Narrative Therapy with Children and their Families
Approaches to Serious
Narrative Therapy with Children and Their Families
The narrative therapy approach involves the whole family and especially children by respecting their unique language, problem-solving resources, and views of the world. When the grown-up talk becomes serious and focused on analyzing problems, it is likely to turn children off. The authors of this book ask, "What might it mean for us as helpers of families and children to be light on our toes when confronting weighty problems? Is it possible to play and to maintain a sense of humor while dealing effectively with distressing, frightening, or perilous situations? How can we invite children and family members to bring forth their imaginative and creative resources while coming to grips with the sociocultural complexity of problems?" These questions determine the nature of their inquiry into playful approaches to serious problems.
The authors begin by elucidating a basic theory of collaborative narrative play that allows new choices and stories of hope and change to emerge. They encourage appreciation for ways of communicating that appeal to children, whether in the sandtray or with puppet "co-therapists: and respect for special and unusual abilities, such the ability to "read hearts" or connect with imaginary friends.
Compelling case examples draw the reader into the book from the first pages. Children who might have been labeled belligerent, hyperactive, anxious, or out of touch with reality are found to be capable of taming their tempers, controlling frustration, facing fears, and using their imaginations to the fullest. Family members discover how to use play to bolster the child's attempts to "grow up and shrink the problem down,""get the better of Trouble," or "catch Sneaky Poo before it sneaks out." In addition to the case vignettes throughout the first two parts of the book, there are five extended case stories in part three.
Realistic, heartening, pragmatic, and just plain fun, narrative therapy encourages children and their families to use resources that have been overlooked to turn the tables on the problems they face. Therapists, parents, teachers, or anyone helping children and families will find that this book turns their thinking around, tooin the most unexpected and illuminating ways.
JENNlFER FREEMAN and DEAN LOBOVlTS are marriage, family, and child therapists in Berkeley, California. Jennifer's publications and presentations focus on the integration of narrative and expressive arts with play and family therapies. DAVlD EPSTON is co-director of The Family Therapy Centre in Auckland, New Zealand. Together with Michael White, of Adelaide, Australia, he innovated the narrative therapy approach and wrote Narrative Means to Therapeutic Ends. Jennifer, David, and Dean are on the faculty of the Graduate School of Professional Psychology at John F. Kennedy University in Orinda, California.
"This book is the most compelling response yet to the long-standing need for a way to engage children and adults equally as participants in family therapy. It demonstrates how narrative therapy is ideally suited to the gifts and needs of children, The authors illustrate narrative therapy's deep respect for individual experience and its exquisite sensitivity to the interplay between the personal and the sociopolitical. The book's comprehensive scope, careful organization, and utter lucidity make it an extraordinarily powerful and accessible textbook on narrative therapy. Playful Approaches to Serious Problems is a joyful and brilliant gift to child and family therapy."
Richard Chasin, M.D. Co-director, Family Institute of Cambridge. Associate Clinical Professor of Psychiatry, Harvard Medical School.
"This is a remarkable chronicle of the fruition of the narrative approach to working with children and their families and of many children's triumph over weighty problems. In these author's hands the 'narrative' brings children's own creative solutions to center stage, while adults--parents, therapists, and readers--are genuinely impressed and charmed by the children's commitment and resourcefulness. This is a book about children, but the appeal to ingenuity in the desire to escape from emotional pain and discomfort can also be applied to many adult patients. This book and the children in it are guides and consultants to the possible in contemporary psychotherapy."
Lee Combrink-Graham, M.D. Adult, Child, and Family Psychiatrist. Behavioral Health Medical Director, Oxford Health Plans.
"This is a delightful and refreshing book that significantly fills the gap in the literature on working with children and their families. The authors present a broad range of 'spirited' ideas about practice and share with their readers a license to create, one that is vividly portrayed in the detailed illustrations of their work. The text is engaging and constitute an invitation to therapists to step beyond the boundaries of the known in their work with children."
Michael White, Dulwich Centre, Adelaide, Australia.
"Inspirational, respectful, and playful at thesame time. Freeman, Epston, and Lobovits once an for all dispel the myth that narrative approaches are too intellectual for working with children. The authors, three exceptionally creative therapists with a wealth of experience, immerse us in the stories of their work. Their incredibl enthusiasm for and unshable belief in the knowledge and potential of children and their families shines through on every page. Every child and family therapist should won this treasure trove of ideas!"
Jill Freedman, M.S. W. co-author of Narrative Therapy
Volume 25, Number 4, October 1999
Freeman, J., Epston, D., & Lobovits, D. (1997). Playful approaches to serious problems.
This is a well-written, enjoyable book about how to access children's creativity and resourcefulness to overcome difficult circumstances. Presented are a vast array of interesting approaches to engendering hope in children--that draw on their positive attributes and competencies when faced with weakness and helplessness. This book will enliven parents, educators, and psychotherapists by providing a way of conversing with children that brings out the joy of raising and guiding them. Through an enlightening range of both brief and extended case examples, the authors make the case for the effectiveness of these narrative approaches as well as capturing their playful spirit.
The essence of the authors' message is captured at the beginning of the book: Inviting worry, despair, and hopelessness, weighty problems can immobilize families as well as the people who serve them. We wonder whether it is to the problems' advantage to be taken quite so seriously. By the same token is their very existence threatened by humor and playfulness. (p. 3)
Externalization, which separates persons from problems, relieves the pressure of blame and defensiveness. The authors note that with some distance between self and problem, family members can consider the effects of the problem on their lives and bring their resources to bear on their relationship with it. The possibilities for children and families to develop alternative, more helpful narratives include not only conversation, but also drawing and painting, cartoons, poetry, journal, or letter writing, sculpture, and guided fantasy. The authors show how helpers can build upon children's talents, while also considering the family and sociopolitical context within which children's difficulties live.
The approach to parents recognizes their predicaments, the limitations of their own self-narratives and the sociopolitical context within which they relate. While the authors assume that most parents intend to be helpful and loving to their children, they also describe how parental attitudes and behavior may not serve them or their children well. Problematic parent behavior is also externalized. By inviting parents to examine their relationship with unhelpful attitudes and behavior, therapists avoid parent blaming and open possibilities for parents to improve matters. Clear examples of helpful conversations with parents and children abound with the caveat that the authors are not representing ''techniques, but guidelines for approaching effective dialogue. This volume is certainly a valuable contribution to the field of child and family therapy.
Thomas W. Lund, PsyD Catskills Family Institute Kingston, NY
The title of this book captures it well. Playful Approaches to Serious Problems offers a wonderfully creative set of ideas for working with children and their families from a narrative perspective. Reading it was a refreshing experience. When I initially began working as a family therapist, I was attracted to the opportunities for creativity that were offered in the work. The prevailing theories of the day allowed and encouraged me to be inventive, playful, and at times outrageous. I felt very alive in the work and it nourished my soul. Later, I became interested in narrative ideas, in part, because they addressed the very serious broader sociocultural contexts in which families move in a similar inventive and playful way. These days, much of my work consists of training and consulting in community agencies. The all too common refrain that I hear is, "This work just isn't fun anymore!" As the therapy industry continually tries to do more with less and the increase in clinician stress is topped only by the rise in paperwork requirements, we risk losing touch with the creativity and values that brought many of us into this field and sustain us as we continue to practice. In this distressing context, this book is a wonderful antidote. As I read it, I found myself enlivened and invigorated. While the book has a light-hearted tone, it does not minimize the seriousness of the problems confronting the children and families described in it. Instead, it addresses those problems in ways that effectively invite families (and therapists) to step out from under the weight of the seriousness of problems.
The book is divided into three sections and filled with wonderful stories, clinical vignettes, and examples of children's artwork and creative expressions. The first section lays out the rationale, conceptual underpinnings, and clinical practices for working with children and their families from a narrative approach. The ideas are presented in an accessible language with concrete examples and a special focus on situations where the ideas are difficult to implement. The book also extends narrative work in interesting and thought-provoking ways. In this regard, it is useful for readers at multiple levels of familiarity with narrative ideas. The work described in this book begins with getting to know children and their families outside of the problems that bring them to therapy and consistently remains anchored in an approach that appreciates and honors the uniqueness of each individual. The book offers ways to connect with parents as well as children and devotes particular focus to helping parents out from under guilt and self-blame in order to better appreciate their children's uniqueness and free up their own creativity and problem-solving abilities.
One important extension of narrative theory is the authors' encouragement of a shift from externalizing problems in order to defeat those problems to externalizing problems in order to address the ongoing relationship between persons and problems. The authors suggest that many of the metaphors for approaching problems in narrative therapy have tended to foster an adversarial or aggressive relationship between problems and persons. They encourage us to reflect on the consequences of these oppositional "power over" metaphors and draw instead on metaphors of "power in relation to the problem." The authors then utilize their focus on problem-person relationships to juxtapose the influence of the problem on the person with the influence of the person on the problem in order to help persons develop different relationships with the problems in their lives. I find this a useful shift and one that each of the authors has described elsewhere (Freeman & Lobovits, 1993; Roth & Epston, 1996; see also Stacey, 1997). It helps us to move away from militaristic metaphors such as beating, defeating or silencing problems which fit with patriarchal ways of being and have the potential to replicate those ways of being at the same time that we are seeking alternatives to them. Their focus on the relationship between persons and problems allows us to better explore the complexity of that relationship and encourages a lighter and more playful approach. The second section of the book describes their continued expansion of narrative ideas. They focus on ways to draw on play therapy and expressive arts to extend narrative work to include nonverbal as well as verbal communication. They examine ways to use puppets and stuffed animals as co-therapists with the possibilities of reflecting conversations between the therapist and these special "co-therapists." They describe ways to honor and draw on imaginary friends and children's "weird and special abilities" that have otherwise been demeaned or pathologized as a way to fit our work to the unique pathways to change offered by particular children. Throughout all of this, the authors retain a distinct focus on the broader social, cultural and economic pressures that weigh on families and support the existence of problems. They describe ways to address the sociocultural context in an effective and yet playful fashion.
The final section offers five extended case stories that allow an in-depth immersion in the application of these ideas. This section includes an exploration of the authors' own thinking and reflections in each situation and brings to life the rich spirit and profound humanity of their work. While the book offers innovative ways of working with children and families, what I found most moving was the respectful sensitivity and determined hopefulness that consistently emerges throughout. Reviews often end with recommendations. In keeping with that tradition, I would strongly encourage readers to buy this book. It is a wonderful book that is both thought-provoking and rejuvenating. It will benefit the children and families who consult you, it will enliven your work, and it just may revitalize your spirit.
William C. Madsen, Ph.D. Family Institute of Cambridge Watertown, MA
Freeman, J.C. & Lobovits, D.H. (1993). The turtle with wings. In S. Friedman (Ed.). The New Language of Change: Constructive Collaboration in Psychotherapy. New York: Guilford.
Roth, S. & Epston, D. (1996). Consulting the problem about the problematic relationship: An exercise for experiencing a relationship with an externalized problem. In M. Hoyt (Ed.) Constructive Therapies II. New York: Guilford.
Stacey, K. (1997). Alternative metaphors for externalizing conversations. Gecko, 1 29-51.
Here is a book for those therapists who are sometimes perplexed when confronted with the "I don't know's"--the shrugs and the discomfort of young children in therapy. While children may find adult talk difficult and even boring, they can certainly engage with adults who understand a child's way of knowing the world. David Epston, a pioneer in narrative therapy, and his two gifted colleagues, Jennifer Freeman and Dean Lobovits, convey deep respect for that way of knowing. These three authors share their gifts in a very readable albeit densely packed book.
In answer to the question of whether it makes sense "to be light on our toes when confronting weighty problems," the authors offer a Playful approach to the difficulties of children. It is child-focused narrative family therapy in which both children and their caretakers learn to play with problems in ways that lead to creative resolutions. Externalization, a linguistic practice at the core of this approach, is inherently playful and lighthearted even in the face of deadly serious problems. Play and imagination, familiar provinces to children, become powerful resources in the resolution of difficulties that oppress them and their families. The authors demonstrate persuasively haw playful conversations can have the serious effect of turning problem stories into narratives of hope and change.
Therapists unfamiliar with narrative approaches will find this a primer of the basic ideas and assumptions. Those who are experienced will welcome the refresher and new twists. The whole process of playfully separating the child from the problem, developing the counter plot, publishing the news of change, and insuring the continued growth of the new and preferred life story is covered. All the way along, the process is amply illustrated with practice examples. The book ends with five extended "case stories" which very helpfully treat the reader to the thoughts and perceptions of the therapist.
The three authors, brought together by a mutual excitement about narrative therapy, present intriguing and delightful variations in their approaches. They do indeed deal playfully with extremely serious problems and pay special attention to social, cultural, and economic pressures that "divide and conquer" families. One wishes the scope of the book could have allowed for a more expanded treatment of abuse, violence, medication, and family power inequities that affect children.
Therapists will find this playful approach a demanding discipline. Rather than a set of techniques, it is a world view. A light approach it is, but not one to be undertaken lightly.
Jo annn Allen is at the Ann Arbor Center for the Family in Ann Arbor, Michigan.
Filled with clinical vignettes. . . Playful Approaches to Serious Problems by family therapists Jennifer Freeman, David Epston, and Dean Lobovits, is an in depth course in externalization, a staple of narrative therapy. Externalizing aims to separate people from their problems. . .
While externalizing may sound like simply a linguistic trick, Freeman, Epston, and Lobovits provide numerous examples of how it has helped children and families make changes in therapy. And it seems to come naturally to children who often split off troublesome parts of themselves in order to preserve a sense of being good and lovable. Siding with that tendency through externalization unleashes wonderful creativity. Maria herself came up with the toilet paper intervention, for example. She was guided, I'm sure,' by her therapist's (Jennifer Freeman's) suggestion that temper is an opponent that can be beaten, not a personality trait. But what therapist could come up with the fitting idea of flushing it away?
For Freeman, Epston and Lobovits, externalizing happens in three spheres. They begin by talking about the child as separate from the problem. Maria isn't an angry child, Freeman suggests. Rather, her life is being disrupted by Temper, a tricky intruder who trips up many children. Next, the therapist involves the child's family in the fight against the problem. Maria's mother, for example, might become Maria's co-conspirator, helping Maria find even more ways to resist the hicks of Temper. Finally, problems are set in a socio-political context, exposing the cultural beliefs that support them. Maria's mother, for example, might be invited to examine our societal belief that children's misbehavior reflects their parents'--especially their mother's--inadequacies. How has this belief affected her image of herself as a parent? How has it affected her relationship with Maria? And how has it sided with Temper to disrupt the family!
As anyone who has spent a therapy hour with a 6-year-old can testify, talking is not always a child's preferred way of dealing with problems. In recognition of this, Freeman, Epston and Lobovits add techniques of art and play therapy that translate the abstract ideas of narrative therapy into children's "language,"
This is an important contribution since children tell us they often feel left out of therapy because it's all just "grown-up talk." In contrast Playful Approaches is alive with therapists who draw, perform puppet shows, model in clay, and play in the sandbox with children and their families. Five-year-old Rachel, for example, created the "Sleeping Soundly Handbook" with her therapist's help. Full of drawings and stories, the Handbook chronicles Rachel's success in conquering fears of sleeping alone in her room. The final drawing is captioned: "Me and my slippers are smiling because I slept by myself." The willingness of Freeman, Epston, and Lobovits to meet children in their own worlds shines through in this books and contributes much to their therapeutic success as any technique. . .
Although aimed at practitioners already familiar with the narrative therapy model, this book offers a useful perspective for any therapist working with children. The underlying assumption of the model is that individuals, even quite young children, have the capacity to let go of their problems. The basic strategic principles involve disentangling the person from the problem ("externalizing the problem" moving from a blaming perspective to a cooperative alliance against the problem; and allowing opportunities for individual creativity to flower. Various implementations ofthe basic premises are illustrated by an abundance of moving and intriguing case studies that engage the children in the fight against the problem and gain some control of their lives through strategies involving letters, art work, apposite stories, and such "unlicensed co-therapists" as stuffed animals. . . the authors . . . never dismiss the seriousness of their clients' problems. They are also realistic in pointing out that these are not miracle cures that leave a family problem-free; that they are, rather, a change in the relationship to the problem that enables lives to be lived more fully, in spite of reemergence of the old bugbears, or the normal development of new challenges.--Caroline Purves, PhD (private practice), Berkeley, Calif
1 PLAYFUL COMMUNICATION
1 Playful Communication in Family Therapy
2 Getting to Know the Child Apart from the Problem
3 Stories of Hope
4 Parents in Child-Inclusive Family Therapy
5 Thinning the Plot, Thickening the Counterplot
6 Building a Narrative through Letters
7 Publishing the News
II PLAYFUL MEANS
8 Therapies of Aesthetic as well as Literary Merit
9 Unlicensed Co-therapists
10 Weird and Special Abilities
11 Family Politics in Action
12 An Imagination of One's Own
III PLAYFUL STORIES
13 Jonathon: "I Have Overcome That Much and I Don't Think I'll Be Able to Go Back"
14 Tony: "The Spiritual Boy Is Fine"
15 Jason: "I'm Lighting My Own Lantern Now"
Sophia: "I Won't Make a Place for You in My Heart,
17 Terry: "So after a Long Time in Horror I Live in Peace Again"
© Dean Lobovits, David Epston, Jennifer Freeman
Date Last Modified: 4/21/2k