Narrative Therapy vs. Solution-Focused Therapy What is Superior for Clients in Crisis?

This paper will explore two similar approaches to therapy for clients in crisis: that of narrative therapy and solution-focused therapy. Both therapeutic techniques evolved as a way of helping clients deal with problems in a proactive manner, versus focusing on delving into the individual's past history or attempting to reform the individual's character. However, although they share many similarities, solution-focused therapy has increasingly found favor with both therapists and clients as a way of developing positive cognitive approaches to deal with difficulties. This paper will explore possible reasons why this is so and if solution-focused therapy is indeed superior to narrative therapy. It will conclude with a discussion of another therapy that has also been offered as an alternative to narrative-based therapy -- reality therapy -- which similarly offers a grounded way for clients to perceive their problems anew, versus simply develop new stories with which to frame their current dramas.

Narrative Therapy

Narrative therapy makes use of the ability of the individual to craft his or her own story as a way to facilitate self-empowerment. "This therapy intends to view problems as separate entities to people, assuming that the individual's set of skills, experience and mindset will assist him/her reduce the influence of problems throughout life" ("Narrative therapy," 2010). Rather than viewing someone to whom things are done, this form of therapy views the protagonist as the actor and director of his or her own life story. The therapist is seen as a guide, not a director of what the client should do.

Narrative therapy is designed to give clients tools to empower themselves: "Placing the client as an expert, and understanding his/her story instead of attempting to predict it, indicates the therapist's mindset" ("Narrative therapy," 2010). The client gains a sense of direction over his or her own life and is not dependent upon the therapist. "The problem becomes the antagonist of the story," not the client, and "certain behaviours are based on particular 'unhealthy' or 'undesired' characteristics -- such as lack of patience, aggressiveness, etc." which must be defeated, and an alternative ending is suggested instead ("Narrative therapy," 2010).

The separation of the person from the problem encourages the individual not to fall into self-defeating cognitive mechanisms like identifying him or herself as inherently 'broken' by saying, 'this always happens to me because I am a bad person.' Such self-defeating ideas makes it difficult to adopt a new way of being in the world or a positive approach to finding a solution. "Narrative therapy was created as a non-pathologizing, empowering, and collaborative form of therapy that recognizes that people possess natural competencies, skills, and expertise that can help guide change in their lives" ("Narrative therapy," 2015). It is the client that ultimately decides which narrative is most effective to deal with the issue that is the focus of the therapeutic relationship.

Although the role of the therapist is relatively non-directive in narrative therapy, he or she still plays an important role. The therapist has a critical task of helping the client identify nonproductive storylines he or she has been telling about him or herself and finding more productive ways to view the conflict. "The therapist also helps people to see what is 'absent but implicit' ... By exploring the impact of the problem, it is possible to identify what is truly important and valuable to a person in a broader context, beyond the problem" ("Narrative therapy," 2015). In distinct contrast to psychoanalysis, the focus is on dealing with current problems and ultimately transforming the problem rather than the person or explicating deep-seeded issues in the client's psyche.

Solution-Based Therapy

Narrative therapy can take many years to implement and arose out of the humanist school of psychology of Karl Rogers in the 1960s. Solution-based therapy, in contrast, has a much different history. Solution-Focused Brief Therapy (SFBT), also called Solution-Focused Therapy, "was developed inductively in an inner city outpatient mental health service setting in which clients were accepted without previous screening," in short, amongst clients with severe problems who did not have extensive amounts of time to devote to therapy ("What is solution-focused therapy," 2016). "The SFBT approach assumes that all clients have some knowledge of what would make their life better, even though they may need some (at times, considerable) help describing the details of their better life" ("What is solution-focused therapy," 2016). Like narrative therapy, it starts with the assumption...

"SF therapists have learned that most people have previously solved many, many problems and probably have some ideas of how to solve the current problem" ("What is solution-focused therapy," 2016). Common questions of solution-based therapists include: "Are there times when this has been less of a problem?" or "What did you (or others) do that was helpful?" ("What is solution-focused therapy," 2016).
A good solution-focused therapist will also help clients identify differences between problems in the past and current problems and ensure that clients are able to put issues in perspective when past problems are not as severe as current problems. "SF therapists may help clients identify these exceptions by asking, 'What is different about the times when this is less of a problem?'" ("What is solution-focused therapy," 2016).

Solution vs. Narrative Therapy

Solution-focused therapy has been increasingly favored as a way of helping patients deal with crisis in no small part due to its shorter duration -- few clients have the time or the resources to devote to long years of analysis. However, its focus on the future versus the past has been found to be particularly helpful. Rather than to create new general storylines about the client's life in general, the therapy focuses on the issues the client wants solved through the use of specific techniques. Solution therapy is extremely goal-oriented. One technique is to ask clients to imagine what he or she would need to completely solve the problem in the form of a miracle. "This unusual sounding tool is a powerful in generating the first small steps of 'solution states' by helping clients to describe small, realistic, and doable steps they can take as soon as the next day" ("What is solution-focused therapy," 2016). Often, the so-called impossible miracle is not nearly as elusive as the client initially believes.

Solution-focused therapy also focuses on helping clients view their problems in more realistic terms. Even new narratives can still be unrealistic and influenced by the client's extreme emotional state. Solution-focused therapy attempts to quantify the distress the client is feeling to give the client perspective. "Scaling questions (SQ) can be used when there is not enough time to use the MQ and it is also useful in helping clients to assess their own situations, track their own progress, or evaluate how others might rate them on a scale of 0 to 10" ("What is solution-focused therapy," 2016). Being able to quantify a problem by putting a number on it can help reduce the emotional intensity the client feels about the issue.

It should be noted that solution-based therapy is still effective as a way of empowering clients. Midway through a solution-focused therapy session, a therapist usually will ask the client during a consultation break if "Is there anything that I did not ask that you think it would be important for me to know?" to check in that the client feels that his or her most critical issue is being addressed ("What is solution-focused therapy," 2016).

Reality-Based Therapy

Reality-based therapy is yet another approach that reflects the idea that a firm grounding in reality, versus framing a new story about the client's issue, is the most effective way to cope with a potential problem. Reality-based therapy likewise focuses in the present and upon the current problem, versus problems in the past or the patient's former relationships. The intention is to focus on "behavior," much like solution-based therapy, "which means focus on what counselees can do directly - act and think" ("Reality therapy"). Reality therapy uses different techniques than solution-based therapy -- it does not ask clients miracle questions or take specific consultation breaks but it still focuses on the client creating realistic and specific solutions to his or her problems in a concrete fashion. It also attempts to help clients see where they are making excuses and attributing their problems to forces they cannot control, versus attempting to take action.

Conclusion

In all three therapies, the emphasis is on the client making choices to see his or her problems in a different light. Narrative therapy, despite its many strengths, lacks the focus and goal-oriented approach of solution-based therapy. For clients with only a short…