Narrative change in psychotherapy: differences between good and bad outcome cases in cognitive, narrative, and prescriptive therapies

Abstract

This study aimed to clarify the relationship between changes in the patients' narratives and therapeutic outcomes. Two patients were selected from three psychotherapeutic models (cognitive, narrative, and prescriptive therapies), one with good therapeutic outcome and the other with bad therapeutic outcome. Sessions from the initial, middle, and final phases for each patient were evaluated in terms of narrative structural coherence, process complexity, and content diversity. Differences between patients' total narrative production were found at the end of the therapeutic process. Good outcome cases presented a higher statistically significant total narrative change than poor outcome cases.

Narrative Therapy vs. Cognitive-Behavioral Therapy for moderate depression: Empirical evidence from a controlled clinical trial

“…Although widely practiced throughout the world, NT remains underresearched (Busch, 2011;Chenail, DeVicentis, Kiviat, & Somers, 2012;Etchison & Kleist, 2000). Some qualitative process research studies (Matos, Santos, Gonçalves, & Martins, 2009;Moreira, Beutler, & Gonçalves, 2008) and several case studies (Betchley & Falconer, 2002;Cashin, 2008;da Costa, Nelson, Rudes, & Guterman, 2007;Draucker, 1998;Kropf & Tandy, 1998;Nylund, 2002;Palgi & Ben-Ezra, 2010;Rothschild, Brownlee, & Gallant, 2000;Young, 2008) suggest positive outcomes for a wide range of problems and disorders. However, only one of these qualitative studies (Kropf & Tandy, 1998) has addressed the effectiveness of NT for depression, and none have done so in a controlled clinical trial.…”

A view from the outside: Reflections on Relational Systems Evaluation

“…As noted in Urban, Hargraves, et al (this volume), each of these outcomes enhances the adaptive capacity of the program, enabling the program team greater flexibility to co‐evolve with their environments. These outcomes mirror two of the primary outcomes of psychological counseling: a reformulated, co‐constructed personal narrative that enables a client to better adapt and function within their environment (Moreira, Beutler, & Gonçalves, 2008), and a more developed evaluative mindset, internalized from skilled questions asked by the counselor, that enables the client to go forward, learning and adapting while using this new mindset (Dobson & Dobson, 2018).…”

Phenomenological-narrative contributions to understand the narrative strategies that shape the autobiographical account throughout different moments of the therapeutic process

“…In other research studies using the NA-Grid and the above-mentioned coding systems for the analysis of narrative process, structure, and content (NSCCS, PCCS, and CMCS), respectively, clients' self-narratives have been assessed during the initial, middle, and final stages of the therapeutic process by comparing cases of poor and good therapeutic results. These studies have shown a greater multiplicity of content, a greater structural narrative coherence, and a greater complexity of the narrative process in clients' self-narratives after a successful therapeutic process (Botella & Cutura, 2015;Moreira, Beutler, & Gonçalves, 2008). In another research line, Gonçalves and his team have used the IMCS to study the different moments in the therapeutic process, attending to those segments when clients show signs of change (innovative moments) or, in contrast, ambivalence to change (ambivalence) with regard to the content of their problematic self-narrative.…”

“…In other research studies using the NA-Grid and the above-mentioned coding systems for the analysis of narrative process, structure, and content (NSCCS, PCCS, and CMCS), respectively, clients’ self-narratives have been assessed during the initial, middle, and final stages of the therapeutic process by comparing cases of poor and good therapeutic results. These studies have shown a greater multiplicity of content, a greater structural narrative coherence, and a greater complexity of the narrative process in clients’ self-narratives after a successful therapeutic process (Botella & Cutura, 2015 ; Moreira, Beutler, & Gonçalves, 2008 ).…”