Case Study: narrative therapy in family counseling

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[. . .] Mary is resentful that Jennifer seems to respond better to Phillip’s parenting techniques, whereas Jennifer might feel that her mother is not adequately empowering her. Stress also flows horizontally between Philip and Mary.

Counseling Models and Theory

Narrative Therapy

Narrative therapy has been found to be at least as effective as cognitive-behavioral therapy, with even greater opportunities for family counseling applications (Lopes, Goncalves, Machado, et al., 2014). Using narrative therapy requires active engagement on the part of the client, who participates fully in co-constructing their own future. By envisioning new roles for themselves, clients like Mary also help create new outcomes for the family. Mary’s role as mother can be understood, externalized, and then changed in ways that better serve her needs, Jennifer’s needs, and the needs of Christine and Phillip. When integrated with family systems theory, narrative therapy can be shown to be a particularly efficacious treatment intervention. Even if Mary remains the only client, she can participate in the process of re-inventing herself and her identity. Ideally, though, Phillip will also participate in the narrative therapy so that he can support Mary on their collective family journey.

Multicultural and Legal Issues

The case study does not clearly indicate whether there are any multicultural issues. However, if the therapist and the client are from different ethnic backgrounds, it would be important to conduct research and to vocalize any concerns related to communications differences and different attitudes towards gender roles in the family. Otherwise, there are no legal or ethical issues of note in this case, so long as the therapist conforms to the ethical and legal tenets of the profession, maintains confidentiality, and practices in accordance with core competencies.

Short Term Goals

Goal 1: Narrative Therapy for Mary Role Identification

The first and foremost goal in therapy is to help Mary identify her demands and expectations, based on her image of herself as an unfit mother. Mary has cultivated an idealized vision of what she perceives a mother should be, and she does not seem to fit that vision. Instead of changing her concept of what a mother should be, Mary has instead coped through dysfunctional methods that can be changed by a process of self-awareness and taking the first steps in narrative therapy.

Goal 2: Narrative Therapy for Mary Reintegration into Work

Blended with the long-term goals, Mary may need to envision methods of changing her role in the family. This could entail her going back to work, allowing Philip to take care of Jennifer full time. If Jennifer prefers Phillips care, this could be an ideal opportunity for Mary to seek the solace she needs from the social world. She has clearly expressed the sense of stress that comes from not having access to friends outside of the family, and thrived off of her work relationships. To achieve this goal, Mary will start to look for a new job or solicit her former employer to return to work.

Long Term Goals

Goal 1: Mary Returns to Work

Whereas the short term goals depend fully on narrative therapy as the first step towards revising her role and identity, the long term goals involve taking decisive action. A reasonable time frame for taking action on work would be six months. By six months, Mary should be spending at least part time hours outside of the home in the workplace, where she can recharge her self-esteem and self-efficacy and cease placing the burden upon herself to be an idealized mother.

Goal 2: What About Christine?

Understandably, Jennifer consumes the bulk of her parents’ attention since the accident did not happen too long ago. Within the year, though, the parents—both Mary and Phillip—need to start focusing more on Christine. To achieve this goal, Mary and Phillip need to prove that they are spending enough time nurturing Christine’s needs, and this may require Christine to come in for a family counseling session.


Amiot, C.E., Sablonniere, R., Terry, D.J., et al. (2007). Integration of social identities in the self. Personality and Social Psychology Review 11(4): 364-388.

Lopes, R.T., Goncalves, M.M., Machado, P.P.P., et al. (2014). Narrative therapy vs. cognitive-behavioral therapy for moderate depression. Psychotherapy Research 24(6): 662-674. [END OF PREVIEW]

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