Sample 3 bipolar on female adult populationNicole Valerio
Hello Sir
We are a premier academic writing agency with industry partners in UK, Australia and Middle East and over 15 years of experience. We are looking to establish long-term relationships with industry partners and would love to discuss this opportunity further with you.
Thanks & Regards
visit our website.
www.onlineassignmenthelp.com.au
www.freeassignmenthelp.com
www.btechndassignment.cheapassignmenthelp.co.uk
www.cheapassignmenthelp.com
www.cheapassignmenthelp.co.uk/
http://www.cheapassignmenthelp.net/
Este artículo de Morga y Long es una revisión de la evidencia cualitativa con respecto a la efectividad de las intervenciones de terapia ocupacional en niños con trastorno del desarrollo y de la coordinación
A critical review of three articles reveals flawed empirical
evidence underpinning the case for integrating pharmacotherapy and
psychotherapy. Medical model dominance favors biology in a diathesis/
stress framework, creating myths of valid diagnosis, underlying biological
causes, and targeted pharmacological treatments. Meanwhile, a for-profit
pharmaceutical industry influences clinical trials, constructing an illusory
justification for medical intervention and bolstering the integration hypothesis.
The apparent logic of integration threatens to diminish the crucial,
empirically supported role of clients in psychotherapy outcome.
The authors call for the inclusion of client feedback in intervention
choices, based on accurate, unbiased information, and a continued critique
of pharmacotherapy
Autism Spectrum Disorders (ASD) in Kenya: Barriers Encountered in Diagnosis, ...QUESTJOURNAL
ABSTRACT: Autism is one of five disorders that fall under the umbrella of Pervasive Developmental Disorders (PDD). While protocols for screening, diagnosis and treatment has increased in recent years in highincome countries (e.g., the United States, and the European Union countries), there is little to no available research in Africa. In an effort to close the knowledge gap in Kenya, a country in East Africa, this study sought to understand the difficulties that parents, care givers and special needs providers encounter as they experience the diagnosis, and treatment of autism in Kenya. 39 parents, caregivers and 11 special needs providers were participants in this study. Eight major themes emerged as difficulties that parents, care givers and special needs providers encounter as they go about in the diagnosis, and treatment of autism in Kenya. These major themes were; the lack of awareness, limited research, cultural factors, the lack of treatment protocols, the lack of institutional/government support and the out –of- reach financial price-tag for treatment of children with autism, social stigma, isolation and broken families.
Running head RESEARCH PROPOSAL ON COUPLES COUNSELING RESEA.docxtoltonkendal
Running head: RESEARCH PROPOSAL ON COUPLES COUNSELING
RESEARCH PROPOSAL ON COUPLES COUNSELING 5
Research Proposal on Couples Counseling
Social Work Practice Research I (SOCW - 6301 - 3)
Introduction
This research proposal is about undertaking research to find the best therapy method for couples between individual, group, and couples therapy. The proposal will detail the findings of past researchers and will occasionally focus on the therapy methods in the context of a couple that is experiencing conflict mainly based on the rejection of their same-sex marriage by their respective families. It will also detail the methodologies used by other researchers in investigating the therapy methods. The study will reveal the most recommended therapy method and the variations of the method.
Research Problem and Question
Many couples quarrel because their respective families reject their union or relationship or marriage. Most of the affected couples are those whose respective families are deeply divided on the basis of religion, race/ethnicity and socio-economic status. However, some families just oppose relationships because they threaten their traditions, which are mostly rooted on religion. Some families oppose gay or lesbian relationships or marriages. Even when a family member reveals that he or she may attracted to a member of the opposite sex, the other family members may rise up against that family member. It may make teenagers and young adults hide about their sexual orientation. The stigmatization may be too unbearable for the affected individuals, who may choose to go into seclusion and engage in suicidal actions. There are couples like Kathleen and Lisa who courageously seek the help of therapists. Upon setting a stage for positive development, couples can ease the tension in the mind. They can open up to people and feel ready to solve problems together. The question that comes in mind in light of these facts is: What it the true impact of sexual orientation-based rejection by family members on a relationship? How can a social worker help couples overcome sexual orientation-based rejection by family members on a relationship? The research question of the study is: which between individual, group, and couples therapy is the best therapy method for couples?
Literature Review on Individual, Group, and Couples Therapy
The therapeutic alliance concept is mainly associated with individual psychotherapy, particularly in literature. Yet, the concept is increasingly used together within the marital and family therapy domains. According to Pinsof and Catherall (1986), “a systemic perspective is brought to bear on the concept within individual psychotherapy. A new, integrative definition of the alliance is presented that conceptualizes individual, couple and family therapy as occurring within the same systemic framework”. The authors examined family, couple and individual therapy and used some methodologies and deve ...
Sample 3 bipolar on female adult populationNicole Valerio
Hello Sir
We are a premier academic writing agency with industry partners in UK, Australia and Middle East and over 15 years of experience. We are looking to establish long-term relationships with industry partners and would love to discuss this opportunity further with you.
Thanks & Regards
visit our website.
www.onlineassignmenthelp.com.au
www.freeassignmenthelp.com
www.btechndassignment.cheapassignmenthelp.co.uk
www.cheapassignmenthelp.com
www.cheapassignmenthelp.co.uk/
http://www.cheapassignmenthelp.net/
Este artículo de Morga y Long es una revisión de la evidencia cualitativa con respecto a la efectividad de las intervenciones de terapia ocupacional en niños con trastorno del desarrollo y de la coordinación
A critical review of three articles reveals flawed empirical
evidence underpinning the case for integrating pharmacotherapy and
psychotherapy. Medical model dominance favors biology in a diathesis/
stress framework, creating myths of valid diagnosis, underlying biological
causes, and targeted pharmacological treatments. Meanwhile, a for-profit
pharmaceutical industry influences clinical trials, constructing an illusory
justification for medical intervention and bolstering the integration hypothesis.
The apparent logic of integration threatens to diminish the crucial,
empirically supported role of clients in psychotherapy outcome.
The authors call for the inclusion of client feedback in intervention
choices, based on accurate, unbiased information, and a continued critique
of pharmacotherapy
Autism Spectrum Disorders (ASD) in Kenya: Barriers Encountered in Diagnosis, ...QUESTJOURNAL
ABSTRACT: Autism is one of five disorders that fall under the umbrella of Pervasive Developmental Disorders (PDD). While protocols for screening, diagnosis and treatment has increased in recent years in highincome countries (e.g., the United States, and the European Union countries), there is little to no available research in Africa. In an effort to close the knowledge gap in Kenya, a country in East Africa, this study sought to understand the difficulties that parents, care givers and special needs providers encounter as they experience the diagnosis, and treatment of autism in Kenya. 39 parents, caregivers and 11 special needs providers were participants in this study. Eight major themes emerged as difficulties that parents, care givers and special needs providers encounter as they go about in the diagnosis, and treatment of autism in Kenya. These major themes were; the lack of awareness, limited research, cultural factors, the lack of treatment protocols, the lack of institutional/government support and the out –of- reach financial price-tag for treatment of children with autism, social stigma, isolation and broken families.
Running head RESEARCH PROPOSAL ON COUPLES COUNSELING RESEA.docxtoltonkendal
Running head: RESEARCH PROPOSAL ON COUPLES COUNSELING
RESEARCH PROPOSAL ON COUPLES COUNSELING 5
Research Proposal on Couples Counseling
Social Work Practice Research I (SOCW - 6301 - 3)
Introduction
This research proposal is about undertaking research to find the best therapy method for couples between individual, group, and couples therapy. The proposal will detail the findings of past researchers and will occasionally focus on the therapy methods in the context of a couple that is experiencing conflict mainly based on the rejection of their same-sex marriage by their respective families. It will also detail the methodologies used by other researchers in investigating the therapy methods. The study will reveal the most recommended therapy method and the variations of the method.
Research Problem and Question
Many couples quarrel because their respective families reject their union or relationship or marriage. Most of the affected couples are those whose respective families are deeply divided on the basis of religion, race/ethnicity and socio-economic status. However, some families just oppose relationships because they threaten their traditions, which are mostly rooted on religion. Some families oppose gay or lesbian relationships or marriages. Even when a family member reveals that he or she may attracted to a member of the opposite sex, the other family members may rise up against that family member. It may make teenagers and young adults hide about their sexual orientation. The stigmatization may be too unbearable for the affected individuals, who may choose to go into seclusion and engage in suicidal actions. There are couples like Kathleen and Lisa who courageously seek the help of therapists. Upon setting a stage for positive development, couples can ease the tension in the mind. They can open up to people and feel ready to solve problems together. The question that comes in mind in light of these facts is: What it the true impact of sexual orientation-based rejection by family members on a relationship? How can a social worker help couples overcome sexual orientation-based rejection by family members on a relationship? The research question of the study is: which between individual, group, and couples therapy is the best therapy method for couples?
Literature Review on Individual, Group, and Couples Therapy
The therapeutic alliance concept is mainly associated with individual psychotherapy, particularly in literature. Yet, the concept is increasingly used together within the marital and family therapy domains. According to Pinsof and Catherall (1986), “a systemic perspective is brought to bear on the concept within individual psychotherapy. A new, integrative definition of the alliance is presented that conceptualizes individual, couple and family therapy as occurring within the same systemic framework”. The authors examined family, couple and individual therapy and used some methodologies and deve ...
Abstract:
It is difficult to find in Spanish a word that can translate the meaning of Counselling and encompassing all those elements and nuances that you are your own. The translations more frequently used are "assisted advice" and/or "aid relationship" and/or advice, it also includes all the skills that are necessary to establish that interpersonal relationship.
Although the communication skills, and in particular communication of bad news and the relationship with users are currently not part of the university education within the degree in Medicine, Nursing, Physiotherapy or Psychology if it has been of concern on the part of practitioners in these areas present sufficient levels of training in this core competency. In fact, we presented/displayed a communication where the little information received in the own hospital on the part of parents with children with Syndrome of Down is reflected in particular on this genetic alteration before making decisions referred to the birth from the boy. Thus, just as the curative art is learned can be learned the abilities of communication referred the unexpected news, which will help to diminish the psychological cost for the professional and the own patient.
FOCUS ON ETHICSJeffrey E. Barnett, EditorEthics and Mu.docxbudbarber38650
FOCUS ON ETHICS
Jeffrey E. Barnett, Editor
Ethics and Multiculturalism: Advancing Cultural
and Clinical Responsiveness
Miguel E. Gallardo
Pepperdine University
Josephine Johnson
Livonia, Michigan
Thomas A. Parham
University of California, Irvine
Jean A. Carter
Washington, D.C.
The provision of ethical and responsive treatment to clients of diverse cultural backgrounds is
expected of all practicing psychologists. While this is mandated by the American Psychological
Association’s ethics code and is widely agreed upon as a laudable goal, achieving this mandate is
often more challenging than it may seem. Integrating culturally responsive practices with more
traditional models of psychotherapy into every practitioner’s repertoire is of paramount importance
when considering the rapidly diversifying population we serve. Psychologists are challenged to
reconsider their conceptualizations of culture and of culturally responsive practice, to grapple with
inherent conflicts in traditional training models that may promote treatments that are not culturally
responsive, and to consider the ethical implications of their current practices. Invited expert
commentaries address how conflicts may arise between efforts to meet ethical standards and being
culturally responsive, how the application of outdated theoretical constructs may result in harm to
diverse clients, and how we must develop more culturally responsive views of client needs, of
boundaries and multiple relationships, and of treatment interventions. This article provides addi-
tional considerations for practicing psychologists as they attempt to navigate dimensions of culture
and culturally responsive practice in psychology, while negotiating the ethical challenges presented
in practice.
Keywords: ethics, multicultural, psychotherapy, culture, cultural competency
MIGUEL E. GALLARDO received his PsyD in clinical psychology from the
California School of Professional Psychology, Los Angeles. He is associate
professor of psychology at Pepperdine University Graduate School of
Education and Psychology and maintains a part-time independent and
consultation practice. His areas of research and practice include culturally
responsive practices with Latinos and multicultural and social justice
issues. He co-edited the book Intersections of Multiple Identities: A Case-
book of Evidence-Based Practice with Diverse Populations in 2009.
JOSEPHINE JOHNSON received her PhD in clinical psychology from the
University of Detroit. She has a full-time independent practice in Livonia,
Michigan; is a consultant to community mental health and residential
treatment facilities; and provides clinical supervision. Her professional
interests include cultural competency and business-of-practice issues. She
chaired the American Psychological Association Task Force on the Imple-
mentation of the Multicultural Guidelines.
THOMAS A. PARHAM received his PhD in counseling psychology at South-
ern Illinois University at Carbond.
Family Therapy CourseUsing the brief case description below, pre.docxssuser454af01
Family Therapy Course
Using the brief case description below, prepare a script you could use to call the mock client’s pediatrician for a 10-minute conversation. To prepare, consider the following: What facts do you need to communicate to the doctor? What will the doctor likely want to know from you? What will you want to be sure to tell the doctor about your diagnosis of him having ADHD and treatment plan for family? You diagnose that he should be placed on medication and pediatricians nurse prescribe the diagnosis level
Case description: Your client is an 8-year-old male whose parents are concerned might have ADHD. He is the middle child of three boys. You have met the parents and the child in your initial sessions. At this point, you have had only three sessions with the family. Your client says he has lots of friends, he hates school because it’s boring, and his parents yell at him too much!
Write a mock transcript of an imaginary phone call between you and the client’s physician. In your mock discussion, include information you would provide to the doctor about your assessment, treatment plan, and orientation to treating ADHD; include the doctor’s questions or responses to the information you provide. Also, include questions you would ask the doctor, and the doctor’s responses.
Transcript Length: 5 pages
A NATIONAL SURVEY OF FAMILY PHYSICIANS:
PERSPECTIVES ON COLLABORATION WITH
MARRIAGE AND FAMILY THERAPISTS
Rebecca E. Clark
Lifespan Family Healthcare, Newcastle, Maine
Deanna Linville
University of Oregon
Karen H. Rosen
Virginia Polytechnic Institute and State University
Recognizing the fit between family medicine and marriage and family therapy (MFT),
members of both fields have made significant advances in collaborative health research
and practice. To add to this work, we surveyed a nationwide random sample of 240 family
physicians (FPs) and asked about their perspectives and experiences of collaboration with
MFTs. We found that FPs frequently perceive a need for their patients to receive MFT-
related care, but their referral to and collaboration with MFTs were limited. Through
responses to an open-ended question, we gained valuable information as to how MFTs
could more effectively initiate collaboration with FPs.
Despite the success of medical family therapists in providing integrative, collaborative
healthcare, we know little about how commonly family physicians (FPs) and marriage and fam-
ily therapists (MFTs) collaborate in routine patient care. To our knowledge, there have been
no studies published from the perspective of the FP that describe the extent to which FPs seek
the collaboration of MFTs, the degree to which they are aware of MFT as a field, their per-
ceived need for their patients to receive MFT, or their attitude toward MFT as a potential
resource for patient treatment.
Leaders in family medicine and MFT recognize the common occurrence of mental health
concerns arising in a medical visit. In fact, it ...
Exploring Adventure Therapy as an Early Intervention for Struggling AdolescentsWill Dobud
This paper presents an account of a research project that explored the experiences of adolescents struggling with behavioural and emotional issues, who participated in a 14-day adventure therapy program in Australia referred to by the pseudonym, ”Onward Adventures.” All participants of this program over the age of 16 who completed within the last two years were asked to complete a survey. Additionally, the parents of these participants were invited to complete a similar survey. The qualitative surveys were designed to question participants’ and parents’ perceptions of the program (pre- and post-), the relationships (therapeutic alliance) built with program therapists, follow-up support, and outcomes of the program. Both participants and parents reported strong relationships with program leaders, stressed the importance of effective follow-up services, and perceived positive outcomes when it came to self-esteem and social skills, seeing comparable improvement in self-concept, overall behaviour, and coping skills.
Similar to Volume 39 n um ber 2a pril 2017pages i l6 l3 ld o iio .i (18)
2024.06.01 Introducing a competency framework for languag learning materials ...Sandy Millin
http://sandymillin.wordpress.com/iateflwebinar2024
Published classroom materials form the basis of syllabuses, drive teacher professional development, and have a potentially huge influence on learners, teachers and education systems. All teachers also create their own materials, whether a few sentences on a blackboard, a highly-structured fully-realised online course, or anything in between. Despite this, the knowledge and skills needed to create effective language learning materials are rarely part of teacher training, and are mostly learnt by trial and error.
Knowledge and skills frameworks, generally called competency frameworks, for ELT teachers, trainers and managers have existed for a few years now. However, until I created one for my MA dissertation, there wasn’t one drawing together what we need to know and do to be able to effectively produce language learning materials.
This webinar will introduce you to my framework, highlighting the key competencies I identified from my research. It will also show how anybody involved in language teaching (any language, not just English!), teacher training, managing schools or developing language learning materials can benefit from using the framework.
Read| The latest issue of The Challenger is here! We are thrilled to announce that our school paper has qualified for the NATIONAL SCHOOLS PRESS CONFERENCE (NSPC) 2024. Thank you for your unwavering support and trust. Dive into the stories that made us stand out!
Acetabularia Information For Class 9 .docxvaibhavrinwa19
Acetabularia acetabulum is a single-celled green alga that in its vegetative state is morphologically differentiated into a basal rhizoid and an axially elongated stalk, which bears whorls of branching hairs. The single diploid nucleus resides in the rhizoid.
Unit 8 - Information and Communication Technology (Paper I).pdfThiyagu K
This slides describes the basic concepts of ICT, basics of Email, Emerging Technology and Digital Initiatives in Education. This presentations aligns with the UGC Paper I syllabus.
A Strategic Approach: GenAI in EducationPeter Windle
Artificial Intelligence (AI) technologies such as Generative AI, Image Generators and Large Language Models have had a dramatic impact on teaching, learning and assessment over the past 18 months. The most immediate threat AI posed was to Academic Integrity with Higher Education Institutes (HEIs) focusing their efforts on combating the use of GenAI in assessment. Guidelines were developed for staff and students, policies put in place too. Innovative educators have forged paths in the use of Generative AI for teaching, learning and assessments leading to pockets of transformation springing up across HEIs, often with little or no top-down guidance, support or direction.
This Gasta posits a strategic approach to integrating AI into HEIs to prepare staff, students and the curriculum for an evolving world and workplace. We will highlight the advantages of working with these technologies beyond the realm of teaching, learning and assessment by considering prompt engineering skills, industry impact, curriculum changes, and the need for staff upskilling. In contrast, not engaging strategically with Generative AI poses risks, including falling behind peers, missed opportunities and failing to ensure our graduates remain employable. The rapid evolution of AI technologies necessitates a proactive and strategic approach if we are to remain relevant.
Embracing GenAI - A Strategic ImperativePeter Windle
Artificial Intelligence (AI) technologies such as Generative AI, Image Generators and Large Language Models have had a dramatic impact on teaching, learning and assessment over the past 18 months. The most immediate threat AI posed was to Academic Integrity with Higher Education Institutes (HEIs) focusing their efforts on combating the use of GenAI in assessment. Guidelines were developed for staff and students, policies put in place too. Innovative educators have forged paths in the use of Generative AI for teaching, learning and assessments leading to pockets of transformation springing up across HEIs, often with little or no top-down guidance, support or direction.
This Gasta posits a strategic approach to integrating AI into HEIs to prepare staff, students and the curriculum for an evolving world and workplace. We will highlight the advantages of working with these technologies beyond the realm of teaching, learning and assessment by considering prompt engineering skills, industry impact, curriculum changes, and the need for staff upskilling. In contrast, not engaging strategically with Generative AI poses risks, including falling behind peers, missed opportunities and failing to ensure our graduates remain employable. The rapid evolution of AI technologies necessitates a proactive and strategic approach if we are to remain relevant.
Volume 39 n um ber 2a pril 2017pages i l6 l3 ld o iio .i
1. Volume 39/N um ber 2/A pril 2017/Pages I l6 - l3 l/d o i:IO .I7
7 4 4 lm e h c .3 9 .2 .0 3
THEORY
Narrative Family Therapy: Practical
Techniques fo r More Effective W ork
w ith Couples and Families
E ric G . S u d d e a th
A le x a n d r ia K. K e rw in
S u z a n n e M . D u g g e r
U n iv e rs ity o f Mississippi
This article provides counselors with an introduction to the
knowledge and skills involved in
providing narrative family therapy (NFT). Following an
overview o f the theoretical foundations
undergirding this therapeutic approach, a case study is used to
illustrate the use o f numerous
N F T techniques. These techniques include eliciting stories to
meet families apart from their
problems, recognizing cultural discourse and its impact on
family narratives, externalizing
the problem from the family, and re-authoring the story through
the identification and under-
standing o f exceptions and unique outcomes and the
identification and enactment o f preferred
narratives. The article concludes with recommendations for
further development o f competence
in this area.
2. Despite the fact that many client issues stem from, involve, or
affect
family relationships, therapists have predominantly focused on
the individual
when providing counseling services (Ivey, D ’Andrea, & Ivey,
2012). This focus
on the individual has its roots in the early development of
psychoanalysis and
continues to be reflected in training standards such as those
generated by the
Council for Accreditation of Counseling and Related
Educational Programs
(CACREP, 2016). Historically, this emphasis on individual
therapy has its basis
in the influence of Freud and many of his colleagues (Nichols,
2013). These
pioneers recognized the correlation between client symptoms
and early nega-
tive interactions with family members, and this contributed to
their erroneous
conclusion that it would necessarily be more difficult for clients
to resolve their
issues with family members present in the therapy room
(Nichols, 2013).
Although contemporary counselors may not agree with this
conclusion,
their professional preparation continues to emphasize individual
approaches.
Indeed, there are only two standards addressing family or
systems issues in the
Eric G. Suddeath, D e p a rtm e n t o f Leadership and
Counselor E ducation. U niversity o f M ississippi;
3. Alexandria K. Kerwin, D e p a rtm e n t o f Leadership and
Counselor E ducation, U niversity o f M ississippi;
Suzanne M . Dugger, D e p a rtm e n t o f Leadership and
Counselor Education, U niversity o f M ississippi.
Correspondence concerning this a rticle should be addressed to
Eric Suddeath, D e p a rtm e n t o f Leadership
and Counselor Education, U niversity o f M ississippi,
University, M S 3 8 6 5 5 . E -m a il: [email protected] go.olem
iss.
edu
1 16 0 j o u r n a l o f M e n ta l H e a lt h C o u n s e lin g
Whitney
Sticky Note
Suddeath, E. G., Kerwin, A. K., & Dugger, S. M. (2017).
Narrative Family Therapy: Practical Techniques for More
Effective Work with Couples and Families. Journal of Mental
Health Counseling, 39(2), 116–131.
Exploratory Analyses o f Cognitive Schemas
entire set of CACREP standards for the eight common core
areas. O ne stan-
dard requires that accredited counselor preparation programs
address “theories
of individual and family development across the lifespan”
(CACREP, 2016,
F[3][a]). The second standard calls for attention to “a systems
approach to con-
ceptualizing clients” (CACREP, 2016, F[5][b]). With only these
4. two standards
addressing family or systems, counselor preparation programs
typically dedicate
relatively little time to these topics. Therefore, new counselors
often enter the
field less prepared to provide counseling services to couples and
families than
to individuals and groups.
However, when practicing in agency settings, counselors are
highly likely
to be assigned to counsel couples or families, an d counselors
in private practice
settings will often encounter requests for couple and family
counseling. In a
study examining the types of services delivered by clinicians
working with man-
aged care clients, respondents indicated that 30.0% of cases
were couples and
47.5% were family cases (Christensen & Miller, 2001). Given
this and the eth-
ical responsibility counselors have to maintain “high standards
of professional
competence” (American M ental Health Counselors Association,
2015, C [l]),
there is an ongoing need for counselors to expand their areas of
competence
to include couples and family counseling. Counselors must
continue adding
to their cache of tools to ensure that they remain current and
competent in
working with a wide range of clients. W hen seeking to add to
their metaphoric
toolbox, professional counselors should select tools with
sufficient scientific
evidence supporting their use (Patel, Hagedorn, & Bai, 2013).
5. Narrative family therapy (NFT) is one approach from which
professional
counselors may draw in order to effectively serve couple and
family clients.
Narrative therapy was co-constructed in the early 1980s by W
hite & Epston
(1990). This approach grew in popularity during the 1990s and
is now a widely
practiced modality of therapy (Madigan, 2011), with
considerable research
examining its application with multiple populations.
Specifically, researchers
have found narrative therapy effective in working with blended
families (Gold,
2016; Jones, 2004; Shalay & Brownlee, 2007), treating couples
impacted by
infidelity (Duba, Kindsvatter, & Lara, 2008), addressing
adoption issues (Stokes
& Poulsen, 2014), assisting families in which adolescents have
come out as les-
bian, gay, or bisexual (Saltzburg, 2007), reducing parent-child
conflicts (Besa,
1994), supporting homeless families (Fraenkel, Hameline, &
Shannon, 2009),
and improving the family functioning of couples (Rabiee, Zadeh
& Bahrami,
2008). Thus, although more research is needed to achieve
inclusion in the
National Registry of Evidence-Based Programs and Practices
(Substance Abuse
and M ental Health Services Administration, 2016), research
supporting the use
of narrative therapy approaches with families does exist.
The purpose of this article is to introduce counselors to the
6. knowledge
and skills involved in providing NFT. This article will begin
with an overview
of the theoretical foundations undergirding this therapeutic
approach. The
authors will then introduce a case study and illustrate the use of
numerous
N F T techniques. T he article will conclude with
recommendations for further
development of competence in this area.
0 Journal o f Mental Health Counseling 117
T H E O R E TIC A L F O U N D A T IO N S O F
NARRATIVE FAMILY THERAPY
There are two primary theories that have influenced approaches
to family
therapy: systems theory and social constructionism. Systems
theory is the basis
of traditional family therapies, while social constructionism
also informs more
contemporary, postmodern approaches to family counseling
(Gehart, 2014;
Ivey et al., 2012).
Systems Theory
Systems theory focuses on the complex and reciprocal
influences of
family members on one another, the attachm ent style and
boundaries within
a family system, the external impacts on the family system, and
the family sys-
7. tem ’s tendency toward homeostasis. Counselors wishing to
practice N FT will
benefit from understanding family stories through the lenses of
these system
theory constructs. For example, the concept of circular causality
will prompt
exploration of how the complex interactions among family
members result in
reciprocal, bidirectional influences on each m em ber’s stories.
In hearing these
stories, counselors will also be wise to notice the attachment
styles and types of
boundaries that exist among the family members. Similarly, it
will be essential
to conceptualize the family as a system within a wider cultural
and contextual
ecological system and to consider the importance of societal or
environmental
messages and events, both for the family’s stories and for the
stories of each
individual family member. Finally, in helping families
understand, challenge,
and change their stories, it will be important to recognize the
dual importance
of stability, through the maintenance of homeostasis, and
change, via growth
and adaptation, to the rewriting process. These concepts, drawn
from systems
theory, are essential to the effective practice of NFT.
Additionally, counselors
must understand concepts associated with the epistemology of
postmodernism
and the theory of social construc tionism.
Postmodernism and Social Constructionism
Counselors engaged in the practice of N FT are less interested
8. in facts
and more interested in the stories families and individual family
members have
constructed. This is due to the integral role social
constructionism plays in
the practice of narrative therapy. Social constructionism, and
the postmodern
epistemology on which it is based, contends that the seeking of
facts is futile.
Unlike modernists, who believe in objective truth and contend
that there is a
correct or incorrect way of viewing reality, postmodernists
contest the notion
that truth can be objectively known (Becvar & Becvar, 1999;
Hansen, 2015).
Rather than focusing on discovery and understanding of an
objective reality,
postmodernists champion the exploration and understanding of
multiple,
sometimes differing, but always valid views of reality. Social
constructionism
is based on postmodernism and places particular emphasis on
the impact
of social and cultural contexts in shaping perceptions of reality
and creating
shared knowledge (Hoyt, 1988).
1 18 0 Journal o f Mental Health Counseling
Exploratory Analyses o f Cognitive Schemas
The nature of reality. From this perspective, reality and
meaning are
9. co-constructed through interaction with others within a social
and cultural
context (Nichols, 2013). One’s beliefs and values become
internalized as
“reality” through this process. Although their clients may
present their stories
as “reality” or fact, narrative therapists seek to help clients
recognize how their
“realities” are simply internalized “stories” that have been
influenced by their
familial, social, and cultural contexts. Narrative therapists
empower clients to
build on this recognition by considering alternative ways of
viewing their sit-
uation. This philosophical lens offers greater flexibility and
power to consider
other interpretations of the stories clients tell about themselves,
others, and
their problems (Freedman & Combs, 1996; Flansen, 2015).
Given that a fam-
ily’s truths are socially constructed, they can also be
deconstructed and recon-
structed. These concepts are essential to the process of NFT
(Hansen, 2015).
The importance of language. It is also important for narrative
family
therapists to recognize the language that clients use in their
stories and the
impact of this language for understanding and labeling their
experiences
(Jones, 2003). In fact, it is so important that narrative family
therapists use story
and language not only as nouns but also as verbs, perhaps in
recognition of the
impact each can have. In this sense, language is the medium by
10. which family
members story (create meaning from) their experiences, and
how families
language (express meaning about) their interactions is largely
dependent on
the dominant cultural discourses available to them (White &
Epston, 1990).
These stories, which are based in societal and cultural messages
or mores, often
reflect people’s beliefs about their own identities as well as
each of their family
members’ identities.
Narrative therapists encourage clients to question these
messages instead
of automatically judging themselves by what society deems
right or wrong,
good or bad, and normal or abnormal. Toward this end,
narrative therapists aim
to help individuals recognize their selective attention to societal
and cultural
messages. Depending on the predominant cultural discourse
influencing the
family, the story and the language may differ dramatically.
Instead of noticing
only what fits their problem narrative, clients are encouraged to
consider ways
in which their narrative might be enriched by a strengths-based
perspective
(Gehart, 2014).
Based in systems theory, postmodernism, and social
constructionism, nar-
rative therapy is an intentional and dynamic dialogue in which
new meaning
can be created (Hoyt, 1998). These principles are evident in a
11. variety of tech-
niques and interventions used by narrative family therapists.
The remainder of
this article will use a fictional case study to describe and
illustrate the counsel-
ing process using NFT techniques. It will conclude with
recommendations for
further development of expertise in NFT.
CASE STUDY: THE HENDERSON FAMILY
Wien couples or families seek counseling, it is not uncommon
for them
to arrive not only with a description of their complaints but also
with an idea
1190 Journal of Mental Health Counseling
of the problem. Such was the case with the Henderson family, a
fictional com-
posite of actual families with whom we have worked.
About two years after they married, Steve and Anna Henderson
sought
couples counseling. Aged 35 and 32 respectively, each of them
had previously
been married and divorced, and they were now co-parenting
Anna’s 11-year-
old son, Tony. However, things were not going smoothly. Steve
and Anna
complained of difficulties connecting and communicating with
one another
and also reported tension between Tony and Steve. Anna
attributed these diffi-
12. culties to Steve’s recent change in mood, and Steve admitted
that he had been
“on edge” quite a bit lately. Specifically, Steve had become
increasingly angry
and impatient with Anna and Tony over the last 3 months.
This represented a change from the family’s previous level of
functioning.
Steve and Anna agreed that Steve got along well with Tony
when he and Anna
were dating and first married, and they both affirmed that
communication
used to be their strongest asset. Now, though, they were
struggling to connect
emotionally and physically, and the couple also expressed
concern for Tony
because of a recent drop in his grades and increased defiance at
home. Anna
reported feeling torn between wanting to defend her child and
wanting to
support her husband. Sne recognized Steve was going through a
difficult time
but stated that his anger made her want to withdraw, which
usually made Steve
even more upset.
Faced with such a scenario, professional counselors may find
themselves
tempted to rely on the bulk of their training, which, as
discussed earlier, likely
emphasized individual approaches to treatment. In doing so, it
would not
be unusual for counselors to agree with the couple’s working
hypothesis on
entering therapy: that Steve is responsible for the problems that
have arisen in
13. the family. In such a case, a counselor might teach the couple
conflict reso-
lution skills, refer Steve for some individual counseling to work
on his anger,
or, should he refuse, work with Anna to evaluate whether to
remain in the
marriage. As the remainder of this article will illustrate,
however, a systemic
approach using NFT techniques may yield far better treatment
outcomes.
NARRATIVE FAMILY THERAPY T E C H N IQ U E S
Eliciting Stories: Meeting the Family Apart from the Problems
When many families first seek counseling, they have reached
what seems
to be an impasse or are struggling with what seems to be an
insurmountable
problem. As with the Hendersons, the family has often
identified one member
as “the problem” and hopes that the counselor will form an
alliance to over-
come or change that individual in order to fix the problem.
However, an overarching goal of NFT is to help family
members sepa-
rate themselves and one another from their problems and to
work together to
overcome a common problem rather than to change one another.
Therefore,
although they certainly listen carefully to these presenting
concerns during the
initial phase of counseling, narrative family therapists also
strive to understand
how each individual family member perceives the problem and
14. to elicit stories
120 Q Journal o f Mental Health Counseling
E x p l o r a t o r y A n a l y s e s o f C o g n i t i v e S c h e
m a s
that may provide examples of the problem. Techniques used in
this phase of
N FT consist primarily of attending and listening skills, which
are foundational
to all forms of counseling. W hile eliciting and listening to
these stories, the
counselor strives to conceptualize them through the lenses of
family systems
theory and social constructionism.
Additionally, narrative family therapists not only listen to
stories about
problems and failures but also elicit stories about strengths and
successes.
This is referred to as meeting the family apart from the
problems (Freedman
& Combs, 1996). By meeting family members apart from their
problems, the
narrative therapist gets to know the family’s strengths as well as
the social and
cultural contexts that may inform their interpretation of
experiences (Leslie,
2011). The counselor is interested in hearing about what the
various family
members enjoy doing, their hobbies, what they like about where
they live,
how they feel about their friends and family, and what their
15. typical week looks
like (Gehart, 2014). The narrative family therapist is also
listening for unique
outcomes, or times when the family has overcome or minimized
the effects of
the presenting problem. Although unique outcomes play a
greater role in later
phases of the counseling process, it is also important for
narrative family thera-
pists to be attentive to them in the initial phase (Leslie, 2011;
Nichols, 2013).
Helping families to remember parts of their story that are not
character-
ized by conflict or problems aids in instilling hope and helping
families enact
their preferred narratives later in therapy. In addition to hearing
what brought
Anna and Steve into therapy, the counselor wanted to get to
know them apart
from their current problems. O ne important ritual Tony, Anna,
and Steve
enjoyed was going on family walks in the cool of the evening.
They smiled as
they recounted how they would laugh, talk about the day, and
enjoy some fresh
air together as a family. The counselor tucked this story away
for later, when
he would use externalizing questions and conversations to
highlight unique
outcomes.
After taking time to learn more about this family and their lives
outside
of the context of their problem in the first session, the counselor
began to use
16. externalizing conversations and questions to get a better sense
of the influence
of the problem on the family, the times in which the family
overcame the prob-
lem, and their vision of how life would be once the problem was
gone. While
listening to and processing these stories, narrative family
therapists use systems
theory and social constructionism to guide their
conceptualization. Especially
important to N FT is the recognition of cultural discourse.
Recognizing C ultural Discourse
As noted earlier, narrative family therapists are guided by
postmodernism
and social constructionism. Specifically, narrative family
therapists recognize
that families create stories largely based on their cultural and
social contexts,
which greatly influence the genesis and maintenance of
problems (Leslie,
2011). Therefore, instead of seeking to discover the objective
truth, narrative
family therapists are constantly listening for the potential
impact of social and
0 Journal o f Mental Health Counseling 121
cultural discourse on the stories families internalize as truth.
Because the
beliefs and values of one’s culture are internalized as reality,
many families
develop deeply held negative narratives about themselves that
17. are rooted in
cultural discourse (Madigan, 2011).
Later in the counseling process, narrative family therapists
strive to help
clients recognize how such cultural discourse has influenced
their negative
beliefs. Narrative family therapists then empower clients to
consider alternative
ways of viewing their situation instead of judging themselves by
societal norms.
In order to help families accomplish this, the counselor begins
by listening for
societal or cultural contributions to the family members’ stories
for the purpose
of case conceptualization and implementation of interventions
(Shalay &
Brownlee, 2007).
As Steve and Anna shared their concerns, it was clear that they
both
identified Steve as the primary problem. As the counselor and
couple explored
this, Steve admitted that he was worried about whether he was
really “cut out”
for marriage. After all, his first marriage ended in divorce. W
hen the counselor
probed to understand more, Steve shared that he had an
argument with his
ex-wife approximately three months ago. Not only did she
blame Steve for the
divorce, she also said she felt sorry for his new wife and
stepson, as they really
got a “loser” in the deal.
This conversation shed light on the impact of cultural discourse
18. on the
Henderson family and, more specifically, on Steve. The societal
norm that
“marriage is forever” contributed to his feelings of failure, and
the comments
from his ex-wife reinforced his fears that he may not be “cut
out” for marriage.
Externalizing the Problem: Separating the Problem from the
Family
In the next phase of NFT, the counselor uses questions and
conversations
to help the family separate itself from its current problems.
Family members
often believe that problems reside within themselves or their
family members,
and this perspective often hinders families from solving their
problems, as it
positions family members to fight for power over one another
rather than to
collaborate toward a solution to the problem (White, 2007). W
hen counselors
use the technique of externalization, which Gehart (2014)
identified as the
“signature technique of narrative therapy” (p. 405), they ask
questions and
engage in conversations to understand the history of the
problem, the context
in which it takes over, the impact it has on the family’s life, and
the tactics it
uses to overthrow the family (Freedman & Combs, 1996; White,
2007). Next,
narrative family therapists use language that frames the family’s
problem as
an “external entity” (Nichols, 2013, p. 274). Using externalizing
19. language
reinforces that the problem does not reside within the family
system or within
a single individual. Instead, the problem is external to the
family. This allows
family members to decrease their need to blame and/or change
one another,
and insteac unifies them around defeating a common problem
(White, 2007).
In this way, externalizing conversations, questions, and
language help
family members view the problem as the problem instead of
viewing a partic-
122 0 jo u rn a l o f Mental Health Counseling
Exploratory Analyses o f Cognitive Schemas
ular family member as the problem (Gallant & Strauss, 2011;
Leslie, 2011).
By viewing the problem this way, family members can keep
their identities
separate from the problem (Gehart, 2014). Rather than viewing
the problem
as residing within the individual family members,
“externalization open[s] up
possibilities for them to describe themselves, each other, and
their relationships
from a new, non-problem-saturated perspective; it enable[s] the
development
of an alternative story of family life, one that [is] more
attractive to family m em -
bers” (White & Epston, 1990, p. 39).
20. Because anger appeared to be at the center of many of the
Henderson
family’s conflicts, the counselor decided to begin to externalize
this experience.
The transcripts excerpted in the following sections further
illustrate how the
counselor utilized externalizing conversations and questions to
understand the
influence of tine problem more clearly.
Exploring the Influence o f the Problem
To better understand the influence of anger on the family, the
counselor
asked about the history and contexts in which anger showed up,
the impact
it had on their lives in the past and present, the ways (if any) in
which anger
influenced or related to other parts of their lives, and the tactics
anger used to
influence the family. In this session segment, the counselor
helped Anna and
Steve explore the influence of anger on their relationship.
Counselor: So, anger sometimes unexpectedly jumps in the
middle of
your conversations?
Anna: Yeah, it comes up at some of the most inopportune times.
Even
when we are being light-hearted or just talking about our day . .
.
it makes it hard to want to talk to Steve.
Counselor: M hm m . . .
21. Steve: W hen she pulls away, it makes me even more upset. I
know we
are both trying hard to connect, but lately it seems it always
ends
in me being angry and her shutting down. 1 hate it. I don’t want
to
lose Anna or Tony, and I’m afraid what will happen if things
don’t
change.
Counselor: So anger tries to pit you against each other, even
despite your
best efforts and desire to connect.
Both: Yeah.
Counselor: Steve, what things is anger trying to distract you
from?
Steve: W hat do you mean?
Counselor: Does anger’s influence cover up other things that are
going on
inside of you?
Steve: Hmm m , I never thought about it that way. Maybe. I
guess after
my argument with my ex-wife, I have been feeling overwhelmed
and worried if I am actually a good father and husband. I
usually
keep what’s going on inside me bottled up because I don’t want
to burden Anna or Tony. I try my best to hold it in, but I think
sometimes it causes me to be short with them both.
0 Journal o f Mental Health Counseling 123
22. Counselor: Anger distracts you from the fear of losing your
family and
being a good husband and father.
Steve: (With his head down) M hmm.
In the next session, in which Tony was also present, the
counselor helped
the Henderson family explore the influence of anger on the
relationship
between Steve and Tony.
Counselor: Tony, 1 really appreciate you coming in again today.
I remem-
ber from our last session that you said you liked watching
cartoons
about ninjas. Can you tell me what a ninja looks like?
Anna and Steve: (Looking at me, puzzled)
Tony: M m m ... Yeah, I think so. They dress in stuff that makes
them hard
to see, and they attack you when you least expect it!
Counselor: Right, they are super sneaky, and their clothing
makes it hard
for anyone to know their true identity.
Tony: I remember watching a cartoon about it once, it was about
a ninja
named Sam. He would go around stealing people’s candy. He
was
finally caught, and turns out he was just really hungry.
Counselor: Sounds like you’ve had some experience with
23. ninjas! I know
this may sound crazy, but did you know that anger is kind of
like
a ninja?
Tony: (Leaning in)
Counselor: Yeah, it sometimes sneaks its way in between people
when
they are least expecting it and makes them really upset or hurt
at one another. Has anger ever snuck in between you and Steve?
Tony: It has, and sometimes it even feels like a karate chop to
the stom-
ach!
Counselor: So, the anger ninja not only comes between you both
but even
makes your stomach hurt.
Tony: M hmm. Especially when Steve yells at my mom or me.
That
makes me really angry too. I sometimes yell or get sarcastic
with
him, but I usually just go back to my room and play video
games.
T hat’s what I used to do when my dad and mom would argue.
Counselor: Sounds like the anger ninja really tries hard to keep
you two
at odds. How has the anger ninja interfered with you being able
to
have the kind of relationship you and Steve used to have?
Tony: W ell... I guess it stops me from wanting to spend as
much time
24. with him. It’s like the anger ninja steals all of the happiness out
of
Steve and my mom. 1 really miss having fun with him.
Counselor: The anger ninja has tried really hard to steal away
the kind of
relationship you really want with Steve.
Tony: Yeah. (Sigh)
Re-Authoring the Story
The ultimate goal of N FT is to offer family members an
opportunity
to re-author their story through the co-construction of preferred
narratives
124 ^ Journal o f Mental Health Counseling
E x p lo r a t o r y A n a ly s e s o f C o g n itiv e S c h e m a
s
(Gallant & Strauss, 2011). Therefore, in this next phase, the
narrative therapist
helps families re-author their stories (Gehart, 2014). The re-
authoring process
involves the identification of exceptions and unique outcomes,
is followed by
the use of questions designed to more fully understand the
context and m ean-
ing of the externalized outcomes as well as the exceptions, and
concludes with
the identification of a preferred narrative.
25. It is important to note that, in NFT, the counselor is not viewed
as the
expert on the family’s problems or stories. Therefore, the
counselor does not
provide tire family with a re-authored narrative. Instead,
through therapeutic
dialogue, the counselor facilitates the family’s …
JOURNAL OF COUPLE & RELATIONSHIP THERAPY
–
A Journey of Remembering: A Narrative Framework for
Older Couples Experiencing Infidelity
Macy E. Williamsona and Andrew S. Brimhallb
aChapel Hill Pediatric Psychology, Chapel Hill, North Carolina,
USA; bHuman Development & Family
Science, East Carolina University, Greenville, North Carolina,
USA
KEYWORDS
Couple therapy; narrative
therapy; infidelity; older
couples; ageism
ABSTRACT
The purpose of this article is to discuss the importance of ther -
apeutic attention to infidelity in older couples and suggest a
theoretical framework for working with this population. A
description of ageist discourses that potentially explain and
com-
26. plicate the problem of infidelity is presented. A clinical vignette
is
used to highlight these discourses and provide recommendations
clinicians can use to help couples re-story experiences around
infidelity.Rationale for the use of narrative therapy is presented
through empirical literature on its use with older couples and
infi-
delity, specifically focusing on dominant discourses connected
with each of these experiences. Creating new narratives can
help
older couples focus on the strength and wisdom that accompa-
nies age rather than messages of weakness and frailty.
According to the General Social Survey (conducted by the
University of Chicago),
data from 2011 showed that affairs in spouses over the age of
60 are increasing
(Smith, Marsden, & Hout, 2011). In the 15-year span from 1991
to 2006, the lifetime
rate of infidelity for men over 60 increased from 20% in 1991 to
28% in 2006. For
women over 60, the increase was even more striking: up from
5% in 1991 to 15%
(Parker-Pope, 2008; Smith et al.). While many potential
explanations exist, many
scholars wonder if this increased rate of infidelity is one reason
that recent statistics
indicate that divorce rates have doubled among persons aged 50
and older and that
25% of the divorces in 2010 included a person over age 50
(Brown & Lin, 2012).
Growing apart over time is a common theme in couples who
report mari-
tal distress in later life (Putnam, 2011). Needs, desires, and
roles change as cou-
27. ples age together, and difficulty adapting to these changes can
often culminate
in dissatisfaction (Canham, Mahmood, Stott, Sixsmith, &
O’Rourke, 2014; Wu &
Schimmele, 2007). Common changes faced by older couples
include (a) changes in
their interests and values (Canham et al., 2014); (b) adjusting to
physical changes,
including illnesses (Ford & Chamratrithirong, 2012; Karraker &
Latham, 2015); (c)
retirement and loss of personal and professional identity (Cohan
& Cole, 2002;
CONTACT Macy E. Williamson, MS, LMFTA [email protected]
p, LLC
Williamson, M. E., & Brimhall, A. S. (2017). A journey of
remembering: A narrative framework for older couples
experiencing infidelity. Journal of Couple & Relationship
Therapy, 16(3), 232–252.
http://dx.doi.org/10.1080/15332691.2016.1253516
mailto:[email protected]
Whitney
Sticky Note
Williamson, M. E., & Brimhall, A. S. (2017). A journey of
remembering: A narrative framework for older couples
experiencing infidelity. Journal of Couple & Relationship
Therapy, 16(3), 232–252.
Whitney
Highlight
28. Whitney
Highlight
JOURNAL OF COUPLE & RELATIONSHIP THERAPY 233
Kropf & Tandy, 1998; Perrig-Chiello, 2014); and (d) loneliness
and social isolation
(Hawton et al., 2011). All of these changes have the potential to
undermine the cou-
ple’s relationship and make them more vulnerable to infidelity
(Canham et al., 2014;
Ford & Chamratrithirong, 2012; Karraker & Latham, 2015). For
example, some
women cited instances where severe illness and job loss created
circumstances where
husbands felt disempowered and compensated by seeking sexual
gratification with
others to confirm their manhood (Canham et al., 2014).
Given these recent trends, it is important that couple and family
therapists under-
stand some of the unique characteristics of older adults and why
a growing number
of them are engaging in affairs. Similarly, it is important that
these characteristics
are understood so that interventions can be tailored to older
individuals in a way
that is appropriately sensitive to the developmental needs of
this population. Using
a narrative framework, the purpose of this article is to highlight
some of the dom-
inant discourses older couples experience as they age and
discuss how these mes-
sages may increase their likelihood of engaging in extramarital
affairs. Relying on
29. a vignette created from the shared clinical experiences of the
authors, the article
will apply narrative therapy and discuss specific
recommendations when working
with older couples. Couples between the ages of 55 and 75
represent the target pop-
ulation of this discussion, as this is the age group that appears
most frequently in
the literature regarding older couples and infidelity (Atkins,
Eldridge, Baucom, &
Christensen, 2005; Smith et al., 2011).
Ageism, Older Couples, and Infidelity
Investigating the increasing rates of infidelity in older adults
requires a critical eval-
uation of ageist discourses and sociocultural messages that
society sends older cou-
ples about the meaning of aging. Butler (1969) first introduced
“ageism,” which
he described as consistent and systematic discrimination of
older people. Implicit
ageism has become a pervasive form of prejudice in some
places, where older adults
report feeling marginalized and even invisible (Butler, 1969;
Jackson, 2015). A trou-
bling aspect of the ageist discourse is that it has become more
complex over time,
resulting in a continuum where society labels old age in both
favorable (i.e., health,
independence, and economic and social vitality) and derogatory
ways (i.e., ill-
ness, physical and social decline, and dependency; McHugh,
2003; Rozanova, 2010;
Rozanova, Northcott, & McDaniel, 2006). Understanding these
complexities may
30. shed light on the occurrence of infidelity and how to manage it
therapeutically.
Dominant Discourse #1: Weak and Frail
The loss of control and autonomy that many older adults
experience can become
a repressive dominant discourse (Gardner & Poole, 2009).
Rather than being seen
as a source of wisdom, resiliency, and strength, the idea of
aging is associated with
decline, weakness, and insignificance (Ivey, Wieling, & Harris,
2000; Jackson, 2015;
Nelson, 2005). Specifically, society perpetuates stereotypes that
older people are
234 M. E. WILLIAMSON AND A. S. BRIMHALL
rigid, mentally disoriented, and immobile and possess li mited
ability to change (Ivey
et al., 2000; Nelson, 2005). Researchers have often critiqued the
media for repre-
senting older adults this way—especially women (Kessler,
Rakoczy, & Staudinger,
2004; Whitfield, 2001). Norms and preferences that evaluate
women on the basis
of youthful beauty (smooth unwrinkled skin, thinner figure,
firmer breasts, and
colorful hair) can be marginalizing and oppressive for aging
women (England &
McClintock, 2010). This message is potentially reinforced when
older women hear
stories of men “replacing” their wives with younger women
(England & McClin-
31. tock, 2010; Graf & Patrick, 2014). Similarly, social messages
that a man’s worth is
defined through his position, power, and prestige can lead those
who are unable to
work or those who retire to question their ability and identity
(Landis, Peter-Wight,
Martin, & Bodenmann, 2013; Story et al., 2007). Both of these
messages are often
amplified by media portrayals of sexual impotency, physical
ailments, and mental
deterioration (Beugnet, 2006; Rozanova, 2010).
Although common, this dominant discourse reiterates the
message of weakness,
inadequacy, and frailty and potentially undermines an
individual’s ability to feel like
they are accomplished members of society who have something
of value to con-
tribute; either to their partners or to the rising generation. And
yet, developmen-
tal theorists have consistently agreed that the ultimate task of
satisfied older adults
is to create and maintain a sense of legacy and meaning in the
generations that
follow (Erikson, 1986/1963; Levinson, 1986; Vaillant, 2002).
Feeling this sense of
despair, partners may seek reassurance from others to
compensate for their sense of
decreasing vitality, thus increasing the possibility for
emotional, physical, or com-
bined type affairs (Ford & Chamratrithirong, 2012; Karraker &
Latham, 2015). From
a sociocultural perspective, Williams (2011) argues that
infidelity for women is often
related to relationship dissatisfaction, whereas men report a
desire for sexual excite-
32. ment. This dominant discourse, and the ageist beliefs it is
founded on, may help
provide a more in-depth explanation for why older couples may
specifically be vul-
nerable to infidelity. Women, whose identity has often been
attached to their physi-
cal appearance and their relationships, may worry that their
partners are no longer
interested in them and may experience distance and a loss of
emotional connec-
tion. Similarly, men who retire and experience a loss of
professional identity may
feel weak, withdraw from their partners, and compensate by
trying to display their
prowess through sexual conquests (Glass & Wright, 1992;
Williams & Knudson-
Martin, 2013; Scheinkman, 2005). Understanding this discourse
may provide some
etiological insight into the occurrence of infidelity and
illustrates how this experi-
ence can be especially crippling when it occurs in older age.
These messages also have the potential to reinforce a fear
experienced by older
adults that others forget about them because they have already
lived their lives.
Empirical and clinical literature reveals that this fear may not
be unfounded since
older couples are routinely omitted from empirical research
(Ivey et al., 2000; Story
et al., 2007). Family scholars assume, perhaps naively, that the
old have lived pro-
ductive lives and they are blissfully content. As a result,
clinicians and scholars often
minimize concerns expressed by older populations and fail to
take their problems
33. Whitney
Highlight
Whitney
Highlight
JOURNAL OF COUPLE & RELATIONSHIP THERAPY 235
as seriously (Grimm, 2003; Ivey et al., 2000). Perhaps it is for
these reasons that
older adults are often less likely to seek help from professionals
(Gardner & Poole,
2009; Kane, 2004). While potentially destructive, this tendency
to minimize prob-
lems experienced by older couples highlights another dominant
discourse that is
often associated with growing old.
Dominant Discourse #2: The Golden Years
As with many narratives, those uncomfortable with a discourse
of weakness and
frailty constructed a different narrative. These researchers
emphasize the idea that
couples who have been married longer have “bucked the odds”
and embraced the
“secrets” to marital longevity (Henry, Berg, Smith, &
Florsheim, 2007; Levenson,
Carstensen, & Gottman, 1993; Luong, Charles, & Fingermann,
2011; Rook, Mavan-
dadi, Sorkin, & Zettel, 2007). In some instances, compared with
younger cou-
ples, older couples have reported higher marital satisfaction
34. overall (Henry et al.,
2007; Levenson et al., 1993; Rook et al., 2007). Some suggest
that increased emo-
tional regulation in older age and socioemotional selectivity
may play a role in
this phenomenon (Luong et al., 2011; Story et al., 2007).
Socioemotional selectivity
states that as people age, (a) the pursuit of emotional
satisfaction with close others
increases in priority; (b) older couples experience less
opportunities for emotional
closeness with others, and, as a result, (c) they increasingly turn
to one another to
meet this need (Carstensen, 1992; Carstensen et al., 2011;
Levenson et al., 1993; Story
et al., 2007). Media portrayals of this discourse depict old age
as a time of opportu-
nity, self-fulfillment, and expanded emotional growth with a
romantic partner (Rud-
man, 2006; Rozanova, 2010)—a time for long walks on
beautiful beaches. To target
baby boomers (the largest consumer market), publications,
television programming,
and Internet bloggers have painted a picture of glorious
retirement where people are
ageless and vital indefinitely (McHugh, 2003; Rozanova, 2010).
While this new narrative seems appealing, and perhaps eases the
collective con-
science about the aging population, it does not seem to capture
the entire story. As
the recent literature suggests, both infidelity and divorce are
increasing among older
adults. This suggests that not all older couples are experiencing
these “golden years”
as a time of reflection, satisfaction, and relaxation. For those
35. who may be feeling
frail and weak (Dominant Discourse #1), experiencing marital
distress, or who are
feeling the effects of physical, emotional, and social changes,
they are potentially
left in a rather troublesome and restrictive situation. Who do
they turn to for help?
They may feel that their concerns are not justified, that there is
something wrong
with them, and that, as a couple, they are abnormal. However, if
they feel these feel-
ings, and try to seek help, their concerns are likely to be
dismissed or minimized by
professionals, leaving them potentially feeling stuck and
isolated (Gardner & Poole,
2009; Ivey et al., 2000; Kane, 2004).
To make matters worse, if the socioemotional selectivity theory
is accurate and
older adults prune their support network until they rely
primarily on their partner,
then think of the potential devastation that occurs when one of
the partners has an
236 M. E. WILLIAMSON AND A. S. BRIMHALL
affair. Partners face a difficult choice. Either they stay in the
relationship simply to
maintain access to their primary support network or they decide
to leave, knowing
they may face social isolation as they sever these central ties.
While the experience
of infidelity can be detrimental to any marriage, regardless of
age, the public percep-
36. tion of older couples and their overall satisfaction may be
particularly distressing for
couples who do not experience this period as golden. This may
create an enhanced
distress that would benefit from being addressed
therapeutically. Given the power-
ful messages associated with these dominant discourses, a
therapeutic framework
such as narrative therapy, which fundamentally centers on
unique experience and
meaning, and subsequent re-storying of the problem, may be
well suited for older
couples facing infidelity (White & Epston, 1990).
Foundations of Infidelity Treatment and the Narrative Approach
Narrative couple therapy can offer a medium through which
couples can be freed
from these potentially destructive discourses and biases,
whether overly positive or
negative. Hare-Mustin (1989) defined bias as an inclination to
emphasize certain
aspects of experience over others, and argued that traditional
mental health models
fail to attend to the role of societal biases and norms on
interpersonal power related
to person variables, such as age and infidelity. One of the
inherent goals of narra-
tive therapy is to subvert societal bias by privileging aspects of
experience that have
previously been neglected (White, 2007).
Specific connections between the pillars of narrative therapy
and infidelity exist
in the literature. Bermudez and Parker (2010) suggest narrative
therapy as an effec-
37. tive vehicle to deconstruct the infidelity experience and
construct preferred narra-
tives around a new relationship. Addressing the societal norms
related to infidelity
becomes crucial. Parker, Berger, and Campbell (2010) suggest
that society’s perpet-
uated, dysfunctional view of infidelity could hinder a couple’s
ability to overcome
the experience. Narrative therapists often argue that the notion
of infidelity itself is
highly socially constructed and, as such, can be addressed as an
oppressive domi-
nant discourse within narrative contexts (Abrahamson, Hussain,
Khan, & Schofield,
2012). Narrative therapy can aid in focusing on the exploration
of these stigmas and
helping older couples to emerge from the oppression they
impose. In their study,
Abrahamson and colleagues found that meaning making was a
central factor in
couples who remained together after the affair. This suggests
that the creation of
meaning within each couple’s specific context allows them to
place the infidelity in
context and begin to externalize the thoughts, feelings, and
experiences surrounding
the infidelity (Bermudez & Parker, 2010).
In addition, many suggest that narrative therapy is well suited
for older gener-
ations because of the value they place on storytelling, often
enjoying the opportu-
nity to reflect on stories of their past (Caldwell, 2005; Erikson,
1986/1963; Gardner
& Poole, 2009; Kropf & Tandy, 1998; Vaillant, 2002). The use
of deconstructing
38. problem-saturated stories by replacing thin descriptions with
more contextually
thick ones potentially holds the most promise for this
population, as their age
Whitney
Highlight
Whitney
Highlight
Whitney
Highlight
Whitney
Highlight
JOURNAL OF COUPLE & RELATIONSHIP THERAPY 237
provides opportunities for experiences that thickly describe both
the experience of
infidelity and experiences outside of infidelity (Bermudez &
Parker, 2010). Based on
their extensive histories, their ability to find unique outcomes
may be enhanced.
Based on these trends in infidelity treatment, we recommend
narrative therapy as
a therapeutic approach well designed to work with older couples
experiencing infi-
delity. The remainder of the article will apply narrative therapy
to a case composite of
older couples the authors have seen clinically. The vignette
highlights the oppressive
39. discourses that many older couples may experience and provides
recommendations
for how to help.
Clinical Vignette
John, 66, a cisgender man, and Barbara, 64, a cisgender woman,
represent a couple
married for 43 years, presenting to therapy for an affair that
occurred 1 year ago.
This vignette is composed through the perspective of a white,
heterosexual cou-
ple because it most accurately depicts the couples seen by the
authors in therapy.
It is important to acknowledge that any variation in the
demographics of race, eth-
nicity, or sexual orientation would require clinicians’ adaptation
to the complexi-
ties of infidelity with older couples. Specific attention should
always be given to the
couple dynamic and how cultural messages around gender,
power, and oppression
have both developed and maintained the couple’s interaction. In
addition, while this
example focuses on John’s infidelity, the authors recognize that
both genders actively
participate in affairs (Brand, Markey, Mills, & Hodges, 2007).
This particular exam-
ple is based on the literature that suggests males’ engagement in
affairs is more com-
mon (Smith, 2006).
At the beginning of therapy John reported that he engaged in a
3-month sexual
affair that began just over a year ago. Although the affair ended
several months ago,
40. John recently disclosed the affair to Barbara. According to
John, he became involved
with a woman from the church he and Barbara attend. The
following descriptions
help highlight the dominant discourses, both around aging and
infidelity, which
infiltrated John and Barbara’s problem-saturated stories. These
problematic narra-
tives provide insight into the details that a narrative therapist
would highlight during
the assessment process, in an attempt to understand the
influence of infidelity and
aging on the couple’s story.
John reports that at the time of the affair, he had recently
retired from his job
managing a construction company, which he held for over 20
years. John’s position
involved manual labor and he reported enjoying the “white and
blue collar” nature
of his work. John noticed that physical tasks became more
difficult and time con-
suming, which he attributed to arthritis worsening in his hands
and knees. John
also reported his management abilities declining and noticed
that both his reac-
tion and processing time were becoming more delayed; to the
point where it was
beginning to affect the productivity of the company. John
reported that retiring was
particularly distressing for him and reported feeling like a
“weak, old man who was
mentally deteriorating” (Dominant Discourse #1). According to
John, he had always
41. 238 M. E. WILLIAMSON AND A. S. BRIMHALL
feared becoming weak in his old age. These messages were
reinforced by messages
he was seeing on television about sexual impotence, physical
ailments, and nursing
homes—all indications that older people were weak and needed
assistance. John
internalized these messages and became entrenched in a
narrative that is indicative
of the social and relational discourses informed by public
perceptions of weakness
and cognitive deterioration (Nelson, 2005; White, 1993). John
wanted to share these
concerns with Barbara but was worried his fears would
reinforce this image of a weak
man who needed help. As this narrative gained strength, John
reported distancing
himself because he was afraid Barbara would not want to be
married to a man who
was broken and needed help.
John reported that it was during this time that a woman at
church began making
comments about how helpful he was and how Barbara must be
lucky to have such
a strong and capable man at home. He acknowledged that it was
easier to share his
concerns with this woman because his fear of rejection was not
nearly as high. Also,
Barbara had repeatedly expressed her concern that they did not
seem as happy as
other couples at church and that others seemed more content
with life and pleased
with their retirements (Dominant Discourse #2). Afraid to
42. reinforce Barbara’s con-
cern, John reported suppressing feeling weak and inadequate.
According to John, it
was appealing, given his emotional context, to hear another
woman refer to him as
strong and capable. However, once the affair occurred, John felt
even weaker because
he did not resist.
Barbara’s narrative was going through a similar transition. She
reported feeling
“out of touch” with the world around her. Barbara had typically
been known to be
“fashionable” and “trendy.” However, Barbara had begun to
notice receiving fewer
compliments on her appearance and remembered her daughter
gently telling her
to “get with the times.” As a result, Barbara reported feeling
outdated and unattrac-
tive. As these feelings increased, she noticed herself avoiding
some of John’s sexual
advances, reporting that she worried he would find her
unattractive. These experi-
ences were beginning to inform Barbara’s perception of her own
identity (Dominant
Discourse #1). Given society’s fascination with youth and
beauty, narratives sur-
rounding appearance and relevancy are common for aging
women (Ivey et al., 2000).
While Barbara’s reactions were based on her own fears, John
often interpreted her
avoidance as evidence that she did not want to be with an older
man whose health
was deteriorating. Similarly, John’s affair solidified Barbara’s
problem-saturated story
and reinforced that John found her unattractive.
43. The stories shared by Barbara and John have a strong
connection with the
marginalization many people in older age experience (Landis et
al., 2013; Story
et al., 2009). Notions of weakness, cognitive decline, loss of
youthfulness, a decline
in attractiveness, and a lack of control are strong messages that
might contribute to
John’s feeling more vulnerable to an affair as well as making it
harder for John and
Barbara to heal (Ivey et al., 2000; Nelson, 2005). John was
becoming entrenched in a
story of himself where his choices seemed restricted, and other
options were painful,
disappointing, and, in this case, destructive to his marriage
(White & Epston, 1990).
Barbara’s problematic narratives were reinforcing the idea that
she was unwanted
JOURNAL OF COUPLE & RELATIONSHIP THERAPY 239
and therefore makes it particularly challenging for John to
provide reassurance. She
was at risk for internalizing the infidelity as a part of her
identity because it con-
firmed the destructive narratives already oppressing her before
the affair (White,
2007).
Barbara and John’s individual and relational narratives provide
areas for ther-
apeutic attention within the context of narrative therapy. The
exploration of John’s
44. narrative of his own physical weakness, cognitive decline,
rigidity, and loss of control
may increase understanding of his own actions in pursuing the
affair. Collaborative
examination of Barbara’s narratives of loss of attractiveness,
being out of touch, and
loss of autonomy will also help free herself from these problem-
saturated narratives
so she can see the problem itself more clearly. The expansion of
Barbara’s individual
narratives of self before the affair may also create insight into
the couple’s dynamic
and interaction process. Highlighting Barbara and John’s
relational narrative of mar-
ital failure as a problematic societal discourse will likely be
pivotal in freeing them
from the place of isolation and marginalization where they are
currently entrenched
(White & Epston, 1990).
Clinical Recommendations from a Narrative Couple Therapy
Perspective
From a narrative perspective, collaborative creation of preferred
relational and
individual narratives (re-storying) can be achieved chiefly
through deconstructing
the problem-saturated story, identifying and subverting
problematic dominant dis-
courses, externalizing the problem, and locating unique
outcomes within the cou-
ple’s narratives (Freeman & Combs, 2015; White & Epston,
1990). While the linear
organization of these clinical recommendations may suggest a
definite, sequential
ordering, this is not always the case. The phases of the narrative
45. framework can
operate fluidly, where goal setting and the creation of preferred
identities can be
achieved during externalization activities, or unique outcomes
may emerge while
deconstructing problem-saturated stories. With this in mind, the
presentations of
these recommendations are structured in a way that is
sequential, and can be imple-
mented as such. Clinicians should typically begin with
understanding the oppressive
narratives and work toward re-storying these narratives.
Throughout the process, therapists should also attend to the
more acute, infi-
delity related issues that arise such as emotional and behavioral
reactions, negoti-
ation of disclosure, and feelings of mistrust (Blow & Hartnett,
2005; Gordon, Bau-
com, & Snyder, 2008). While narrative therapy’s focus tends to
lean more toward
treatment of the couple as a whole, it is necessary that
clinicians work through these
more specific issues, particularly on the front end of treatment.
Indeed, the infidelity
treatment literature tends to center on a general three-step
process: address issues
that arise from the impact of infidelity, explore the context and
meanings related
to the infidelity experience, and work toward what is needed to
move on after the
affair (Gordon, Baucom, & Snyder, 2008; Blow & Hartnett,
2005). For couples who
are motivated to remain together, working on the relationship as
a whole rather
than focusing specifically on the infidelity can be helpful for
46. the involved spouse
(reducing blame and defensiveness) as well as lay the
foundation for reestablishing
Whitney
Highlight
Whitney
Highlight
Whitney
Highlight
240 M. E. WILLIAMSON AND A. S. BRIMHALL
trust and intimacy (Atkins et al., 2005). It is also important to
note that goal-setting
within the context of any narrative approach is a collaborative
process unique to the
specific client and dependent on both the problematic and
preferred narratives of
the client (White, 2007). Similarly, the infidelity literature
cautions against develop-
ing a universally accepted outcome for treatment, and
recommends that therapists
should be actively involved in developing a shared
understanding with the couple of
what is considered a successful outcome (Blow & Hartnett,
2005). That being said,
these recommendations are largely intended for couples hopeful
to remain together.
This section will highlight each of these recommendations and
how they apply to
John and Barbara.
47. Understanding and Deconstructing the Problem-Saturated Story
From a narrative perspective, people make meaning out of life
by organizing key
events into stories. These stories are created through
interactions with others, and
can determine which aspects of our experience we express
(White & Epston, 1990).
White (2007) suggests that the narratives people form have a
strong connection with
societal norms and the oppression and marginalization certain
groups experience
within society. Clients typically offer thin descriptions as part
of their dominant nar-
rative, but these rarely …
Witnessing and Positioning: Structuring
Narrative Therapy with Families and
Couples
Jill Freedman, MSW
Evanston Family Therapy Center, Evanston
In this paper, the author describes a way of structuring family
therapy that fits with the narrative metaphor, creat-
ing space for stories to be understood, deconstruc ted and further
developed. In this process, people move
between positions of telling and witnessing. Family members
engage in shared understanding and meaning making.
Keywords: narrative therapy, positioning, outsider-witness,
48. couple therapy, family therapy
Key Points
1 For narrative therapists, family therapy is a context where we
can deconstruct problematic stories, tell and
retell preferred stories, and witness family stories and
individual stories of other family members.
2 A witnessing structure in which family members listen to
another member tell his or her story can contrib-
ute to understanding and meaning making.
3 Through responding to questions we ask members in the
witnessing position, they can contribute to thick-
ening preferred stories.
4 If it is difficult for family members to listen and understand
while witnessing, we can facilitate a particular
position from which to listen, such as listening as one would to
a friend.
5 If more distance would be helpful for people to really listen
and understand, we can offer other options,
such as using video so that the witnesses are actually hearing
and seeing family members tell their stories at
a later time.
The narrative metaphor suggests that people make sense of their
lives through stories
(Brown & Augusta-Scott, 2007; Duvall & Beres, 2011;
Freedman & Combs, 1996;
Madigan, 2011; White & Epston, 1990; White, 2007;
Zimmerman & Dickerson,
1994). Although each of us has a huge number of experiences,
only a few of these
49. become the stories that shape us and through which we shape
our lives. Some of these
stories are about individual people and others are about family
and relationships.
When couples or families come to therapy each person may
have different stories that
are prominent for them and that they think are most relevant;
there may be some
shared stories that different family members tell; and there may
be similar stories that
different family members tell but that they have made different
meaning of, perhaps
emphasizing different aspects of the same event or maybe
understanding the same
event in different ways.
Narrative therapists focus on rich story development – the
telling and retelling of pre-
ferred stories. Rather than a single-storied life we are interested
in helping people develop
Address for correspondence: Jill Freedman, MSW, Evanston
Family Therapy Center, 1212 1/2
Elmwood Avenue, Evanston, Illinois 60202 USA.
[email protected]
Jill Freedman is the Director of the Evanston Family Therapy
Center. With Gene Combs she is the
author of ‘Narrative Therapy: The social construction of
preferred realities’ (W.W. Norton).
Australian and New Zealand Journal of Family Therapy 2014,
35, 20–30
doi: 10.1002/anzf.1043
20 ª 2014 Australian Association of Family Therapy
50. Whitney
Sticky Note
Freedman, J. (2014). Witnessing and positioning: Structuring
narrative therapy with families and couples. Australian and New
Zealand Journal of Family Therapy, 35(1), 20–30.
Whitney
Highlight
Whitney
Highlight
Whitney
Highlight
multiple stories. Our focus is not on solving or eliminating
problem stories. We are
interested in multiple stories contributing to people’s
experience. Often when a problem
story becomes a single strand of a multi-storied life, the
problem looks quite different or
becomes less significant and people have different options
about how they relate to it.
Additionally, we think of our identities as both storied and
relational (Combs &
Freedman, 1999; Freedman & Combs, 2004; Hedtke &
Winslade, 2004; White, 1989;
White, 2007). We make ourselves up as we go along in relation
to each other. So not
only are the stories we tell ourselves important, but the stories
we tell others about our-
selves and our lives, and the stories others hear us tell, and the
stories that they tell about
51. us, are important because they shape our identities.
We think of family therapy as a context where we can
deconstruct problematic
stories, tell and retell preferred stories, and witness family
stories and stories of other
family members.
This process is not quite as simple as it sounds. One
complication is that people
often orient to therapy not as a place to tell and retell stories,
but as a place in which
a ‘neutral’ third party will weigh in on different versions of a
problem or advise people
in terms of solutions or evaluate the situation to determine the
‘real problem’ or ask
questions to connect the problem with family history or teach
communication skills.
We are up to something quite different.
A Witnessing Structure
In order to accomplish the telling, retelling, and witnessing of
stories, it is very useful
to set up a structure. We can call this a witnessing structure
(Freedman & Combs,
2004, 2008). As one family member tells a story we ask the
others to be in a reflect-
ing or witnessing position to hear and understand the story as it
is told by the first
family member. We then ask those who have been acting as
witnesses to contribute
to the telling and meaning making of the story. We think of
their contribution as a
retelling that thickens and adds richness to the story. The
52. original speaker becomes a
witness to the retelling of the story that he or she has told. We
may then ask ques-
tions to invite the family member who spoke originally to
engage in a retelling of the
retelling. Through this process family members gain
understanding of each other’s
stories and engage in developing and thickening preferred
stories.
Initiating and/or Negotiating a Witnessing Structure
We can initiate this structure informally by beginning to engage
in it or we can
explicitly describe it and ask family members to join in. We
usually begin informally
with the therapist simply talking directly to one person and
respectfully referring to
the others in the third person. It is important to watch other
family members to
make sure that they are engaging in the process. If they seem
not to be engaged or if
they interrupt, it can be helpful to explain the process. We
might say something such
as, Would it be okay if I talk to Bethany for a bit? Then I’ll ask
you some questions about
our conversation. At another point each of you will also have
some time to talk and I’ll
ask everyone else to listen. If family members continue to
interrupt or indicate by their
actions that they disagree it can be helpful to reassure them
about how we are listen-
ing by saying something like, I am guessing that your
experience of this and what you
think is most important to talk about may be different than what
Bethany is describing.
53. Witnessing and Positioning
ª 2014 Australian Association of Family Therapy 21
Whitney
Highlight
Whitney
Highlight
Whitney
Highlight
I understand that family members often have different
understandings of the same events.
I am keeping that in mind and I will make sure there is time for
us to listen to what you
think is most important, too.
If even after this kind of reassurance family members continue
to interrupt or state
their disagreements we may say something like, Have you had a
conversation already
about this? Did it go this way with each of you saying how you
disagree and what you
think? Was it helpful? Is it okay if we try something different?
These questions pave the
way for explicitly negotiating the witnessing structure.
We may say, In our experience when people talk directly to
each other about some-
thing problematic, what they are listening for is how they
disagree or what they want to
54. say to counter what is being said. It is extremely hard to really
listen and understand
when your attention is on what you want to say next or on how
someone is wrong or how
they are leaving something out. We would like to create a space
where you can really listen
to each other. Would that be okay?
Our questions – Is it okay if we try something different? and
Would that be okay? –
are real questions. On occasions people have told us that they
have not spoken at all
about something and that they were waiting until they came to
therapy to say some-
thing to other family members, which they would like to do
directly. We are negotia-
ble about the structure. Usually though, we find the witnessing
structure extremely
helpful and most families and couples are happy to join in with
this kind of conversa-
tion.
Unpacking Problem Stories and Identities
Once we have set up the structure our task is to ask questions
that will eventually
help family members move into the development of preferred
stories. In order to be
able to do this it is usually important to have some
understanding of the problem
and its effects. Often it is very meaningful for people to have
the experience of other
family members listening to and understanding what they find
problematic. As we lis-
ten we can ask questions to deconstruct or unpack the
problematic story. Through
55. deconstruction we hope to expose how the problem was
constructed. We are inter-
ested in deconstruction to the extent that we can develop gaps
that allow people to
see beyond the problems to other events that may be openings to
preferred stories
and so that problems do not take over people’s identities. One
very basic practice of
deconstruction is externalizing. Through externalizing
conversations we unpack prob-
lem identities that are constructed through psychological and
linguistic practices that
identify people as problems (Epston, 1993; White, 1988/1989;
Russell & Carey,
2004).
For example, a family came to therapy because in their words,
Sean, the 7-year-
old was ‘fearful’. His father had worries that a boy at the end of
first grade who was
afraid to spend the night at a friend’s house, clung to his
parents’ legs at the top of
the sledding hill as the other kids reveled in the snow, and
would not go on a class
field trip unless one of his parents went along, was likely to be
made fun of by the
other kids and that that was just the beginning of things that
Sean deprived himself
of.
At the beginning of my conversation with Sean he didn’t answer
verbally but he
did nod for yes and shake his head for no. In this way we
determined that he agreed
Jill Freedman
56. 22 ª 2014 Australian Association of Family Therapy
Whitney
Highlight
with his parents that the fears were a problem and that they
were even responsible for
denying him a voice in the conversation with me. When I asked
Sean if the fear
talked to him he shook his head no. When I asked if it showed
him pictures, first he
shook his head again but then stopped and said, ‘Sometimes’.
‘Wait a minute. I thought I heard something. Was that you
Sean?’ I asked.
‘Uh huh’, he said.
‘That was you again?’ I asked.
Sean nodded.
‘And the fears have kept you from speaking, but you spoke
anyway. Is that right?’ I
asked.
Sean nodded again.
‘Did you use your bravery to speak?’
Sean nodded.
‘Well, I want to find out more about that, and I also want to
know about the pictures
the fears show you. We’ll come back to the pictures. Can I ask
you more about the
bravery first?’
This was a segment of an externalizing conversation in which
we talked about the
fears as being separate from Sean. We deconstructed Sean’s
57. identity as fearful. Rather
than addressing him as a fearful boy, we addressed Sean as a
boy with a relationship
with fear. This helped create a gap through which we could see
beyond the fear to
moments of bravery.
As we have deconstructing conversations like this we are
helping the person who
may have been thought of as problematic to recognize his or her
relationship with the
problem, which also implies that he or she has choices about
how to relate to it. We
are also offering the people in the witnessing position the
opportunity to see the
problem as separate from their family member. This new view
may help family mem-
bers join in responding to the problem and it may help them
recognize when the
problem is not in play. In this example, their recognition can
help keep the spark of
new story (that Sean has a relationship with fears but can use
his bravery to do things
anyway) alive and growing.
As we engage in these conversations it is important that we
keep some of our
attention on the family members in the witnessing position so
that we can have some
impression about how they are taking the conversation. The
nonverbal expressions we
see may alert us to ask more about something before proceeding
to a conversation
with the witnesses or to choose which of the witnesses we might
want to address first.
58. After the brief conversation with Sean I turned to Maureen,
Sean’s mother and
said, ‘We talked about the fearfulness but not the bravery. Did
you know about
Sean’s bravery before. . .? Do you think it might have been at
play in some of the
events we discussed where we recognized the fears?’
‘I hadn’t thought about this before’, she said, ‘but maybe just
being willing to go on
the field trips and go to the sledding hill took bravery. Maybe
Sean has been brave all
along’.
‘Do you think so?’ I asked.
‘Maybe so’, she answered.
During both parts of this conversation I was aware both of who
I was talking to
and of the family members who were listening. My allegiance is
always to preferred
stories. I want to make sure to support people in describing the
problems they experi-
Witnessing and Positioning
ª 2014 Australian Association of Family Therapy 23
ence and their effects, while also thinking about the questions I
can ask that will give
both the person answering and those witnessing the opportunity
either to understand
the problem in new ways that offer more possibilities or to first
glimpse and then
59. develop preferred stories.
After hearing Maureen’s comments about Sean and his bravery I
turned back to Sean
and said, ‘What’s it like to hear your mom talk about your
bravery?’
He nodded.
‘Would you say that’s a good thing or a not so good thing?’
‘Good’, he said.
‘Do you think it will help you use your bravery to know that
your mom recognizes it?’
He nodded.
‘Do you think your dad recognizes your bravery too?’
Sean nodded again.
I turned to Dan, Sean’s father. ‘Dan, we’ve talked about how it
takes some bravery for
Sean to speak and to even go places that the fear makes hard for
him. Is this something
you knew or is it new to hear about this?’
‘It’s new’, he said. ‘I guess I’ve been focused on the bigger
actions and I still think
those are important’.
‘Is it good to know that even if the fear has stopped Sean from
bigger actions, he’s still
using his bravery?
‘Yeah I guess it’s good’.
‘Why is it good?’
‘It gives me hope’.
‘So you are hoping he can build on that bravery. . . use it more?
Is that right?’
‘Yeah. I think so’.
The witnessing structure, which encourages people to listen,
rather than join in talk-
ing, helps create space for new stories. Which questions we ask,
especially when we turn
60. to someone who has been in a witnessing position, are crucial.
Asking, Do you agree with
what was just said? or What were you thinking as Mary was
talking? may be useful at times
but at other times questions as broad as these can completely
negate what we could have
accomplished with the witnessing structure. If what we are
interested in is the telling and
retelling of preferred stories, it may be much more useful to
choose a unique outcome –
something that would not be predicted by the problematic story
– that emerged in the
conversation and ask questions about it, both to make sure that
it is witnessed and not for-
gotten, and to offer the possibility of thickening it through more
conversation about it.
We can interview one family member serving as a witness about
what he or she heard
and then go back to the original family member for reflections
on what the witness said
or we can ask questions of many family members serving as
witnesses before asking the
original family member for reflections on what the witnesses
have contributed. We are
guided by what we think will be most useful in rich story
development – the telling and
retelling of preferred stories. We are quite influential in setting
up this process and in
the questions we ask but family members are at the center. We
ask about what they want
to talk about and invite them to evaluate the usefulness of our
conversation.
Positioning the Witnesses
61. In almost all therapy conversations with more than one person I
use a witnessing
structure. But sometimes it seems that although family members
are quiet when one
Jill Freedman
24 ª 2014 Australian Association of Family Therapy
Whitney
Highlight
of them speaks, they don’t really listen to each other. They
simply wait for their turn.
In those situations, it is unlikely that the conversation will be
useful. People are sim-
ply repeating what they have said in previous conversations. If
these conversations had
been helpful, they probably would not have sought therapy.
When this occurs I’ve found it very helpful to talk with people
about listening in
a different way. I might give the example of my partner at times
saying, I wish you
would listen to me right now the way you listen to someone who
comes to you for therapy!
I often talk with the family about how we listen differently
depending upon our role
or upon the context, but that these positions are available to us
at other times. Then
I negotiate a particular position with family members from
which to listen. We can
set up this position very quickly, we can spend a whole therapy
conversation setting
62. this up, or it can be something that family members work on
between times. There
are a couple of considerations in how much time we spend
setting up a witnessing
position. Of course, it is important that we take the time
required to make sure that
the position is meaningful and that the witness or witnesses can
access the position
experientially – that they can truly listen from inside a
particular position. It is also
important that we don’t take so much time that the family
members who have come
for help go away wondering how what we’ve talked about
relates to their concerns.
Witnessing as a Friend
There are many positions that are possible. We may directly
suggest a position or
negotiate one with family members. A position that I have used
often is that of a
friend. First we have a brief discussion of how we listen to a
friend. This conversation
may include being in touch with how we want the best for our
friends, how we strive
not to judge, how we stay in touch with what is important to
them, how the listening
is about them, not us, and so on. We may talk about a particular
friendship in which
they have experienced themselves as supportive and
understanding.
I have found this position helpful in many contexts. For an
example I will describe
my work with a family in which the mother and father
discovered drugs hidden in
63. their son’s room. The parents’ initial response was extremely
critical and punishing.
The son’s only response was to accuse them of betraying all
trust by going through
his private things. By the time this family came to therapy they
were barely speaking
to each other and the only agreement they had reached was in
their description of the
parent–child relationship as hostile. I negotiated with Frank and
Julia, the parents, to
listen to their son, Eric, from a position of friendship. I assured
them that later, when
I interviewed them and it was Eric’s turn to listen, they would
have a chance to talk
about their parental concerns. They agreed to listen to my
conversation with Eric as
they would listen to a friend – trying to understand, wanting to
be supportive, staying
in touch with what Eric cared about and did outside of this new
discovery.
In this atmosphere, Eric, after talking about the betrayal he felt
about his room
being searched, talked about the drug use, including his
confusion about whether it
was a problem, and his acknowledgement about what it would
be like for parents to
discover hidden drugs. From the position of friendship, Frank
and Julia could show
that they understood how Eric became involved in taking drugs
and what the attrac-
tion was. They also raised some questions about possible effects
and consequences,
which Eric acknowledged in his response to their reflections.
When I switched and
interviewed Frank and Julia while Eric listened as a friend, Julia
64. described the guilt
Witnessing and Positioning
ª 2014 Australian Association of Family Therapy 25
Whitney
Highlight
she felt about having gone through Eric’s things. She was able
to explain her motiva-
tion in doing that as she saw her son change before her eyes.
Speaking as a friend,
Eric could understand why his mother searched his room and to
connect with her
concerns as a parent.
These were not easy conversations. I had to remind all three
family members,
repeatedly, about the positions they had agreed to, from time to
time interrupting
and saying something such as, Listening as a friend, Eric, what
do you think Julia was
caring about in searching your room? Also, these initial
conversations did not resolve
the problems that the family members struggled with in relation
to drug use. How-
ever all three participants agreed that they were useful. Eric
said that his parents’
understanding made it much more likely that he would talk with
them. He was sur-
prised that he found himself talking about his own misgivings
and they did not jump
on that as the whole truth. Frank said that he felt reassured that
65. Eric was thinking
about these things and was not completely taken over by drugs.
Julia said that she
was most happy that it felt like they could work together. They
did continue to work
together both in therapy and in their own conversations at home.
Other Witnessing Positions
Witnessing as inspired by a particular person
Rather than a general category, such as ‘friend’, we can
collaborate with people to
find a particular person as inspiration for a position. Michael
White (2004) in his
paper Narrative practice, couple therapy and conflict dissolution
describes interviewing
the person who will be in the witnessing position about someone
from whom they
have experienced significant acknowledgement, understanding,
compassion, or accep-
tance. He describes asking questions to facilitate a conversation
in which they specify
this person’s relational skills, ideas about life, purposes, and
commitments. After such
a carefully facilitated interview, the person can often step into
that position.
Witnessing as though surrounded by a team
We can also ask people if there was a team surrounding them,
helping them stay in a
position of listening and understanding, who would be on the
team. This might
include people they are currently involved with, those from
their past, as well as
66. people no longer living, fictional characters, and public figures.
Once the team mem-
bers are named we can ask the witnesses what each of them
would contribute. Would
there be particular words that they would say or expressions on
their faces? We can
then ask the witnesses to imagine that these team members are
there surrounding
them as they listen and offer reflections.
Witnessing using the position of a different context
For some people, naming a different context in which they
listen with patience,
respect, and willingness to understand is a useful path to
finding a witnessing posi-
tion. Perhaps as part of a worship group or in the context of
work, a person might
experience different ways of witnessing and understanding that
could be useful in
therapy conversations.
For all of these positions, helping people enter into
experientially vivid stories of
times they have been in the particular desired position is
helpful. We are interested
not just in going through different motions, but in people having
different experi-
Jill Freedman
26 ª 2014 Australian Association of Family Therapy
ences of their family members’ stories. To this end we may ask
67. people to relate a
story about a friendship in which they offered support and
understanding. We might
ask them how they were able to stay in the position of
friendship and what it was
like. Or we may ask why they would choose a particular person
as a team member
and what it was like to be with this person. We may ask
hypothetical questions about
what they imagine they would be in touch with about
themselves if the whole team
were by their side.
Witnessing from the position of what Is important
People often elevate being ‘right’ over what is important.
Sometimes asking, Is it more
important to be right or to understand each other? can be useful.
For example, I worked
with a heterosexual couple in the process of divorcing. Caroline
experienced herself as
in the right because Al had had an affair during their marriage
and had introduced
the woman he was involved with to their children as though she
was a co-worker.
Their daughter was refusing to see Al, but he thought it was his
right to see his
daughter. He believed that Caroline was poisoning their
relationship. It was very diffi-
cult to get Al and Caroline to listen to each other until we had a
conversation about
what was most important. Both of them agreed that what was
most important was
that their children do well. They also agreed that good
relationships with both parents
would be best for their children.
68. Listening from the position of wanting the best for their
children, which included
relationships with both parents, made our conversations much
easier. Al and Caroline
acknowledged that there were other issues between them, but
they agreed that they
could get to those later. What was most important in therapy
was that they both
wanted to be in the position of doing the best for their children.
Listening from the position of the relationship
With some couples, listening from the vantage point of ‘the
relationship’ can be help-
ful. This position requires listening not as an individual person,
but as the relation-
ship. Some people seem to find this easy to do. For others it is
quite difficult. One
couple who struggled with being in this position wrote a letter
from the relationship
to themselves as a way of helping themselves move into this
position for the next
time. I include the letter they wrote from their relationship as an
example of the pos-
sibility of developing a witnessing position between therapy
meetings:
Dear Margaret and Bill,
Sometimes I feel as if you are co-workers. By this I mean that
sometimes it’s as if you
come together to accomplish some common goal but that there
is not necessarily a per-
sonal bond between you. Like, as long as you get all the needed
tasks done then you
are on track. But I need to feel that you are special to each
69. other. That there are things
about each of you that draw the other closer to you. That
sometimes these feelings
grow so strong that you can’t help but let it out somehow. That
when one of you
leaves the house or returns home the other is moved in some
way that is different than
if it were anyone else. That being next to each other sometimes
brings an impulse to
touch, to caress, to nuzzle, and THIS IS NOT ABOUT SEX,
although sex would be
one extension of these feelings. Lately I get glimpses of it: after
a disagreement or when
you are away from home together – a tenderness that is
differently warm and envelop-
ing. That marks your togetherness as unique – that no one else
could fill this job
description or pay this rent. I can see that both of you want
more of this. Would it
Witnessing and Positioning
ª 2014 Australian Association of Family Therapy 27
Whitney
Highlight
help if you wrote down those things which for each of you are
examples of affection,
what you do and like to have done to be romantic and to
separate me (your relation-
ship) as different than all others. It strikes me that this could
serve as a guide for trans-
lation. Instead of English–Spanish it would be Margaret-Bill,
70. the better to understand
each other. It seems like a pretty dumb idea but my guess is that
there is a lot that you
are each missing. Perhaps there are messages being sent that are
not recognized for what
they are. You love each other. Maybe this means something
different to each of you.
Isn’t it something that things got so low not so long ago and
already I can hope that
you can learn to understand each other’s way of loving. Don’t
let me down.
With hope,
Your relationship
After writing this letter, both Margaret and Bill found it much
easier to serve as a
witness from the position of their relationship. They also found
this position more
available to them in life outside of therapy.
We may ask different family members to be in the same position
or in different
positions. We may change the positions over time if a new
position seems more fit-
ting.
Helping People Stay …