Academic journal article Journal of Mental Health Counseling

Narrative Family Therapy: Practical Techniques for More Effective Work with Couples and Families

Academic journal article Journal of Mental Health Counseling

Narrative Family Therapy: Practical Techniques for More Effective Work with Couples and Families

Article excerpt

This article provides counselors with an introduction to the knowledge and skills involved in providing narrative family therapy (NFT). hollowing an overview of the theoretical foundations undergirding this therapeutic approach, a case study is used to illustrate the use of numerous NFT techniques. These techniques include eliciting stories to meet families apart from their problems, recognizing cultural discourse and its impact on family narratives, externalizing the problem from the family, and re-authoring the story through the identification and understanding of exceptions and unique outcomes and the identification and enactment of preferred narratives. The article concludes with recommendations for further development of competence in this area.


Despite the fact that many client issues stem from, involve, or affect family relationships, therapists have predominantly focused on the individual when providing counseling services (Ivey, D'Andrea, & Ivey, 2012). This focus on the individual has its roots in the early development of psychoanalysis and continues to be reflected in training standards such as those generated by the Council for Accreditation of Counseling and Related Educational Programs (CACREP, 2016). Historically, this emphasis on individual therapy has its basis in the influence of Freud and many of his colleagues (Nichols, 2013). These pioneers recognized the correlation between client symptoms and early negative interactions with family members, and this contributed to their erroneous conclusion that it would necessarily be more difficult for clients to resolve their issues with family members present in the therapy room (Nichols, 2013).

Although contemporary counselors may not agree with this conclusion, their professional preparation continues to emphasize individual approaches. Indeed, there are only two standards addressing family or systems issues in the entire set of CACREP standards for the eight common core areas. One standard requires that accredited counselor preparation programs address "theories of individual and family development across the lifespan" (CACREP, 2016, F[3][a]). The second standard calls for attention to "a systems approach to conceptualizing clients" (CACREP, 2016, F[5][b]). With only these two standards addressing family or systems, counselor preparation programs typically dedicate relatively little time to these topics. Therefore, new counselors often enter the field less prepared to provide counseling services to couples and families than to individuals and groups.

However, when practicing in agency settings, counselors are highly likely to be assigned to counsel couples or families, and counselors in private practice settings will often encounter requests for couple and family counseling. In a study examining the types of services delivered by clinicians working with managed care clients, respondents indicated that 30.0% of cases were couples and 47.5% were family cases (Christensen & Miller, 2001). Given this and the ethical responsibility counselors have to maintain "high standards of professional competence" (American Mental Health Counselors Association, 2015, C[l]), there is an ongoing need for counselors to expand their areas of competence to include couples and family counseling. Counselors must continue adding to their cache of tools to ensure that they remain current and competent in working with a wide range of clients. When seeking to add to their metaphoric toolbox, professional counselors should select tools with sufficient scientific evidence supporting their use (Patel, Hagedorn, & Bai, 2013).

Narrative family therapy (NFT) is one approach from which professional counselors may draw in order to effectively serve couple and family clients. Narrative therapy was co-constructed in the early 1980s by White & Epston (1990). This approach grew in popularity during the 1990s and is now a widely practiced modality of therapy (Madigan, 2011), with considerable research examining its application with multiple populations. …

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