Clinical priorities are essential to the therapeutic process and each model of therapy has a different set of clinical priorities that are generally rooted in the philosophical underpinnings that inform the model. Narrative therapists do not see themselves as problem solvers. Conversely, they see themselves as story editors who help people to separate themselves from problem saturated stories by deconstructing the cultural assumptions about their unique life experiences (Nichols, 2010). Narrative therapists believe clients are not exclusively responsible for the deficit conclusions they relate in therapy (Madigan, 2011). This post highlights the most essential clinical priorities in narrative therapy.
Clinical priorities
There are several things that therapists prioritize during the therapeutic experience. The main clinical priority of narrative therapy is to help clients discover their more preferred stories (Shovlin, 1999). This discovery will open opportunities for them to re-author their lives (Shovlin, 1999) . Embodying authenticity is a clinical priority that allows the therapeutic conversation to loosen and opens up (Freeman & Combs, 1996; Nichols, 2010).
Re-authoring begins with identifying events, actions, thoughts, and experiences (outcomes) that do not fit into the problem saturated story (Dickerson & Zimmerman, 1993). In doing this, therapists suspend judgmental attitude about what is going on with clients (Nichols, 2010). This suspension of judgment is the not knowing stance (Nichols, 2010). This stance does not mean that the therapist does not know anything. Conversely, it is the view where therapists are knowledgeable about the therapy process but not the content and meaning of clients’ lives. Not knowing is a stance that therapists refrain from asking questions from a position of pre-understanding (Freeman & Combs, 1996). This stance helps clients with the re-authoring process.
Suspending judgment is another clinical priority and it opens the door for clinicians to help clients remove blame (Nichols, 2010). A priority of narrative therapists is to eradicate internalized conversations that restrain clients. Externalization is the technique that therapist use to help the clients to see the problem as operating outside of them or having a different personality. Identifying alternative stories is another clinical priority, and they are derived from the events, actions, thoughts, and experiences that fall outside of the problem saturated story (Freeman & Combs, 1996; Nichols, 2010). Knowing the clinical priorities of narrative therapy help therapists to situate their work with clients in the philosophical underpinnings of the model.
Summative comments
In summary, the clinical priorities of narrative therapists are to remove blame, suspend judgmental attitude, and be authentic. The clinical priorities also help clients identify unique outcomes, externalize the problem, discover more preferred stories, and identify alternative stories. These priorities help clinicians with the conceptualization of the therapeutic process.
