抑郁症主要叙事疗法的解析

叙事疗法在治疗抑郁症的过程中,以把人和问题分开的外化思维和“问题从哪里来”的解构思维为基础,从个体监控、家庭监控和社会文化层面的监控三个视角,去追溯困扰抑郁症来访者问题的源头。从而可以有距离地看待“抑郁症”这个问题,提高患者对抑郁症的掌控感和力量感。叙事疗法从患者生命中的闪光点着手,通过寻找抑郁症患者生命中的独特结果,重塑、改写和丰厚抑郁症患者想要的生命故事,从而重建患者的自我身份认同,开启崭新的生命历程,带着新的自我身份认同,从而应对生命中的问题和困难。     

Toward a Developmentally Informed Narrative Therapy

Narrative approaches to psychotherapy emphasize the impact of the stories or narratives we construct on our reality and behavior. However, little effort has been made to elucidate how individuals' differential capacities for meaning-making influence the process of re-storying lives. The present article introduces to family therapy a model of the changing nature of individuals' ability to create meaning. The model, referred to as developmental-constructivism ( 10 ), suggests that, in addition to contextual factors, individual differences in the capacity for organizing experience will influence therapeutic efforts to generate new and more adaptive narratives. The model is also presented as a heuristic for comparing and integrating two influential approaches to narrative therapy: the externalizing approach of Michael White and the solution-focused approach of Steve de Shazer.     

Narrative Sexual Identity Therapy

Sexual identity therapy is an alternative to the two polarized positions of sexual reorientation therapy and gay-integrative therapy for clients who present with sexual identity concerns. This alternative model focuses on sexual identity—the private and public acts of identifying and communicating one's sexual preferences—and how the decision to do so is informed by dominant stories about what sexual attractions mean to a client. As one expression of sexual identity therapy, this paper presents narrative sexual identity therapy, an approach that utilizes a narrative therapeutic approach and techniques to facilitate exploration of dominant narratives and counter-narratives that speak to sexual identity with the goal of achieving a synthesis that reflects felt congruence of clients' beliefs/values and behavior/identity.     

Narrative Child Family Therapy

In this article, child family therapy is presented as a hermeneutic activity shaped by an interest in the evolving narrative. Over brief, analytic play interviews, the therapist documents a child's narrative understanding of the presenting family problem. This allows psychological meaning to be jointly constructed in therapeutic conversation with the child and family. The idea of play as narrative integrates child psychotherapy into recent social constructionist thinking in family therapy. The article also discusses how narrative therapists can use prior theory and training.     

A Family Therapy Narrative

The evolution of the field of family therapy since its inception in the 1950s is traced in this article. Major contributory forces as well as key pioneers in the first generation and leaders in successive generations are highlighted. This is followed by an elucidation of the conceptual foundations and basic principles undergirding almost all of the main theoretical schools. Expansion in this now vast field is underscored through attention to the proliferation of the number of books and journals addressing family therapy/psychology topics as well as mention of the internationalization of the field. A typology of extant theoretical models is also presented. The article closes with a discussion of contemporary issues and trends.     

A Sequential Analysis of Externalizing in Narrative Therapy with Children

Externalizing, or separating the person from his/her problem-saturated story, is a central approach in narrative therapy. Michael White, one of the therapy’s founders, lately revised his map of the externalizing process in therapy according to Vygotskian theory. In this study we sought to determine whether White’s proposed process was evident in therapy sessions. Sequential analysis indicated that therapists scaffolded children’s responses according to White’s map, and therapists’ and children’s utterances tended to advance across the levels of the map over the course of a session, indicating that White’s model of narrative therapy matched the therapy’s empirical process.     

叙事疗法的生命伦理学关怀

简要回顾了叙事疗法的诞生和在中国的传播过程,探讨了叙事疗法在三个方面的生命伦理学关怀:以生命权力的平等为前提、以人文生态的和谐为途径、以生命意义的丰富为旨归.最后探讨分析了叙事疗法的发展潜力,并指出叙事疗法所蕴含的生命伦理学关怀是一个重要的推动因素.     

Changes in Decentering Across Cognitive Behavioral Group Therapy for Social Anxiety Disorder

To further improve treatments, we need to better understand potential common treatment mechanisms, such as decentering, or the ability to observe thoughts and feelings as objective events in the mind rather than personally identifying with them (Safran & Segal, 1990). Therefore, this study examined whether 12 sessions of Cognitive Behavioral Group Therapy (CBGT) for 63 clients (57.6% female, 50.8% White) diagnosed with social anxiety disorder led to increases in decentering and whether increased decentering was associated with improved outcome. Furthermore, this study examined whether decentering was associated with outcome over and above a competing mechanism—cognitive reappraisal. Overall, results indicated that CBGT in this study led to similar outcomes compared to previous studies and decentering increased over CBGT (d’s from 0.81 to 2.23). Change in decentering predicted improvement on most, but not all, measures of outcome and those who no longer met criteria for social anxiety disorder at posttreatment had significantly greater change in decentering across therapy and significantly higher decentering scores at post-treatment compared to those who retained a social anxiety disorder diagnosis at posttreatment. Finally, changes in decentering predicted outcome over and above changes in reappraisal on all outcome measures. These results largely support the role of decentering in CBGT for social anxiety; however, the implications of the inconsistencies in results based on which outcome measure was used are discussed.     

后现代叙事心理治疗探幽

近15年来国际心理治疗界出现一种由科学隐喻向叙事隐喻转变的潮流.它突出了心理问题的多维性和生活方式的多样性,强调整体联系的视角,与中国文化中的"大人"思想相契合.对叙事心理治疗做探讨,分为三个部分:什么是叙事心理治疗,介绍对叙事心理治疗的整体理解;叙事心理治疗的哲学渊源,介绍叙事心理治疗的理论基础;伦理问题,探讨叙事心理治疗在组织实施过程中权力关系与责任分布.     

后现代叙事心理治疗探幽

近15年来国际心理治疗界出现一种由科学隐喻向叙事隐喻转变的潮流。它突出了心理问题的多维性和生活方式的多样性,强调整体联系的视角,与中国文化中的“大人”思想相契合。对叙事心理治疗做探讨,分为三个部分:什么是叙事心理治疗,介绍对叙事心理治疗的整体理解;叙事心理治疗的哲学渊源,介绍叙事心理治疗的理论基础;伦理问题,探讨叙事心理治疗在组织实施过程中权力关系与责任分布。     

Using a Session Feedback Form in Cognitive Therapy with Children

This article presents a new written form for eliciting session feedback from children. The importance of session feedback is discussed and the specific written form is presented. Clinical applications and advantages of the session feedback form are also reviewed. Additionally, the uses of the session feedback form in supervision are explained. Finally, cautions and limitations are outlined.     

Narrative Therapy Using a Reflecting Team: An Ethnographic Study of Therapists' Experiences

Narrative therapy in the last 15 years has been utilized by many clinicians and yet there is a lack of research on therapists' experience of this approach. This ethnographic research explores the views and perceptions of eight narrative therapists who belonged to a narrative team in an outpatient clinic. These therapists were observed and interviewed. Five themes emerge from the data. The themes include a sense of success in reducing the clients' problems as well as some limitations of narrative therapy. Two recommendations for research and practice involve the use of narrative therapy without a team and the use of narrative therapy in addressing issues of family violence.     

Adding Silence to Stories: Narrative Therapy and Contemplation

A review of the literature reveals that one particular form of contemplation—mindfulness—has been integrated into cognitive-behavioral therapy. Built upon this background, this article raises the issue of combining contemplation and narrative therapy. It first examines the unique experiences that occur when one enters into silence. Then, it explores the implications of these experiences for narrative therapy. A contemplative-based approach to narrative therapy differs from traditional narrative therapy in that it utilizes: (a) contemplative skills, (b) contemplative and narrative metaphors, (c) modified interventions, and (d) broader views of reality and self. The outcome is an enlarged narrative approaches that possess numerous benefits and possibilities for future treatment models. P. Gregg Blanton is a Professor of Human Services at Montreat College. He is a Clinical Member and Approved Supervisor of AAMFT.     

The Narrative/Collaborative Process in Couples Therapy:

A narrative approach to couples therapy provides a glance at the emerging postmodern dialogue. This article discusses changes in the therapeutic relationship, content, and process, emphasizing a feminist perspective. The client/therapist relationship is viewed as a collaborative process by which hierarchical distinctions are decreased. Externalization, deconstruction, and re-authoring are described and demonstrated through a clinical vignette. Our own evolving story as couples therapists is also presented.     

On the Right Track: Client Experience of Narrative Therapy

This article presents an ethnographic research on eight families' experience of narrative therapy and discusses six major themes found in the interviews including externalizing conversation, developing the alternate story, personal agency, reflecting/consulting teams, building a wider audience, and the helpful and unhelpful aspects of the therapy. The findings and the notation that families found the therapy to be very effective are also included.     

The Small and the Ordinary: The Daily Practice of a Postmodern Narrative Therapy

In this article, I contrast assumptions of a modernist worldview and a postmodern worldview as they relate to clinical practice. Two exercises are described that help therapists develop insight into and practice with the kind of thinking that is consistent with a postmodern narrative clinical practice. Particular attention is paid to the ways that even the small and the ordinary — single words, single gestures, minor asides, trivial actions — can provide opportunities for generating new meanings. Five concepts that I routinely use in my professional and personal life and that are consistent with a postmodern narrative practice — discourse, externalizing the internalized discourse, exceptions, power as the means to produce a consensus, and characteristics of narrative — are illustrated.     

Case Formulation in Poststructural Narrative Therapy

This article offers a formulation structure for poststructural narrative therapy. As a self-declared constitutionalist approach, narrative therapy has neglected the issue of formulation, perhaps out of concern that it might lead to an essentialist and seemingly objective account of the person. However, provided care is taken around these dangers, there are advantages to formulation: It can provide much needed theoretical discipline in our thought, encourage us to reflect on how persons become trapped in problem-saturated identities and situations, and permit previously unforeseen intervention strategies. This article offers a simple structure for the development of a narrative therapeutic formulation, presented in four parts: subject positions, discourses, normalizing judgments, and disqualified knowledges. An example of a case is used to illustrate.