Modalities / Postmodern

Narrative Therapy

Michael White / David Epston · 1990
Key text: Narrative Means to Therapeutic Ends (1990)
Postmodern Focus: Narrative + Relational Short-medium Indiv + Family + Community

Core Mechanism

Externalizing problems + re-authoring preferred identity narratives through unique outcomes

Ontology

Dominant cultural narratives constrain identity; problems are social/linguistic constructions, not internal pathology

Therapeutic Voice

"So depression has been telling you that you're worthless. When has there been a time when you didn't believe depression's story?"

View of the Person

A self constituted by stories — dominant narratives constrain identity, and re-authoring is possible

Origins & Influences

Narrative Therapy was developed in the 1980s and 1990s by Michael White in Adelaide, Australia, and David Epston in Auckland, New Zealand. White was a social worker heavily influenced by Foucault's analysis of how institutional power produces the categories through which people understand themselves — including psychiatric diagnoses. Epston brought an anthropological sensibility and Gregory Bateson's ideas about how meaning is constituted through difference and context. The core move — 'externalizing the problem' ('The problem is the problem, the person is not the problem') — was White's clinical innovation, but its philosophical roots run through Foucault (power produces subjects), Derrida (meaning is deferred, never fixed), and Bruner (narrative as the primary mode of human meaning-making). Narrative Therapy is explicitly political in a way most therapies are not: it assumes that many personal problems are better understood as effects of dominant cultural narratives about gender, race, class, and normality. The therapist's job is not to diagnose or treat but to help people 're-author' their stories by identifying 'unique outcomes' — moments when they already acted outside the dominant narrative — and building alternative story lines from there.


Evidence

Not listed in major guidelines

Limited RCTs; some in specific populations

No comprehensive meta-analysis

Philosophical tension with RCT methodology. Some studies in grief and children.

Depression & Mood Disorders
Effect: Limited RCT data
Qualitative evidence strong
White & Epston, 1990 (1990)

Conditions

Epistemology

ConstructivistCritical

Blind Spots

Can feel intellectually abstract; political framing may not resonate with all clients; limited controlled research

Contraindications

Active psychosis with severely impaired narrative coherence, acute crisis requiring immediate stabilization, severe cognitive impairment, young children without sufficient language development for narrative co-construction


Training

Graduate training + workshops. No formal certification required

Dulwich Centre offers intensives; no certification

Graduate coursework + workshops

$500-3K for intensives

Equity & Cultural Adaptations

Cross-cultural adaptationsAddresses systemic powerBIPOC-adapted researchRefugee/displacement populationsMen's mental health adaptationsDisability/chronic illness affirming

Philosophical Roots

Foucault (power/knowledge, subjugated knowledges); Ricoeur (narrative identity); Derrida (deconstruction); Bruner (narrative as mode of knowing); Bateson (ecology of mind); social constructionism

Related Modalities


Clinical Vignettes

See how Narrative Therapy formulates these cases:

Test Yourself

What is externalization?

Show answer

Separating person from problem — 'the anger' not 'your anger problem.'


Sources