NARRATIVE THERAPY USING A REFLECTING TEAM: AN ETHNOGRAPHIC STUDY OF THERAPISTS’ EXPERIENCES Thomas St. James O’Connor Andrea Davis Elizabeth Meakes Ruth Pickering Martha Schuman

ABSTRACT: Narrative therapy in the last 15 years has been utilized by many clinicians and yet there is a lack of research on therapists’ experience of this approach. This ethnographic research explores the views and perceptions of eight narrative therapists who belonged to a narrative team in an outpatient clinic. These therapists were observed and interviewed. Five themes emerge from the data. The themes include a sense of success in reducing the clients’ problems as well as some limitations of narrative therapy. Two recommendations for research and practice involve the use of narrative therapy without a team and the use of narrative therapy in addressing issues of family violence. KEY WORDS: narrative therapy; therapists; ethnography; reflecting team.

Since its introduction more than 15 years ago, narrative therapy has developed into a variety of approaches and produced a significant body of writing (Kahle & Robbins, 1998; O’Connor, 1999; Coulehan, Friedlander, & Heatherington, 1998; Weingarten, 1998; Minuchin, Thomas St. James O’Connor, ThD, is Associate Professor, Pastoral Care and Counseling, Waterloo Lutheran Seminary at Wilfrid Laurier University, 75 University Avenue West, Waterloo, Ontario, Canada N 3C5 and a Teaching Chaplain/Family Therapist at St. Joseph’s Healthcare, Hamilton, Ontario ([email protected]). Andrea Davis, MTS, is a teacher in London, Ontario, Canada; Elizabeth Meakes, MTS, is a Teaching Chaplain/ Family Therapist at St. Joseph’s Healthcare, Hamilton, Ontario; Ruth Pickering, MD, is a child psychiatrist in private practice in Hamilton, Ontario; Martha Schuman, MSW, is a retired social worker/family therapist in Oakville, Ontario. Reprint and correspondence should be addressed to Dr. O’Connor. Contemporary Family Therapy 26(1), March 2004  2004 Human Sciences Press, Inc.

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1998; Kogan & Gale, 1997; O’Connor et al., 1997b; Focht & Beardslee, 1996; Larner, 1996; Brunette, 1995; Tomm, 1989; White & Epston, 1989; Sells et al., 1994; Smith, Winston, & Yoshioka, 1992). Despite the written literature on narrative therapy, there is a scarcity of research on therapists’ experiences of narrative therapy. This research answers the question: “What are therapists’ experiences of narrative therapy?”

REVIEW OF THE LITERATURE The literature on narrative therapy includes qualitative research, case studies, as well as personal and theoretical reflections. No quantitative studies were found. Kahle and Robbins (1998) summarized the literature, describing six narrative approaches. These approaches were Anderson and Goolishian’s (1988) collaborative language systems, Durant’s (1993) competency based approach, de Shazer’s (1985, 1991) solution focus, Freedman and Combs’ (1996) social construction narrative, Andersen’s (1987) reflecting team, and White’s (1989) narrative therapy. Weingarten (1988) presented five post-modern narrative ideas. For Weingarten, the essence of narrative was the importance of discourse, focusing on the exceptions to the problem, using power as the means to produce a consensus and distinguishing narrative from modernist thought. Little is written of therapists’ experiences of narrative therapy in general, although a few studies have focused on reflecting teams. Sells and associates’ (1994) ethnographic study examined five therapists’ and seven couple clients’ experiences of reflecting teams. The therapists stated that the many opinions and insights from the reflecting team were very helpful to the couple, considering the reflecting teams were especially helpful when the couple was stuck and less so when the couple was not stuck. The couples disagreed with this perception; they believed that the reflecting team was helpful both when they were stuck and when they were not stuck. Smith, Winston, and Yoshioka (1992) in another qualitative study found that therapists’ experiences of reflecting teams were generally positive with some limitations. From the therapists’ perspectives, reflecting teams were positive because the reflecting teams created and encouraged dialogue among team members, resolved client difficulties, and offered many views on the clients’ problems. Limitations existed when clients had no previous experience of such teams and there were physically too many people in the interview room (Smith et al., 1992).

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O’Connor and associates (1997b) used ethnography in examining eight families’ experiences of narrative therapy. Overall, clients found narrative therapy helpful. The presenting problem was reduced and clients appreciated the respectful approach, the recognition by team members of their efforts to overcome their problems, and the helpful comments of the reflecting team. Other studies examined the use of narrative therapy with children. Focht and Beardslee (1996) used narrative therapy in helping children talk about parents with an affective disorder. Larner (1996) found narrative therapy combined with play therapy with children helpful. Weston, Boxer, and Heatherington (1998) did a study of 92 children, aged 5–12, concerning the children’s understandings about family arguments. They found that the children saw multiple interacting causes to family arguments and suggested that further narrative research be focused on how children in families perceive change in relation to therapists’ construction of an alternative story of a problem. Other studies on narrative therapy focused on change. Kogan and Gale (1997) examined how a master narrative therapist managed talk in a therapy session with a client. Using the verbatim account of Michael White with a client, they summarized the findings in the metaphor “de-centering.” The narrative therapist de-centered the client from problem saturated talk. (De-centering means the therapist focused on the strengths of the client’s narrative and moved the conversation away from the negative aspects of the client’s narrative.) Coulehan, Frielander, and Heatherington (1998) utilized grounded theory and phenomenology with eight clients. This study examined Carlos Sluzki’s narrative approach concerning how changes take place in clients’ construction of the problem. Four clients noted that they were able to see the problem in a more helpful way and four clients noted that they were not able to do this. Reflecting teams were helpful in this process. Kahle and Robbins (1998) utilized a case study demonstrating the externalizing conversation in a new way. As a family pushed the problem out, these therapists externalized the success of the family. Their case study indicated that externalizing success further empowers personal agency. Morrison and associates (1997) examined the experience of teaching narrative therapy in a graduate program. Students were being trained in narrative in the clinical setting and the academic course was meant to be isomorphic in process and content with the training. The study indicated that the course was positive and challenging for all involved.

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Critiques also exist of narrative therapy. Brunette (1995) critiqued narrative therapy in arguing that there are essential ideas and assumptions in it. He believes that not all the ideas in narrative therapy are constructed. Minuchin (1998) criticized narrative therapy for its failure to focus on the family. Steinglass (1998) noted the difficulty in testing the validity of post-modern family therapy approaches. However, he argued that the core elements of narrative therapy need to be tested using a variety of research methods: personal reflections, qualitative, and quantitative methods. In conclusion, the literature contained ethnographic studies on therapists’ and clients’ experiences of reflecting teams and personal reflections on teaching and practising narrative therapy. However, there was no study found on the experience of a narrative team at the beginning stage of its work as a team using a narrative approach and a reflecting team.

METHODOLOGY The purpose of this study was to discover narrative therapists’ perceptions and meanings of their practice of therapy. A previous study by four of the researchers had examined clients’ experiences of narrative therapy (O’Connor et al., 1997b). In the present study, the researchers sought to discover what therapists found helpful and not helpful about narrative therapy. Such a discovery could help improve the practice of narrative therapy. In order to answer the research question, an ethnographic method was chosen for a number of reasons. First, in ethnographic research, the main forms of data collection are interviews and field notes. Interviews allow for the discovery of complex and rich descriptions of experience. Ethnographic research seeks to study and understand a culture (Newfield et al., 1995; O’Connor et al., 2001). In this case, the focus was the culture of narrative therapists regarding their experience of therapy. Second, the persons being interviewed and observed in ethnography are not regarded as subjects but as participants and co-researchers. The researchers in this study were participant observers and part of the phenomenon being investigated (Gale, 1993). Specifically, four of the research team were also members of the narrative therapy team. Third, this ethnographic research was similar to narrative therapy in terms of the interview, in the examination of meanings and perceptions and in the roles of interviewer and

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interviewee. The research method was isomorphic to the clinical approach. Participants agreed to an interview through informed consent. The interview was semi-standardized in format (Berg, 1995). The interview questions were designed to develop a rich description of the therapists’ perceptions of narrative therapy. The four general questions were: 1) What has been helpful in narrative therapy? 2) What has not been helpful in narrative therapy? 3) What is your overall experience of narrative therapy? 4) What is an image or symbol to describe your experience of narrative therapy? Each of these research questions included subsequent questions that could be used to facilitate a rich description of the experience. The interviewers were graduate students who completed a graduate course in qualitative research and had training in interview skills. The interviews were conducted at an outpatient clinic. The interviews were audio taped, transcribed verbatim, and offered to the therapists for editing and correction. The revised transcripts were analyzed by two members of the research team. One member (A.D.) of the research team was an outside investigator who had been educated and trained in ethnographic research. She provided the initial coding of the data and also offered an outsider position to the narrative therapy experience. Coding of the data from the interviews utilized both latent and manifest content analysis (Berg, 1995). These codes were developed through an inductive approach to the written interviews. Such an approach examines written texts and begins to note themes, commonalities, differences, and concepts. These were then clustered together in order to make sense of the data (Miles & Huberman, 1984). The researchers developed common codes that encompassed the richness and complexity of the informants’ descriptions. The agreement on the common codes by the primary investigator and the outside expert strengthened the analysis using the principle of triangulation (O’Connor et al., 1997a; Berg, 1995; Moon, Dillon, & Sprenkle, 1990; Sells et al., 1994; Miles & Huberman, 1984).

Context of the Study and Narrative Theory of the Therapists In terms of the context of the study and sample, the narrative therapy team works within a large outpatient clinic in a teaching hospital affiliated with a faculty of health sciences in a university. The clinic is a regional center for pediatrics and child psychiatry. At the time of the study, there were eight members on the narrative team. Length of

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time on the narrative team ranged from four months to four years with a mean of two years and three months. The team was known in the clinic as the CAST team—Co-constructing Alternate Stories in Therapy. Five team members were female and three were males. In terms of clinical experience, the team consisted of a child psychiatrist, a social worker, two family therapists, two chaplains, and two students. Four are clinical members of the American Association for Marriage and Family Therapy. In terms of the narrative theory that informs the practice of the team, the work of Michael White is core. White believes that narrative therapy is more an approach than a consistent theory. White’s narrative therapy draws on the philosophy of Michael Foucault and the anthropology of Gregory Bateson and is part of social constructivism (White & Epston, 1989). Social constructivism holds that knowledge is constructed. Narrative therapists believes that humans construct stories to make sense of their experience. These stories are many and varied. Some are dominant and are primary means of interpreting reality. Others are less dominant, used occasionally to interpret reality, and are known as alternate stories (White & Epston, 1989; O’Connor et al., 1997b). According to White’s view on narrative therapy, persons seek help when there is a problem that they cannot overcome. The problem is embedded in a dominant narrative that robs the person(s) of success. A primary task of narrative therapy is to discover unique outcomes, i.e., moments when the problem did not exist and/or was defeated by the clients. These unique outcomes underline the alternate story of success. The alternate story builds personal agency and focuses on moments of success (Tomm, 1989). The therapist in conversation with the clients discovers, affirms, and co-constructs the alternate story. This alternate story then becomes a dominant story. Narrative therapists believe that this hermeneutical shift brings success in reducing the problem. Narrative therapy employs a number of strategies in building the alternative story. One is externalizing the problem (White & Epston, 1989; Tomm, 1989; O’Connor et al., 1997b; O’Connor, 1999). The problem is not viewed as within a person but from outside and oppresses him or her. Another strategy is the use of a reflecting team (Sells et al., 1996; Smith at al., 1992). The reflecting team is a group of narrative therapists who watch from behind a one-way mirror. At some point, they are invited into the session to share their perceptions. The role of the reflecting team is to help create new openings in the building of

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the alternate story. A third strategy is the use of therapeutic letters sent to clients after a therapy session (White & Epston, 1989; O’Connor et al., 1997b). These letters underline the story of success and stress the positive qualities that clients have shown in defeating the problem. Another strategy is building the audience for change (O’Connor et al., 1997b; O’Connor, 1999) by inviting other people that are close to the clients to help build an audience for change. These others are encouraged to underline the story of success and to become an audience of support and affirmation. This audience often includes grandparents, parents, siblings, co-workers, teachers, bosses, social workers, the reflecting team, and others. While these four aspects of narrative therapy are employed by the team in this ethnographic study, other narrative therapists, as Kahle and Robbins (1998) point out, do not use reflecting teams or all of these elements.

FINDINGS The data from this study are rich and diverse. Each theme has both positive and challenging aspects to it. The overall sense of the data was that these eight therapists who were beginning to work together on this new narrative team found narrative therapy to be very positive and very successful in reducing the problems of clients. They used many metaphors to describe their experiences. Most found narrative therapy as “unburdening” for both the clients and the therapists (Therapist 1). Narrative therapy created “various pathways” for families in solving their problems and for the narrative therapists who were working with the families (Therapist 4; Therapist 7). Five themes emerged from the data. Some themes appeared in every transcript; other themes were present in a few transcripts. Table 1 itemizes themes and their appearances in the eight transcripts.

Theme 1: Narrative Therapy is Successful with Clients in Reducing Presenting Problems Success with enthusiasm. All eight therapists (100%) found the narrative approach to be successful with clients in reducing presenting problems. This reduction of the presenting problem ranged from somewhat successful to very successful. Because of the reduction of the presenting problem, there was a feeling of excitement about the approach.

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TABLE 1 Five Themes and Their Percentages in Interviews Names of Themes Theme 1. Narrative is Successful with Clients in Reducing Presenting Problems Success with enthusiasm Reasons for Success: Promotes personal agency in clients; Respectful of clients; Marked improvement in clients Theme 2: Limitations of Narrative Requires Specialized Training Difficult to Address Family Violence Requires many staff Time Consuming Theme 3: Ambivalent Experience of Consulting/Reflecting Teams Reasons for Ambivalence: Rich and helpful for clients Excellent learning for clients and therapists Theme 4: Consulting/Reflecting Teams can be Overwhelming for Therapists Theme 5: Co-construction is Helpful, Exciting, and Challenging

# of Interviews in % Which Theme Appears (out of 8) 8

100

8

100

8

100

8 3 7 7 4

100 37.5 87.5 87.5 50.0

3 3 7

37.5 37.5 87.5

7 5

87.5 62.5

6

75

8

100

Therapist 1 exclaimed: “I’m really enthusiastic about it. . . . I think what is really helpful is it avoids blaming patients and families.” Another therapist noted: “I like it very much. . . . It is not focused on the problem of the client” (Therapist 3). Therapist 6 added, “It’s been exciting for me as a therapist working with this approach [narrative] and I have seen it being really effective with families.”

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Reasons for success. The success of the approach hinged on three items. One was that narrative promotes personal agency in clients. The eight therapists (100%) mentioned that narrative therapy empowers clients to develop their own agency in addressing their problems. This happened in a variety of ways. Narrative therapists respect the solutions that families have already developed (unique outcomes). Therapist 1 noted, “I also find that what I am discovering in doing this work is that people have always been working on their problems much more than we as therapists thought they were.” Narrative therapy opened space and various pathways and affirmed families’ efforts at change. “[Using narrative therapy] allows more possibilities for action, more possibilities for viewing self in more positive ways—giving self credit” (Therapist 2). “The externalizing conversation promoted personal agency in the families. I really like the idea of situating the problem outside of the person. It’s more hopeful because it’s not situated inside of the person. They have control over it—situating the problem as they defined it in the words that they used to describe it. It really helps them build up some force against it and see that they can push it back and get some power into them—not letting it run their lives or push them around” (Therapist 4). Second, narrative therapy respected the clients. Eight therapists (100%) mentioned that narrative therapy respected clients. Therapist 2 said, “Narrative therapy makes it easier to work in a way that is nonjudgmental and is respectful.” To this, Therapist 6 added, “The helpful part of working with that [narrative] model is that it’s very affirming of both the therapist and the client—meaning that there’s sort of no wrong or right.” Therapist 7 commented, “I found I really enjoyed how it [narrative therapy] is very respectful of clients, really looking at what they want to get out of therapy when they come in and what they would label as progress.” The third area of success of narrative therapy was a marked improvement in the clients in terms of solving their problems. Three (37.5%) therapists noted a marked improvement in the clients in a few therapy sessions. For example, Therapist 4 referred to other therapeutic approaches in the institution which saw clients more than once a week with a high drop-out rate, “I am really amazed at the difference from one interview to the next. . . . Sometimes there are big gaps— something’s happened—it’s quite remarkable seeing people shift. Maybe because we are not giving them three appointments per week, it seems more hopeful” (Therapist 4). Therapist 1 compared aspects of narrative

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therapy to the use of standard diagnostic nomenclature, which is the dominant therapeutic approach in the institution. According to Therapist 1, use of standard diagnostic categories can negatively label and pathologize clients as patients. Therapist 1 emphasized, “I think that it is very successful. I think that we are seeing some families very briefly and effectively and so that we don’t construct them into patients.”

Theme 2: Limitations of Narrative Therapy Four limitations of narrative therapy were mentioned. One was mentioned by seven (87.5%) therapists. They noted that narrative requires specialized education and training/practice. “I guess in terms of my own use of it [narrative therapy], I think if I could grow in this particular type of therapy: skills, phrases, words, all that would come with more experience in using it” (Therapist 2). Therapist 1 underlined the challenge of learning this approach, “It is a highly disciplined approach to therapy, harder to learn the more experience you have as a therapist.” A second limitation was dealing with issues of family violence. In the issue of family violence, field notes indicated that the therapist and team move from multiple interpretations of violence (post-modernist) to a right or wrong understanding of violence (modernist). Four (50%) mentioned this limitation: We have recently been seeing a lot of families who have experienced a great deal of violence in their lives, quite often physical violence. It has been difficult for me to understand how to go back to that experience of violence and look at how that affected people and then pull it within the narrative model” (Therapist 5). Another therapist echoed this struggle: “The only aspect that I’m struggling with is how to work in the narrative approach, in areas like family violence” (Therapist 1). A third limitation was the number of staff required for consulting/ reflecting teams. Three (37.5%) mentioned that narrative therapy requires more staff. Field notes indicated that sessions in which a consulting/reflecting team are used, there were at least three members of the team observing the therapist working with the family behind the oneway mirror. Often, there were five staff present behind the one-way mirror. Sometimes, there were persons who were learning the narrative

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approach and there have been as many as ten behind the one-way mirror. Finally, three therapists (37.5%) mentioned that a narrative session with a team behind the mirror was time consuming. With consulting/reflecting teams, the therapeutic session was usually 11⁄2 hours which is longer than the 50-minute session. Therapist 1 noted, “But the problem is that we don’t always have the time.” Others said this as well. “I am always aware of the limits of time” (Therapist 2). Therapist 8 reflected, “there are fewer sessions than other forms of therapy but spaced over a longer time, allowing for slow change. This approach is slow. . . . It is not a quick fix but it is successful.”

Theme 3: The Ambivalent Experience of the Consulting/Reflecting Teams A significant part of the interviews are devoted to the therapists’ experiences of the consulting/reflecting teams. Again, the data were centered on two experiences. One was the rich nature of these teams that offer clients multiple interpretations and pathways for their solutions. The other was that the input from these teams can be overwhelming to the clients and therapists alike and not well used by the clients. On the positive side, seven therapists (87.5%) noted that the reflecting/consulting teams allowed access to a wide range of input for the client. Sometimes, it’s helpful to let the family know there is a child psychiatrist behind the mirror, especially if the parents are considering whether their child has a psychiatric disorder. It’s helpful for them to know that they are getting a psychiatric assessment at the same time—the multi-disciplinary nature of the team is particularly helpful and rich and that they are getting a number of different perspectives that is rich itself—knowledge, training” (Therapist 4). One of the therapists also emphasized the affirmation that takes place when other therapists watch one do therapy, “It’s actually very helpful having other people watching your work and commenting on it and giving you ideas” (Therapist 5). Five therapists (62.5%) noted a second area of helpfulness. The reflecting or consulting teams offered excellent learning experiences for both experienced therapists and students. Therapist 3 noted, “I

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liked it very much when I first saw it and I think that’s why I wanted to stay here, because it is a very positive way of training [in] therapy.” Another commented, “I enjoy watching other therapists work. I find that it increases my ability as a therapist. Very rich for me and helpful to my growth as a professional. I have learned from the clients and the therapists on the team” (Therapist 8).

Theme 4: Consulting/Reflecting Teams Can Be Overwhelming On the challenging side, six of the therapists (75%) noted that the input from the reflecting/consulting team can be overwhelming for therapists. The consulting team meets only with the therapist and the reflecting tem meets with the family and offers reflections. In the practice of this team, the reflecting team approach is used more often than the consulting teams approach. “Sometimes, I find it [the team] confusing when I return to meet with the team after being with the family and I start to get all these observations and ideas from the team. I find it sometimes overwhelming especially when I return to be with the family and offer them feedback from the consulting team” (Therapist 8). Another therapist echoed similar views and linked it to being an introvert. For me it’s too overwhelming because I am an introvert, again, and it’s just like you’re bombarded with people who have ideas. It’s great to have ideas but the thing is . . . I have to go back in there with the client- . . . the introvert, . . . likes to process, take time to process” (Therapist 6). Five therapists (62.5%) preferred the reflecting team over the consulting team. “I don’t like the consultation as much as the reflecting team. I wish they’d do more reflecting team as opposed to consulting team” (Therapist 6). Another valued the interdisciplinary aspect of the reflecting team. I like the reflecting team approach. I prefer that to the consulting team . . . With the reflecting team, the family gets multiple constructions right from the “horse’s mouth.” I think that this particular CAST team offers a lot to a family in therapy in terms of reflecting team, an interdisciplinary approach” (Therapist. 8).

Theme 5: Co-construction Is Helpful, Exciting, and Challenging Eight therapists (100%) liked the skill and process of co-constructing with the family a story of success over the problem. Externalizing the problem, discovering unique outcomes and drawing out the

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alternative story were all part of this process done in a conversational style. The eight therapists did not want to impose their views on the family and believed that the process of co-construction was most helpful. “The conversational style using the family narrative and constructions is in my mind requiring more skill and is successful. But it does not necessarily leave the impression of great success—even though it is!” (Therapist 8). Four (50%) also mentioned that the process of co-construction can be very challenging at times. The challenge was to co-construct an alternate story and not impose one. One therapist also said, “I’m not a story teller” (Therapist 6). She sometimes found it hard to co-construct an alternate story with families.

DISCUSSION What are narrative therapists’ experiences of narrative therapy? This ethnographic research indicates that narrative therapy was found by the therapists to be successful and helpful both to clients and therapists. This theme was strongest in the data. Narrative therapists gave three reasons for this success. First, narrative therapy promoted personal agency in clients. Second, narrative therapy respected clients and did not pathologize or categorize the clients. Third, clients became more able to deal with their presenting problem during the course of therapy. There was improvement in the presenting problem of the clients over the course of therapy. These therapists were excited and hopeful about the use of narrative therapy with clients. Narrative therapy unburdened the therapist and the family and opened up various pathways for growth. While there was confidence in narrative therapy, there was also awareness of some limitations. The specialized training required to do narrative therapy and the difficulties in addressing family violence using narrative therapy were two challenges mentioned. Also, narrative therapy as practiced in this outpatient clinic required many staff and was time consuming. The narrative therapists were also ambivalent around the consulting/reflecting teams and the process of co-construction. Therapists experienced both the consulting/reflecting teams and the process of co-construction as rich and helpful as well as being challenging and overwhelming. There are many possible reasons for this response. As one therapist noted, this narrative team is at the beginning stage and the enthusiasm about narrative therapy’s success could be an initial excitement about

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a new approach. People who have discovered something new that solves some immediate problems are usually excited about the new approach. Would this team be so excited after five to 10 years of working together using narrative therapy with a variety of clients? A second possible interpretation is that narrative therapy works and these therapists have discovered that. As previously mentioned, the clients of this team were also interviewed and that research has already been published (O’Connor et al., 1997b). In that research, the clients report overall that narrative therapy is successful in reducing the presenting problem. The therapists are also aware that there are limitations to narrative therapy. The uncertainty on the team in using narrative therapy in addressing family violence might also be due to the beginning stage of this team. Lipchik and Kubicki (1996) report some success in eliminating violence by using a solution focused approach to domestic violence under certain conditions. However, the research on family therapy and domestic violence is sparse (Stith et al., 2002). Possibly with more experience, the team will be able to utilize narrative therapy or some adaptation of it in addressing family violence. Surprises in this study for the research team were three. The interviews indicated first, limitations of narrative therapy; second, ambivalence of the consulting/reflecting teams; and third, the ambivalence of the process of co-construction. Field notes indicate that informal conversations with therapists emphasized the success of narrative therapy. Certainly, the success of narrative therapy with clients in resolving clients’ presenting problems has emerged as the strongest theme in the interviews. However, limitations of narrative therapy and the ambiguity of narrative therapy were also part of the interviews. The researchers were surprised that these emerged as strongly as they did. The ambiguities and limitations were not part of the informal conversations. Usually persons excited by a new approach “at the beginning” find it harder to be critical of the approach. There is some difference in findings in this study with two other studies on reflecting teams (Sells et al., 1994: Smith et al., 1992). Sells and associates and Smith and colleagues state that the therapists report a positive experience of the reflecting team. This research differs in that those participating in this research are more ambivalent about the consulting/reflecting teams. Narrative therapists in this research found the consulting/reflecting teams both rich and helpful and also sometimes overwhelming. ‘Too much of a good thing’ is not always helpful. The richness of consulting/reflecting teams can be too much for the therapist at some points.

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Areas for Future Research While this ethnography answers the research question, it also raises more questions and areas for further research. One area of further research is a longitudinal study. Would these same therapists five or ten years later say the same thing about their experience of narrative therapy? Another area is family violence. This particular team switched from the post-modern approach where there are many interpretations and stories to a right and wrong approach with violence. Can a postmodern approach that stresses a variety of interpretations be used with family violence? How can narrative be used more effectively when dealing with instances of family violence? Another area of concern is the utilization of narrative therapy when the therapist is working alone. This study took place in an outpatient clinic which is a teaching hospital affiliated with a university. There are many staff with many students and a commitment to this clinical work. There is also some time allowed to do research. The team itself had eight members. Those working alone in private practice do not have such resources and most often do not have peers who have the time to be on a reflecting team. What parts of narrative therapy can be used by therapists who work alone? What might the outcome be for the clients? This is an area for further research. More research is needed on therapists’ experiences of narrative therapy in different contexts.

CONCLUSION This ethnographic research on the experiences of therapists using narrative therapy at the beginning stage notes the therapists’ energy and enthusiasm. Narrative therapy according to these therapists is helpful with clients in reducing the presenting problem. In addition, narrative therapy opens up various pathways to therapists and clients and is unburdening to the therapists who practice it. The clients of these narrative therapists also believe that this approach is helpful. More research needs to be done, research that moves beyond the beginning stage.

REFERENCES Anderson, H., & Goolishian, H. (1998). Human systems as linguistic systems: Preliminary and evolving ideas about implications for clinical theory. Family Process, 37, 371– 393.

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