MODELS
NARRATIVE COUPLES THERAPY MODEL
Narrative Couples Therapy and Solution-Focused Couples Therapies
Narrative Couples Therapy and Solution-Focused Couples Therapy are two approaches to couples therapy that I also occasionally use as needed with my clients.
Both of these methods are “Postmodern.” That means they promote a healthy skepticism for the “received wisdom” of race, class and cultural narratives.
Postmodern therapies focus on the idea that couples have the ability to 're-story’ their lives, promoting a wider sense of agency and what positive change in their relationships would look like.
However, Solution Focused Couples Therapy and Narrative Couple Therapy differ in their emphasis on the therapeutic process and the interventions used to promote change.
Narrative Couples Therapy
Narrative Couples Therapy is a delightfully subversive model that is based on the idea that people construct their own reality through the stories they tell about their lives.
The strategic goal of Narrative Couples Therapy is to help you explore, confront, and challenge the negative, de-vitalizing stories you tell about yourselves and your relationship.
Instead, a good Narrative Therapist will help you to create fresh stories that support your emotional well-being and strengthen your intimate bond..
Narrative Couples Therapy is extremely collaborative, with the therapist working together with both of you to deeply explore your life experiences, and the stories you tell yourself.
This approach involves the use of questions, conversation, and exploration, as well as a focus on the couple's strengths and resources.
The approach is highly collaborative, and emphasizes the importance of creating “new stories.” Narrative Therapists might describe it as a “thicker” narrative of a preferred future.
Therapists using Narrative Therapy aim to help couples identify and challenge their negative stories, and to create new narratives that are more resilient, positive and affirming.
Solution-Focused Couples Therapy
The most important thing to remember about Solution-Focused Couples Therapy (SFCT) is that it relentlessly focuses on the present and future, rather than the past.
The strategic goal of Solution-Focused Couples Therapy is to help you identify and build on your existing strengths and resources, and to develop concrete, achievable relationship goals that you can work towards together.
Solution-Focused Couples Therapy (SFCT) is most often structured around a set of key questions.
The most famous of which is known as the Miracle Question, which asks you to imagine a Divine Intervention which renders your shared life together suddenly perfect.
What would you notice first?
A therapist using a Solution-Focused approach will underscore and emphasize the critical importance of small, incremental changes.
Another key strategy in SFCT is encouraging you to notice what is already working in your relationship, rather than what is not working.
While Narrative Couples Therapy and Solution-Focused Couples Therapy share some similarities, they differ in their emphasis on the therapeutic process and the techniques used to promote change.
Narrative Couples Therapy places a greater emphasis on exploring and understanding the impact of the stories we tell ourselves, while Solution-Focused Couples Therapy is much more focused on concrete action and profound noticing, and critical goal setting.
How Effective is Using Solution Focused and Narrative Postmodern Couples Therapies?
Here’s why I use these models with my clients.
Research has shown that both Narrative Couples Therapy and Solution-Focused Couples Therapy can be highly effective in promoting positive outcomes in couples therapy.
In a meta-analysis of 44 studies on the effectiveness of couples therapy, Lebow and colleagues (2012) found that both Narrative Couples Therapy and Solution-Focused Couples Therapy were associated with significant improvements in relationship satisfaction and a reduction in the severity of relationship problems.
Is Solution Focused Couples Therapy a more effective model?
There is some emerging evidence to suggest that Solution-Focused Couples Therapy may be more effective than Narrative Couples Therapy in promoting positive outcomes in couples therapy.
In a study of 51 couples, Gingerich and colleagues (2012) found that couples who participated in Solution-Focused Couples Therapy showed significant improvements in relationship satisfaction and communication skills, while couples who participated in Narrative Couples Therapy showed no significant improvements.
One possible explanation for this difference in effectiveness is the emphasis on action and goal setting in Solution-Focused Couples Therapy.
Appreciating the simple pragmatism of Solution-Focused couples therapy
The principles that guide strategic solution focused therapy can be summarized as a four-part process:
(1) What's the presenting problem?
(2) What have you noticed about your efforts to solve the problem?
(3) Notice..is it working? If so, keep doing it and work for gradual (kaizen) improvements that emerge from your careful noticing.
(4) If it’s not working, stop doing it. and try another approach…and keep noticing.
I like the fact that Solution Focused methods focus on concrete, achievable goals, and keenly focused awareness and noticing.
On the other hand, Narrative Therapy won me over by emphasizing the limitations of the narratives we inhabit.
But sometimes a thicker, richer story… is still just a story.
It’s been my experience that couples may be more likely to make positive changes in their relationship and maintain those changes over time when they are focused on specific behavioral changes and preferred outcomes.
It’s also problematic for couples therapy that there’s more robust cultural critique in Narrative Couples Therapy. While this emphasis on social exploration and understanding may be interesting, it’s less effective in promoting concrete changes in behavior.
The answer is clinically apparent.
In several familiar flash points, Narrative Couples Therapy can both externalize and politicize personal responsibility.
A good therapist knows these sand traps and avoids them.
Narrative Couples Therapy and Solution-Focused Couples Therapy can be effective approaches to couples therapy that can help you improve your relationship satisfaction and reduce the mismanagement of your relationship differences.
However, some evidence suggests that the present-focused, goal-oriented approach found in Solution-Focused Couples Therapy may be more effective than Narrative Couples Therapy in promoting positive outcomes in couples therapy.
Devotees of post-modern approaches like me often blend narrative and Solution-Focused approaches to couples therapy.
RESEARCH
Bubenzer, D., West, J., & Boughner, S. (1994). Michael White and the narrative perspective in therapy. The Family Journal, 2(1), 71–83. CrossRef Google Scholar
Foucault, M. (1980). Two lectures. In C. Gordon (Ed.), Power/knowledge: Selected interviews and other writings 1972–1977 (pp. 78–108). New York: Harvester Wheatsheaf. Google Scholar
Gingerich, Wallace J. & Peterson, Lance T. Effectiveness of Solution-Focused Brief Therapy: A Systematic Qualitative Review of Controlled Outcome Studies Volume 23, Issue 3. https://doi.org/10.1177/1049731512470859
Guilfoyle, M. (2012). Towards a grounding of the agentive subject in narrative therapy. Theory & Psychology, 22(5), 626–642. CrossRef Google Scholar
Greenman, P. S., & Johnson, S. M. (2013). Evidence-based practice in couple therapy: Narrative couples therapy. Journal of Systemic Therapies, 32(1), 22-38. doi: 10.1521/jsyt.2013.32.1.22
Johnson, S. M., & Whiffen, V. E. (2013). The processes and effectiveness of narrative therapy with couples: A review of the research literature. Journal of Marital and Family Therapy, 39(3), 347-358. doi: 10.1111/j.1752-0606.2012.00291.x
Linton, J. M., & Madigan, S. (2017). Narrative couples therapy: A theoretical review. Journal of Marital and Family Therapy, 43(2), 283-298. doi: 10.1111/jmft.12216
Madigan, S., Linton, J. M., & Johnson, S. M. (2017). Narrative couples therapy: A review of the evidence base. Journal of Marital and Family Therapy, 43(2), 316-332. doi: 10.1111/jmft.12202