‘Therapeutic emplotment’: a new paradigm to explore the interaction between nurses and patients with a long‐term illness

Abstract

This paper presents a discussion of the use of 'therapeutic emplotment' during health professional-patient interactions when caring for patients with a long-term illness, with implications for nursing. Therapeutic emplotment' develops from two philosophical strains: one emphasizing the connection of speech to actions, the other the linguistically mediated nature of human experience. Mattingly defines therapeutic emplotment as the creation of story-like structures through therapist-patient interactions which encourage the patient to see therapy as integral to healing. A literature search for the period 1994-2010 was undertaken using the keywords therapeutic emplotment, chronic illness, illness narratives, nursing narratives and nurse-patient interaction in the following databases: CINAHL, MEDLINE, COCHRANE, Social Care online, PsycInfo and AnthroSource. Reference lists of papers and books were examined for relevant studies published before 1994. Differing from other social scientists, Mattingly highlights potential of narratives to create experiences in clinical practice. With therapeutic emplotment, narratives become 'tools' in the hands of health professionals to shape the interaction with patients with a long-term illness and are constructed by them together. This introduces changes in the way health professionals, including nurses, look at their practice. Therapeutic emplotment may provide nurses with a way of improving communication and relationship skills to help patients reach therapeutic goals; its use may also help qualitative research that explores the impact of nurses' interactions with patients on the quality of care. Therapeutic emplotment may be used by a broader range of health professionals, including nurses, for clinical and research purposes.