Narrative Therapy Research Articles

Exploring the Effectiveness of Narrative Therapy Among Prolonged Grief Disorder

According to WHO, Prolonged Grief Disorder (PGD)is a potentially disabling condition that affects approximately 10% of suffering people. Narrative therapy is effective in treating prolonged grief disorder. This study aimed to investigate the efficacy of narrative therapy for those suffering from prolonged grief disorder. Data was collected by using semi-structured interviews consisting of four therapy sessions over a follow-up of four months using a qualitative research methodology with two participants who were purposefully sampled and had been diagnosed with prolonged grief disorder. Both clients showed improvement after four follow-up sessions. Client 1 reported good progress, showing the core narratives of loss, emotional regulation, and positive transformation. In the process of externalization techniques and homework, such as letter writing, she reported having better emotional health or a new perspective. Client 2 also reported to have benefited from the therapy, but she had faced more profound challenges, such as self-blame and suicidal ideation, requiring psychiatric referral. The outcomes demonstrated that narrative therapy is very effective in managing prolonged grief disorder.

Intensive Narrative Exposure Therapy for Posttraumatic Stress Disorder: A 1-Week Intervention.

Posttraumatic stress disorder (PTSD) is associated with some of the poorest mental and physical health outcomes. There is often high dropout from treatment for PTSD, especially among those who have experienced chronic or multiple traumatic events. One increasingly popular PTSD treatment delivery model targeting treatment retention is intensive treatment delivery. Narrative exposure therapy (NET) is an exposure-based PTSD treatment designed to address multiple trauma exposures, but NET has not been systematically delivered in an intensive brief format. The current study aimed to determine the feasibility, acceptability, and preliminary efficacy of intensively delivered NET to a highly traumatized sample (HI-NET). A trauma-exposed clinical sample (n = 8; range of lifetime traumatic events: 5-15; 100% endorsed history of interpersonal violence; mean age = 46; 87% White) participated in daily NET sessions for 1 week. Participants completed self-report measures assessing PTSD, depressive, and dissociation symptoms as well as trauma-related cognitions at baseline, 1 week posttreatment, and 1-, 3-, and 6-month follow-up timepoints. HI-NET was feasible, with all participants attending all sessions. Participants reported high levels of acceptability and satisfaction. Participants showed significant reductions in PTSD symptoms (≥12 points on the PTSD Checklist for Diagnostic and Statistical Manual of Mental Disorders-5 [PCL-5]) from baseline (M = 49.00, SD = 16.34) through 6-month assessment (M = 24.29, SD = 16.89, g =1.88). Depressive symptoms, the frequency and intensity of dissociative symptoms, and dysfunctional trauma-related cognitions all significantly decreased alongside PTSD symptoms. This is the first investigation of an intensive delivery of NET, an evidence-based treatment for PTSD that can target multiple traumatic events. After only six sessions delivered to a highly traumatized sample, there was a significant decrease in PTSD symptoms that remained decreased over time. HI-NET is feasible, acceptable, and efficacious, yet larger clinical trials with more diverse samples are needed.

Study protocol for a randomized controlled trial to adapt a posttraumatic stress disorder intervention of patients with opioid-stimulant polysubstance use receiving methadone maintenance treatment

BackgroundThe purpose of the Treatment for Harnessing Resiliency, Improving emotional regulation, and empowering indiViduals for a brighter future (THRIVE) study is to adapt an evidence-based posttraumatic stress disorder (PTSD) treatment for use among a polysubstance population receiving methadone maintenance treatment (MMT) at an opioid treatment program. Polysubstance use of high-risk combinations, such as illicit opioids and stimulants, is a critical public health issue. Individuals who engage in these high-risk combinations are more likely to have histories of childhood trauma, multiple traumas, PTSD, and greater PTSD severity as compared to mono-substance using individuals. Trauma, co-morbid mental health disorders such as PTSD, and polysubstance use complicate treatment outcomes. This study will use eight study phases to adapt an existing evidence-based PTSD intervention, Skills Training in Affective and Interpersonal Regulation with Narrative Therapy (STAIR-NT), via a massed treatment model (i.e., condensed treatment schedule) for patients in MMT who are engaged in sustained opioid-stimulant polysubstance use.Methods and analysisThe intervention is an adapted version of the STAIR-NT protocol. The massed version created includes four 60-min sessions of skill building and two weeks of four 60-min sessions of narrative therapy. A preliminary randomized controlled trial (RCT) with 80 participants, randomized 1:1, will be conducted to assess the intervention's implementation and impact on primary short-term outcomes of polysubstance use and PTSD symptoms.Ethics and disseminationThe results of this study will inform a fully-powered effectiveness trial for individuals with PTSD and polysubstance use receiving MMT. The findings are expected to provide valuable insights into improving both PTSD and substance use outcomes, and real-world implementation insights to integrating trauma-informed care in treatment settings for vulnerable populations.RegistrationThis study is registered at ClinicalTrials.Gov as NCT06307340. Registration date 03/2024.

Narratology Talks to the Talking Cure in Persuasion

Abstract This essay puts Persuasion in conversation with psychotherapeutic approaches to Austen and cognitive literary studies (more broadly, approaches that draw on the sciences of mind). Narrative therapy provides a heuristic for Persuasion, accounting for Anne Elliot's recovery from melancholy to achieve a sense of well-being. In line with the goals of narrative therapy, she learns to tell a different story about herself than the one that has oppressed her since her broken engagement. The novel represents the therapeutic elements involved in such reenvisioning, including validation; holding; the availability of alternative, better narratives as models; and awareness of the cultural factors that have contributed to her state of mind. Conversely, narratology accounts for the representation of Anne's experience, showing how literary devices, including embedded narrative, focalization, and voice, convey Anne's transformation from melancholy and passive spinster to active and vital woman who defends her actions and renews her engagement on better terms. This transformation depends not only on interpersonal exchanges but also on her realization that cultural “master narratives” infiltrate our most intimate stories.

Narrative exposure therapy in a child protection context: Breaking intergenerational cycles by providing a pathway through past trauma

Narrative exposure therapy in a child protection context: Breaking intergenerational cycles by providing a pathway through past trauma

Effectiveness of narrative therapy for depressive symptoms in adults with somatic disorders: A systematic review and meta-analysis

BackgroundDepression is a common mental health condition and a main risk factor for suicide. Narrative therapy aims to reframe beliefs through storytelling. Despite evidence of effectiveness, there is a lack of evaluation for specific adult populations. This meta-analysis evaluated the effect of narrative therapy on depressive symptoms in adults with somatic disorders. Only 2 of the included studies examined patients with depression, highlighting the need for further research on this specific population. MethodsA comprehensive search of PubMed, Web of Science (all databases), the Cochrane Library, CINAHL, CNKI, and CBMdisc was conducted in April 2024. Study selection and data extraction were conducted by two researchers independently. The Cochrane tool and GRADEPro GDT tool were utilised to determine risk of bias and methodological quality of included studies. Stata17.0 was used for statistical analysis. ResultsThe results showed that narrative therapy had a significant effect on depressive symptoms in adults with somatic disorders (SMD=-1.64; 95% CI, -1.95 to -1.32; p<.001; 4,879 participants; low-quality evidence). Sensitivity analysis showed that the results were robust and reliable. DiscussionThis meta-analysis found that narrative therapy appears to have a significant effect on depressive symptoms in adults with somatic disorders. However, the study is limited by a predominance of Chinese studies and low quality of evidence. Future research is needed to confirm these findings.

From Adversity to Agency: Storytelling as a Tool for Building Children’s Resilience

Children who experience Adverse Childhood Experiences (ACEs)—including trauma, family instability, or significant loss—are at increased risk for enduring mental, emotional, and physical challenges, including conditions such as depression, anxiety, and chronic health issues. Without effective support, these adverse experiences can have lasting effects on a child’s well-being, often persisting into adulthood and impacting mental, emotional, and physical health outcomes over the long term. Storytelling is a powerful method to support resilience in these children by enabling them to process emotions, make sense of complex experiences, and view themselves as active agents in their lives. By framing their experiences within personal narratives, children can create coherent stories that aid emotional regulation and support mental well-being. Through storytelling, children can frame their struggles as part of a larger, purposeful journey, fostering a sense of agency and self-worth. Techniques such as narrative therapy, story circles, and resilience-themed books-exemplified by The Adventures of Gabriel—help children explore their experiences, visualise positive outcomes, and strengthen social bonds. Moreover, storytelling is an accessible tool that aids in perspective—taking, allowing children to relate their challenges to those of characters, which reinforces their ability to overcome adversity and navigate life’s complexities with strength and optimism.

Time Travelling with Ron Chenail, Sally St. George, Dan Wulff, and David Denborough: An Interview about Connecting Histories of Family Therapy, Narrative Therapy and Qualitative Research

Dear Readers, we have a question for you: Do you know about the origins and history of the journals you decide to submit your manuscripts to for publication? We are most pleased to present to you an interview with the three Co-Editors-in-Chief of TQR (Ron Chenail, Sally St. George, and Dan Wulff) and David Denborough of the Dulwich Centre delving into the origins of TQR in the early 1990s. The roots of TQR were intertwined with family therapy authors and practitioners (Tom Andersen, Michael White, and many others) and that continues today. We think that you will find these historical relationships and influences to be fascinating and instructive in understanding how one qualitative research journal came into being and how it is positioning itself to go forward. We are using this interview to introduce this special issue on practice-based research, in particular, narrative therapy and research.

Our journey with an AI assistant offering narrative therapy on WhatsApp

ABSTRACT This study examines the integration of AI chatbots into social work, with a focus on democratising AI for use in Narrative Therapy (NT). As AI becomes more accessible, social work encounters new opportunities to utilise these tools in practice, but also faces significant challenges. The study explores the feasibility of using customisable GPT platforms to develop an AI chatbot for NT sessions and assesses its performance. An autoethnographic case study was conducted using a chatbot configured with the OpenAI Assistant API to perform NT on WhatsApp. Findings suggest that while practitioners can configure the chatbot to guide users through NT stages and adapt to interactions, there are still limitations, such as the need for basic coding and technical knowledge for deployment and enhancement. The study highlights both the potential and the challenges of AI in social work, advocating for enhanced training, interdisciplinary collaboration, and the cautious development of AI-assisted practices.

Language as a Medium of Transformation in Narrative Therapy: A View from Clinical Psychology Practice

Language as a Medium of Transformation in Narrative Therapy: A View from Clinical Psychology Practice

Art Therapy and Narrative Therapy Interventions for Pain Management: A Case Study with a Post-Quadruple Amputation Oncology Patient.

This case discussion describes the use of an expanded interdisciplinary palliative care team structure that integrated art therapy and narrative therapy to meet the needs of a woman with a history of chronic pain and Burkitt lymphoma, who had received quadruple amputation due to complications of treatment. The concurrent interventions of art therapy, narrative therapy, and traditional palliative care consultation services resulted in high-quality, trauma-informed care, contributing to effective psychosocial coping and enhanced total pain management. The addition of expressive therapeutic modalities to inpatient palliative care consultation requires close collaboration and may be particularly valuable when addressing complex needs in the setting of prolonged hospitalizations.

A Meta-Analysis of the Effect of Modified Gastric Tube Length on Enteral Nutrition in Stroke Patients

Objective: To systematically evaluate the effect of modified length of gastric tube implantation in stroke patients. Methods: Randomized controlled studies on the effect of narrative therapy on negative emotions of malignant tumor patients were published in PubMed, EMbase, Web of Science, Cochrane Library, CNKY. Wanfang Data, VIP Database and CBM disc from database establishment to May 2021. RewMan 5.2 software was used for the meta-analysis. Results: Ten articles were included, involving 1140 patients in total. Results of meta-analysis showed that improved length of gastric tube implantation could reduce the incidence of aspiration pneumonia in stroke patients with enteral nutrition [OR = 0.18, 95% CI (0.10, 0.31), P &lt; 0.00001], reduce gastroesophageal reflux rate (OR = 0.13, 95% CI (0.04, 0.38), P &lt; 0.0002], the incidence of aspiration (OR = 0.23, 95% CI (0.11, 0.38), P &lt; 0.00001], the incidence of abdominal distension and diarrhea (OR = 0.13, 95% CI (0.06, 0.28), P &lt; 0.00001], the incidence of choking cough (OR = 0.20, 95% CI (0.07, 0.61), P &lt; 0.005], but no difference between the two groups in terms of reducing gastric residual (OR = 0.10, 95% CI (2.40, 2.60), P = 0.94]. Conclusions: The modified length of the gastric tube can replace the traditional length of the gastric tube in the application of stroke patients, can reduce the complications of enteral nutrition, is safe and feasible. However, due to the limitation of the quality and quantity of the included studies, we should be cautious about the results of this meta-analysis and expect to carry out more large-sample and high-quality randomized controlled trials for demonstration.

Adapting the Tree of Life group for adults with intellectual disabilities: a feasibility and acceptability study

Objectives The narrative therapy tool, Tree of Life (ToL), has demonstrated positive effects for different populations. This article explores the feasibility and acceptability of ToL in a community day centre for people with intellectual disabilities in England. Methods ToL was delivered as a four-week group (11 attendees). The group programme, materials, and the evaluation method were adapted (e.g. easy-read format and high attendee–staff ratio). Triangulation was used with feasibility metrics, observations, an outcome measure, and qualitative feedback from participants and staff at the centre. Thematic analysis was used for the semi-structured interviews. Results Good feasibility indicated with high acceptability and an overall positive impact. Data from attendee interviews are captured in six themes (e.g. Relating to a tree as a metaphor) and staff feedback in four themes (e.g. Connecting via new stories). Conclusions The ToL intervention is feasible and highly adaptable to people with intellectual disabilities. The article provides a practical guidance for clinicians trained in ToL on how to adapt this model. Care in the community may benefit from ToL groups as this study showed to enhance community cohesion and quality of life by creating space for practicing social skills with a strengths-based approach.

A small, old, and slightly rough mirror: Encountering traumatic experiences in Nanjing Museum of the Site of Lijixiang Comfort Stations

AbstractThis paper investigates how traumatic events are curated and narrated in the Nanjing Museum of the Site of Lijixiang Comfort Stations. Drawing on narrative therapy in museology, the paper offers a perspective for understanding and interpreting the narrative practice in public space. It follows the reconstruction of narrative structures through a variety of viewpoints, including spatial narratives, exhibition narratives, public engagement in response to traumatic memories, and the logical and emotional encounters in museums. Visitors' learning of traumatic experiences in the museum shows a kind of indissoluble connection, a type of empathetic mutual understanding, a kind of community engagement that contributed to the recovery, and a kind of responsibility to prevent such traumatic events from happening again.

Study of Effectiveness of Spiritual Therapy on Life Satisfaction According to Coping Strategies in Patient with Cancer in Tehran

Encounter to Chronic diseases destroy the physical, psychic, economic, communicational, emotional balance of patient and his/her primary care and create new problems for the family members. The person is taken cancer diagnosis tolerate more physical and psychic pain than her/his family members. In this situation Existence of social protection like to give psychological interventions to patient and his/her primary care is need to increase positive emotions and decrease negative emotions. Spiritual therapy can be useful to arrive the goal. The aim of current study is comparsion of effectiveness of spiritual therapy on life satisfaction according to coping strategies in patient with cancer. The study population included patients with cancer were hospitalized for treatment in tehran in octobr 2015. Sampling method was Accessible and voluntary. 20 person participate as sample in this study. The current study was Semi-pilot with pre test and post test and control group. There were one pilot group and one control group such that experimental group member Received spiritual therapy in period of staying in hospital. control groups member received no intervention. All persons participated in two groups filled out the life satisfaction questionnaire as pre test and post test. To determine Intermediate effect of coping strategy filled out Lazarus and Folkman coping strategies questionnaire. Proposed 2 hypotesis based on this study and data analized with ANOVA and Multivariate covariance. Based on multivariate covariance resultes hipotesis two rejected. Based on Anova hipotesis one accepted. This means that spiritual therapy directly increased life satisfaction in patient with cancer but the mediated effectiveness of it was not meaningful. According to effectiveness of narrative therapy on life satisfaction in patient with cancer it is necessary clinical psychologies presence in Oncology ward.

Therapeutic writing in Palliative Care: a systematic review – A death free of tubes with narrative communication skills

ABSTRACT This review aims to improve the full scope of “therapeutic encounters” in palliative care, promoting the well-being and quality of life of patients through narrative therapy and therapeutic writing as a communication tool. Palliative care seeks to alleviate the suffering of terminally ill patients and their families. Narrative interventions help patients and families to construct the experience of disease through the re-signification of symptoms. The PRISMA guided this systematic review. A total of 349 articles were analyzed, and 42 showed insightful results. The results demonstrate the relevance of narrative therapy and the use of therapeutic writing as a way to promote the well-being and quality of life of patients in palliative care, health professionals, and the general population. The focus on reflection, the meaning of the experience, and emotional expression translated into the reduction of anxiety and depression. It highlights the need to reflect and develop psychological research on palliative intervention and the identification of the expressive and communicational value of narrative therapy poetry therapy (poetry), journaling and music in palliative care.

Experiences of externalisation in recovery from Anorexia Nervosa: a reflexive thematic analysis

BackgroundMany individuals perceive Anorexia Nervosa (AN) as a part of their personal identity. Externalisation of the problem is a practice that is often taken up within NICE recommended treatments for AN. Dominant understandings of externalisation are that this practice involves making the “problem” a separate entity, external to the individual. It is an attitude taken by the client and family, stimulated by the therapist to build engagement with treatment and supportive relationships around the individual. However, there is a paucity of research exploring the therapeutic effects of this approach. This research aims to address this gap by exploring the role of externalisation in treatment for AN to elicit an understanding of how this practice is experienced including how it can help and hinder recovery.MethodsThirteen adults with a current and/or past diagnosis of AN participated in semi-structured interviews. This qualitative study used a reflexive thematic analysis.AnalysisParticipants described their experience of externalisation as a journey which is depicted by four main themes. ‘Separating the AN from the self’ reflects the tensions inherent in learning to distinguish between one’s perceived sense of "self" and "the AN". ‘Making sense of the AN’ describes the experience of language forms used to separate the AN from the individual’s identity. ‘Feeling seen, or unseen as a person beyond the AN’ illustrates the helpful and harmful effects of externalising practices on relationships. ‘Navigating a complex relationship with the AN’ depicts the effects of one-, versus two-way externalisation on the individual’s relationship to AN.ConclusionsThe notion of separating one’s internal dialogue from one’s concept of self may initially be rejected by the individual experiencing AN. However, as the individual develops trust in the therapist and becomes socialised to common forms of externalising language, they may begin to realise two sides within them, a perceived “healthy self” and “the anorexia voice”. However, social-cultural discourses around eating contribute to ambiguity during the differentiation between these two voices, thus elucidating the effects of an absence of problem deconstruction alongside externalisation within ED-focussed treatments. Externalising practices were most helpful when led by the individual using their own experience-near language and least helpful when they did not permit the individual to feel seen as a person beyond the AN. Therapists, treatment teams and family members should be cognisant of the emotional effects of language used to externalise AN. Importantly, they should ensure that externalisation is practiced within the spirit of narrative therapy from which it originates.

Effect of an integrated narrative program (INP) on quality of life among patients with non-small cell lung cancer (NSCLC): An experimental trial

PurposeTo investigate the effectiveness of an integrated narrative program (INP) in enhancing the resilience, self-efficacy and quality of life of postoperative NSCLC patients. Methods135 patients participated in this trial. 45 participants were recruited into the integrated narrative program group and received both the digital storytelling intervention and narrative therapy after a randomized controlled trial, while the control group (n = 45) received routine care and the intervention group (n = 45) underwent the digital storytelling intervention (DST). Questionnaires were administered to assess resilience, self-efficacy and quality of life at baseline (T0) (within 3 days before surgery), immediately after intervention (T1), one month post-intervention (T2), and three months post-intervention (T3). A linear mixed effects model was conducted via the intention-to-treat analysis. ResultsDuring follow-up assessments, the INP group exhibited significantly greater increase in resilience, self-efficacy, and quality of life (all P < 0.001) compared to both DST group and control group, which were consistent with the sensitivity analysis results (all P < 0.001). ConclusionThe INP was more effective than DST in improving the resilience, self-efficacy, and quality of life of postoperative NSCLC patients, and these benefits could persist for at least three months post-intervention. Due to the fact that the INP process is relatively complicated, so we recommend the use of web-based platforms for INP interventions in future clinical work.

Adult recollections of childhood memories in individuals convicted of sexual offences: implications for narrative therapy

ABSTRACT This study examines the autobiographical memories of 84 individuals convicted of sexual offences. Our results indicate that despite their adverse childhoods, chaotic families, and compromised social competence, justice-involved clients can engage meaningfully in longform narrative interviews that contain probing personal and reflective questions about their early lives. In fact, many participants expressed gratitude that they were invited to engage and share their experiences in this way. This pioneering interdisciplinary study has important practical implications for providers of psychotherapeutic treatment who work with custodial and community samples of people convicted of sexual offences. We conclude by emphasising the value of narrative therapy and present directions for future research. PRACTICE IMPACT STATEMENT Most therapeutic approaches offered in correctional settings emphasise a cognitive behavioural approach intended to dismantle cognitive distortions. Our results suggest that the willingness and ability of justice-involved individuals to participate in narrative therapy has been likely underestimated. Accordingly, this study will help clients and clinicians alike to make the treatment experience more personalised and meaningful.

Narrative exposure therapy for the treatment of trauma-related symptoms among adolescent survivors of sex trafficking: A pilot study

Background: India is home to 14 million survivors of human trafficking, with most being trafficked for sexual exploitation. Trafficking constitutes crimes that violate the rights of survivors, and despite its psychological consequences, there is little evidence-based guidance to meet the needs of these individuals. Aim: The current study aimed to examine the outcome of narrative exposure therapy (KIDNET) among adolescent survivors of sex trafficking in improving trauma-related symptoms, along with psychological distress, dissociation, depression, and anxiety. Methods: A pre-post study design was used with 20 adolescent female survivors of trafficking aged 13 to 17 years, with ten participants in the KIDNET group and ten participants in a waitlist control group. Trafficking Victim Identification Tool and Standard Progressive Matrices were administered as screening measures. The Clinician-Administered PTSD Scale for Children and Adolescents, Kessler’s Psychological Distress Scale, Shutdown Dissociation Scale, Patient Health Questionnaire, and Beck Anxiety Inventory were administered as outcome measures. Fourteen sessions of KIDNET were conducted for the clinical group, while sessions were conducted for the control group post delivery of intervention for the clinical group. Results: Findings suggest an overall improvement in the severity of trauma-related symptoms in the KIDNET group, with significant improvement in psychological distress, depression, and anxiety. Conclusion: Results indicate that KIDNET may be a promising and acceptable treatment for adolescent survivors of sex trafficking, and this intervention module may be safely delivered in further randomised controlled trials to ensure that the holistic needs of this vulnerable group are appropriately addressed.