Therapy approaches, explained

Narrative therapy

The problem is not you. The way we tell our lives often keeps only the side the problem has taken over; narrative therapy helps you find the overlooked moments and write them into a story you can own.^[3,4]

Start with the basics Find a therapist

…the core of narrative work: it is about how we take ownership of our own story, and keep expressing that process.

5-Minute Psychology, “Narrative Practice: Taking Charge of Your Life Story (Encyclopedia of Psychotherapy, Part 3)”

Narrative therapy's answer: the problem isn't you, and what was left out can be written back in

Have you noticed that after being corrected in front of everyone, what stays in your head isn't just the mistake but a sentence about your whole self: "I'm just not good enough"? Yet in the same week you also put your hand up and asked a question, and none of that counted. Who decided which events get written into your story?

1The worldview

The answer is three turns: externalise, find the exceptions, re-author

That opening question is where narrative therapy starts. Narrative therapy (also called narrative practice) was developed in the 1980s by Michael White and David Epston, who published Narrative Means to Therapeutic Ends in 1990. White worked in Adelaide, Australia, and the Dulwich Centre he co-founded, open since 1983, is one of the tradition's most important institutions. Its introduction describes the approach as respectful and non-blaming, for counselling and community work, and as treating people as the experts in their own lives. It is used in individual counselling and in community work, which is why it has two names, therapy and practice.^[1,4,5]

Its answer rests on three views. The first is that people make sense of themselves through stories. We link the events of our lives in sequence into a plot with a theme, then draw conclusions from it about who we are. When a problem fills the plot, such as “I'm not good enough”, experiences that don't fit it are easily missed, the story thins, and the person is mistaken for the problem. The second is that the problem is one thing and the person another. Narrative therapy treats problems as separate from people, and holds that everyone already has many skills, beliefs and values.^[3,4]

The third is that identity is not a fixed essence to be dug out from inside. Drawing on the anthropologist Myerhoff and the philosopher Foucault, White held that identity is a public, social achievement shaped by history and culture. What counts as “success”, “failure” or “normal” often comes from society's dominant stories, not only from a private truth. So the aim isn't to swap in a more positive label but to let people take back the position of naming and authoring their own story. Who gets to define you is itself worth asking, and it is the question we began with.^[3]

So the opening scene can go another way: not rushing to argue "not good enough" down, but three linked turns: separate the problem from the person, find the moments the problem didn't decide, then link those moments into another plot and identity. They aren't strictly in order, and often alternate within one session.

ExternalisingThe problem has a name and tricks; it isn't you
ExceptionsFind the moments the problem covered up
Re-authoringLink them into a preferred story and identity

Re-authoring starts from events: two landscapes, action and identity

How does the third turn, re-authoring, actually proceed? Borrowing from the psychologist Bruner, White saw a person's story as two “landscapes of the mind”: the landscape of action is events linked through time, and the landscape of identity is the conclusions drawn from them. Re-authoring means moving back and forth between the two. At first people usually conclude from fixed traits, what their faults or strengths are, which White thought a poor guide to what to do next; only as they move towards what they value, hope for and commit to do they find ground to decide how to proceed.^[2,3]

This isn't a way to inflate one small moment into “you are so resilient”. The person draws the conclusion from the events; the therapist's questions only help ground it in them.

1Landscape of action
What happened, when, and what followed: events, circumstances, sequence and plot.
After the criticism I stayed and fixed the report.
2Landscape of identity
What those events say: intentions and purposes, values and beliefs, hopes and commitments, and what the person has learned from them.
It seems I care a lot about doing things well and don't give up easily.

2The method

Not improvised: four kinds of conversation put the three turns into questions

Back to the opening scene: the hand that went up has to be found through questions. Narrative therapy has no fixed protocol, but it has a clear structure. White set out the questions he used most as “maps”, each giving a direction and order for inquiry rather than a script to read out. The posture he aimed for he called decentred and influential: putting the person's story, knowledge and skills first while building a scaffold of questions that lets them describe another story line more richly.^[2,3]

1Externalising conversationName the problem close to experience, then ask its effects, how you judge them, and whyExternalising
2Finding unique outcomesNotice moments the problem didn't decide, and have you give them meaningExceptions
3Re-authoring conversationLink them through time into a plot, then ask what it shows you valueRe-authoring
4Re-membering and witnessingBring in the significant people in your life, or outsider witnesses, to hear and respond to the story taking shapeRe-authoring

Back to the opening: one public correction, two tellings

1The opening scene: in a meeting, a colleague points out an error in your report in front of everyone.

The problem decidesAfter separating the two

Externalising: what to call it

The problem decides“I'm just not good enough.”

After separating the two“That ‘not good enough’ voice is back.”

Externalising: what it does

The problem decidesThe conclusion becomes a verdict on yourself: I can't do anything right.

After separating the two“It stops me speaking up, keeps me awake, and makes me distant with my family.”

Exceptions: the overlooked moment

The problem decidesOnly this one mistake is remembered.

After separating the twoRemembering that last week you still raised your hand and asked a question.

Re-authoring: a new description

The problem decides“I'm a failure.”

After separating the two“I'm someone who gets scared and still goes forward.”

Afterwards

The problem decidesSpeaking up even less, believing the verdict more.

After separating the twoStill nervous, but with one step to take: next time, write the question down and take it in.

The point isn't turning negative into positive. The error is still an error and the nerves haven't gone; what changes is that the problem no longer equals the person, and the overlooked moment has a place, and what gets written into the story is no longer decided by that voice alone. Try writing what you value and one time it showed up

3The skills

Six ways of working that open the opening scene step by step

Every step in that example rests on a specific way of working, grouped here by the turn each mainly serves. Each works mostly through questions, and the person decides whether and how to answer.

Externalising: separating the person from the problem

Make the problem something you can talk about and stand against.

Externalising conversation: name, effects, evaluation, reasons
White's statement of position map 1 has four kinds of question: first, negotiating an experience-near, particular definition of the problem (in your words, not a diagnostic term); second, mapping its effects across the areas of life, only those that matter most to you; third, your evaluation of those effects (is this OK with you? where do you stand?); fourth, your reasons. The fourth matters most: explaining why you won't accept the problem often names what you hold dear. The right to name is yours, and a name can be changed at any time.^[2,3]
Hear it in a session
1. Client
  I always feel I'm not good enough. Every time I hand something in, or before a meeting, that thought comes.
2. Therapist
  It turns up on time. I'd like to try asking differently: if you thought of it as something that has come into your life, rather than as you, what would you call it? If it doesn't fit, we can change it any time.
3. Client
  …It's like a voice. Let's just call it “Not Good Enough”.
4. Therapist
  The “Not Good Enough” voice. What does it do? How does it make your life different?
5. Client
  I don't dare speak in meetings and I sleep badly. At home I'm more distant with my family, because my head keeps replaying things.
6. Therapist
  How do you see those effects yourself? Are they OK, or do you not like them?
7. Client
  I don't like them. Honestly, I really don't.
8. Therapist
  Could you say why you don't like them?
9. Client
  Because I actually care about my work, and I want the energy to be with my family. And it makes me worse at both.
10. Therapist
  Caring about your work and about your family: these are things you hold dear. Have I heard that right?
11. Client
  Yes.
12. Therapist
  Later we could look together for moments when “Not Good Enough” didn't have the last word. Would you like to try that?
13. Client
  OK, though I can't think of any right now.
14. Therapist
  No hurry; it's normal not to think of any yet. We'll look slowly.
Notice: The therapist asks consent before proposing a name, and the name is the client's (she says “like a voice”, and the therapist uses her word). Then come effects, evaluation and reasons, with no arguing against “I'm not good enough” and no “but you're actually fine”; once she says she cares about work and family, the therapist only checks they heard right. Change is small: she can't think of exceptions yet, and isn't pushed.
Method based on^[2,3]
“Interviewing” the problem: its tricks
White designed an exercise for therapists: one person plays the problem and another interviews it like an investigative reporter. Where does it have influence in your life? What tricks and what ways of speaking does it use to undermine your knowledge and skills? Who stands with it? What plans does it have ready if its dominance is threatened? The aim is to make the problem visible and discussable, so it's easier to find ways of standing against it. It is a training exercise; in the therapy room the same curiosity becomes shorter questions.^[3]

Exceptions: finding what was covered up

What else is in your life beyond what the problem decides.

Unique outcomes: moments the problem didn't decide
Unique outcomes (also called exceptions) are events that don't fit the problem story, such as the raised hand at the start, or a time you didn't give up. At first they are faint traces, full of gaps and not yet named, and they are the way into another story line. White cautioned that a therapist can too easily cheer at an exception and draw the conclusion for the person; then it is the therapist's position that matters, not theirs. So the person is asked to define the moment, evaluate it and give their reasons, and only then to link it to earlier events.^[3,6]
Hear it in a session
1. Therapist
  Last time we talked about “Not Good Enough”. Was there a moment this week when it wasn't so loud, even a small one?
2. Client
  …At Wednesday's meeting I had a question, and I actually asked it. My palms were sweating afterwards, though.
3. Therapist
  You put your hand up and asked. What made that possible?
4. Client
  I think I thought: if I don't ask and then get it wrong, that's worse for the team.
5. Therapist
  “Not wanting to let the team down.” How do you see this: good, bad, or a bit of both?
6. Client
  Mostly good, I suppose. But I'm also a bit scared that people thought my question was stupid.
7. Therapist
  Both are there. Why do you see it as good?
8. Client
  Because then I felt I was doing something, not hiding.
9. Therapist
  “Not hiding.” Has there been an earlier time when you stepped forward like that?
10. Client
  At school, once, a classmate was being laughed at and I said something.
11. Therapist
  What do that moment and Wednesday's have in common?
12. Client
  …Both times I felt something mattered more, so even though I was scared, I did it.
Notice: Wednesday's question in this conversation is the moment that didn't count in the opening scene. The therapist doesn't say “well done” for asking the question; they ask what made it possible, then how she sees it and why. She says both “good” and “still scared”, and both are accepted. Only then do they ask about an earlier, similar moment and let her find what's in common. This is a start, not a conclusion: she will still feel scared.
Method based on^[3,6]

Re-authoring: weaving a preferred story

Link the pieces, thicken them, and let others hear them.

Re-authoring: thickening the other story line
Re-authoring answers the opening question of which events get written into the story. It invites people to do what they already do, linking events into a plot through time, but this time choosing the overlooked unique outcomes and taking them into another story line. The therapist alternates questions from the landscape of action and the landscape of identity so the person can fill the gaps: what happened around this? What does it say you value? Only once there are enough identity conclusions are near-future proposals invited, such as “what might a next step be?”, and rarely earlier.^[2,3]
Re-membering: who would recognise this you?
White took “re-membering” from the anthropologist Myerhoff: life as a membership club, where you can revise who belongs and whose voice carries weight. The significant figure needn't be someone you know, or even a person; it could be a book's author, a comic character or a childhood toy. There are usually two sets of questions: what this figure contributed to your life and who you are in their eyes; and what you contributed to theirs. It isn't passive recollection but a purposeful return to those relationships, reclaiming the sense of having been seen.^[3]
Hear it in a session
1. Therapist
  Putting the two events together, how would you describe this way of acting?
2. Client
  …Something like “scared, but still moving forward”.
3. Therapist
  In your life, who would be least surprised by that description?
4. Client
  My grandmother. She used to say I was “willing to get on with it”.
5. Therapist
  In your grandmother's eyes, what kind of person are you?
6. Client
  Willing, not afraid of trouble, not fussy about credit.
7. Therapist
  If she heard you say “scared, but still moving forward” today, what would she say?
8. Client
  (Smiling) She'd probably say, “That's right.”
9. Therapist
  Does that “that's right” suggest anything for next week's meeting? It needn't be anything big.
10. Client
  Maybe… write down the question I want to ask and take it in with me.
11. Therapist
  Is that enough, or would you rather do it differently?
12. Client
  That's fine for now. Anything bigger and I'm afraid I won't manage.
Notice: The therapist asks the client to name someone who really knows her, then invites her to take that person's view, rather than offering an assessment. The conclusion (“scared, but still moving forward”) is in the client's own words; the next step is hers to choose, and a small one. The therapist's “is that enough?” returns the decision to her.
Method based on^[2,3]
Definitional ceremony and outsider witnesses
Borrowed from Myerhoff, a definitional ceremony lets a person tell their story before a small group of outsider witnesses, who then respond to what they heard. It is layered: the person tells, the witnesses retell (first retelling), the person retells what they heard from the witnesses, and sometimes there is a third round. Witnesses don't applaud, judge, advise or moralise; they respond in turn: which expression caught my attention? What image did it evoke? Why does it resonate with my own life? Where has it taken me? The story is publicly acknowledged, which can make new actions possible. Taking part is the person's choice.^[3]

The dialogues are illustrative composites, not real clients; skills that stir strong emotion or touch on trauma should be done with a trained therapist.

In the room: listen first, then ask, then take one small step

Now you know how it sees a person and how it works. The next questions: what is it actually like, does it work, and what is it not for?

If you decide to try it, how does a course go? There is no fixed number of sessions. The Australian study above used eight manualised sessions, but real length depends on what you bring and is agreed with your therapist. ^[4,7]

1First, listening to your storyThe therapist stays curious, asks only questions they genuinely don't know the answer to, and checks from time to time whether this conversation suits you.
2Name the problem and see its effectsCall it by your own words, then look at where it appears in your life, how you judge those effects and why.
3Find moments it didn't decideNotice the moments that don't fit the problem story, and say for yourself what they mean.
4Thicken the other story lineLink the moments through time, see what they show you value, and think about who would recognise this you.
5Take a small step and let the story be heardIf you wish, consider a small step to take soon; and where it would help, invite witnesses to hear the story.

Those it fits first are people stuck inside one conclusion

Narrative therapy is often used with people stuck inside a label, a criticism or a conclusion like “this is just who I am”, as in the opening scene where one "not good enough" fills everything. In research depression has been studied most, then distress linked to physical illness and eating disorders, but as above, the evidence is still preliminary.^[4,7,9,10]

Depression and low self-worth
Feeling stuck in labels such as “failure” or “ill”
Pressure from family or social expectations
Emotional distress that comes with long-term illness
Eating difficulties (as a support; evidence is limited)
People wanting to rethink their values and direction

Everyone is different. If you are thinking of hurting yourself or ending your life, please don't face it alone: call The Samaritans' 24-hour line on 2896 0000, or 999 in an emergency. If you are in a relationship that hurts you, or have been abused, talk with a therapist first so that your safety comes first.

Does it work? So far the evidence is thin

After those ways of working, the natural question is whether it helps. The short answer: research on narrative therapy is still sparse, and hard to do rigorously. Every item below is “more evidence needed”. That doesn't mean it doesn't work, only that we can't yet say it has solid evidence. They run from most to least certain.

For adult depression: promising, but no firm controlled trials
Two studies stand out. In an Australian study, 47 adults had eight sessions of manualised narrative therapy; afterwards about three-quarters showed reliable improvement in symptoms and about half clinically significant improvement, and symptom gains held at three months, though gains in relationships did not. In a Portuguese study, 63 adults were assigned to narrative therapy or CBT, and both improved significantly. Neither study had a real no-treatment control group, only comparison with waiting-list figures from other research, so we can't be sure how much of the improvement the therapy itself produced.^[7,8]
Against CBT: not shown to be as good
In the Portuguese trial, CBT scored better than narrative therapy on a depression symptom questionnaire, with no clear difference on a second questionnaire of overall distress and functioning. This is a single direct comparison with a modest sample, so we can't say the two work equally well, and certainly not that narrative therapy works better.^[8]
Depression with physical illness: a large effect, but low-quality evidence
A 2024 meta-analysis pooling many studies found depressive symptoms fell clearly in people with physical illness after narrative therapy. But the authors rated the evidence low in quality, the studies came mostly from China, and only two involved people who actually had depression. So it is a sign, and calls for more rigorous research.^[9]
For eating disorders: mostly therapists' accounts, not measured outcomes
A 2022 systematic review found 33 studies, only three of which used standard questionnaires; the rest relied on session transcripts and therapist reports. They most often described shifts in identity narratives and a greater sense of agency over the problem, with symptom change reported less often. The review concluded there was only limited support.^[10]
Why is the evidence so thin?
A 2000 review already noted that research on narrative therapy's effectiveness was in its infancy, and discussed why a broader base had not developed. One reason is that the approach is hard to define: a study of UK practitioners found that they disagreed about what narrative therapy is and which techniques it uses, and identified eight distinct accounts. Without a clear definition, comparable clinical trials are hard to run.^[11,12]

Note that not all the studies' “narrative therapy” follows White's practice strictly, and the studies' methods differ from one another. Many of the benefits readers care about, such as a changed sense of identity or more agency, are also hard to capture with standard questionnaires, so research often rests on interviews and case records, which are valuable but can't show cause. The honest summary today: narrative therapy appears to help some people, but we don't know for whom it works best, and it hasn't been shown to beat other established therapies.^[9,10,12]

To be honest: narrative therapy's limits and critiques

Re-writing the story sounds appealing, but beyond the thin evidence the approach has drawn some critiques worth knowing:^[11,13,15]

1How far do you follow?

The approach's worldview is that much depends on perspective, with no single objective truth. But a therapist may sometimes suspect that a story line doesn't serve the client, such as “I don't need anyone”, which might really be self-protection. Whether to strengthen that story, and how far, has no standard answer. The posture White described is decentred but influential: not imposing an agenda, but building a scaffold of questions so the person can examine their own view. It remains a hard call that rests on the therapist's judgement.

2It leans on imagination and reflection

Externalising, naming a problem and evaluating its effects all call for some imagination and a view of one's own. White himself described the questions of re-authoring as stretching and exercising the imagination and meaning-making resources. For people who think in more concrete, direct terms this may not be the most comfortable starting point, and the therapist may need to adapt, or combine it with other approaches.

3Where is the family?

The family-therapy pioneer Minuchin argued in 1998 that postmodern approaches, narrative therapy among them, may lose the information that family members' actual dialogue produces, as well as the therapist's active shaping of family interaction; he asked whether the family had been misplaced and the work returned to individual psychology. Narrative practitioners see this differently, but the critique is a reminder that telling one person's story can sometimes leave out the voices around them.

4“Narrative” can mean many things

Even among trained practitioners there are different accounts of what counts as narrative therapy; some treat it as a political stance, others integrate it with other approaches. So when you hear “narrative therapy”, it's worth asking the therapist how they actually work.

So, to the opening question of who decides which events count, narrative therapy offers a serious way of asking, but not the only road; a good therapist adjusts to where you are and what you need.

Take this with you

That voice will probably still come, and the evidence for narrative therapy is still thin. You needn't drive it out or swap in a prettier sentence; just, each time you hear "this is just who I am", ask once more: is that all of me? Which page hasn't been written in yet?

Narrative therapy videos

Episodes are in Cantonese.

All episodes

Start with this one敍事療法 Narrative Practice！掌控自己的人生故事！心理治療百科（三）敍事療法（Narrative Practice）認為世間沒有唯一的客觀真理，每個人都有權重新書寫和定義自己的人生故事，從而活出更理想的人生。本集從後現代與社會建構主義的世界觀講起，解釋為什麼一個被主流論述判定為「失敗」的人，其實可以發掘出另類故事情節，建立新的身份與力量。並介紹敍事工作的具體操作，包括尋找獨特結果與五階段的鷹架式對話，以及這套手法的限制。Listen to the episode· About 16 min

2023年2月24日約 21 分鐘
Peter係假心理學家？探討心理學的未來發展
心理學的未來，在於跳出「病態本位」的框架：指出DSM-5雖然讓精神診斷變得可重複、可研究，卻同時令整個行業過度傾側在描述精神病態，而忽略了人卓越的精神面向。這集承接傅柯（Michel Foucault）對精神病學的批評，介紹麥克·懷特（Michael White）的敍事工作與跨診斷療法如何把「為問題命名」的權力交回當事人，並回應外界對樹洞香港與「心理學家」稱謂的爭議。
收聽這集

Want to try alone first: a four-step path

Not ready to see a therapist yet? Start with these four steps at your own pace. The deeper work of externalising and re-authoring is best kept for therapy.

Courses

Therapists who practise Narrative therapy

TreeholeHK's counsellors and clinical psychologists use Narrative therapy to fit what you need, alongside other approaches.

Book therapy

Winnie Heimgartner-WongPsychotherapistView profile

Narrative therapy's neighbours: also about meaning and your own position

Narrative therapy sits next to several approaches that likewise value meaning and the client's own position.

Solution-focused brief therapy (SFBT)Also postmodern, and also looks for exceptions to the problem; SFBT looks back less and moves towards the future, while narrative therapy links exceptions into a story and identity with a history.^[3]
Acceptance and commitment therapy (ACT)ACT helps people identify values and commit to action; narrative therapy can add where those values come from, by placing them in a person's story.^[3]
Cognitive behavioural therapy (CBT)CBT checks thoughts against evidence and practises behaviour; narrative therapy asks less “is it accurate?” and more “who defined this and what does it do to your life?”. In one depression trial both improved, with CBT scoring better on symptoms.^[3,8]
Person-centred therapyLikewise trusts the client as the expert on their own life and values the relationship. Narrative therapy adds a systematic scaffold of questions for building another story line.^[4]

Other therapy approaches

FAQ

Is narrative therapy just positive thinking?

No. Narrative therapy doesn't deny the problem or ask you to call bad things good. It takes the problem's effects seriously, asks how you judge them and why you won't accept them, and then notices real events that don't fit the problem story. White even cautioned therapists against rushing to praise such events, since that puts the weight on the therapist's position.^[3]

Are 敘事治療, 敘事療法 and narrative practice the same?

Essentially yes. In Chinese it is written 敘事治療 or 敘事療法 (some write 敍事), and in English narrative therapy or narrative practice. “Practice” is used because the ideas are applied beyond psychotherapy too, in community work and in how we reflect on ourselves and the world.^[4,15]

Is it related to narrative exposure therapy?

Not directly; the names just sound alike. Narrative exposure therapy is a short-term treatment for people with repeated trauma from war or organised violence, in which traumatic memories are faced in therapy and organised into a chronological narrative. It has its own research, and the evidence on this page doesn't carry over to it, nor the other way round.^[14]

Do I have to give my problem a name?

No. Naming is an invitation, not a requirement. The therapist asks you to describe it in words close to your own experience, not diagnostic terms or anything that sounds “professional”; if a name doesn't fit, it can be changed any time, or you can talk without naming it.^[3]

I'm not imaginative or good at metaphor. Is it for me?

You can try, but tell the therapist frankly. Narrative questions do ask for some imagination and reflection, though they can be made more concrete: more about what happened and what you did, less abstract metaphor. Some people do better starting with a different approach.^[3]

How do I find a narrative therapist in Hong Kong?

Look for specific narrative training and membership of a professional body, and ask how they actually use the approach. Further down are TreeholeHK's therapists who use narrative therapy; read their backgrounds before you book.

References

1.White, M., & Epston, D. (1990). Narrative means to therapeutic ends. W. W. Norton.
2.White, M. (2007). Maps of narrative practice. W. W. Norton.
3.White, M. (2005). Michael White workshop notes [Externalising conversations exercise; statement of position maps 1 and 2; therapeutic posture; re-authoring conversations; re-membering conversations; definitional ceremony and outsider-witness responses]. Dulwich Centre. dulwichcentre.com.au
4.Morgan, A. (2000). What is narrative therapy? An easy-to-read introduction. Dulwich Centre Publications. (Excerpt hosted by Dulwich Centre.) dulwichcentre.com.au
5.Dulwich Centre. (n.d.). About Dulwich Centre. dulwichcentre.com.au
6.Carr, A. (1998). Michael White's narrative therapy. Contemporary Family Therapy, 20(4), 485–503. doi.org/10.1023/a:1021680116584
7.Vromans, L. P., & Schweitzer, R. D. (2011). Narrative therapy for adults with major depressive disorder: Improved symptom and interpersonal outcomes. Psychotherapy Research, 21(1), 4–15. doi.org/10.1080/10503301003591792
8.Lopes, R. T., Gonçalves, M. M., Machado, P. P. P., Sinai, D., Bento, T., & Salgado, J. (2014). Narrative therapy vs. cognitive-behavioral therapy for moderate depression: Empirical evidence from a controlled clinical trial. Psychotherapy Research, 24(6), 662–674. doi.org/10.1080/10503307.2013.874052
9.Hu, G., Han, B., Gains, H., & Jia, Y. (2024). Effectiveness of narrative therapy for depressive symptoms in adults with somatic disorders: A systematic review and meta-analysis. International Journal of Clinical and Health Psychology, 24(4), 100520. doi.org/10.1016/j.ijchp.2024.100520
10.Conti, J., Heywood, L., Hay, P., Shrestha, R. M., & Perich, T. (2022). Paper 2: A systematic review of narrative therapy treatment outcomes for eating disorders—bridging the divide between practice-based evidence and evidence-based practice. Journal of Eating Disorders, 10, Article 138. doi.org/10.1186/s40337-022-00636-4
11.Etchison, M., & Kleist, D. M. (2000). Review of narrative therapy: Research and utility. The Family Journal, 8(1), 61–66. doi.org/10.1177/1066480700081009
12.Wallis, J., Burns, J., & Capdevila, R. (2011). What is narrative therapy and what is it not? The usefulness of Q methodology to explore accounts of White and Epston's (1990) approach to narrative therapy. Clinical Psychology & Psychotherapy, 18(6), 486–497. doi.org/10.1002/cpp.723
13.Minuchin, S. (1998). Where is the family in narrative family therapy? Journal of Marital and Family Therapy, 24(4), 397–403. doi.org/10.1111/j.1752-0606.1998.tb01094.x
14.Robjant, K., & Fazel, M. (2010). The emerging evidence for narrative exposure therapy: A review. Clinical Psychology Review, 30(8), 1030–1039. doi.org/10.1016/j.cpr.2010.07.004
15.樹洞香港. (2023). 敍事療法 Narrative Practice！掌控自己的人生故事！心理治療百科（三）[Podcast episode]. TreeholeHK. treehole.hk

Want someone alongside you?

You can do the exercises on your own. When you're stuck, a trained therapist can take you further.

Book therapy

Externalising conversation: name, effects, evaluation, reasons

White's statement of position map 1 has four kinds of question: first, negotiating an experience-near, particular definition of the problem (in your words, not a diagnostic term); second, mapping its effects across the areas of life, only those that matter most to you; third, your evaluation of those effects (is this OK with you? where do you stand?); fourth, your reasons. The fourth matters most: explaining why you won't accept the problem often names what you hold dear. The right to name is yours, and a name can be changed at any time.^[2,3]

Hear it in a session

Client
I always feel I'm not good enough. Every time I hand something in, or before a meeting, that thought comes.
Therapist
It turns up on time. I'd like to try asking differently: if you thought of it as something that has come into your life, rather than as you, what would you call it? If it doesn't fit, we can change it any time.
Client
…It's like a voice. Let's just call it “Not Good Enough”.
Therapist
The “Not Good Enough” voice. What does it do? How does it make your life different?
Client
I don't dare speak in meetings and I sleep badly. At home I'm more distant with my family, because my head keeps replaying things.
Therapist
How do you see those effects yourself? Are they OK, or do you not like them?
Client
I don't like them. Honestly, I really don't.
Therapist
Could you say why you don't like them?
Client
Because I actually care about my work, and I want the energy to be with my family. And it makes me worse at both.
Therapist
Caring about your work and about your family: these are things you hold dear. Have I heard that right?
Client
Yes.
Therapist
Later we could look together for moments when “Not Good Enough” didn't have the last word. Would you like to try that?
Client
OK, though I can't think of any right now.
Therapist
No hurry; it's normal not to think of any yet. We'll look slowly.

Notice: The therapist asks consent before proposing a name, and the name is the client's (she says “like a voice”, and the therapist uses her word). Then come effects, evaluation and reasons, with no arguing against “I'm not good enough” and no “but you're actually fine”; once she says she cares about work and family, the therapist only checks they heard right. Change is small: she can't think of exceptions yet, and isn't pushed.

Method based on^[2,3]

FAQ

Is narrative therapy just positive thinking?

Are 敘事治療, 敘事療法 and narrative practice the same?

Is it related to narrative exposure therapy?

Do I have to give my problem a name?

I'm not imaginative or good at metaphor. Is it for me?

How do I find a narrative therapist in Hong Kong?

References

1.White, M., & Epston, D. (1990). Narrative means to therapeutic ends. W. W. Norton.
2.White, M. (2007). Maps of narrative practice. W. W. Norton.
3.White, M. (2005). Michael White workshop notes [Externalising conversations exercise; statement of position maps 1 and 2; therapeutic posture; re-authoring conversations; re-membering conversations; definitional ceremony and outsider-witness responses]. Dulwich Centre. dulwichcentre.com.au
4.Morgan, A. (2000). What is narrative therapy? An easy-to-read introduction. Dulwich Centre Publications. (Excerpt hosted by Dulwich Centre.) dulwichcentre.com.au
5.Dulwich Centre. (n.d.). About Dulwich Centre. dulwichcentre.com.au
6.Carr, A. (1998). Michael White's narrative therapy. Contemporary Family Therapy, 20(4), 485–503. doi.org/10.1023/a:1021680116584
7.Vromans, L. P., & Schweitzer, R. D. (2011). Narrative therapy for adults with major depressive disorder: Improved symptom and interpersonal outcomes. Psychotherapy Research, 21(1), 4–15. doi.org/10.1080/10503301003591792
8.Lopes, R. T., Gonçalves, M. M., Machado, P. P. P., Sinai, D., Bento, T., & Salgado, J. (2014). Narrative therapy vs. cognitive-behavioral therapy for moderate depression: Empirical evidence from a controlled clinical trial. Psychotherapy Research, 24(6), 662–674. doi.org/10.1080/10503307.2013.874052
9.Hu, G., Han, B., Gains, H., & Jia, Y. (2024). Effectiveness of narrative therapy for depressive symptoms in adults with somatic disorders: A systematic review and meta-analysis. International Journal of Clinical and Health Psychology, 24(4), 100520. doi.org/10.1016/j.ijchp.2024.100520
10.Conti, J., Heywood, L., Hay, P., Shrestha, R. M., & Perich, T. (2022). Paper 2: A systematic review of narrative therapy treatment outcomes for eating disorders—bridging the divide between practice-based evidence and evidence-based practice. Journal of Eating Disorders, 10, Article 138. doi.org/10.1186/s40337-022-00636-4
11.Etchison, M., & Kleist, D. M. (2000). Review of narrative therapy: Research and utility. The Family Journal, 8(1), 61–66. doi.org/10.1177/1066480700081009
12.Wallis, J., Burns, J., & Capdevila, R. (2011). What is narrative therapy and what is it not? The usefulness of Q methodology to explore accounts of White and Epston's (1990) approach to narrative therapy. Clinical Psychology & Psychotherapy, 18(6), 486–497. doi.org/10.1002/cpp.723
13.Minuchin, S. (1998). Where is the family in narrative family therapy? Journal of Marital and Family Therapy, 24(4), 397–403. doi.org/10.1111/j.1752-0606.1998.tb01094.x
14.Robjant, K., & Fazel, M. (2010). The emerging evidence for narrative exposure therapy: A review. Clinical Psychology Review, 30(8), 1030–1039. doi.org/10.1016/j.cpr.2010.07.004
15.樹洞香港. (2023). 敍事療法 Narrative Practice！掌控自己的人生故事！心理治療百科（三）[Podcast episode]. TreeholeHK. treehole.hk

Narrative therapy

Narrative therapy's answer: the problem isn't you, and what was left out can be written back in

The answer is three turns: externalise, find the exceptions, re-author

Re-authoring starts from events: two landscapes, action and identity

Not improvised: four kinds of conversation put the three turns into questions

Back to the opening: one public correction, two tellings