Narrative Therapy: Definition, Techniques, Efficacy

Narrative therapy is a style of therapy that helps people become—and embrace being—an expert in their own lives. In narrative therapy, there is an emphasis on the stories that you develop and carry with you through your life.

As you experience events and interactions, you give meaning to those experiences and they, in turn, influence how you see yourself and the world. You can carry multiple stories at once, such as those related to your self-esteem, abilities, relationships, and work.

Developed in the 1980s by New Zealand-based therapists Michael White and David Epston, narrative therapy seeks to have an empowering effect and offer counseling that is non-blaming and non-pathological in nature. (This means that your narrative therapist won’t just see you as a walking diagnosis but as a complicated and nuanced human being with a story to tell.)

Techniques

There are a variety of techniques and exercises used in narrative therapy to help people heal and move past a problematic story. Some of the most commonly used techniques include the following.

Putting Together Your Narrative

Narrative therapists help their clients put together their narrative. This process allows the individual to find their voice and explore events in their lives and the meanings they have placed on these experiences. As their story is put together, the person becomes an observer to their story and looks at it with the therapist, working to identify the dominant and problematic story.

Externalization

Putting together the story of their lives allows people to observe themselves as though outside of their own story. This helps create distance between the individual and their problems, which is called externalization. This distance allows people to better focus on changing unwanted behaviors. For example, a client might name anxiety “the Goblin” and explain to their therapist how they feel when “the Goblin” is around and how they cope with it.

Deconstruction

Deconstruction is used to help people gain clarity in their stories. When a problematic story feels like it has been around for a long time, people might use generalized statements and become confused in their own stories. A narrative therapist would work with the individual to break down their story into smaller parts, clarifying the problem and making it more approachable.

Unique Outcomes

When a story feels concrete, as if it could never change, any idea of alternative stories goes out the window. People can become very stuck in their story and allow it to influence several areas of their lives, impacting decision-making, behaviors, experiences, and relationships.

“Unique outcomes” in narrative therapy are aspects of the person’s story that contradict or don’t align with the negative or problematic story the person is telling. A narrative therapist will recognize these contradictions and help the person understand that there have been moments in their life that do challenge their overarching narrative.

What Can Narrative Therapy Help With

While narrative therapy is a relatively new treatment approach, there is some evidence that it may be helpful for a variety of conditions. Mental health conditions it might help include:

This approach can also be useful for anyone who feels like they are overwhelmed by negative experiences, thoughts, or emotions. This type of therapy stresses the importance of people not labeling themselves or seeing themselves as “broken” or “the problem,” or for them to feel powerless in their circumstances and behavior patterns.

Benefits of Narrative Therapy

Narrative therapy holds a number of key principles, including:

• Respect: People participating in narrative therapy are treated with respect and supported for the bravery it takes to come forward and work through personal challenges.
• Non-blaming: There is no blame placed on the client as they work through their stories, and they are also encouraged to not place blame on others. Focus is instead placed on recognizing and changing unwanted and unhelpful stories about themselves and others.
• Client as the expert: Narrative therapists are not viewed as an advice-giving authority but rather a collaborative partner in helping clients grow and heal. Narrative therapy holds that clients know themselves well and exploring this information will allow for a change in their narratives.

Narrative therapy challenges dominant problematic stories that prevent people from living their best lives. Through narrative therapy, people can identify alternative stories, widen people’s views of self, challenge old and unhealthy beliefs, and open their minds to new ways of living that reflect a more accurate and healthy story.

Narrative therapy does not aim to change a person but to allow them to become an expert in their own life.

Effectiveness

Narrative therapy appears to offer benefits in the treatment of a number of different conditions and in a variety of settings. Some evidence supporting the effectiveness of this approach:

• One 2020 study found that adults with depression and anxiety who were treated with narrative therapy experienced improvements in self-reported quality of life and decreased symptoms of anxiety and depression.
• A 2016 study found that narrative therapy was effective at helping children improve empathy, decision-making, and social skills.
• Other research from 2020 has found that married women experienced increased levels of marital satisfaction after being treated with narrative therapy.

Further research is needed to determine what mental health conditions narrative therapy might treat most effectively.

Things to Consider

Narrative therapy may present some challenges that you should consider before you begin treatment. Some things to be aware of before you begin:

• This type of therapy can be very in-depth. It explores a wide range of factors that can influence the development of a person’s story. This includes factors such as age, socioeconomic status, race, ethnicity, gender, and sexual identity. 
• It involves talking about your problems as well as your strengths. A therapist will help you explore your dominant story in-depth, discover ways it might be contributing to emotional pain, and uncover strengths that can help you approach problems in different ways.
• You’ll reevaluate your judgments about yourself. Sometimes people carry stories about themselves that have been placed on them by others. Narrative therapy encourages you to reassess these thoughts and replace them with more realistic, positive ones.
• It challenges you to separate yourself from your problems. While this can be difficult, the process helps you learn to give yourself credit for making good decisions or behaving in positive ways.

This process can take time, but can eventually help people find their own voice and develop a healthier narrative.

How to Get Started

Narrative therapy is a unique, specialized approach to counseling. There are training opportunities for therapists to learn more about narrative therapy and how to use this approach with clients.

Trained narrative therapists are located throughout the world and can be found through online resources and therapist directories. You might also consider asking your doctor to refer you to a professional in your area with training and experience in narrative therapy.

During your first session, your therapist may ask you to begin sharing your story and ask questions about the reasons you are seeking treatment. Your therapist may also want to know about how your problems are affecting your life and what your goals for the future are. You will also likely discuss aspects of treatment such as how often you will meet and how your treatment may change from one session to the next.