The Narrative Approach in Social Work

Commonly in therapeutic work, clinicians must keep progress notes, billing documents, and other important paperwork that together comprise a client’s case file. Learn more about how best to use the narrative approach in social work.

This collection of documents is often required by an agency’s operating procedures and often helpful for clinicians in keeping track of client progress. However, from the client’s perspective, such documents can be seen as records of the client’s mental illness or “degrading psychiatric files1.”

The narrative approach in social work offers an alternative that stands in contrast to clients’ commonly held negative perceptions of case files through the creation of counter documents and therapeutic letters.

Client and Clinician Work Together

In narrative therapy in social work, the client and clinician work together to identify the client’s preferred stories or self-narratives, empowering the client to re-story her/his life. Alternative documents are a key part of that work, and “there is now a rich history of documentation within narrative therapy1.”

In their book, Literate Means to Therapeutic Ends, Michael White, and David Epston, considered the founders of narrative therapy, provide a wide range of examples of counter documents and therapeutic letters aimed at celebrating the client’s preferred stories.

The authors state: “awards of various kinds, such as trophies and certificates can be considered examples of alternative documents. Such awards often signal the person’s arrival at a new status in their community, one that brings with it new responsibilities and privileges2.”

How the Narrative Approach in Social Work Uses Counter Documents and Therapeutic Letters

Counter documents and therapeutic letters can be utilized in a variety of therapeutic settings and can take many different forms. Awards and certificates are particularly useful in acknowledging client progress toward a number of goals.

Clinicians might offer clients a “Survivor” medal for those who experienced traumatic events or provide a “Winning against bad habits1” certificate to clients who are working to limit a specific behavior.

Along with such celebratory documents, clinicians might choose to write therapeutic letters to their clients, detailing the progress and triumphs they have seen through their therapeutic relationship.

Therapeutic letters can take the place of or supplement process notes or case notes, allowing the clinician to express her/his professional opinion of progress achieved in session directly to the client. This practice can serve to build trust between client and clinician by maintaining openness and a spirit of disclosure.

Narrative Approach in Social Work Promotes Trust Between Client and Clinician

This practice can serve to build trust between client and clinician by maintaining openness and a spirit of disclosure. Counter documents and therapeutic letters are a crucial component of narrative therapy that can be easily blended with other theoretical approaches to celebrate clients’ achievements and emphasize a strengths-based perspective.

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Narrative Therapy in Practice: Counter Documents and Therapeutic Letters
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Narrative Therapy in Practice: Counter Documents and Therapeutic Letters
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The narrative approach in social work offers an alternative view of case files. Find out how you can help your client view them positively.
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