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| Narrative assessment
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Narrative
psychologists believe that the structures and elements of which stories
are composed act to direct our thought processes. Instead of viewing
logic as the guiding force behind information processing, they view
people as organizing life events into unique plot structures and
creating themes that give them significance.
This quest for meaning is especially evident in peoples’ attempts to
develop self-narratives that give them a sense of identity and
coherence, and that allow them to share their experiences with others
(Neimeyer & Levitt, 2001). This "storying" of complex life
experiences draws on the distinctive language, scripts, and symbols
derived from different cultures and traditions, as well as the unique
life histories of their individual authors. The rapid development of
this narrative perspective over the last
20 years owes partly to its broad relevance across cognitive,
developmental and clinical areas of research.
The Narrative Process Coding System illustrates the use of
constructivist methods to assess the topical and thematic shifts that
characterize client accounts of their experience (Angus, Levitt &
Hardke, 1999).
- First, an investigator using the
system segments the
dialogue
of a transcribed therapy session into topic units that are identified
through
shifts in protagonists and themes. For instance, a client may begin a
session by discussing a recent trip to Florida and then shift to an
examination
of disappointing family vacations in childhood. The identification of
such topic segments can allow researchers to consider how themes are
maintained
or changed through discussion and how the interpersonal
psychotherapeutic
process can act to facilitate narrative development.
- Second, the
researcher
codes these topic segments into one of three narrative processes. External
narrative sequences are dominated by
event description. An account of a vacation itinerary would be an
example of this narrative type. Internal narrative sequences
focus upon emotional and
experiential states. A description of the storyteller’s awe or
uneasiness at first glimpsing the ocean would exemplify this narrative
process. Finally, reflexive narrative sequences entail
analysis and interpretation of events and internal reactions in order
to understand their significance. An exploration of the meaning
of
relaxation in one's life would be classified as reflexive.
Through
the assessment of narrative processes, researchers can study
how changes in the client’s storytelling about life events are
evidenced in therapy. For example, investigators have found that
experiential therapists tend to shift discourse from external event
descriptions toward internal and reflexive processes to promote
self-exploration and meaning-making, while clients tend to shift into a
more external process, to integrate
their therapeutic insights into their daily life experiences.
Likewise, narrative process assessment of various types of treatment
could suggest what forms of client processing are associated with more
favorable outcomes in different forms of therapy. For example,
prompting clients toward a external storytelling, communicating
childhood events and experiences, seems to facilitate progress in
psychodynamic therapy, whereas encouraging a more reflexive,
interpretive style appears to promote more rapid gains in a cognitive
treatment (Angus et al., 1999).
Other constructivist methods for assessing different dimensions
of clients’ self-narratives include various content scales for
coding the extent to which people feel like "origins" of life choices
or "pawns" of fate, as well as their level of "cognitive anxiety"
associated
with the diagnosis of serious illness (Gottschalk, Lolas & Viney,
1986).
Another method, the Narrative Assessment Interview, involves
asking open-ended questions inviting the client’s self-description from
internal and external perspectives at the outset and termination of
therapy. Systematic
coding of the responses can yield a clear depiction of client change
over
treatment, while permitting clients to convey this change in their own
words, rather than having to “translate” their meanings into the
sometimes
alien language of the assessor. |
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| References
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- Angus,
L., Levitt, H., & Hardtke, K. (1999).
Narrative processes and psychotherapeutic change: An integrative
approach to psychotherapy research and practice. Journal of
Clinical Psychology, 55, 1255-1270.
- Gottschalk,
L. A., Lolas, F. & Viney, L. L. (1986). Content analysis of
verbal behavior in clinical medicine. Heidelberg, Germany:
Springer Verlag.
- Neimeyer,
R. A. & Levitt, H. (2001). Coping and coherence: A
narrative perspective on resilience. In R. Snyder (Ed.), Coping
with stress (pp. 47-67). New York: Oxford.
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Robert A. Neimeyer & Heidi
Levitt
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