Narrative Therapy Explained

Narrative therapy is a talking therapy that treats you as the author of your own life. It separates the person from the problem, then rebuilds the life story that the problem has come to dominate.

What is narrative therapy?

Michael White and David Epston developed narrative therapy.¹ Its founding institute, the Dulwich Centre in Australia, explains the approach in its own words. Problem-saturated stories are common in therapy.² These are accounts of a life in which the problem explains nearly everything, and it starts to feel like the whole of who someone is.

The person is not the problem; the problem is the problem, and from there therapist and client work on a fuller and more accurate story of that person's life. For a broader overview, see our narrative therapy page.

Why stories shape who we are

The philosopher Paul Ricoeur called this sense of self narrative identity.³ We understand ourselves much as we understand characters in a story.

These self-stories are built from the resources of history, language, and culture.³ That is why a story can be rewritten without losing yourself.

Storytelling therapy is another name people use for this same family of ideas, and narrative therapy is the practical version, the one that happens in the consulting room. A narrative view can inform many different psychotherapies.²

Key concepts of narrative therapy

Three moves are central to the work.

• Externalisation. Naming the problem as something outside the person is called externalisation.¹ You might speak of "the worry" rather than "my anxiety", which makes it easier to look at without shame.
• Mapping the problem's influence. You and the therapist work out where the problem has an effect. Relationships, beliefs, moods, and choices all get mapped. The map shows where the problem is strongest, and where it has least effect.
• Reauthoring. Therapy then reworks, or re-authors, the first story into a new story. The new story allows more flexibility about the past and new strategies for the future.⁴

Sparkling moments

Sparkling moments are the approach's best-known idea. Narrative therapists call them unique outcomes.⁵ They are the parts of your life that do not fit the problem story.

A narrative therapist listens for these exceptions closely, and an exception might be any time the problem had less effect on what you did or felt. Each one is evidence for a truer and fuller story.

Reauthoring works from these exceptions. Creating new meaning through re-storying is central to the approach.¹

What happens in a narrative therapy session

Sessions are collaborative conversations rather than assessments, and the therapist's stance throughout is curious and respectful rather than expert. You stay the expert on your own life.

A course of narrative therapy tends to move through these steps:

• Looking at the stories you currently use to describe your life.
• Naming the problem and externalising it.
• Mapping how the problem affects relationships, beliefs, and feelings.
• Noticing sparkling moments the problem story leaves out.
• Building a preferred story around your values and abilities.
• Recording change as it happens.

Some narrative therapists use therapeutic letters.¹ These letters record progress and the new story as it develops. Narrative therapists also prefer everyday language over therapeutic jargon.⁵ You should rarely need a glossary to follow your own therapy.

Is narrative therapy evidence based?

Different bona fide talking therapies tend to produce broadly similar results.² Bona fide here means a genuine, established therapy.

Researchers know this as the Dodo effect. The benefits of therapy come largely from common factors. Common factors are the things every therapy shares, such as the relationship between therapist and client. A strong alliance with a quality therapist matters more than the specific model.²

One condition applies. Both therapist and client need confidence in the shared frame.² The frame is the shared understanding of what the work is and how it will proceed. From a narrative view, every therapy involves storytelling and story retelling.⁴

We do not claim narrative therapy outperforms other approaches, and the reference literature gives it no separate claim to superiority. What matters is whether its style suits you, and whether the way it works matches the way you already think about your own difficulties. There must be a fit between the person and the approach.⁴

Pros and cons of narrative therapy

Possible benefits

• A stronger sense of agency. You become the story's author rather than a diagnosis.
• Useful distance from problems. Externalising makes issues easier to examine and discuss.
• Clearer contact with your values, skills, and history of coping.
• A reusable skill. Spotting and editing unhelpful stories works beyond therapy too.

Limits and criticisms

• It relies heavily on talking. People who process less verbally may find it difficult.
• Its reflective pace can feel slow during acute distress.
• It seldom acknowledges its overlap with cognitive and behavioural theory.¹
• Therapists trained in the approach are scarce in some regions.
• It holds no proven advantage over other established therapies, as covered above.

Who can benefit from narrative therapy?

The approach suits people whose difficulties are closely connected to a harsh story about themselves, including many people living with depression, anxiety, or low self-worth.

• Individuals. Anyone who no longer recognises themselves in the story they tell about their life. The approach is non-pathologising, meaning it does not treat you as a disorder to be corrected, and it centres strengths and values.
• Couples and families. Narrative therapy is an established school within couple and family therapy. It is listed alongside emotionally focused, integrative, and other family therapy schools.¹ Couples can externalise "the conflict" instead of blaming each other.
• Children. The approach adapts for children through stories and play. Child-specific evidence is thinner, so expectations should stay modest.
• Groups. Narrative work can run in group settings. Groups add shared telling and the experience of being witnessed.
• After trauma. Narrative work aims to re-author painful experience into a new story, one that expands present and future options.⁵ Trauma treatment often aims to turn painful memories into a coherent and contained story.⁶ Evidence for narrative therapy specifically for trauma remains limited.

Is narrative therapy right for you, and how to start

Three honest questions can guide the decision.

• Do you find meaning in telling and re-telling your experiences?
• Can you commit to a reflective, sometimes gradual process?
• Are you comfortable doing most of the work through conversation?

If the answers are yes, the next step is simple. Read our guide on how to find the right therapist. Then search the TherapyRoute directory for clinicians who list narrative therapy. A first consultation is the best test of fit.

Frequently asked questions

How long does narrative therapy take?

There is no fixed timeline, and length depends on your goals and on the depth of the work you want to do. Discuss expected duration with your therapist early on.

Can narrative therapy be done in groups?

Yes. Group formats add shared storytelling and mutual witnessing. Ask a prospective group facilitator about their training.

Is narrative therapy suitable for children?

It adapts well for children, using stories, play, and metaphor. Choose a therapist experienced in working with children, and bear in mind that child-specific research on the approach is limited.

Will medical aid or insurance cover it?

Funding differs by country. In South Africa, some medical aid schemes contribute to psychotherapy. Elsewhere, public health systems or private insurance may cover part of the cost.

Narrative therapy is usually billed simply as psychotherapy. The question to ask your scheme or insurer is how psychotherapy in general is covered where you live.

How should I prepare for a first session?

No special preparation is needed, though it can help to note recurring themes in your life beforehand. Bring whatever stories seem most important to you.

This article is for information only. It is not a substitute for advice from a qualified professional.

References and further reading

This article is for general information and is not a substitute for professional assessment or care. If this is affecting your life, consider reaching out to a qualified mental health professional.

References

1. [1] Kaplan & Sadock's Comprehensive Textbook of Psychiatry, 10th ed (2017) - 30.6 Family Therapy (narrative model row: Epston/White/Anderson, externalization, unique outcomes, re-storying, therapeutic letters, overlap caveat).
2. [2] Bradley Lewis, M.D., Ph.D. Narrative Psychiatry. In Kaplan & Sadock's Comprehensive Textbook of Psychiatry, 10th ed (2017, vols 1+2).
3. [3] Bradley Lewis, M.D., Ph.D. Narrative Psychiatry. In Kaplan & Sadock's Comprehensive Textbook of Psychiatry, 10th ed (2017, vols 1+2) (pp 7236-7243).
4. [4] Kaplan & Sadock's Synopsis of Psychiatry, 11th ed (2014) — EFFICACY (pt 4).
5. [5] Kaplan & Sadock's Comprehensive Textbook of Psychiatry, 10th ed (2017) - 30.13 Narrative Psychotherapy.
6. [6] Gabbard's Treatments of Psychiatric Disorders (2007) — Print: Chapter 32. Posttraumatic Stress Disorder and Acute Stress Disorder (pt 2).