Narrative Therapy Of Depression Essay

Question:

Write a critical evaluation of the Narrative Therapy Session, providing examples from the session citing the transcripts provided, identify the strengths and weaknesses of the model in practice, and discuss any ethical and professional issues that might be identified.

Answer:

Introduction:

Human mind is often compared to a labyrinth. Truly said, it is difficult to understand what a person might feel at a given time or how he/she might respond to a small thing. Studies reveal that our past experience play a critical role in determining how we may react to upcoming situations or how do we go about our lives in the future. The human mind stores away information in far away corners. Consciously it is impossible for an individual to know what lies in the deeper layers of our experience. (Ribeiro et al, 2016,p.687)We are interacting with ourselves every moment, that too without realizing it!

Thus it can be noted that experience play an important role in the life of an individual. The Narrative Therapy approach is based on this belief. Therapists help individuals to overcome any problem that they might be facing by delving in their experience or “stories”.

Developed by Michael White and David Epston, narrative theory is a form of therapy which makes a person look at his/hers problem from a third eye perspective and encourages people to use their capabilities to address the problem that they might be facing. Though out an individual’s life a person’s personal experience go on to make chapters in their biography. These experiences and stories are enchased by the therapist to help the narrator understand the purpose of his/hers life.( Vetere & Dowling,2016,p.12) The therapy finds its base on the inherent competencies and skills which individuals process naturally and how these can be used in the times of need to help them guide their own life. Thus narrative therapy can be stated as a nonpathologizing, collaborative and empowering method of intervention. The therapy uses the strategy of externalizing conversation, re-authoring, remembering conversation and unique outcomes. Externalizing conversation underlines the fact that the person is not the problem. It is the situation which requires change. Re-authoring focus on the internal ideas a person might have and how these ideas can be made use to bring change in the current situation, i.e. rewriting or re-authoring new stories. Remembering- conversation help individuals to identify with their social achievement. Finally unique outcome guide the client towards the newer plains.


In the following assignment we will look into the practical examples of using the therapy and thereby understand how the various aspects of the same operate. In the following example we come across a young girl studying in the 8th standard. Like most if the kids of her age, Kristy is over burdened and finds it extremely difficult to maintain an effective academic background, an active social life , as well as managing her basket ball lessons. (Gon?alves et al, 2016,p.460)She made it clear through her conversation with Steven Mulligan (therapist) that the process is tiring, since she has to practice a strict time management process. Through the use of narrative therapy, Kristy understood that it is important for her to learn this fine art of time management since it is an important element of her future job roles

Narrative therapy rests on the concept that simply objectifying the problem or stating it acts as a the solution of the same. For example Kristy feels she is unable to give the required amount of attention to the activities that she pursues. However through the process of the therapy she comes to state that she is sure that she is not the only one in her age group facing this issue. She knows hundreds of other eighth grader find it difficult to manage their activities, but eventually they get it done in the end. Thus there is some way of doing it and gradually she will be able to identify it.


The technique used in this case is called “re-authoring” or “re-storying” .In this model the practitioner helps the client to find their own voice and narrate their story. It is believed, that this model, through storytelling, help an individual to find meaning and purpose in their personal experience. This technique is so named since it helps clients “re-write” their story based on their own experience.( Lopes et al,2014p.670) While this narrative therapy proceeds, the therapist and the client is to develop an “alternative” story line, this helps the client in establishing a contrast between the problem and the person’s true nature, and provides the client an opportunity to rewrite their existing story. For example, Steven Mulligan asks Kristy about what her parents, grandparents, friends and her sister perceive of her. Kristy replies that her friends may say that she is “loyal, honest and supportive”. Her parents may say that she is a good child, focused on studies and stays out of trouble. These ideas about what others might think about her may give Kristy the confidence required at the moment and help her face the problem in hand. Another way, narrative therapy helps people is by identifying what maybe absent but implied. By understanding the problem, it is possible to discover, what is truly important to the person, in a wider context; beyond the problem. This helps the person by identifying the experiences which may not be visible upfront but guide their judgments and decisions later in life. Like Kristy knows that she should not take part in activities which she might not be able to handle at the moment. But she has developed this idea that she should not be wasting or whiling her time. Thus even if she might be suffering under the yoke of time management, she takes part in activities, thus keeping herself pre occupied.( Ricks et al,2014,p.100) Beneath all this, Kristy exhibits a deep concern for her near and dear once. She feels bad when she is unable to give time to her friends, family and grandparents. This is highlighted when she feels her sister; Kelly might say that Kristy should be “around more often”. She also has this strong desire to stand up to the expectations that her family members might have of her and to make them proud.

The method of narrative therapy underlines the person’s, in this case Kristy’s strength and skills. The therapist is seen to be motivating Kristy every now and then by saying that she has got things in her control at a young age. Another major strength of the method is, it allows the individual to solve the problem themselves. (DeMille & Montgomery,2016,p.10) Through the conversations therapists make the clients realize their hidden potential and how they can use these hidden stories to overcome their current problem. For example the conversation with Kristy started on the note that the young girl was concerned about how she is going to effectively manage her time to incorporate all the activities that she takes part in, including her academics and social life.( Gudi?o et al,2017,p.270) Through the conversation, the therapist was able to help Kristy to realize that she has a strong will power and a firm determination based on which she can take over anything she wishes to. In addition to that the therapist helped in building parallel storyline for the girl. Kristy is seen to mention during the conversation that her friends have strong faith in her decision, and very often come to seek advices from her. This will go on to re emphasis the confidence level of the young girl, and make her realize that whatever decision she takes in relation to effective time management will be a thought after one. The therapy helps the client to look at their problem objectively. This in turn helps the client to consider alternative interpretation to the stories. Like initially Kristy seemed to be quite upset about the fact that she is unable to incorporate all her activities within a given time frame. (Denborough,2014,p.200). However, as the conversation proceeds she is seen to be concerned about making her parents proud. It is in this light, it is revealed that she takes part in multiple activities along with her desires to keep a high academic score. In addition to the above mentioned merits, the theory is quite creative and fun for those who have been in therapy before and have been disillusioned. (Robinson, Jacobsen& Foster,2015,p.30)


Since psychology is the science that deals with the human mind, it difficult to evolve a perfect tool or method of analyzing situations and people. To that end narrative theory is marked by certain limitations.( Ribeiro et al,2016,p.170) Firstly compared with oriental methods of psychology, such as psychotherapy, narrative therapy is new and yet does not have strong literatures to support it. Another problem faced in this therapy method, is many a time clients find it uncomfortable to be their own exp0ert while driving the process. Though this technique proves to be of use for many, it has a few negative impacts. (Ikonomopoulos et al,2015,p.461) This method relies heavily on a person’s past experience in order to solve the current problems. However, many a time, individuals identify themselves through the problems he/she has gone through in the past, thus leaving them hopeless, isolated and empty. Finally this method cannot be applied to all types of clients. For example, a client with low mental ability will not be able to make use if the method, the same is applied for clients with limited language skills.

Like other therapies, narrative therapy also has a concern of ethical issues. Since it involves identifying and accessing the personal information of clients, high level of confidentiality must be maintained by practitioners.( Graham,2017,p.705) For example in this case, the therapist seeked for Kristy’s permission in order to use their conversation as an example. In addition to that therapists must also understand the cultural impact of their work and their practice. However in some cases, it is important for the therapist to mention when and not confidentiality can be maintained.

It is an ethical bindation that therapists make their qualification and experiences known. Many lawsuits have been charged against therapist who have presented themselves to be more qualified than they actually are. It is seen in the above example that Steven Mulligan begins the discussion by giving his own introduction. (Sword et al, 2014, p.200)During such sessions, since a lot of personal information is shared by the client there remains a chance that a relationship might develop between the therapist and the client. This relationship is important since it helps in the easy transfer of information from one end to the other. However, therapists must employ caution and should be able to draw a limit on such relationships as a part of their ethical practice. (AnjaBjor?y & Nylund,2016,p.89).


Another important ethical concern is that the therapist must never try to establish his/her belief and idea on the client. There may be times when the client may say things which do not seem “normal”. It is the duty of the therapist to listen to such comments and not portray the slightest hint of disagreement to what might be saying. (Baumgartner & Williams,2014,p.10)

Conclusion:

Narrative Therapy is a new technique employed by professionals. It is effective to deal with ADSD, anxiety, depress and helps children to cope up with the pressure they might be under. In the above assignment we try to understand how the therapy works by using the conversation between Kristy King (client) and Steven Mulligan (therapist). Kristy is seen to be struggling with her packed and hectic schedule. At the beginning of the conversation, she seems to be concerned about the fact that she is not being able to handle her priorities properly and thereby not being able to put her best. As the conversation proceeds we learn that, it is Kristy herself who is pushing the limits. She does not like lazing around, even though she enjoys it sometime. The fourteen years old seems overly matured and is in the pursuit to make her parents and family members proud. The conversation which began on the note of concern about her hectic schedule ended on the note with the young girl realizing that she has all the strength required to get her along this though “stage”. As the therapist goes on to create alternate storyline, based on what Kristy thinks others perceive her as, the confidence of the young girl is seen to rise. She answers the therapist with more confidence and has clear vision about what she wants from life.

References:

AnjaBjor?y, S. M., & Nylund, D. (2016). The practice of therapeuticletter writing in narrative therapy. The Handbook of Counselling Psychology.

Baumgartner, B., & Williams, B. D. (2014). Becoming an insider: Narrative therapy groups alongside people overcoming homelessness. Journal of Systemic Therapies, 33(4), 1-14.

DeMille, S. M., & Montgomery, M. (2016). Integrating narrative family therapy in an outdoor behavioral healthcare program: A case study. Contemporary Family Therapy, 38(1), 3-13.

Denborough, D. (2014). Retelling the stories of our lives: Everyday narrative therapy to draw inspiration and transform experience. WW Norton & Company.

Gon?alves, M. M., Ribeiro, A. P., Silva, J. R., Mendes, I., & Sousa, I. (2016). Narrative innovations predict symptom improvement: Studying innovative moments in narrative therapy of depression. Psychotherapy Research, 26(4), 425-435.

Graham, J. M. (2014). Narrative therapy for treating video game addiction. International journal of mental health and addiction, 12(6), 701-707.

Gudi?o, O. G., Leonard, S., Stiles, A. A., Havens, J. F., & Cloitre, M. (2017). STAIR Narrative Therapy for Adolescents. In Evidence-Based Treatments for Trauma Related Disorders in Children and Adolescents(pp. 251-271). Springer International Publishing.

Ikonomopoulos, J., Smith, R. L., & Schmidt, C. (2015). Integrating narrative therapy within rehabilitative programming for incarcerated adolescents. Journal of Counseling & Development, 93(4), 460-470.

Lopes, R. T., Gon?alves, M. M., Machado, P. P., Sinai, D., Bento, T., & Salgado, J. (2014). Narrative Therapy vs. Cognitive-Behavioral Therapy for moderate depression: Empirical evidence from a controlled clinical trial. Psychotherapy Research, 24(6), 662-674.

Ribeiro, A. P., Braga, C., Stiles, W. B., Teixeira, P., Gon?alves, M. M., & Ribeiro, E. (2016). Therapist interventions and client ambivalence in two cases of narrative therapy for depression. Psychotherapy Research, 26(6), 681-693.

Ribeiro, A. P., Gon?alves, M. M., Silva, J. R., Br?s, A., & Sousa, I. (2016). Ambivalence in narrative therapy: A comparison between recovered and unchanged cases. Clinical psychology & psychotherapy, 23(2), 166-175.

Ricks, L., Kitchens, S., Goodrich, T., & Hancock, E. (2014). My story: The use of narrative therapy in individual and group counseling. Journal of Creativity in Mental Health, 9(1), 99-110.

Robinson, T., Jacobsen, R., & Foster, T. (2015). Group Narrative Therapy for Women With Attention?Deficit/Hyperactivity Disorder. Adultspan Journal, 14(1), 24-34.

Sword, R. M., Sword, R. K., Brunskill, S. R., & Zimbardo, P. G. (2014). Time perspective therapy: A new time-based metaphor therapy for PTSD. Journal of Loss and Trauma, 19(3), 197-201.

Vetere, A., & Dowling, E. (Eds.). (2016). Narrative therapies with children and their families: A practitioner's guide to concepts and approaches. Taylor & Francis.

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