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Narrative Counseling Theory: Case Study Analysis

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Narrative Counseling Theory: Case Study Analysis

Introduction

The narrative theory of counseling is one of the theories that enable counselors to offer psychological treatment for their clients effectively. This case study analysis details the use of the narrative theory in navigating the case of Ana, a 24-year-old female. Ana immigrated from Guatemala in the first generation. She presents at the counselor’s office depressed and anxious, having been furloughed three months ago from her employment position as a loan officer at a local bank. Ana admits that she also worries a lot for her husband, a military officer presently serving in a combat zone overseas, scheduled to stay away for the next eight months. Ana does not mention having any supportive friends but confesses that she does not want to seek help from her wealthy family in Guatemala. This analysis details Ana’s counseling goals and intervention strategies, the treatment process, and her social and cultural needs based on the narrative counseling theory. Finally, the paper describes how the narrative theory supports the use of a constructivist philosophy and how the counselor would employ collaborative approaches in the interaction with Ana.

Counseling Goals and Intervention Strategies

Ana’s counseling by the narrative theory will target various goals. The session will aim at transforming the effects of Ana’s problem instead of transforming her as an individual. This perspective will enable Ana to visualize how the issues she has served her rather than harming her. The first goal of the therapy will be to alleviate her anxiety about how she would raise the baby by herself and the deployment of her husband overseas (Gabalda, Stiles, & Pérez Ruiz, 2016). Secondly, the therapy will aim at alleviating the symptoms of her depression, including anorexia and insomnia, due to the financial problems caused by her job loss (Ribeiro et al., 2016). Finally, the counseling sessions will target restoring her hope of better times ahead despite her job loss and presumed lack of supportive friends and family.

The counselor will engage in different intervention strategies to achieve the set objectives. The first of the four strategies will be to put together a narrative (Gabalda, Stiles, & Pérez Ruiz, 2016). Enabling Ana to tell their story as a narrative will enable her to realize the meaning, heal, and reestablish herself towards a successful therapy. The second strategy, externalization, will help Ana perceive her problems as external and changeable, hence lifting her self-confidence. The third strategy will be a deconstruction, where the counselor will seek to reduce generalization of the issue and make it specific, thereby clarifying the root. The final strategy will be to use unique outcomes, helping Ana reimagine her problem from different perspectives, encouraging her to follow fresh storylines (Gabalda, Stiles, & Pérez Ruiz, 2016).

Process of Treatment

The treatment process will target the achievement of treatment objectives within the eight sessions that Ana noted that she is allowed by her insurance company.  A three-step process involving normalization and strengthening, deconstruction, and reconstruction, and finally celebrating and connecting, will be applied to solving Ana’s situation (Maree, 2019). The first strategy, normalization, and strengthening will involve the counselor exploring other challenges Ana might have faced in the past and probing how she navigated them, providing her with an opportunity to draw motivation from reflecting upon the past. The counselor’s role at this stage will be to explore Ana’s past problems by asking leading and solution-focused questions. Solution-focused questions will help the counselor identify Ana’s ambivalent strengths. The second strategy, deconstruction, and reconstruction, the counselor and Ana will work towards understanding any underlying assumptions that might play a part in the problem’s occurrence. The counselor will take part in leading the deconstruction process while allowing Ana to expose the assumptions that might be challenging and navigate beliefs to bring awareness to the situation and open up new possibilities. The awareness of the assumptions will provide Ana with the power to reestablish a fresh personal narrative for her plot. The reconstruction will ensure that Ana establishes a narrative consistent with her personal goals without restrictions by external influences. The final stage of the treatment process will be a celebration and connecting. This stage will enable Ana to rejuvenate and reestablish connections with the social world, including her family and friends.

Social and Cultural Needs of the Client

Research studies have shown that narrative theory provides counselors with a framework addressing the client’s cultural and social needs. According to Zimmerman (2017), the narrative theory makes theoretical assumptions founded on an in-depth understanding of the role of culture in the development of an individual’s identity. The narrative theory methodology prompts the client to narrate their story, in their words, avoiding intrusion into the social circles and cultural perceptions of the client. The treatment process will ensure that Ana reflects upon the assumptions that might have resulted in her problem. Reflecting upon these against the backdrop of the theory stating that there is no truth, diverse interpretations of reality will help Ana conceptualize her social relations and cultural beliefs positively, seeking a solution. Therefore, Ana will be able to construct meaning from her situation within her cultural and social contexts. The meaning will be created through the narrative to crystallize how she lived her life, correctly positioning herself and her connections in the plot of her narrative (Maree, 2019).

Consequently, she will see the influence of culture as a determinant of her life. The counselor, within the narrative theory framework, will help Ana to appreciate that the problem detached from her as an individual. Rajaei and Jensen (2020) elaborate that the narrative assessment whereby the counselor’s role is to assess the problem instead of the client enables them to express the problem plot from their own cultural and social lens. Consequently, there is a reduced risk of misunderstandings based on cultural differences or variations in social perspectives.

Constructivist Philosophy

The application of the narrative theory in counseling Ana will support constructivist philosophy throughout the process. The constructivist philosophy emphasizes individuals’ involvement in the unfolding of their stories (West-Olatunji & Rush-Ossenbeck, 2016). Diverse strategies elaborated in the constructivist philosophy will concur with the strategies of the narrative theory. Lincoln and Hoffman (2019) state that counseling, like constructivism, will emphasize the essence of human relationships in Ana’s development and well-being. First, by providing her with a platform to narrate the story in her own words, aiming at the problem with a solution-focused question to identify Ana’s ambivalent strengths, the constructivist philosophy of collaborating with the client in establishing unique methods for the client’s achievement of proactive change. The solution externalization, deconstruction, and reconstruction stages of the narrative theory will seek to have the client actively participate in their therapy as an agent, challenging their perspectives in a collaborative alliance that distributes the change responsibilities. As elaborated in the constructivist philosophy, the counselor will take part in the change process by only contributing clinical expertise and a vested interest in the client’s change (West-Olatunji & Rush-Ossenbeck, 2016). A collaborative approach will help Ana view the problem from different perspectives, thereby creating and accomplishing the objectives of the counseling service.

Postmodern Approaches

The narrative theory uses the postmodern approaches to structure the conversation in a trajectory of new possibilities and meanings. Consequently, the approach utilizes questions in exploring the dominant imperatives and cultural processes of the client (Metcalf & LPC-S, 2017). The questions aim to minimize the confusion that would impede the therapy progress by empowering the client and helping them discover their experience and establish a sense of the direction they prefer. Besides, the questions asked by the counselor offers the client a chance to explore different perspectives of their situations, formulating alternative stories to support a preferred direction they select. The client charts their way, which minimizes the risks, and enhances the flow of the process. Kwok (2016) explains that the narrative counselor uses the postmodern approach by actively taking part as process facilitators with a relational necessity to fascinate, care, contact, openly empathize, exhibit respectful curiosity and take an interest in the process. The counselor follows, affirms, and stays guided by the client’s narrative to create process facilitators and participant-observer roles that join the postmodern human inquiry view and therapy.

Conclusion

Summarily, the narrative approach to counseling would be most applicable in Ana’s situation. The theory would guide the counselor to prompt Ana to develop a story of her life and problems, view the story from different perspectives, external from her individuality, and select a different plot to realize. The narrative theory framework would ensure Ana’s social and cultural needs are respected and addresses, using the constructivist philosophy and postmodern approaches in minimizing harm or confusion that might impede the therapy process.

References

Gabalda, I. C., Stiles, W. B., & Pérez Ruiz, S. (2016). Therapist activities preceding setbacks in the assimilation process. Psychotherapy Research26(6), 653-664.

Kwok, W. L. (2016). Narrative therapy, theology, and relational openness: Reconstructing the connection between postmodern therapy and traditional theology. Journal of Psychology and Theology44(3), 201-212.

Lincoln, J., & Hoffman, L. (2019). Toward an integration of constructivism and existential psychotherapy. Journal of Constructivist Psychology32(2), 108-125.

Maree, K. (2019). Shaping the story: A guide to facilitating narrative career counseling. BRILL.

Metcalf, L., & LPC-S, L. S. (2017). Solution-focused narrative therapy. Springer Publishing Company.

Rajaei, A., & Jensen, J. F. (2020). Empowering Patients in Integrated Behavioral Health-Care Settings: A Narrative Approach to Medical Family Therapy. The Family Journal28(1), 48-55.

Ribeiro, A. P., Braga, C., Stiles, W. B., Teixeira, P., Gonçalves, M. M., & Ribeiro, E. (2016). Therapist interventions and client ambivalence in two cases of narrative therapy for depression. Psychotherapy Research26(6), 681-693.

West-Olatunji, C. A., & Rush-Ossenbeck, M. (2016). Constructivist Theories: Solution-Focused and Narrative Therapies. Counseling and Psychotherapy: Theories and Interventions, 419.

Zimmerman, J. (2017). Neuro-narrative therapy: Brain science, narrative therapy, poststructuralism, and preferred identities. Journal of Systemic Therapies36(2), 12-26.

 

 

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