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What Is Narrative Therapy?

By Olivia Guy-Evans, published March 10, 2022

by Saul Mcleod, PhD


Narrative therapy was developed in the 1980s by therapists Michael White and David Epston. It is still a relatively novel approach to therapy which seeks to have an empowering effect and offer therapy which is non-blaming and non-pathological in nature. 

This therapy involves the client talking about their life stories- or narratives- with the therapist, focusing on ones that are saturated in problems.

With the therapist, they discuss and challenge these narratives which may be causing a lot of emotional distress, to overcome them. 

This approach centres on people as the experts in their own lives and views problems as separate from the person.

This therapy also assumes that people have many skills, competencies, beliefs, values, commitments, and abilities that will assist them to reduce the effect of problems in their lives. 

What is a narrative?

A narrative is a story. As humans, we have many stories about ourselves, others, our abilities, self-esteem, and work, among many others.

The way we have developed these stories is determined by how we have linked certain events together in a sequence and by the meaning that has been attributed to them. 

We like to interpret daily experiences in life, seeking to make them meaningful. The stories we have about our lives are created through linking certain events together in a particular sequence across a period of time and finding ways of making sense of them – this meaning forms the plot of the story.

As more and more events are selected and gathered into the dominant plot, the story gains richness and thickness. 

The idea is that identity is formed by the narrative of an individual’s life and there are several narratives that are at work at once. The interpretation of a narrative can influence thinking, feelings, and behaviour.

Many narratives are useful and healthy, whereas others can result in mental distress. Mental health symptoms can come about when there is an unhealthy or negative narrative, or if there is a misunderstanding or misinterpretation of a narrative. 

What is the aim of narrative therapy?

Narrative therapy seeks to change a problematic narrative into a more productive or healthier one.  This is often done by assigning the person the role of narrator in their own story.

Narrative therapy helps to separate the person from the problem and empowers the person to rely on their own skills to minimise problems that exist in their lives. 

This therapy aims to teach the person to view alternative stories and address their issues in a more productive way.

Narrative therapy can be used with individuals but can also prove useful for couples or families.

Narrative therapists are also not interested in diagnosing individuals – there is no use of the Diagnostic and Statistical Manual of Mental Disorders (DSM) during any point of the therapy. 

What is the role of the therapist?

The role of the narrative therapist is to search for an alternative way of understanding a client’s narrative, or an alternative way to describe it.

The belief is that telling a story is a form of action toward change, therefore the therapist will help clients to objectify their problems, frame these problems within a larger sociocultural context, and teach the person how to make room for other stories. 

During therapy, the therapist acts as a non-directive collaborator. They treat the client as the expert of their own problems and do not impose judgements.

Instead, the therapist is purely curious and investigative. They are not particularly interested in the cause of a problem but are open to a client’s perception of the cause. 

Techniques

There are many techniques that the therapist can use to help the person to heal and move past a problematic story in their lives:

Putting together the narrative

The therapists help their clients to put together their narrative. This will usually involve listening to the client explain their stories and any issues that they want to bring up.

This allows the person to express their thoughts and explore events in their lives and the meanings they have placed on these experiences.

The therapist may find what is known as a ‘problem saturated narrative’ comes up, which will be what is causing the client the most distress. 

As the story comes together, the client becomes an observer to their story and can then review this with the therapist.

When the therapist communicates to the client during this stage, they will make sure to utilise the client’s use of language since the client is treated as the expert to their narrative. 

Externalizing the problem

Once the story is put together, the idea is that it allows the client to observe themselves. The therapist encourages the client to create distance between the individual and their problems, which is called externalization. 

The externalization techniques lead clients towards viewing their problems or behaviours as external, instead of an unchangeable part of themselves.

The therapist may ask the client to give a name to the problem, so it is seen as a separate entity, such as ‘anger’ or ‘worry’. The client will then be encouraged to use the given name of the problem when talking about it, likewise the therapist will ask questions referring to the problem by the given name. 

The distance given to the problem allows people to focus on changing the unwanted behaviours.

As people practice externalization, they will see that they are capable of changing. The general idea being that it is easier to change a behaviour that they do, than to change a core personality characteristic.

They will come to realise that they themselves are not the problem, instead the problem is the problem. 

Deconstruction

Often, when a client has a problematic story, especially when it has been prevalent for a long time, the problem can feel overwhelming, confusing, or unsolvable.

Because of these feelings, people can use overgeneralized statements which can make the problematic stories worse.

The narrative therapist would work with the individual to break down, or deconstruct their stories into smaller, more manageable parts in order to clarify the problem.

Deconstructing makes the problems more specific and reduces overgeneralizing; it also clarifies what the core issue or issues may be. Through deconstructing, the whole picture becomes easier to understand. 

The therapist and client may also seek to deconstruct identity and have an awareness of larger societal issues e.g., sociocultural, and political effects which may be acting on the client.

They may find that the context of gender, class, race, culture, and sexual identity also play a part in the interpretations and meanings that are given to events. 

Unique outcomes 

When someone’s problematic stories are well established, people can become stuck in them, unable to view alternative versions of the story. A narrative therapist will help people to not only challenge their stories but encourage them to consider alternative stories. 

Unique outcomes refer to the exceptions to the dominant story. It may also be known as ‘re-authoring’ or ‘re-storying’, as clients go through their experiences to find alterations to their story or make a whole new one. 

There are hundreds of different stories since everyone interprets experiences differently and find their own meaning from them. The therapist will help the client to build upon an alternative or preferred story.

These unique outcomes provide contrast to a problem, reflect a person’s true nature, and allow someone to rewrite their story.

Building upon stories from another perspective can help to overcome problems and build the confidence the person needs to heal from them. 

Benefits of narrative therapy

Empowers the individual

As this therapy stresses that people do not label themselves in negative ways (e.g., as the problem), this can help them to feel less powerless in distressing situations.

They find that they have more control over the stories they have in their lives and how they approach difficult events. 

Supportive 

Narrative therapy treats individuals with respect and supports the bravery it has taken for them to choose to work through their personal challenges.

Non-confrontational

This is a non-judgemental approach to therapy, meaning that the clients are not blamed for anything which is described in their stories.

Likewise, the clients are encouraged not to blame others or themselves. The focus is instead placed on noticing and changing unhelpful stories about themselves and others. 

Client is treated as an expert

Narrative therapy does not aim to change a person, rather it allows them to become an expert in their own lives.

The therapist holds that the clients know themselves well and work as a collaborative partner with the client.

This therapy allows people to not only find their voice but to use this voice for good, enabling them to become experts and live in a way that reflects their goals and values. 

Context is considered

This therapy may also help the client to view their problems in different contexts. These can be social, political, and cultural, among others.

The clients come to recognise that these contexts matter and can influence how they view themselves and their stories. 

What can narrative therapy help with?

Narrative therapy may be helpful for treating the symptoms of a variety of conditions, including:

  • Anxiety disorders

  • Depressive disorders

  • Eating disorders

  • Attention deficit hyperactivity disorder (ADHD)

  • Posttraumatic stress disorder (PTSD)

As well as mental health conditions, narrative therapy may also be useful for the following:

  • Those who feel like they are overwhelmed by negative experiences, thoughts, or emotions.

  • Those with attachment issues.

  • Those who are suffering with grief. 

  • Those who have issues with low self-esteem. 

  • Those who often feel powerless in many situations.

How is narrative therapy used? 

For individuals, narrative therapy challenges the dominant problematic stories that prevent people from living their best lives.

Through the externalizing technique, people can learn to separate themselves from the problem.

They learn to identify alternative stories, widen views of themselves, challenge old and unhealthy beliefs, and be open to new ways of living that reflect a more accurate and healthier story. 

For couples or families, the technique of externalizing problems can facilitate positive interaction.

It can also make negative communication more accepting and meaningful. Being able to see problems objectively can help couples and families reconnect and strengthen their relationships.

Once problems have been identified, this can be used to address how the problem has challenged the core strength of their bond.

How effective is narrative therapy?

Below are some of the studies which have investigated the effectiveness of narrative therapy:

  • A research study looked at evaluating the effectiveness of narrative therapy on increasing couple's intimacy and its dimensions.

    The results showed that this therapy significantly increased intimacy and on three dimensions of emotional, communication, and general intimacy, concluding that narrative therapy can provide valuable implications about the mental health of couples (Khodabakhsh et al., 2015). 

  • Research has found that married women experienced increased levels of marital satisfaction after being treated with narrative therapy (Ghavibazou et al., 2020). 

  • A study of adults with depression and anxiety looked at the effects of narrative therapy and found improvements in their self-reports of quality of life and found they had decreased symptoms of anxiety and depression (Shakeri et al., 2020). 

  • A small sample pilot study looked at determining whether narrative therapy was effective in helping young people with autism who present with emotional and behavioural problems.

    It was found that there were significant improvements in psychological distress as well as in emotional symptoms (Cashin et al., 2013). 

  • A study looked at the effectiveness of narrative therapy in boosting 8-10-year old’s social and emotional skills. The results showed that the children showed significant improvements in self-awareness, self-management, empathy, and responsible decision-making (Beaudoin et al., 2016). 

  • A study explored group narrative therapy for improving the school behaviour of a small sample of girls with attention deficit hyperactivity disorder (ADHD).

    Posttreatment ratings by teachers showed that there was a significant effect on reducing ADHD symptoms 1 week after completing the therapy sessions, and this was sustained after 30 days (Looyeh et al., 2012).

What are the limitations of narrative therapy?

One of the major limitations of narrative therapy is that the research into its effectiveness is still lacking. Further research is also needed to determine what mental health conditions narrative therapy might treat most effectively. 

A reason for a lack of research is that it is still a relatively new approach to therapy. Another reason could be due to it being difficult to quantify.

The view that narrative therapists have is that knowledge is subjective and constructed by each person.

They accept there is no universal truth, so some narrative therapists make the argument that this therapy should be studied qualitatively rather than quantitatively. 

How to get started 

Narrative therapy is a specialised approach to counselling with training opportunities for therapists to learn how to use this approach with clients.

Finding the right therapist can involve looking online through therapist directories. Alternatively, you may consider asking your doctor to refer you to a professional in your area with the right training and experience. 

It is important to choose the right therapist for you. Consider whether you feel comfortable discussing personal information with them. Don’t be afraid to seek a different therapist if the one you have does not quite suit your needs.

When choosing a therapist, consider thinking about what your deal breakers are, qualities that are important, and any other characteristics you value. 

Questions to ask yourself

When you are ready to select a therapist, think about the following:

  • What type of therapy do you want? – Do you want individual, couples, family therapy, or another type?

  • What are your main goals for therapy?

  • Whether you can commit the time each week – what days and time are most convenient for you? 

What can be expected during the first therapy session?

During the first narrative therapy session, the therapist may ask you to begin sharing your story and they may ask questions about why you are seeking treatment.

The therapist may also want to know about how your problems are affecting your life and what your goals for the future are.

Furthermore, they are likely to discuss aspects of treatment such as how often you will meet and how your treatment may change from one session to the next. 

Things to consider

This therapy can be very in-depth, exploring a wide range of factors that can influence the development of your stories.

It also involves talking about problems as well as strengths which may be difficult for some people.

The therapist will help you to explore your dominant story in-depth and discover how it may be contributing to emotional distress, as well as uncovering strengths that can help you to approach your problems in a different way. 

You should expect to re-evaluate your judgments about yourself since narrative therapy encourages you to challenge and reassess these thoughts and replace them with more realistic or positive ones.

It also challenges you to separate yourself from your problems which can be difficult, but this process helps you learn to give yourself credit for making the right decisions for you. 

Do you need mental health help?

USA

Contact the National Suicide Prevention Lifeline for support and assistance from a trained counselor. If you or a loved one are in immediate danger: https://suicidepreventionlifeline.org/

1-800-273-8255

UK

Contact the Samaritans for support and assistance from a trained counselor: https://www.samaritans.org/; email [email protected].

Availiale 24 hours day, 365 days a year (this number is FREE to call):

116-123

Rethink Mental Illness: rethink.org

0300 5000 927

Fact Checking
Simply Psychology content is rigorously reviewed by a team of qualified and experienced fact checkers. Fact checkers review articles for factual accuracy, relevance, and timeliness. We rely on the most current and reputable sources, which are cited in the text and listed at the bottom of each article. Content is fact checked after it has been edited and before publication.

About the Author

Olivia Guy-Evans obtained her undergraduate degree in Educational Psychology at Edge Hill University in 2015. She then received her master’s degree in Psychology of Education from the University of Bristol in 2019. Olivia has been working as a support worker for adults with learning disabilities in Bristol for the last four years.

How to reference this article:

Guy-Evans, O. (2022, March 10). What Is Narrative Therapy?. Simply Psychology. www.simplypsychology.org/narrative-therapy.html

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Cashin, A., Browne, G., Bradbury, J., & Mulder, A. (2013). The effectiveness of narrative therapy with young people with autism. Journal of Child and Adolescent Psychiatric Nursing, 26(1), 32-41.

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Ghavibazou, E., Hosseinian, S., & Abdollahi, A. (2020). Effectiveness of narrative therapy on communication patterns for women experiencing low marital satisfaction. Australian and New Zealand Journal of Family Therapy, 41(2), 195-207.

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Shakeri, J., Ahmadi, S. M., Maleki, F., Hesami, M. R., Moghadam, A. P., Ahmadzade, A., Shirzadi, M. & Elahi, A. (2020). Effectiveness of group narrative therapy on depression, quality of life, and anxiety in people with amphetamine addiction: a randomized clinical trial. Iranian Journal of Medical Sciences, 45(2), 91.

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