What are Narrative therapy questions?

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This blog post will explore what are some potent narrative therapy questions that are used in therapy sessions and also take a brief look into what narrative therapy is and its process. 

We will also explore the various in session interventions that are used in narrative therapy and the application of this kind of therapy.

What are Narrative therapy questions?

Narrative therapy involves a dialogue between the client and the therapist who have been trained in Narrative therapy.

As part of the dialogue, narrative therapy techniques are applied which involves exploration into the client’s narrative of their life through the process of asking questions.  

According to David Epston, asking questions lead to generation of possible narratives that the client holds about their lives. 

Questions that are used in Narrative therapy highlighted by Shapiro, Johanna & Ross, Valerie. (2002)  include:

  • Deconstructive questions that show How Stories Are Constructed. Example,  “Who Told You “Real Men” Don’t Pay Attention To Their Health?”
  • Perspective questions that explore other people’s views of clients For example, “ Does someone have a different idea?”
  • Hypothetical questions that stimulate client imagination to envision different more hopeful outcomes. For example, “Suppose a miracle happened and not caring was solved, how would your life be different?”
  • Story development  questions that explore elements of the preferred story. For Example, “Tell me more about how you were able to resist that fast food? What exactly happened?”
  • Redescription questions that help clients recognize qualities in themselves. For example “What does it say about you as a person that you were able to test your blood sugars daily last week?”
  • Bifurcation questions that encourage clients to align him/herself against the problem. For example,  “Is the event you’re describing on the side of not caring or against not caring?
  • Stopper questions that refocus the patient when he/she seems to be getting stuck or distracted. For example: “Which story are you telling now?”
  • Audience questions that Identify support when building the alternate story. For example, “Who in your life would be least surprised that you are able to make this change?”

Some of the other types of questions asked in narrative therapy are as follows:

Enabling questions

These questions help people to broaden their scope and develop an awareness of their own abilities. Some of the questions include:

“Can you describe the last time you managed to get free of the problem for a couple of minutes?”

Linking Openings with Preferred Experience

These questions are designed to highlight one’s own ability to manage stressors and also apply it in various areas of their life- these questions are asked to help an individual identify their own goals. 

Questions can look like: “Would you like more minutes like these in your life?”

Alternative Story Development questions

These questions move from identifying abilities and skills towards developing a narrative about their struggles. 

Questions include those that cover a person’s feelings, thoughts, behaviours, and desires. It can look like:

“What were each of you thinking/feeling/doing/wishing/imagining during those few minutes?”

Broadening the Viewpoint.

These questions invited people to look at their own narratives from an external perspective with the aimt to develop empathy as well as alternate narratives. 

“What might your friend have noticed about you if she had met up with you in those few minutes?”

Linking with the Exceptions in the Past.

These types of questions are those that invite the client to explore circumstances that allow them to take action and manage their stressors. 

These questions invite the client to look at the exceptions in their lives as opposed to their all-consuming negative and hopeless narratives that they hold onto. 

“Tell me about times when you have managed to achieve a similar few minutes in the past?”

Linking Exceptions from the Past with the Present.

This question links one’s abilities to achieve in managing their stressors with their present perspective of the problem. 

It is designed to help people consider various plans of actions that they could apply or even see the problem in a new light. 

“When you think about those times in the past when you have achieved this, how might this alter your view of the problem now?”

Linking Exceptions from the Past with the Future.

This particular type of question is designed to help clients develop a plan of action by considering things that have worked in the past and applying it in the present or future. 

“Thinking about this now, what do you expect to do next?”

What is Narrative therapy?

Narrative therapy is a form of therapy that was developed by Michael White and David Epston in the 1980s.

This form of therapy seeks to understand the personal narratives that are held by an individual which proves to be problematic. 

The process of therapy starts by externalising the problem, separating the individual from the problem and then redeveloping an alternate more optimistic and hopeful narrative about themselves and their lives. 

This form of therapy highlights an individual’s own skills and sense of purpose to guide them through challenges and believes that each client is an individual who has agency and dignity. 


They view people who come to narrative therapy as people who are courageous and brave in their ability to identify their own challenges and work through it. 

It is a non-blaming form of therapy that does not view clients as the problem, and avoids blame on any of the individuals in therapy. 

Narrative therapy views the client as the expert of their lives and believes that only the client  knows their one life intimately and has the skills and knowledge to address their problems. 

The foundation of this therapeutic process is the process by which they invite clients to take a perspective that may feel foreign and new to them and bring about a seperation between people and their problems. 

What are the stages of Narrative therapy?

The stages in the process of narrative therapy are as follows:

Deconstructing problematic stories. 

This stage involves naming the problem and tracing the history and development of the problem. 

This stage also involves exploring the effects of the problem of life on the individual and also exploring exceptions when the problem does not arise. 

Re-authoring problematic stories.

In this stage, the clients are encouraged to bring forward different outcomes to their problems based on their abilities. 

This is done by highlighting aspects of their experiences and identities that might not have been regarded in their past such as their characteristic traits. 

At this stage, an alternative story that is more optimistic and hopeful is also identified and built upon by developing action strategis to apply past victories into the future and present.   

Remembering conversations. 

Finally, there are certain rituals that are done by the therapist and both therapist and client in the celebrating process such as writing letters to clients.

There is also effort made for clients to reach out and engage with community and social support networks. 

What is the efficacy of Narrative therapy?

While narrative therapy is a relatively new treatment approach as compared to the older therapeutic theories that have been applied, there have been many studies done on the efficacy of this school of psychotherapy. 

A study was done on the effectiveness of Group Narrative Therapy on Depression and anxiety among 26 patients with amphetamine addiction in Iran. 

The participants of the study were randomly divided into intervention and control groups where the intervention group was subjected to 10 sessions of narrative therapy, whereas the control group received no narrative therapy intervention and only psychiatric care. 

The post intervention assessment of the participants found the therapeutic process reduced the level of depression and anxiety in participants who were subjected to narrative therapy interventions. 

According to Clarke for verywell mind,  other applications of narrative therapy find this form of intervention to be effective for cases that involve:

  • Attachment issues
  • Attention-deficit/hyperactivity disorder (ADHD)
  • Eating disorders
  • Grief
  • Post-traumatic stress disorder (PTSD)

Narrative therapy has also been found to be an effective intervention in the younger population. In a study that examines the effectiveness of narrative therapy in the development of social and emotional skills in school going children age 8-10 found that,

“ …children receiving narrative therapy intervention showed a significant improvement in self-awareness, self-management, social awareness/empathy, and responsible decision making.”

Conclusion

This blog post has explored what are some potent narrative therapy questions that are used in therapy sessions and also takes a brief look into what narrative therapy is and its process. 

We have also explored the various insession interventions that are used in narrative therapy and the application of this kind of therapy.

FAQ related to Narrative therapy questions

What is a narrative therapy approach?

Narrative therapy is a form of therapy that was developed by Michael White and David Epston in the 1980s.

This form of therapy seeks to understand the personal narratives that are held by an individual which proves to be problematic. 

The process of therapy starts by externalising the problem, separating the individual from the problem and then redeveloping an alternate more optimistic and hopeful narrative about themselves and their lives. 

What are the limitations of narrative therapy?

One of the limitations of narrative therapy is that it relies on complex philosophical ideas that clients may struggle to understand.

Other limitations also include that the client is given too much freedom when they might require more directives from the therapist in some cases.

How is narrative therapy different from CBT?

While CBT is focused on the reconstruction of belief systems about themselves, narrative therapy is focused on constructing more hopeful and optimistic stories about their lives and themselves.

The techniques used in either therapies are also very different. Where CBT uses disputing as a way to develop healthier beliefs, Narrative therapy uses dialogue to help understand and externalise the problem.

How does change occur in narrative therapy?

Narrative therapy suggests that change occurs when the client pays close attention to unique outcomes or exceptions where they were bigger than their problems and manage to control aor cope with their problems with their own innate abilities. 

It is those innovative moments that help people develop an awareness of their own ability to manage their own lives and help create a more positive narrative about themselves. 

References

Ackerman. C. 19 Narrative Therapy Techniques, Interventions + Worksheets [PDF]. PostivePsychlogy. Retrieved on 12th Dec 2021. https://positivepsychology.com/narrative-therapy/

Beaudoin M, Moersch M, Evare BS. The effectiveness of narrative therapy with children’s social and emotional skill development: An empirical study of 813 problem-solving stories. Journal of Systemic Therapies. 2016;(35)3: 42-59. doi:10.1521/jsyt.2016.35.3.42

Clarke, J. What is Narrative Therapy. Verywell well. Retrieved on 12th Dec 2021. https://www.verywellmind.com/narrative-therapy-4172956#effectiveness

Narrative Therapy: Deconstructing & Re-Authoring Stories: Steve Madigan. Counselling Education. Retrieved on 12th Dec 2021. https://counseling.education/counseling/theories/narrative.html

Shakeri J, Ahmadi SM, Maleki F, Hesami MR, Parsa Moghadam A, Ahmadzadeh A, Shirzadi M, Elahi A. Effectiveness of group narrative therapy on depression, quality of life, and anxiety in people with amphetamine addiction: A randomised clinical trial. Iran J Med Sci. 2020;45(2):91-99. doi:10.30476/IJMS.2019.45829

Shapiro, Johanna & Ross, Valerie. (2002). Applications of narrative theory and therapy to the practice of family medicine. Family medicine. 34. 96-100.

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