The research evidence for narrative therapy as an effective and helpful practice continues to grow. But what is it about narrative therapy that makes it so effective and useful? How is change facilitated? Understanding key features and details of practices and how they work, assists us in making further developments, continuing to innovate and adapt practice to context, and provide improved training programmes. The works included in this collection explore these pivotal questions.

Researching narrative therapy— how does it work?

Siu Wai Lit
China Journal of Social Work, Volume 8, Issue 2, 2015, pp. 122-135 DOI: 10.1080/17525098.2015.1039171

The rich literature about death and dying, the use of narrative analysis, and the extensive study of liminality in the field of medicine and the social sciences provide valuable insights into the experience of end-of-life care. However, the study of the transformation(s) in liminality, especially with regard to people suffering from terminal cancer, is still limited. Based on use of a narrative therapy group with people suffering from terminal cancer, this paper explores how the use of double-listening technique in narrative therapy groups, through the seeking of the dialectical experiences of the group members, facilitates transformations in liminality. The facilitation of the ‘transformative power’ of liminality is important because entering into the ‘transformative space’ of the liminality of patients with terminal cancer not only helps the social workers and other helping professions better understand the ambiguous experience of ‘knowing and not knowing’ and ‘acting and not acting’, but also extends the possibilities and alternatives in making sense of the dialectics (e.g., so weak and yet so strong, so little and yet so great, etc.) of the patients’ narratives.

Margaret M. Leahy,Mary O’Dwyer, Fiona Ryan
In press Journal of Fluency Disorders (2012), doi:10.1016/j.jfludis.2012.03.001

Narrative therapy (White & Epston, 1990) was developed as an approach to counselling, as a response to the power relations that influence people’s lives. Its use with people who stutter has been documented. A basic tenet of narrative therapy is that the dominant problem-saturated narrative is challenged by externalizing the problem, in due course facilitating development of an alternative narrative. Within this process, the definitional ceremony involving outsider witnesses is a key procedure used to influence change. This paper describes definitional ceremonies, and their application within a narrative approach to therapy for stuttering. The analysis of a specific definitional ceremony is presented, leading to an exploration of identity as a public and social achievement. A definitional ceremony involving a woman who stutters and family members was recorded and analysed using two methods: interpretative phenomenological analysis and Heideggerian hermeneutic phenomenological analysis. Details of the clinical application of definitional ceremonies with this client are described. Results from both methods of analysis were found to be similar. Notable results include the fact that the stuttering per se was not presented as the problem; rather, the impact of stuttering, especially the experience of bullying, was a dominant theme. This paper shows how definitional ceremonies can open opportunities for clients to present themselves in a preferred way, forming the basis for a new story and revised identity. Emerging themes can be identified for reflection and discussion with the client for therapeutic benefit. Educational objectives: (1) to describe and explain to readers the process of narrative therapy, with special attention to the use of definitional ceremonies; (2) to provide detail regarding the clinical processes involved with a specific definitional ceremony with one client; (3) to have the reader appreciate the specific importance of involving outsider witnesses in the therapy process; (4) to discuss the outcomes of the use of this particular definitional ceremony.

CARRIJO, Rafael Santos  and  RASERA, Emerson Fernando. Psicologia Clínica [online]. 2010, vol.22, n.1, pp. 125-140. ISSN 0103-5665.

This case study aims to understand the change process of a person in group psychotherapy, from a narrative perspective. Participant observation and an analysis of the notes of twelve sessions of a short-term group allowed us to investigate episodes and therapeutic interventions that had contributed to the construction of a narrative in which the person self-described as more autonomous, surpassing the previous narrative saturated by the problem. It was observed that narrative resources such as, the identification of unique outcomes, externalizing the problem and the reinforcement of confrontational narratives have helped to construct new meanings through the creation of a dialogical space in the group context. In spite of the fertility of the use of narrative proposals in the group field, our reflections pointed out some challenges to be faced in this approach.

Heather L. Ramey, Donato Tarulli, Jan C. Frijters, Lianne Fisher
Contemp Fam Ther (2009) 31:262–279DOI 10.1007/s10591-009-9095-5

Externalizing, or separating the person from his/her problem-saturated story, isa central approach in narrative therapy. Michael White, one of the therapy’s founders,lately revised his map of the externalizing process in therapy according to Vygotskian theory. In this study we sought to determine whether White’s proposed process was evidentin therapy sessions. Sequential analysis indicated that therapists scaffolded children’s responses according to White’s map, and therapists’ and children’s utterances tended to advance across the levels of the map over the course of a session, indicating that White’s model of narrative therapy matched the therapy’s empirical process.

Miguel M. Gonçalves, Marlene Matos & Anita Santos, University of Minho, Portugal

In the narrative metaphor of psychotherapy, clients transform themselves by changing their life stories. According to White and Epston (1990), the construction of change occurs from the expansion of unique outcomes—or innovative moments, as we prefer to call them—that is, the development of episodes outside the problem-saturated narrative. Unique outcomes operate as exceptions to the rule (i.e., to the problem-saturated story) that can be changed to a new rule (i.e., a new narrative). We suggest that some forms of unique outcomes can operate as shadow voices (Gustafson, 1992) of the problem-saturated story, allowing a temporary release from the problem, but facilitating a return to it. In our view, there is a particular type of unique outcome—reconceptualization—that facilitates sustained change. This kind of innovation facilitates the emergence of a meta-level perspective about the change process itself and, in turn, enables the active positioning of the person as an author of the new narrative.

Munro, L., Knox, M., & Lowe, R (2008)

Journal of Deaf Studies and Deaf Education 13:3

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This article explores the use of constructionist therapy with a reflecting team of hearing therapists seeing deaf clients. Using findings from two in-depth interviews, post-session reflections and a review of the literature, we propose that this model has the potential to cater to the diversity of the lived experiences of deaf people and also to address issues of power and tensions between medical, social, and cultural models of deafness. The interviews found there was real value in sharing multiple perspectives between the reflecting team of hearing therapists and these deaf clients. In addition, the clients reported feeling safe and comfortable with this model of counseling. Other information that emerged from the interviews supports previous findings regarding consistency in interpreting and the importance of hearing therapists having an understanding of the distinctions between Deaf and hearing worlds. As the first investigation of its kind in Australia, this article provides a map for therapists to incorporate reflecting teams with interpreters, deaf clients, and hearing therapists. The value of this article also lies in providing a much needed platform for future research into counseling outcomes and the efficacy of this constructionist model of therapy.

Strong, T. (2008). The International Journal of Narrative Therapy and Community Work, (Issue 3), 59-71. 

This paper examines the narrative therapy practice of asking and answering externalisation questions. It looks at some of theoretical and clinical literature related to the use of these questions and then turns a micro-dynamic look at some examples of how such questions were asked and answered in the course of therapeutic dialogue. The focus is on learning from these analyses to  enhance therapists’ ability to engage clients in collaborative and resourceful externalising conversations.

Marlene Matos, Anita Santos, Miguel Gonçalves and Carla Martins 
(2008) Psychotherapy Research,

Narrative therapy suggests that change happens by paying close attention in therapy to ‘‘unique outcomes,’’ which are narrative details outside the main story (White & Epston, 1990). In this exploratory study, unique outcomes were analyzed in five good-outcome and five poor-outcome psychotherapy cases using the Innovative Moments Coding System (Gonc¸alves, Matos, & Santos, 2008). Across 127 sessions, innovative moments were coded in terms of salience and type. In accordance with the theory, results suggest that innovative moments are important to therapeutic change. Poor- and good-outcome groups have a global difference in the salience of the innovative moments. In addition, results suggest that two particular types of innovative moments are needed in narrative therapy for therapeutic change to take place: re-conceptualization and new experiences. Implications for future research using this model of analysis are discussed.

O’Connor, T., Meakes, E., Pickering, M., & Schuman, M. (1997)

Contemporary Family Therapy. 19(4), 479-495.

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This article presents an ethnographic research on eight families’ experience of narrative therapy and discusses six major themes found in the interviews including externalizing conversation, developing the alternate story, personal agency, reflecting/consulting teams, building a wider audience, and the helpful and unhelpful aspects of the therapy. The findings and the notation that families found the therapy to be very effective are also included.

Kogan SM, Gale JE. Fam Process. 1997 Jun;36(2):101-26.

Postmodern models of therapy stress the participation of the clinician in a nonhierarchical, non-objectifying role, and highlight the therapist’s embeddedness in the same processes of social construction as are the individual and the family. While much theory has been published in recent years, the actual conduct of a therapy session derived from the premises of postmodernism remains unclear. We investigated how a postmodern therapist manages talk in an actual session. We used textual analysis to examine a couples therapy session conducted by a prominent narrative therapist. Analysis of the talk led to descriptions of the couple’s and therapist’s agenda, and their interaction. The therapist’s agenda is described in terms of “decentering” both the local unfolding narrative and its embeddedness in larger cultural stories. Five conversational practices: matching/self-disclosure, reciprocal editing, turn management to deobjectify, expansion questions, and reversals are examined. These practices inform the deployment of a decentering agenda in this specific text.