In Summary:
- David Newman, founder of Sydney Narrative Therapy, explains how the approach re-conceptualises mental-health challenges and troubling behaviours.
- Narrative therapy encourages clients to identify coping strategies they themselves have already used.
- Narrative therapy can be seen as a set of principles and a framework for therapists rather than a rigid protocol.
- Narrative therapy can be beneficial for both individuals and groups.
- The APS offers a narrative therapy CPD activity.
By positioning people as separate from their problems, this collaborative therapy approach empowers clients to re-author their own stories.
Clients who seek out therapy often make two assumptions, says social worker David Newman: first, that there is something ‘wrong’ with them, and second, that a therapist can help them ‘fix’ it.
A client grappling with low mood might describe themselves as mentally ill; another with PTSD might say they are broken by trauma. Both clients might understandably look to a therapist for a prescription.
In narrative therapy, however, these assumptions are challenged. Instead of viewing a history of depression as internal to a client, narrative therapy labels it a ‘story’ that has been shaped by events and cultural norms.
“Put another way, narrative therapy positions people as separate from their problems,” says Newman, honorary clinical fellow at the University of Melbourne School of Social Work and founder of Sydney Narrative Therapy.
To ‘re-write’ these stories, narrative therapy preferences a client’s own knowledge and capabilities. The psychologist's role is to help the client articulate and amplify these capabilities.
“The orienting forces of narrative therapy are the use of the metaphor of story, a commitment to non-pathologising practice and a belief that people are experts in their own lives,” says Newman.
In practice, narrative therapy invites clients to take a step back from their problems and view them objectively so they can assess and tackle them – a technique known as ‘externalising’.
“A client might say: ‘I’m a really anxious person. I’ve been anxious ever since I was young.’ In response, a narrative therapist might say: ‘It sounds like anxiety has been visiting your life for many years. Can you tell me about the effects of the anxiety?’” says Newman.
This prompt encourages the client to start thinking about their history of anxiety as a narrative with a plotline, rather than a personal character trait.
Subsequently, a narrative therapist might ask the client to think about ways they have managed their anxiety in the past, encouraging them to draw on their often-hidden know-how.
“The end result is that clients start to see themselves as having worthwhile knowledge and some kind of expertise in their own lives,” says Newman.
Although narrative therapy originated in social work, its core ideas – such as externalising problems, re-authoring personal stories and viewing people as separate from their issues – align closely with constructivist and humanistic principles that psychologists already embrace in therapies such as CBT or person-centered approaches, offering another engaging way to empower clients beyond rigid diagnostics.
Research, including controlled trials and meta-analyses, shows it’s comparably effective to CBT for depression and PTSD, with effect sizes in the moderate-to-large range (e.g., g=1.18 for PTSD symptoms; SMD=-1.34 for depression reduction) (Ranganathan et al., 2019; Wei et al., 2024; Gonçalves et al., 2014).
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Narrative therapy’s origins and applications
Narrative therapy took shape in the 1980s and 1990s, based largely on research by social workers Michael White and David Epston.
From the outset, the pair were influenced not only by psychology but also by sociologists and philosophers.
“White and Epston emphasised a spirit of adventure in the work,” says Newman. “This led them to explore the requirement for stories to have a supportive audience or outsider witnesses, and to conclude that the therapist should be de-centred – that is, leaving their own language and meanings at the edges of any work they do.”
One tenet of their early work was the idea that social norms informed people’s views of themselves and others. As society shifts and evolves, so too do the stories people tell about themselves and about others.
Today, narrative therapy exists more as a set of principles and approaches than a standardised practice. However, narrative therapy is recognised by Medicare as an acceptable focused psychological strategy (FPS) for Aboriginal and Torres Strait Islander peoples.
“Part of the spirit of it, which I’m really drawn to, is that it’s not a closed book,” says Newman.
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Recounting vivid details
Personifying or characterising problem stories can be very helpful, says Newman.
“You might say something like: ‘If anxiety was a person speaking to you, in what ways would it talk? What would its messages be?’ Or: ‘If anxiety had a colour, what colour would it be?’”
These externalisation practices can be of benefit in and of themselves, helping to build trust and rapport between therapist and client.
“Sometimes it can be playful for clients to richly characterise their problem stories,” says Newman.
They can also reduce the power of the problem story by creating more distance between the person and the problem.
Narrative therapy also has applications for couples and groups. In such contexts, a supportive audience or outsider witnesses can be very helpful, says Newman.
He gives the hypothetical example of a family experiencing significant internal conflict.
“[Say] there’s a huge amount of fighting, bickering, criticism and defensiveness, and what emerges is that everyone except for the mother thinks the mother is the biggest culprit.”
Using the principles of narrative therapy, Newman would first encourage the family unit to externalise the issue.
“Rather than making the mother the culprit – that is, the person who is the problem – we would have a series of conversations to reveal that conflict itself is the problem.”
Newman would then encourage the family to think about actions they had already taken that had proven effective in “closing the door to conflict.”
“The work succeeds because there is an externalised naming of the problem, which is conflict, that the family can then address as a team.”
Putting narrative therapy into practice
Newman has worked with the APS to develop a narrative therapy CPD activity that explores the theories that underpin the therapy and the ethical issues that might arise in its practice.
“This could include how might we work with more than one person when there might be multiple conflicting agendas, or how might we respond if there are matters of abuse, or how might we deal with those who are suicidal,” he says.
Therapists can get a feel for the modality right away by asking clients questions that promote externalisation, says Newman.
“A prime example is asking about the effects of something. ‘What are the effects of the anxiety?’ Or: ‘What are the effects of the alcohol?’ That phrasing separates the problem from the person.”
Another emphasis of narrative therapy practice is to listen to and affirm the client's own capacity for change and help. This approach helps psychologists to avoid giving advice, even inadvertently.
“Try to resist imposing even a small suggestion for what someone might do, even if that suggestion comes from a place of great benevolence and kindness, and even if it’s evidence based. Instead, train yourself to listen out for how people are already helping themselves.
“In narrative therapy, the listening is referred to as ‘double-listening’. This includes listening to the problem story, as well as the ways people are responding to the problem story, which is the material for the preferred or strong story.”
By helping clients distance themselves from their distress and recognise their own latent resilience, psychologists and practitioners can foster a deeper sense of agency and long-term change.
Whether applied to complex family dynamics or individual struggles with anxiety, these techniques provide a versatile addition to any psychologist's toolkit.
To further explore these frameworks and integrate them into your practice, the APS Narrative Therapy CPD activity is currently available as part of the 50% CPD sale.