilson, J., Setterlund, D., & Hughes, M. (2008). Social work and human service practice (5th ed.). Pearson Education.
Payne, M. (2006). Narrative Therapy. London: SAGE Publications.