The narrative therapy theory of change posits that change happens by paying close attention in therapy to unique outcomes, which are narrative details outside the main story (White Epston, 1990).
Understanding Change in Narrative Therapy
Narrative therapy views people's lives and identities as shaped by the stories they tell themselves and others. Often, clients come to therapy with a "problem-saturated story" where the problem dominates the narrative, making it seem overwhelming and inescapable.
The theory of change centers on shifting from this problem-saturated story to a "preferred story" or alternative narrative that highlights strengths, competence, and possibility. This shift isn't about denying the problem but about recognizing that the problem is not the whole story.
The Role of Unique Outcomes
As highlighted by the reference (White Epston, 1990), the crucial mechanism for initiating this change is the identification and exploration of unique outcomes.
- What are Unique Outcomes? These are exceptions or contradictions to the dominant problem story. They are moments, events, thoughts, feelings, or actions that don't fit neatly into the narrative of the problem being all-powerful or ever-present.
- Examples: If someone feels completely controlled by anxiety (the problem story), a unique outcome might be a time when they felt slightly less anxious, a situation where they coped differently than expected, or a small act of defiance against the anxiety's influence.
How Unique Outcomes Drive Change
The therapeutic process in narrative therapy involves carefully listening for, identifying, and then "thickening" these unique outcomes.
- Identifying Unique Outcomes: The therapist asks questions designed to uncover exceptions to the problem's influence. Questions like, "Were there any times when the problem didn't completely take over?" or "Have you ever done something that surprised you in relation to this difficulty?" help bring these moments to light.
- Thickening the Story: Once a unique outcome is identified, the therapist and client explore it in detail. They might ask:
- Who was involved?
- What exactly happened?
- What did you think or feel at that moment?
- What does this moment say about your abilities or values?
- What are the implications of this unique outcome for your life story?
This detailed exploration gives substance and significance to the unique outcome, moving it from a fleeting moment to a significant part of the narrative.
- Building a Preferred Story: By focusing on these exceptions, the client begins to see alternatives to the problem-saturated story. The unique outcomes become building blocks for constructing a new, more empowering narrative about themselves and their capabilities. This process is often referred to as re-authoring.
In essence, narrative therapy facilitates change not by directly fixing the problem, but by helping individuals discover, value, and elaborate on moments where they acted outside the problem's influence, thereby opening up possibilities for a different future.
