Narrative therapy applies stories to assist clients in treatment courses. According to this approach, people can infer different meanings from their experiences and use the same to address their prevailing conditions. A narrative therapy treatment plan can treat depression and handle a crisis. In this case study template, you will discover an excellent narrative therapy case conceptualization and some treatment examples cases.
Introduction to Narrative Therapy
Narrative therapists utilize numerous methods to treat clients. The methods include scaffolding, outsider witnesses, and re-membering. Scaffolding entails helping clients to cope with their challenges by exploiting their past positive memories.
Re-membering involves assisting clients to resolve their problems by moving away from problems-filled memories. Outsider witness is a method that involves using third party’s experience to assist a client to deal with his or her predicament. Narrative therapy is compatible with Christianity in numerous ways.
Like Christianity, narrative therapy uses externalization to give a client the liberty to select his or her treatment course. Nevertheless, narrative therapy does not acknowledge the concept of God. It holds that humans are capable of liberating themselves.
Narrative therapy will help John to revisit his experiences and relate them to his present condition. Through narrative therapy, it is believed that John will be in a position to understand his situation and institute an appropriate treatment course.
Narrative Therapy Case Conceptualization
Different factors influence therapists’ ways of working. The factors include the different clients’ identities and problems. After considering these factors, a therapist uses the most appropriate therapy to help a client. One of the approaches is narrative therapy.
Narrative therapy seeks to help clients to deal with their problems by assisting them to relate their challenges to other people’s experiences and come up with amicable solutions (White, 2005).
Narrative therapy perceives challenges as detached from people, and it holds that people have the capacity to mitigate results of challenges in their lives. This aspect underlines why narrative therapy allows patients to direct their treatment courses. Stories are critical to molding people’s lives (White, 2005).
Thus, narrative therapy uses stories to help people to evaluate their lives and deal with problems that prevent them from living an active and productive life. This paper will discuss a case conceptualization involving a narrative therapy.
Narrative therapy is a psychotherapy that uses stories to help patients to deal with their problems. It was established in the early 1970s by Michael White and David Epston. Narrative therapy became popular in 1990s when therapists started publishing books discussing the use of stories as a therapeutic approach.
In narrative therapy, therapists “ask questions to generate experientially vivid descriptions of life events that are not currently included in their plot of the problematic story” (White & Epston, 1990, p. 45).
Narrative therapy creates a link between a client and his or her problems. Hence, it gives clients opportunities to familiarize with their problems and look for solutions.
White and Epston (1990) hold that human beings “are interpretive beings” (p. 48). People attribute varied meanings to life experiences. Therefore, clients solve their problems by analyzing these experiences and their meanings. White and Epston (1990) assume that people do not construe their lives within a void.
Instead, they control and they are controlled by their circumstances. Hence, the only way that clients can cope with their problems is interpreting them according to their contexts. Life experiences, which are entrenched in people’s narratives, mold personal identities.
Therefore, narrative therapists should aid clients to illustrate their affluent narratives and trails, ways of life, and potentials connected to them. White and Epston (1990) assume that people have numerous stories since it is hard to limit one’s experience within a single story.
These narratives, if systematically organized, may help to solve one’s problems. Clients are capable of identifying the best approaches to use in dealing with their challenges. Consequently, therapists should guide clients to devise mechanisms for dealing with their problems.
A number of studies have proved that narrative therapy is an efficient method of dealing with clients’ problems. A study by Vromans and Schweitzer (2011) sought to determine the effectiveness of narrative therapy in helping clients with major depressive disorders.
The study found that narrative therapy helps in identifying and addressing major depressive disorders among the adults. Additionally, some scholars have used principles of narrative therapy to create ways of addressing economic, gender, and racial challenges that affect society.
For instance, Flanagan (2001) used the ideas of narrative therapy to assist Tasmanians to address poverty issues. Flanagan (2001) used stories relayed by numerous participants to prompt the parliament to initiate poverty eradication campaign.
Narrative therapy is used to solve numerous problems, which include anxiety, depression, and Asperger’s disorder among the adolescents. Therapists allow clients to narrate their experiences and help them to relate the experiences to their prevailing problems.
In doing this, they give clients opportunities to discern the causes of their problems before assisting them to deal with the causes (White & Epston, 1990). For instance, therapists help clients to identify life experiences that subject them to depression or anxiety and assist them to deal with the experiences.
Narrative therapists use externalization techniques to assist clients suffering from the Asperger’s disorders.
Narrative therapy is appropriate for John’s case because it will assist him to identify and cope with the causes of his predicament. The majority of therapy approaches impose treatment courses on clients.
Hence, it becomes hard for clients to continue with the treatment courses, particularly if therapists do not keep them under regular supervisions. For narrative therapy, clients are helped to understand their problems coupled with being given chances to formulate treatment courses that they feel comfortable using.
Thus, narrative therapy will help John to understand the causes of his depressing attitude, low self-esteem, and negative emotions, thus putting him in a position to resolve the problems.
Attitude is one of the ethical issues that may arise when dealing with John’s case. Therapist should endeavor to establish authentic, respectful, and genuinely human relationship with clients. As a therapist, one is not allowed to lure or compel John to disclose information that he feels uncomfortable revealing.
Instead, a therapist should interact with John freely without using any form of coercion (White, 2005). A therapist should be tolerant to all that John says and give him sufficient time to explain himself without interrupting his story.
Confidentiality is another ethical challenge that might arise when dealing with John. John’s case is utterly sensitive. Hence, he may divulge confidential information. A therapist should exercise high level of confidentiality when helping John to deal with his problems.
A therapist is supposed to conceal all information that he or she thinks might compromise John’s healing process.
It is hard for one method of narrative therapy to be used to address different problems due to cultural differences. In John’s case, a therapist might use narrative therapy to help him to re-author his life and utilize his voice to formulate solutions for his problems.
The approach may not succeed in the event that John hails from a community that values the contribution of all family members. It would be difficult for a therapist to guide John to reshape his life due to cultural conflict. Additionally, narrative therapy pays attention to language (White, 2005).
Some terms have different meanings for different cultures. Therefore, another cultural challenge that might arise when helping John is deducing a different meaning from John’s narrative. Hence, a therapist should ensure that he or she gets precise meaning of John’s expressions before assisting him to map out a treatment course.
Narrative therapy can be used in crises. The method creates a serene environment by allowing clients to express themselves without interruptions (White, 2005).
A client is required to come to terms with his or her problems. Narrative therapy facilitates this aspect by giving a client the opportunity to give an account of his or her life encounters. It helps to establish a good rapport between a therapist and client.
Narrative Therapy Treatment Plans
Presenting Problems
John presents himself as a depressed individual after being expelled from the university, losing a job, and being abandoned by his wife within a short period. He had a dream of becoming a civil engineer. Therefore, his enrollment in the university marked the beginning of his journey to achieve this dream.
However, John’s dream was thwarted after the university accused him of orchestrating a strike and it expelled him. After staying at home for two months, John decided to look for a job instead of staying idle. He was lucky to secure a job with a local contractor.
However, three months into the job, John’s employer accused him of embezzlement of financial resources and he was fired. John went home and informed his wife, but she was not ready to bear the challenges they had gone through before he got the job. She packed her belongings and left.
The incidents happened fast, and thus John suffered depression.
Goals for Counseling
John does not know what to do with his life. The first objective of this case conceptualization is to help him to deal with his attitude towards relationships. His financial situation makes him believe that it is hard to get a life partner. The second goal is to assist John to regain his self-esteem.
John developed low self-esteem after his wife left. According to John, his wife was the only consolation he had after losing the job. Her departure shuttered his hopes and made him feel worthless. The feelings of worthlessness made John to become hasty and irritable. He is unable to tame his emotions.
The third goal of the case conceptualization is to assist him to contain his feelings. The three objectives aim at helping John to rebuild his life and live harmoniously with his neighbors.
Narrative therapy will give John an opportunity to identify with his situation by relating it to other life encounters. Consequently, he will be in a position to select the most appropriate treatment course.
White (2005) claims “Scaffolding occurs by identifying unique outcomes and exceptions, and building on past positive events” (p. 79). It is imperative to create tasks that draw a client away from his or her problems. For instance, therapists may help clients to create activities that remind them about their past victories. Such activities make the clients forget their problems.
When dealing with John, I will take him through narratives that give accounts of his achievements. I will use stories to convince him that he can overcome anything and show him that what he is going through is just a minor setback.
Scaffolding will make John change his attitude by showing him that he has the potential to achieve many things despite his situation.
Re-membering
White (2005) alleges, “Re-membering has to do with helping individuals to reconstruct their identities by accenting and expanding on specific positive memories and by limiting problem-saturated memories” (p. 86). It allows clients to revisit their positive experiences and relate them to their present circumstances.
Additionally, remembering gives clients the opportunity to determine the steps to take in the future. Re-membering will help John to cope with his situation. I will use the approach to help John evade problem-saturated memories, which might subject him to prolonged depression.
I will ensure that he does not talk about his experiences in the university or his marriage. The two encounters are responsible for his present condition. I will help him to connect his positive memories with what is going on in his life and use the same to make decision on what to do in the future.
Re-membering will help John to deal with his emotions by ensuring that he avoids revisiting memories that annoy him.
Outsider Witnesses
This method of intervention involves inviting other people to a therapy session (White, 2005). They may be people who are related to a client or have gone through similar challenges. After the session, a therapist interviews the people to know the issues that stood out during the session and learned lessons.
A client learns that many people go through severe challenges. Besides, a client learns how to cope with his or her challenges from the people. As a therapist, I will invite individuals who have gone through the problem that John is encountering.
I will allow them to attend a therapy session and listen to John’s story without criticizing or interrupting him. At the end of the session, I will request the individuals to comment on what they have learnt from the session and how it has changed their lives.
The session will boost John’s self-esteem because he will realize that he is not the only one going through challenges, and if others have made it, he will succeed too.
Narrative therapy Spiritual Applications
John’s challenges might distance him from God. John has tried many ways to solve his problems, but he has not succeeded. Consequently, he might believe that God has abandoned him. Such a belief might draw him away from God and lure him to engage in harmful activities as a means to quench his anxiety.
I would handle this challenge by encouraging John to engage in religious practices like intensifying his spiritual emotions and invoking God’s name whenever he feels depressed. Religious practices would give him courage and relief from depression.
In addition to the bible, church, and prayer, John requires fasting, meditation, and intercession. Fasting will give him an opportunity to communicate with God. It will signify his determination to overcome his problems. On the other hand, meditation will give him a chance to evaluate his life and figure out the cause of his predicament.
He will then devote to address the cause. At times, we need other people to intercede for our challenges. Hence, John needs other people to intercede for him and ask God to relieve him from his sufferings.
Compatibilities
The first compatibility between Christianity and narrative therapy is that “Narrative therapy involves a process of deconstruction and ‘meaning making, which are achieved through questioning and collaborating with the clients” (White, 2005, p. 62).
On the other hand, Christianity encourages the deconstruction of ideas about religion and faith to understand Christ’s teachings (Jones & Butman, 2011). The second compatibility is that both narrative therapy and Christianity encourage externalization (Pembroke, 2005).
Christians use externalization to isolate sinners from sins and discern how to overcome temptations. On the other hand, narrative therapy uses externalization to help clients enter a region of immense freedom. Christians use scriptures to develop doctrines that guide their spiritual life.
In a similar way, narrative therapy uses stories to assist clients to come up with appropriate treatment paths.
Incompatibilities
Narrative therapy is incompatible with Christianity in a number of ways. First, Christianity depends on personal faith while narrative therapy depends on personal experience (Pembroke, 2005). Second, narrative therapy holds that people can redeem themselves.
On the other side, Christianity holds that people can hardly redeem themselves without spiritual intervention. Third, narrative therapy is founded on naturalism, and it does not acknowledge the idea of God.
Thus, it holds that people can overcome their problems by revisiting their experiences, which is not entirely true. On the contrary, Christianity reminds people to rely on God whenever they are in problems (Jones & Butman, 2011).
Conclusion
There is hope that John will manage to deal with his emotions, change his attitude, and regain his self-esteem. Through narrative therapy, John will rediscover his potential and stop lamenting over his predicament.
The primary challenge will be helping John to regain his self-esteem. However, there is hope that he will compare himself with others who have gone through harsh conditions and realize that it is okay to feel the way he feels.
References
Flanagan, J. (2001). The story of the Just Tasmania Coalition 1999-2000. Gecko: A Journal of Deconstruction and Narrative Ideas in Therapeutic Practice, 3(2), 17-35.
Jones, S., & Butman, R. (2011). Modern psychotherapies: A comprehensive Christian appraisal (2nd ed.). Downers Grove, IL: Intervarsity Press.
Pembroke, N. (2005). A Trinitarian perspective on the counseling alliance in narrative therapy. Journal of Psychology and Christianity, 24(1), 13-20.
Vromans, L., & Schweitzer, R. (2011). Narrative therapy for adults with major depressive disorder: improved symptom and interpersonal outcomes. Psychotherapy Research: Journal of the Society for Psychotherapy Research, 21(1), 4-15.
White, M. (2005). Narrative practice and exotic lives: Resurrecting diversity in everyday life. Adelaide, Australia: Dulwich Centre Publications.
White, M., & Epston, D. (1990). Narrative means to therapeutic ends. New York, NY: WW Norton.