Changes in narrative structure and content in schizophrenia in long term individual psychotherapy: a single case study

Abstract

A cornerstone of some forms of psychotherapy for schizophrenia is the assertion that changes in personal narrative and the dialogues from which they spring contribute significantly to recovery from schizophrenia. Yet when such transformation occurs, what changes and according to what dynamics? To address these questions, blind assessments of psychotherapy transcripts were conducted assessing narrative content, structure and metacognition twice a month over a period of 32 months for a single case of integrative individual psychotherapy. These measures improved significantly over time, with analyses of time trends indicating that the degree of improvement of narrative structure from months 4 to 29 was significantly greater than the degree of improvements in narrative content or metacognition (p < 0.05). These findings suggest that narratives in schizophrenia may gain greater degrees of complexity and structure prior to the changing of a story or of the capacity for self-reflection. Copyright © 2005 John Wiley & Sons, Ltd.