Strength-based Approaches: Narrative Therapy

           Did you ever think that you could write narrative stories to help you overcome an addiction?  Well there is an interesting intervention called narrative therapy that allows you to do just that.

Cartoon of Michael White & David Espton

Based off of solution-focused therapy, Michael White and David Epston created this new kind of therapy.  These two men developed their ideas based off of anthropologist and historian Michael Foucault, who believed that generalized therapy was not the way to best help and heal clients  (Wormer & Davis, 2009).  Since the development of narrative therapy, many different therapist have taken their own approach on it and so the therapy varies depending upon the therapist (Morgan, 2000).  

        The main component to White and Epston's narrative therapy is externalization.  At the beginning of this type of therapy the client must separate them self from the label of the problem in order to make decisions on how to deal with it.  In order to do this the client and family members collaborate to create a name for the problem.  An example of this is "an alcoholic becomes a person oppressed by the alcohol bully or booze" (Wormer & Davis, 2009).  In the rest of therapy the client and therapist will refer to the problem as the alcohol bully or booze.  After creating a name for the problem the therapist moves into trying to discover what effect the problem is having on the client's life, as well as how the addiction drags the person into using again (Wormer & Davis, 2009).  A major part of this stage of the therapy is for the therapist to ask questions that do not make the client feel as though they need to defend themselves.  Narrative therapy must strive to be as non-blaming and judgmental as possible (Morgan, 2000).  It is also important for the therapist to use exception questions that work to put a hope in the client that a change is possible in the future (Wormer & Davis, 2009).

       From all of these question asked of the client, the therapist is trying to figure out the life story of the client and find examples of times that they were strong against the addicition or other aspects of life.  By finding these strong aspects, the therapist can use them, when the client is feeling down, in order to to prove that they are strong enough to overcome their addiction and change their future (Wormer & Davis, 2000).  All of these aspects talked about between the client and the therapist are then used in order to create the narrative of the client's life.  The narrative is suppose to focus on what the client sees their future as being after the problem is gone.  Therapists hope for their clients to also relate the changes in their lives to the effect it will have on other people's lives, by getting rid of the addiction (Wormer & Davis, 2000).  Although narrative therapy is typically a one-on-one intervention plan, there are times that it can be used in group settings.  Within group settings a different approach, of not focusing on personal stories and instead creating alternative stories, is taken (Wormer & Davis, 2000).
        When it comes to the cycle of addiction narrative therapy would be very helpful in trying to break the cycle.  The cycle begins with the person feeling depressed and so they commit their addiction in order to alleviate the symptoms.   After the feelings have disappeared unintended consequences arise that make the person feel shame, and guilt.  At this stage of the process narrative therapy could come in, in order to keep the cycle from continuing.  Here the therapy could get the person to talk about the feelings they are having and see that they can overcome the addiction.  Most importantly the person would begin to feel hope and would be able to avoid the depression that usually causes them to start the cycle all over again.  The positives and hopes of narrative therapy would come in great use of breaking the cycle of addiction.

         This strength-based approach would be very helpful in my career as an occupational therapist.  A main focus of OT is to understand what is important to a client and create therapy based off of activities that apply to the client's life.  This major aspect of OT can be greatly seen in narrative therapy since the whole basis of the approach is to understand the person's life and how they want to change it.  This approach could be helpful to use in an OT clinic if you are dealing with client's who have an addiction because you will be able to kill two birds with one stone, by fulfilling the OT aspect and the addictive therapy aspect. 

References

Morgan, A. (2000, December 15). Dulwich centre:a gateway to narrative therapy & community work. Retrieved from http://www.dulwichcentre.com.au/what-is-narrative-therapy.html

Wormer, K. S. V., & Davis, D. R. (2009). Addiction treatment, a strengths perspective. (2nd ed.). United States: Brooks/Cole Pub Co.