Running head: NARRATIVE THERAPY
Case Conceptualization Using the Narrative Therapy
Bryni Tiggs
Liberty University
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Abstract
Star is a twenty-one-year-old woman who has just achieved stardom through a trio girl group
with her sister and one of her friends. It took a substantial amount of hard work, dedication and
loss to get to this point in her life. As a child, Star lost her mother to drug abuse and her and her
sister, Simone, were placed in the foster care system. After suffering abuse in the foster care
system for many years, Star found her godmother, Carlotta and was able to get placed in her care
along with Simone. When the three girls decided to form a girl group, Star’s father resurfaced,
only to die shortly after reconnecting. Recently, Star found out she was pregnant right after her
sister and she became estranged. Star sought help from a counselor when she realized she did not
have anyone in her circle that she could call family. She wanted to give her unborn child the
family she never had. This paper outlines the existential approach to therapy, which could yield
successful results with Star. It outlines the history, research and concerns of the existential
therapeutic approach. It then determines three interventions that could be helpful in working with
Star; paradoxical intention, guided fantasy and self-disclosure. It then ties in a spiritual approach
to therapy and highlights the differences and similarities between existential therapy and
Christian counseling. Existential therapy could be successful in Star’s case because it will lead to
self-reflection and the understanding of her own strength.
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Case Conceptualization Using the Narrative Therapy
Narrative Therapy (2+ pages)
Key Philosophers
Who is/are the developer(s) of the theory?
Human Nature and the Counseling Process
• What did they believe about human nature and the counseling process?
Efficacy Research and Diagnoses
• Explain any research that has been done showing the efficacy of this theory.
• What diagnoses has this theory been shown to be effective with (depression, anxiety,
etc.)?issues concerning bereavement.
The Existential Approach and Star
• What makes this theory appropriate for your client and their presenting problems
you noted in the first paper?
Ethical and Multicultural Concerns
• What are any potential ethical issues that may arise using this theory with your
client?
• What are any potential multicultural issues that may arise using this theory with your
client?
Crisis Situations
Can this theory be used in crisis situations? Why or why not?
Interventions
Star is a twenty-one-year-old singer who recently reached her dreams of stardom through
a girl group with her sister and friend, Take Three. Throughout her life, Star has dealt with
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abandonment, poverty, the death of her mother to drugs, the death of her father and being
separated from her sister by the foster care system. After reconnecting with her sister and
forming the girl group, things started going south again. Star and her sister became estranged
after drama ensued with the girl group. Star’s father also came back into her life but was
murdered only a few months later. In this midst of all of this Star found out she was pregnant.
Star decided it was time to seek help so that she could give her unborn child the life and family
she never had. There are three existential techniques that could be beneficial in helping Star
address her identified problems.
Intervention 1
One of the existential techniques that could be beneficial in Star’s case is one that is a
staple of existential therapy, paradoxical intention. When using paradoxical intention, the
counselor encourages the client “to ‘go with’ a troublesome symptom or problem and experience
it deliberately, while adding humor to the experience” (Murdock, 2017, p. 191). This could help
Star because she is dealing with fears of abandonment and anxiety about the future of her unborn
child. Ascher and Schotte (1999) explained that paradoxical intention can be a successful
strategy when used with clients who are experiencing the fear of potential negative consequences
and problematic anxiety-based behaviors. The counselor could ask Star to purposely put herself
in a situation where she feels isolated. By continuously feeling isolated, Star would be able to
face her fear of abandonment and isolation head-on and lessen the fear and anxiety behind it.
Intervention 2
Another technique that could be helpful with Star is guided fantasy. Murdock (2017)
explained that, in using this technique, the counselor would as the client to meditate on their own
death, boosting awareness of things in life that are important and making the client take
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responsibility for their lives and actions. The counselor could ask Star to think about her own
funeral. They could ask her who might attend and how those people might react or feel at the
funeral. This could open Stars eyes to her importance in the lives of others around her and the
support system that she has. This may also make her realize that her sister still cares about her
and she still has a family even if things do not seem perfect. She can also see how much of an
influence she has had on the lives of others including the father of her child. In this moment, she
may also realize that she is alone. Everyone dies alone, and no one should fear that even though
most do.
Self-Disclosure
The final technique that may be helpful with Star is self-disclosure. Murdock (2017)
stated that “stemming from the ET value that the counselor must be authentic and present, self-
disclosure is seen as deepening the therapeutic encounter” (p. 191). There are two ways that a
counselor could go about doing this. The first is by self-disclosing about feelings during the
therapeutic process. For instance, the counselor could disclose that they feel shut out by Star
when she decides not to disclose certain details about her life or address her feelings. This could
prompt Star to trust the counselor more and be more open and honest about her feelings. It could
also allow Star to see how she closes others out and makes it hard for them to get close to here,
therefore aiding in her own isolation. The second form of self-disclosure that could be used by
the counselor is sharing details about their own existential struggles. For instance, the counselor
could disclose that they once had to deal with issues of abandonment due to their mother, or
father, being addicted to drugs. When someone becomes addicted to drugs, they change and are
no longer worried about the people around them. Even if they are not dead, they are no longer
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mentally available. This could help Star realize that many people deal with issues of
abandonment and that it is something she can work through.
Spiritual Application
Spiritual Challenges
Star did not grow up in a spiritual home, but she was introduced to Christ when she
moved in with her godmother, Carlotta, at the age of seventeen. Carlotta was the leader of the
choir at her Baptist church when Star and her sister moved in. Star watched Carlotta struggle
with the church and her spiritual beliefs when her transgender son was ostracized and then
victimized by the pastor of her church. Because Star did not grow up in the church and has only a
limited and negative view of the church now, there could be some challenges with using
Christian counseling as part of treatment for Star. Since Star has consented and even requested
Christian counseling, this tells the counselor that she is at least still open to the idea of
spirituality and not completely opposed to it.
The first challenge is that, since Star is dealing with existential anxiety due to the fear of
abandonment, Star may feel abandoned by Christ as well. Star may also blame Christ for the
deaths of her mother and father. Before starting treatment, the counselor should disclose on the
informed consent form that spiritual interventions such as prayer and Scripture may be used
throughout treatment. Because Star has not fully dealt with the deaths of her mother and father,
abandonment and spirituality may be a touchy subject for Star. The counselor should pray for
Star before sessions with her and silently throughout when the topic of her parents and
abandonment arise. One Scripture the counselor could pray over Star is “the Lord is near to the
brokenhearted and saves the crushed in spirit” (Psalm 34:18, English Standard Version). This
prayer speaks to Star’s brokenness and provides hope and faith in Christ for a brighter future.
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Star may also feel as though Christ is trying to teach her a lesson. Star never really had a
supportive family of her own and now she is having a child and wanting what she never had for
that child. The counselor could ask Star if she is open to meditating on Scripture in-session. They
could also give Star a Scripture to meditate on as a homework assignment and have her come
prepared to share her thoughts at their next session. A good Scripture for this might be, “it is the
Lord who goes before you. He will be with you; He will not leave you or forsake you. Do not
fear or be dismayed” (Deuteronomy 31:8, English Standard Version). By meditating on this
Scripture, Star may be more relieved about the future of her unborn child and build trust and
faith in Christ in providing for her family.
Spirituality and the Existential Approach
The use of existential therapy may also be helpful in a spiritual sense for Star as many
aspects of this theory are compatible with Christian beliefs. Jones and Butman (2011) described
many of these connections and even stated that “no approach to psychology mirrors the concerns
of faith as well as does existential therapy” (p.332). The first compatibility with Christianity is
that “existentialist psychology emphasizes a whole person who has the capacity to think,
imagine, introspect and develop a sense of meaning in life” (p. 321). This is compatible with
Christian belief of Imago Dei. Imago Dei is the concept that all human beings were created in the
image of God. This gives humans purpose, power and dignity. The second compatibility with
Christianity is the existentialistic views on responsibility and choice. Existentialists believe that
we are all free to make our own decisions and take responsibility for our own lives. This is
compatible with Christian belief as the Bible addresses free will by stating “you, my brothers and
sister, were called to be free” (Galatians 5:13, New International Version). The Bible also
highlights the importance of responsibility by stating that “for whatever one sows, that will he
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also reap” (Galatians 6:7, English Standard Version). The third compatibility with Christianity is
that one of the goals of existential therapy is non-conformity to social norms. The Bible also
takes this stance by stating “and be not conformed to this world: but be you transformed by the
renewing of your mind” (Romans 12:2, King James Bible). The final compatibility is seen in the
therapeutic alliance. The therapist is able to emulate the love and grace of God through the
relationship with the client. Jones and Butman (2011) expressed this by stating, “the process of
joining with the client in their weakness and suffering mirrors the type of nonjudging
relationship likely to foster honest self-reflection rather than an avoidance or denial of sin” (p.
333).
Although many of the core aspects of existential therapy align with Christian beliefs,
there are a few aspects that do not. The first incompatibility with Christian beliefs is the idea of
the superhuman. Some would say that existential therapists put humans on a higher pedestal than
necessary and give them god-like characteristics. This is contrary to Christian belief that Christ is
above all and humans are all born into sin and have all fallen short of His glory (Romans 3:23).
The second incompatibility is that although existentialists and Christians believe in
nonconformity, Christians do believe that we should still submit to authority, obey God’s
commands and follow the instructions of the leaders in the church (Jones & Butman, 2011). The
final incompatibility is existentialist assert that humans can be completely free once they become
aware of every level of their existence. Christianity says that “only through Jesus can persons
come to their full potential” (Jones & Butman, 2011, p. 322).
Conclusion
Existential therapy leads to self-reflection and, in-turn, self-awareness. This could be a
successful treatment for Star as it will help her realize the roles other relationships play in her life
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and discover her own strength and perseverance which should positively affect the life of her
unborn child and her relationships with others. Although this approach could yield desirable
results, there are two challenging aspects that the therapist must take into account.
The first is establishing a therapeutic alliance with Star. Star may be skeptical of therapy,
spirituality and relationships in general due to her history of abandonment which may make it
challenging to establish such a relationship. Jones and Butman (2011) explained that as a client
becomes “more confident in their own identity and purposes, it is the therapist’s job to assist and
guide the client to synthesize their sense of personal meaning” (p. 311). The therapeutic
relationship is key to the underlying goal of existential therapy.
The second challenge that the therapist must consider is the implications of existential
isolation. Breitbart (2017) stated that Yalom referred to existential isolation as “an isolation from
every creature and every element of our perceived world” (p. 404). The realization of such a
crisis could lead to further depression and anxiety if not explored in a beneficial and careful
manner. Breitbart (2017) also explained that existential isolation “refers to the concept that each
of us is responsible for creating our own lives and living that life authentically” (p. 404).
Although the therapist may understand this concept, it will be key that the therapist help Star
reach this realization as well which could prove to be difficult.
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References
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