Introduction: When Stories Need Rewriting

You sit across from your client, watching them recount the same painful narrative they've been trapped in for months. "I'm just fundamentally broken," they say with resignation, as if stating an immutable fact.

As therapists, we recognize these dominant problematic stories that clients tell themselves—stories that have become so entrenched they feel like absolute truths. It's in these moments that narrative therapy offers its most profound value: the ability to help clients separate themselves from their problems, discover neglected aspects of their experiences, and author new, more empowering narratives.

This isn't about denying reality or spinning false positivity—it's about uncovering genuine alternative stories that have been overshadowed by problem-dominant narratives.

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What is Narrative Therapy

Narrative therapy, developed by Michael White and David Epston in the 1980s, views people as separate from their problems and sees them as experts in their own lives.

Unlike approaches that locate problems within individuals,narrative therapy positions problems as external entities influenced by social, cultural, and political contexts.

Core distinguishing principles include:

• Problems are separate from people ("The person is not the problem; the problem is the problem")

• People are the experts on their own lives

• Reality is socially constructed through language and stories

• Multiple perspectives and realities exist simultaneously

• Focus on strengths, resources, and possibilities rather than deficits

Narrative therapy seeks to help clients identify alternative stories that challenge the dominant story that has been limiting their sense of identity and possibility.

Unlike therapies that view problems as reflections of core personality characteristics, narrative therapy challenges the notion that any single story can represent the full complexity of a person's life.

Narrative Therapy Techniques With Step-by-Step Application

1. Externalizing Conversations

Purpose: Separate the person from the problem to reduce shame and create space for new possibilities.

Practical Application:

1. Identify the problem: Ask your client to name the problem (e.g., "anxiety," "self-doubt").

   • "What would you call this challenge that's been affecting you?"

2. Use externalizing language: Consistently refer to the problem as separate from the client.

   • Instead of: "When do you feel most anxious?"

   • Use: "When does Anxiety tend to show up in your life?"

3. Explore the problem's influence: Examine how the externalized problem affects different areas of life.

   • "How does Self-Doubt influence your relationships/work/self-care?"

   • "What tactics does Depression use to maintain its grip?"

4. Map the person's influence on the problem: Identify times when the client has resisted or reduced the problem's influence.

   • "Can you recall a time when you stood up to Perfectionism, even briefly?"

   • "What allowed you to push back against Isolation's demands?"

Clinical Example:

Client: "I'm so depressed, I can't function anymore."

Therapist: "It sounds like Depression has been making things extremely difficult. When did Depression first enter your life?"

Client: "I guess it started after my divorce."

Therapist: "And how has Depression been influencing your daily activities?"

Client: "It makes me stay in bed. I don't have energy to do anything."

Therapist: "Has there been any moment recently, even a brief one, when you've managed to do something despite Depression's influence?"

Client: "Well, I did take my dog for a walk yesterday, even though it was hard."

Therapist: "That's interesting. How did you manage to take that walk despite Depression's attempts to keep you in bed?"

In a narrative therapy session, this process helps clients see that problematic stories don't define their entire identity. Narrative therapists use these techniques to create distance between the person and their problems.

2. Identifying Exceptions and Sparkling Moments

Purpose: Discover exceptions to the problem story that can serve as foundation points for an alternative narrative.

Practical Application:

1. Listen actively for contradictions: Pay close attention to any statements that contradict the dominant problematic stories.

   • Client: "I always fail at relationships." (Later mentions) "My friendship with Alex has lasted 20 years."

2. Ask about exceptions directly: Explore times when the problem was less influential.

   • "Tell me about a time when Anxiety didn't control your decision-making."

   • "Has there been a moment when you responded differently to Anger's demands?"

3. Explore these moments in detail: Dig deep into these unique outcomes to understand what made them possible.

   • "What was different about that situation?"

   • "What personal qualities or skills did you draw upon in that moment?"

   • "Who noticed this difference in you?"

4. Connect these moments: Help clients see patterns in these exceptions that might form an alternative storyline.

   • "What do these different moments tell us about what you value?"

   • "I notice that in each of these situations, you showed remarkable persistence. What does that suggest about who you are apart from the problem?"

Clinical Example:

Therapist: "You mentioned feeling like a 'failure as a parent,' yet you also told me about helping your daughter through her science project last week. Could you tell me more about how you managed to support her despite these strong feelings of inadequacy?"

Client: "I don't know... I just knew she needed help, so I pushed through it."

Therapist: "What personal qualities did you draw on to 'push through' those feelings of inadequacy?"

Client: "I guess I'm pretty stubborn when it comes to my kids. I don't want them to struggle like I did."

Therapist: "This stubborn commitment to your children—where else might that quality show up in your parenting?"

Narrative therapy focuses on these unique outcomes because they reveal aspects of clients' own stories that contradict unhealthy beliefs imposed by dominant narratives. As clients explore events that don't fit the problem story, their story gains richness and complexity.

3. Re-authoring Conversations

Purpose: Help clients develop and strengthen preferred narratives about themselves and their lives.

Practical Application:

1. Name the emerging alternative story: Collaborate with your client to name the new narrative.

   • "Based on these experiences, what might we call this different story about yourself?"

   • "If this weren't a story about 'being a failure,' what kind of story might it be?"

2. Develop the story through landscape of action questions: Focus on concrete events, behaviors, and sequences.

   • "What did you actually do in that situation?"

   • "What steps did you take before and after that moment?"

   • "What other times in your life fit with this new story?"

3. Enrich through landscape of identity questions: Explore what these actions reveal about the person's values, beliefs, purposes, and qualities.

   • "What does taking those actions say about what's important to you?"

   • "What personal qualities enabled you to respond that way?"

   • "How does this connect to who you want to be or become?"

4. Explore the history of these qualities: Trace the lineage of these skills and qualities through the client's life.

   • "When did you first notice this determination in yourself?"

   • "Who else might have recognized this quality in you before you saw it yourself?"

Clinical Example:

Therapist: "We've been talking about these moments when you've stood up for yourself despite Anxiety's influence. What might we call this emerging story about you?"

Client: "Maybe... finding my voice?"

Therapist: "I like that. Let's explore this 'finding your voice' story more. What was the first time you can remember finding your voice, even in a small way?"

Client: "Probably in college when I disagreed with a professor in class."

Therapist: "What personal qualities did you draw on to speak up in that situation?"

Client: "I guess I felt strongly about the topic, and I value truth, even when it's uncomfortable."

Therapist: "This valuing of truth, even uncomfortable truth—how has that shown up elsewhere in your life?"

Narrative therapy encourages clients to become the authors of their own life stories rather than accepting problematic stories imposed by others or by dominant cultural narratives. During therapy sessions, narrative therapists help clients discuss aspects of their personal stories that may have been forgotten or minimized.

4. Therapeutic Documentation

Purpose: Solidify and authenticate new understandings through written documents that clients can revisit.

Practical Application:

1. Create therapeutic letters: Write brief letters after significant sessions to summarize insights and developments.

   • Use the client's exact language whenever possible

   • Highlight unique outcomes and emerging alternative stories

   • Ask questions that invite further reflection

2. Develop certificates and declarations: Create formal documents celebrating important shifts or achievements.

   • "Certificate of Achievement: Successfully Standing Up to Perfectionism"

   • "Declaration of Independence from Self-Criticism"

3. Utilize therapeutic journals: Invite clients to explore events and moments when they resist the problem's influence.

   • Provide specific prompts: "Record moments when you notice yourself responding to Anxiety differently"

   • Suggest they note context, thoughts, feelings, and actions

Example Therapeutic Letter:

Dear Sarah,

I wanted to write following our session yesterday where you shared that remarkable moment when you spoke up in the team meeting despite Anxiety telling you to "stay small and invisible." You mentioned feeling your heart racing but choosing to share your idea anyway, which your manager later praised. You described this as a small step in "finding your voice"—a phrase I found particularly meaningful.

I'm curious: What does this moment tell you about your relationship with Anxiety? Is it changing in some way? You mentioned that your grandmother always encouraged you to "speak your truth." I wonder how she might have responded if she had witnessed you in that meeting?

I look forward to continuing our conversation next week.

Regards, [Therapist's name]

This therapeutic process helps reinforce the new perspectives that emerge during narrative therapy. The documentation serves as a tangible reminder of the client's own meaning-making and helps sustain changes between therapy sessions.

5. Outsider Witness Practices

Purpose: Validate and enrich new narratives through involvement of significant others or therapeutic teams.

Practical Application:

1. Identify potential witnesses: Discuss with your client who might serve as supportive witnesses.

   • Family members, friends, other therapists, or former clients

   • Consider who would appreciate and respect the client's emerging story

2. Prepare witnesses: Brief witnesses on their role and the structure of the process.

   • They should listen without judgment, interruption, or advice-giving

   • Focus on what resonated with them and why

3. Conduct the ceremony: Facilitate a structured conversation.

   • Client shares their emerging preferred story

   • Witnesses respond using the four-part structure (see below)

   • Client reflects on what they heard from witnesses

   • (Optional) Witnesses respond to client's reflections

4. Guide witness responses using this four-part structure:

   • Expression: "What particular expressions caught your attention?"

   • Image: "What images came to mind as you listened?"

   • Resonance: "What was it about your own life that connected with what you heard?"

   • Transport: "How are you different for having witnessed this story?"

Alternative for Individual Therapy: If assembling witnesses isn't feasible, you can:

• Role-play responses from important people in the client's life

• Use chair work techniques to embody different perspectives

• Create imaginary supportive audiences through visualization exercises

Group narrative therapy can be particularly powerful, as it creates a community where personal stories can be witnessed and affirmed. Traditional narrative therapy often incorporates these group elements to enhance the therapeutic approach.

Narrative Therapy for Grief

Grief often arrives with dominant narratives about how people "should" grieve, creating additional suffering when clients feel they're "doing grief wrong." Narrative approaches offer powerful alternatives that honor the uniqueness of each person's life stories.

Key Principles When Working With Grief

1. Grief as a testimony to love: Reframe grief as evidence of meaningful connection rather than as pathology.

   • "What does the intensity of your grief tell us about what this relationship meant to you?"

   • "How is your grief honoring the importance of what's been lost?"

2. Continuing bonds: Challenge the "moving on" narrative by supporting ongoing connections with the deceased.

   • "How might your relationship with [deceased] continue, though in a different form?"

   • "What conversations would you still like to have with [deceased]?"

3. Dual witnessing: Honor both the pain of loss and the strength shown in response.

   • "I'm witnessing both your deep sorrow and how you continue to care for your children despite this pain."

Practical Techniques for Grief Work

1. Re-membering conversations: Actively incorporate the deceased into the client's ongoing life narrative.

   • "How would [deceased] respond if they could see how you're handling this challenge?"

   • "What qualities of [deceased] do you find living on through you?"

   • "Who else keeps [deceased]'s values or stories alive in their actions?"

2. Therapeutic rituals: Co-create meaningful rituals that externalize grief while honoring connection.

   • Writing periodic letters to the deceased

   • Creating memorial objects or spaces

   • Developing personalized anniversary practices

3. Legacy documents: Help clients articulate what they've learned or gained from the relationship.

   • "What did this relationship teach you that you want to carry forward?"

   • Create "Declarations of Contribution" that name the ongoing gifts from the relationship

Clinical Example:

Client: "It's been two years. Everyone says I should be moving on by now."

Therapist: "These 'moving on' expectations seem to be adding pressure to an already difficult experience. What's your sense of what your grief means?"

Client: "I don't want to forget him. Sometimes I feel like my grief is the only thing I have left."

Therapist: "It sounds like your grief is partly a way of honoring the importance of your relationship. I wonder, are there other ways you might honor this connection that feel sustaining rather than depleting?"

Client: "I used to cook his favorite meals sometimes, but I stopped because it made me cry."

Therapist: "What might it mean to reclaim that practice, tears and all, as a way of keeping his presence in your life?"

Narrative therapy works with grief by helping clients construct life-affirming stories that integrate loss while maintaining meaningful connections to loved ones. The benefits of narrative therapy in grief work include decreased symptoms of complicated grief and enhanced emotional skill development.

Narrative Therapy for Trauma

Trauma often creates dominant stories of damage, helplessness, and shame. Narrative approaches help clients reclaim their agency and develop what Michael White and David Epston called a "double-storied" account of trauma—one that acknowledges both the violation and the person's responses to it.

Key Principles When Working With Trauma

1. Safety first: Ensure physiological and psychological safety before narrative exploration.

   • Establish clear boundaries and consent processes

   • Incorporate grounding and regulation skills

   • Move at the client's pace, never pushing for disclosure

2. Honoring responses to trauma: Focus on how the person responded to trauma, not just what happened to them.

   • "How did you manage to survive that experience?"

   • "What did you do to protect yourself during or after?"

   • "How have you resisted trauma's influence on your identity?"

3. Phased approach: Follow a structured progression from safety to processing to integration.

   • Begin with externalizing immediate distress (e.g., flashbacks, nightmares)

   • Gradually explore response-focused trauma narratives

   • Eventually develop preferred identity conclusions

Practical Techniques for Trauma Work

1. Scaffolded questioning: Use the "absent but implicit" to identify values violated by trauma.

   • "For this to have been so distressing, what must be important to you?"

   • "What does your strong reaction tell us about what you stand for?"

2. Double listening: Attend simultaneously to trauma stories and resistance/survival stories.

   • When hearing accounts of violation, listen also for moments of agency

   • Note linguistic markers of resistance ("but," "even though," "still")

   • "Even as you describe these painful events, I'm struck by how you..."

3. Safe externalization: Create appropriate distance while avoiding minimization.

   • Externalize trauma effects rather than the traumatic experience itself

   • "When Hypervigilance convinces you danger is everywhere, what helps you recognize its influence?"

   • Use metaphors: "The trauma left echoes that still reverberate—how have you learned to respond to these echoes?"

4. Collective narratives: Connect individual experiences to broader contexts when appropriate.

   • Link personal experiences to societal/historical patterns without diminishing uniqueness

   • Explore how communities have responded to similar violations

   • Develop "communities of acknowledgment" that witness and validate

Clinical Example:

Therapist: "You've described how Nightmares and Flashbacks have been disrupting your life since the assault. Despite their power, I notice you still managed to attend your daughter's recital last week. How did you do that?"

Client: "I wasn't going to let that... incident... take that away from her too. I just kept focusing on her."

Therapist: "It strikes me that even with these trauma symptoms trying to isolate you, you're finding ways to prioritize your relationship with your daughter. What does that tell you about what's important to you?"

Client: "My kids come first, no matter what. Always have."

Therapist: "This commitment to putting your children first—does that connect to values you held before the trauma, or has it perhaps become even stronger since?"

Narrative exposure therapy, a specific application of narrative techniques for trauma, helps clients create coherent accounts of traumatic experiences within the context of their broader life stories. Narrative therapy aids clients with posttraumatic stress disorder by helping them reframe negative narratives into more empowering ones.

Common Challenges

Challenge 1: Clients Strongly Identify with Problem Stories

Solution: Start with smaller externalizations of specific behaviors rather than core personality issues. For example, begin with externalizing "moments of despair" rather than "Depression" as a whole entity.

Challenge 2: Difficulty Identifying Unique Outcomes

Solution: Broaden your inquiry. Ask about:

• Even the smallest exceptions

• Times when the problem was "less bad" rather than absent

• What prevented the problem from becoming worse

• How others might have noticed differences the client hasn't recognized

Challenge 3: Cultural or Religious Narratives That Reinforce Problems

Solution: Approach with cultural humility. Explore multiple meanings of cultural narratives, looking for liberating interpretations within the client's cultural framework rather than challenging the framework itself.

Challenge 4: Institutional Constraints on Documentation

Solution: Adapt documentation practices to fit your setting:

• Incorporate narrative language into required documentation

• Create brief informal notes for clients that complement official records

• Use verbal summaries that serve similar purposes when written documentation isn't possible

Narrative therapists often face these challenges when helping clients explore their own stories. The therapeutic process requires patience as clients learn to identify alternative stories that challenge old and unhealthy beliefs.

Integrating Narrative Approaches With Other Modalities

Narrative therapy integrates well with:

Cognitive-Behavioral Therapy (CBT):

• Use externalization to reduce shame around "cognitive distortions"

• Frame behavioral experiments as ways to "test the problem's influence"

• Incorporate unique outcomes into cognitive restructuring

Solution-Focused Brief Therapy:

• Combine exception-finding questions from both approaches

• Use scaling questions to track the influence of externalized problems

• Incorporate miracle questions into re-authoring conversations

Internal Family Systems (IFS):

• Externalize "parts" while maintaining the compassionate stance of IFS

• Use narrative documentation to track shifts in the relationship between Self and parts

• Apply witnessing practices to acknowledge parts' contributions

Trauma-Focused Therapies:

• Use narrative approaches to develop coherent, meaningful trauma accounts

• Combine EMDR's desensitization with externalization of trauma effects

• Integrate somatic awareness into unique outcome exploration

Family Therapy:

• Apply narrative techniques to help family members understand each other's personal narratives

• Use externalization to address family patterns without blaming individuals

• Create shared alternative stories that support positive and functional identity development

Narrative therapy's flexibility makes it compatible with many systemic therapies and other mental health approaches. Further research continues to validate its effectiveness across different mental health concerns.

Practical Implementation Steps

1. Start small: Begin with one narrative technique in your existing practice.

   • Try externalizing language with your next client

   • Listen specifically for unique outcomes in an upcoming session

2. Practice the language: Develop comfort with narrative questioning.

   • Write out example questions for common problems you encounter

   • Role-play with colleagues or practice self-reflection

3. Build your resource library: Create templates for therapeutic documents.

   • Develop letter templates that you can customize

   • Design certificate formats for different achievements

4. Track outcomes: Document the impact of narrative approaches.

   • Note shifts in client language and self-description

   • Observe changes in how clients relate to their problems

5. Consider consultation: Connect with the narrative therapy centre or community.

   • Join a study group focused on narrative ideas

   • Attend workshops with experienced narrative therapists

6. Leverage AI Tools: Several AI documentation tools like Supanote.ai can support you with the right questions to ask in the moment, or even in crafting your therapeutic documentation to help your clients

Using AI for Narrative Therapy techniques

Capturing Externalized Language AI note-taking tools can be trained to recognize and preserve externalized language patterns. For example, when using Supanote.ai, therapists can:

• Flag externalized problem terms for consistent tracking throughout treatment

• Create templates that automatically use externalizing language

• Generate therapeutic letters more efficiently while maintaining personalization

Identifying and Tracking Unique Outcomes One of the challenges in narrative therapy is systematically tracking unique outcomes across sessions. AI tools can:

• Tag and categorize unique outcomes as they emerge in session

• Create visualizations showing the development of alternative stories over time

• Generate prompts for follow-up questions based on previously identified strengths

Enhancing Therapeutic Letters AI tools can assist in creating the therapeutic documents that are central to narrative therapy:

• Draft therapeutic letters based on session notes while preserving the client's exact language

• Suggest questions that might further develop emerging alternative stories

• Maintain a library of successful document templates for different therapeutic situations

Implementation Tips To effectively use AI tools like Supanote in narrative therapy:

1. Customize your templates to reflect narrative therapy language and structure

2. Create specific tags for tracking externalized problems, unique outcomes, and alternative story development

3. Review and personalize all AI-generated content to ensure it captures the unique voice and perspective of each client

4. Use the time saved on documentation to enhance the creative, collaborative aspects of narrative therapy

When properly implemented, these tools don't replace the therapist's judgment but rather free up cognitive resources to focus more fully on the therapeutic relationship and the nuanced work of co-constructing meaningful narratives.

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Frequently Asked Questions

Q: How long does it typically take to see results with narrative therapy?

A: Many clients experience significant shifts in perspective after just 2-3 sessions of consistent externalization and unique outcome exploration. However, thoroughly developing and solidifying alternative stories usually requires 8-12 sessions.

Q: How do I respond when clients reject externalization attempts?

A: This often happens when externalization feels artificial or when problems are deeply internalized. Try using more subtle language ("these feelings of worthlessness" rather than "The Worthlessness"), normalize their response, and shift to exploring the history of the problem first before attempting separation.

Q: Can narrative therapy be effective with clients who have severe mental health conditions?

A: Yes, but modifications may be necessary. For clients with psychosis, externalization can help separate the person from their experiences without challenging the validity of those experiences. For clients with personality disorders, focus on small, specific externalizations rather than broad character traits. In all cases, move at the client's pace and combine with appropriate medical management when indicated.

Q: How do I balance narrative approaches with diagnostic requirements in institutional settings?

A: Document required diagnostic information while incorporating narrative language in treatment plans and progress notes. For example, you might write, "Client is developing strategies to recognize and respond differently when Depression attempts to isolate them" rather than "Client is reducing depressive symptoms." Many clinicians effectively maintain dual perspectives—using diagnostic frameworks for institutional requirements while preserving narrative approaches in direct client work.

Q: What's the best way to explain narrative therapy to clients who are used to more directive approaches?

A: Frame it in accessible terms: "This approach helps us separate you from the problems you're experiencing, so we can more clearly see your strengths and develop new ways forward. Rather than me telling you what to do, we'll work together to uncover solutions you've already begun to discover but might not have fully recognized."

Q: How does narrative therapy approach issues related to sexual identity and gender?

A: Narrative therapy is particularly valuable for working with sexual identity issues because it helps clients explore their own meaning and challenge dominant narratives that may pathologize diverse identities. The narrative approach stresses that no universal truth exists about how people "should" express their gender or sexuality. Instead, clients explore their personal narratives and identify what feels authentic to them, free from restrictive social expectations.

Q: Is there evidence supporting narrative therapy's effectiveness?

A: Yes, although research on narrative therapy doesn't typically follow the randomized clinical trial model that other approaches use. Qualitative studies show significant benefits in personal growth, improved relationships, and decreased symptoms across a range of concerns. The evidence is particularly strong for narrative therapy's effectiveness with children, families dealing with grief, and people working through cultural identity challenges.

Related Links

1. Narrative Therapy worksheets

2. Comprehensive Guide to Extinction Psychology

3. Guide to using AI tools in Therapy

4. Top 5 AI Therapy Note Tools

5. How to write Biopsychosocial assessment

6. 32 group therapy activities