Stories of change in group psychotherapy: narrative characteristics of successful change
Abstract
The main goal of the study is to describe narrative characteristics of stories of change in the psychotherapy group, narrated by clients, who reached clinically significant change. The current study was a part of a three-year project, focused on the research of efficiency and curative factors of therapy in daily treatment centers specialized at the treatment of depression and anxiety disorders. From the total participants n=220 (21 groups) in the quantitative part of the project, 32 clients took part in repeated qualitative interviews (in the middle, at the end of treatment, and 8 – 9 months after treatment). The present study involves eight participants who participated in at least two interviews and reached a clinically significant change. Data were analyzed by means of categorical narrative analysis, using the following narrative categories: thematic lines; agency; positioning; values, and beliefs. Results indicate, that some clients develop the agentic capacity only during the process of change, it is a certain „re-authorization “ of one´s action. There appear to be two types of agency, a systematic, directive type and more relaxed, open type. In the category of positioning, clients tend to the narrative delimitation toward other members of the group and also toward the group as a whole. In the category of values and beliefs, clients describe normative and moral aspects of reaching the change in psychotherapy.
https://doi.org/10.29364/epsy.372
(Fulltext in Czech)
Keywords
change in psychotherapy, narrative analysis, agencyLiterature
Adler, J. M. (2012). Living into the story: agency and coherence in a longitudinal study of narrative identity development and mental health over the course of psychotherapy. Journal of Personality and Social Psychology, 102(2), 367–389. http://doi.org/…037/a0025289
Adler, J. M., Skalina, L. M., & McAdams, D. P. (2008). The narrative reconstruction of psychotherapy and psychological health. Psychotherapy Research, 18(6), 719–734. http://doi.org/…300802326020
Angus, L. (2012). Toward an integrative understanding of narrative and emotion processes in Emotion-focused therapy of depression: Implications for theory, research and practice. Psychotherapy Research, 22(4), 367–380. https://doi.org/….2012.683988
Angus, L., & Kagan, F. (2013). Assessing client self-narrative change in emotion-focused therapy of depression: An intensive single case analysis. Psychotherapy, 50(4), 525–534. https://doi.org/…037/a0033358
Bamberg, M. (2005). Positioning. In D. Herman, J. Manfred, & R. Marie-Laure (Eds.), Routledge Encyclopedia of Narrative Theory (s. 445–446). New York: Routledge.
Bamberg, M. (2012). Narrative practice and identity navigation. In J. A. Holstein, & J. F. Gubrium (Eds.), Varieties of narrative analysis (s. 99–124). Los Angeles, CA: SAGE Publications, Inc.
Bohart, A. C., & Tallman, K. (2010). Clients: The neglected common factor in psychotherapy. In B. L. Duncan, S. D. Miller, B. E. Wampold, & M. A. Hubble (Eds.), The heart and soul of change: Delivering what works in therapy (s. 83–111). American Psychological Association. https://doi.org/…37/12075-003
Bruner, J. (1996). The Culture of Education. Cambridge: Harward University Press.
Čermák, I. (2002). Myslet narativně (kvalitativní výzkum „on the road“). In I. Čermák, & M. Miovský (Eds), Sborník z konference Kvalitativní výzkum třetího tisíciletí (s. 11–25). Brno: Psychologický ústav AV ČR, Nakladatelství Albert.
Davies, B., & Harré, R. (1990). Positioning: The discursive production of selves. Journal for the Theory of Social Behaviour, 20, 46–63. https://doi.org/…90.tb00174.x
Dubovská, E., Furstová, J., Růžička, J., & Tavel, P. (2019). Validity of the Czech Version of the Therapeutic Factors Inventory–Short Form (TFI-S). International Journal of Group Psychotherapy, 69(3), 308–327. https://doi.org/…2019.1584527
Epston, D. & White, M. (1992). A proposal for a re-authoring therapy: Rose’s revisioning of her life, and a commentary by Kevin Murray. In S. McNamee, & K. J. Gergen (Eds.), Therapy as a social construction. London: Sage Publications.
Gonçalves, M. M., Matos, M., & Santos, A. (2009). Narrative therapy and the nature of “innovative moments” in the construction of change. Journal of Constructivist Psychology, 22(1), 1–23. https://doi.org/…530802500748
Habermas, T., & Köber, C. (2015). Autobiographical reasoning is constitutive for narrative identity: The role of the life story for personal continuity. In K. C. McLean & M. Syed (Eds.), The Oxford handbook of identity development (s. 149–165). Oxford University Press.
Chrz, V. (2004). Výzkum jako narativní rekonstrukce. In M. Miovský, I. Čermák, & V. Řehan (Eds.), Kvalitativní přístup a metody ve vědách o člověku III., (s. 21–32). Olomouc: Nakladatelství Univerzity Palackého.
Jacobson, N. S., & Truax, P. (1991). Clinical significance: A statistical approach to defining meaningful change in psychotherapy research. Journal of Consulting and Clinical Psychology, 59(1), 12–19. https://doi.org/00224006X/9
Juhová, D., Řiháček, T., Cígler, H., Dubovská, E., Saic, M., Černý, M., Dufek, J., & Evans, C. (2018). Česká adaptace dotazníku CORE-OM: Vybrané psychometrické charakteristiky. Československá psychologie, 62(1), 59–74.
Kazdin, A. E. (2009). Understanding how and why psychotherapy leads to change. Psychotherapy Research, 19(4–5), 418–428. https://doi.org/…300802448899
King, L. A. (2001). The hard road to the good life: The happy, mature person. Journal of Humanistic Psychology, 41(1), 51–72. https://doi.org/…167801411005
Kühnlein, I. (1999). Psychotherapy as a process of transformation: Analysis of posttherapeutic autobiographic narrations. Psychotherapy Research, 9(3), 274–287. https://doi.org/…912331332761
Levitt, H. M., Pomerville, A., & Surace, F. I. (2016). A qualitative meta-analysis examining clients’ experiences of psychotherapy: A new agenda. Psychological Bulletin, 142(8), 801–830. https://doi.org/…7/bul0000057
Lieblich, A., Tuval-Mashiach, R., & Zilber, T. (1998). Applied social research methods, Vol. 47. Narrative research: Reading, analysis, and interpretation. Sage Publications, Inc.
Lieblich, A., McAdams, D., & Josselson, R. (2004). Healing plots: The narrative basis of psychotherapy (1st ed., The narrative study of lives). Washington, DC: American Psychological Association.and Interpretation. London: Sage.
Lincoln, YS. & Guba, EG. (1985). Naturalistic Inquiry. Newbury Park, CA: Sage Publications.
Lucius-Hoene, G., & Deppermann, A. (2000). Narrative identity empiricized a dialogical and positioning approach to autobiographical research interviews. Narrative Inquiry, 10(1), 199–222. https://doi.org/…i.10.1.15luc
Mackrill, T. (2008). Exploring psychotherapy clients’ independent strategies for change while in therapy. British Journal of Guidance & Counselling, 36(4), 441–453. https://doi.org/…880802343837
Madill, A., Sermpezis, C., & Barkham, M. (2005). Interactional positioning and narrative self-construction in the first session of psychodynamic-interpersonal psychotherapy. Psychotherapy Research, 15(4), 420–432. https://doi.org/…300500091249
McAdams, D. P. (1996). Personality, modernity, and the storied self: a contemporary framework for studying persons. Psychological Inquiry, 7, (4) 295–321.
Moertl, K., & Von Wietersheim, J. (2008). Client experiences of helpful factors in a day treatment program: A qualitative approach. Psychotherapy Research, 18(3), 281–293. https://doi.org/…300701797016
Pals, J. L. (2006). Narrative identity processing of difficult life experiences: Pathways of personality development and positive self-transformation in adulthood. Journal of Personality, 74(4), 1079–1110. https://doi.org/…2006.00403.x
Rennie, D. L. (1990). Toward a representation of the client's experience of the psychotherapy hour. In G. Lietaer, J. Rombauts, & R. Van Balen (Eds.), Client-centered and experiential psychotherapy in the nineties (s. 155–172). Leuven University Press.
Rennie, D. L. (2001). The client as a self-aware agent in counseling and psychotherapy. Counseling and Psychotherapy Research, 1(2), 82–89. https://doi.org/…112331385118
Riessman, C. K. (2008). Narrative methods for the human sciences. Thousand Oaks, CA, US: Sage Publications.
Singer, J. A., Blagov, P., Berry, M., & Oost, K. M. (2013). Self-defining memories, scripts, and the life story: Narrative identity in personality and psychotherapy. Journal of Personality, 81(6), 569–582. https://doi.org/…1/jopy.12005
Thornhill, H., Clare, L., & May, R. (2004). Escape, enlightenment and endurance: Narratives of recovery from psychosis. Anthropology and Medicine, 11(2), 181–199. https://doi.org/…410001678677