Clinical Psychology and Psychotherapy

Clin. Psychol. Psychother. 18, 486497 (2011)

Published online 30 August 2010 in Wiley Online Library (wileyonlinelibrary.com). DOI: 10.1002/cpp.723

What Is Narrative Therapy and What Is It Not?

The Usefulness of Q Methodology to Explore
Accounts of White and Epstons (1990) Approach
to Narrative Therapy
Jennifer Wallis,1* Jan Burns2 and Rose Capdevila3
1
Berkshire Healthcare National Health Service Foundation Trust, Berkshire, UK
2
Department of Applied Psychology, Salomons Campus, Canterbury Christ Church University, Kent, UK
3
Faculty of Social Sciences, The Open University, Milton Keynes, UK

Objective. What is narrative therapy and how do you do it? is a question that is repeatedly asked of
narrative therapy, with little consistent response. This study aimed to explore and distil out the
common themes of practitioner definitions of White and Epstons approach to narrative therapy.
Design. This was an Internet-based study involving current UK practitioners of this type of narrative
therapy using a unique combination of a Delphi Panel and Q methodology.
Method. A group of experienced practitioners were recruited into the Delphi Poll and were asked two
questions about what narrative therapy is and is not, and what techniques are and are not employed.
These data combined with other information formed the statements of a Q-sort that was then admin-
istered to a wider range of narrative practitioners.
Findings. The Delphi Panel agreed on a number of key points relating to the theory, politics and prac-
tice of narrative therapy. The Q-sort produced eight distinct accounts of narrative therapy and a number
of dimensions along which these different positions could be distinguished. These included narrative
therapy as a political stance and integration with other approaches.
Conclusions. For any therapeutic model to demonstrate its efficacy and attract proponents, an accepted
definition of its components and practice should preferably be established. This study has provided
some data for the UK application of White and Epstons narrative therapy, which may then assist in
forming a firmer base for further research and practice. Copyright 2010 John Wiley & Sons, Ltd.

Key Practitioner Message:

Narrative therapy and how it is carried out remain unclearly defined, which limits studies of the
efficacy of this approach.
Experienced practitioners of narrative therapy were able to identify a set of core concepts, values and
techniques over which there was some consensus.
This study also identified the different positionings of narrative therapy that have contributed to its
opacity and have highlighted the diversity in therapist practice.

Keywords: Narrative Therapy, Definition, Outcome Evaluation, Q-Sort

INTRODUCTION described narrative therapy. They were asked the follow-

What is narrative therapy and how do you do it? is a
question that has been frequently raised (Harper &
Spellman, 2002). This paper reports the findings of a
study that examined how a small group of knowledge-
able practitioners, constituted as the Delphi Panel,
* Corresponding to: Dr Jennifer Wallis, Berkshire Healthcare National
Health Service Foundation Trust, CAMHS, 3 Craven Road, Reading,
RG1 5LF, Berkshire, UK.
E-mail: jennifer.wallis@berkshire.nhs.uk
ing questions: What is narrative therapy and what is it
not? and What do narrative practitioners do and not do?
From the answers to these questions, statements about
narrative therapy were generated, and a wider group of
practitioners were asked to perform a Q-sort (Watts &
Stenner, 2005). As the combination of a Delphi Poll and
Q-sort was a unique feature of this research, this method-
ology is reported in fuller detail in a different paper
(Wallis, Burns, & Capdevila, 2009). In this paper, we will
concern ourselves more with the theoretical, clinical and
research implications of the findings.

Copyright 2010 John Wiley & Sons, Ltd.

Q Methodology and Narrative Therapy
Narrative Approaches to Therapy
The narrative turn has become a major academic para-
digm (Roberts & Holmes, 1999) spanning the humanities,
social sciences (Flaskas, 2002) and health care (Launer,
1999). Narrative has been influential in psychology
(Bruner, 1986; Crossley, 2000; Polkinghorne, 1988; Sarbin,
1986), psychotherapy (Goncalves & Machado, 1999;
McLeod, 1997; Schafer, 1992; Spence, 1982), psychiatry
(Roberts & Holmes, 1999) and medicine (Greenhalgh &
Hurwitz, 1999). The narrative metaphor implies that
human psychology has an essentially narrative structure,
so that human life can be seen as storied and narrative as
the organizing principle for human action (Sarbin, 1986).
Some therapists argue that all talking cures are narrative
therapies (McLeod, 1997; Papadoupoulos & Byng-Hall,
1998). Narrative has therefore been described as a point
of convergence for the therapy field (Angus & McLeod,
2004, p. 373). However, as these authors acknowledge,
this convergence may obscure some of the differences
and tensions associated with the narrative turn in psycho-
therapy (Angus & McLeod, 2004; Smith & Sparkes, 2006).
Polkinghorne (2004) comments that the development of
what has come to be termed narrative therapy was
primarily the work of practising marriage and family
therapists (p. 53). The most influential approaches using
a narrative metaphor have been Anderson and Goolishians
(1992) collaborative language systems therapy and
White and Epstons (1990) narrative therapy. These two
approaches are often confused and conflated (Monk &
Gehart, 2003). Sometimes, solution-focused therapy (de
Shazer, 1982) is included along with these two approaches
under the broad umbrella of post-modern social con-
structionist therapies (Anderson, 2003). Within the field
of family therapy, many have noted that narrative
approaches to therapy in general, and specifically White
and Epstons (1990) approach, have become increasingly
important (Campbell, 1999; Carr, 1998; Hart, 1995;
Papadoupoulos & Byng-Hall, 1998; Vetere & Dowling,
2005; Zimmerman & Dickerson, 1994). Moreover, Whites
pervasive influence on the development of narrative-
informed therapy has been acknowledged in a handbook
bringing together the many strands of thinking about nar-
rative and psychotherapy (Angus & McLeod, 2004). The
research on which this paper is based focused on how
White and Epstons (1990) approach to narrative therapy
has been taken up by a group of practitioners in the UK.
This approach emerged out of systemic family therapy
(Hart, 1995); thus, many participants were recruited from
the Association of Family Therapy email discussion list,
on the basis that they described themselves as applying
White and Epstons (1990) approach to narrative therapy.
White and Epstons (1990) approach to narrative therapy
has been taken up by systemic therapists with many dif-
ferent emphases, e.g., social constructionism and post-
Copyright 2010 John Wiley & Sons, Ltd.
487
structuralism (Combs & Freedman, 2004; Freedman &
Combs, 1996), discourse, feminism and post-structural-
ism (Madigan & Law, 1998); hermeneutic/collaborative
(Smith & Nylund, 1997); attachment (Byng-Hall, 1998;
Dallos, 2001); communication theories (among others)
(Fredman, 2004), post-modernism (Hoffman, 1990; Parry
& Doan, 1994; Weingarten, 1998) and systemic
(Papadoupoulos & Byng-Hall, 1998; Vetere & Dowling,
2005). These different theoretical influences and unfamil-
iar language may contribute to a lack of clarity about
narrative therapy (Clare, 2001; Harper & Spellman, 2002).
The collaboration between Michael White (from Australia)
and David Epston (from New Zealand) has been highly
influential in the development of this strand of narrative
therapy within systemic/family therapy (White & Epston,
1990). Karl Tomm, influential in Post-Milan develop-
ments of systemic therapy, facilitated this development
by opening up forums for Michael Whites work in
North America in the 1980s (Tomm, 1989, 1993; White,
2001). This contributed to the development of narrative
approaches to therapy among systemic therapists.
However, the origins of family therapy serve to both
clarify narrative approaches to therapy and also blur
them. This is illustrated by Minuchins (1998) critique that
the family seems to have disappeared from the therapeu-
tic process in narrative therapy (p. 399). Among British
family therapists, narrative ideas seem to have been eclec-
tically applied along with social constructionist and post-
modernist ideas broadly in harmony with Milan systemic
ideas (Flaskas, 2002, p. 42). Vetere and Dowling (2005)
comment on their practice arguing that a rapprochement
between systemic therapies and the critical perspectives
of narrative-based social constructionist approaches,
offers a solid, ethically accountable base (p. 10). However,
it is not clear how practitioners in local services are
applying White and Epstons (1990) approach to narra-
tive therapy and what influence systemic or other ideas
have on their practice. Thus, the different emphases of
narrative approaches, variety of theoretical influences
and relationship with systemic psychotherapy have
meant that many seem to have found the answer to
the question What is narrative therapy? somewhat
elusive. To answer this frequently asked question, the
narrative therapy press associated with White and
Epstons approach, Dulwich Centre Publications (2009),
produced a definition of narrative approaches more
generally:
Narrative approaches to counselling and community
work centre people as the experts in their own lives and
views problems as separate from people. Narrative
approaches assume that people have many skills, compe-
tencies, beliefs, values, commitments and abilities that
will assist them to reduce the influence of problems in
their lives. The word narrative refers to the emphasis
Clin. Psychol. Psychother. 18, 486497 (2011)
488
that is placed upon the stories of peoples lives and the
differences that can be made through particular tellings
and retellings of these stories. Narrative approaches
involve ways of understanding the stories of peoples
lives, and ways of re-authoring these stories in collabora-
tion between the therapist / community worker and the
peoples whose lives are being discussed. It is a way of
working that is interested in history, the broader context
that is affecting peoples lives and the ethics or politics of
this work. These are some of the themes which make up
what have come to be known as narrative approaches.
Of course, different people engage with these themes in
their own ways. Some people choose to refer to narrative
practices rather than narrative therapy/community
work as they believe that the phrase narrative therapy/
community work is somewhat limiting of an endeavour
which is constantly changing and being engaged with in
many different contexts.
For a full description of the range of practices that consti-
tute White and Epstons (1990) approach to narrative
therapy, Morgan (2000), Carr (1998), Freedman and
Combs (1996) and White (2007) can be consulted. Although
there are similarities with other approaches to therapy,
White and Epstons (1990) approach to narrative therapy
offers a different view of the problem, focus for therapy,
notion of change and use of written documents. Thus, in
this approach to narrative therapy, the problem is viewed
as external to the person, located in the broader socio-
political context and reflected in discourse, rather than
within the individual or family (Madigan & Law, 1998).
This has led to a shift in the definition of what needs to
be changed (Hoffman, 2002). Moreover, problems or def-
icits are not the exclusive focus of therapy, but exceptions
to the problem or unique outcomes are fully elaborated
(Morgan, 2000). Change is supported by the persons rela-
tionship networks (or audiences), often broader than
family members or groups of professionals (common to
reflecting teams). The persons developing (or preferred)
identity is supported through the use of therapeutic docu-
ments (Morgan, 2000), rather than relying on talk alone.
Alternative stories, as with stories in general, are devel-
oped through the construction of two landscapes: a land-
scape of action and a landscape of consciousness (Bruner,
1986). Whites (1995) application of Bruners idea to
therapy distinguishes between our experiences of events,
sequences, time or plot (landscape of action) and the
meanings or interpretations that are made (landscape
of consciousness/identity) through reflecting on these
events.
Therapeutic documents highlight the alternative story
and provide an alternative record to the official docu-
ments circulating in professional networks that often focus
on problems. The concerns of narrative therapy, therefore,
deconstruct some of the taken-for-granted norms of
Copyright 2010 John Wiley & Sons, Ltd.
J. Wallis et al.
therapy in general and share much in common with critical
psychology (Fox & Prilleltensky, 1997; Parker, 1999).
However, neither these distinctions, the Dulwich Centre
Publications definition of narrative therapy, Morgans
(2000) nor Whites (2007) detailed account of the practices
of narrative therapy have been empirically validated. It is
not clear whether UK narrative practitioners would endorse
the definition of narrative therapy given by the Dulwich
Centre Publications (2004) or whether other local, historical
or contextual issues influence how narrative therapy is
understood and practiced in the UK. Furthermore, the
growing evidence of practitioners becoming more eclectic
and integrative (Pinsof & Wynne, 2000) may mean that
therapists are combining ideas or practices of narrative
therapy within existing approaches to therapy (Flaskas,
2002). Thus, the ways in which UK practitioners have
adopted and put into practice narrative therapy is not clear.
The training routes into narrative therapy may also influ-
ence the way in which narrative therapy is understood and
applied. The different routes into training in narrative
therapy, different levels of intensity of training and the
range of theorists associated with narrative therapy add to
the difficulty of knowing whether there is a shared under-
standing about what narrative therapy is among UK
practitioners.
Research into Narrative Therapy
Research into narrative therapy is at a comparatively
embryonic stage. Few studies exist that would be consid-
ered as good evidence for the effectiveness of narrative
therapy within the traditions of therapeutic outcome
research. Some of the reasons for this may relate to the
type of research valued by narrative therapists and prob-
lems with positivist evidence-based research. Research
coherent with the values of narrative therapy views
research as a form of action (Smith, 1999) and challenges
the power of the researcher, regarding the therapist and
client as co-researchers (Epston, 2001) and privileging
clients interpretations and understandings (Gaddis,
2004). Findings in this context are used to make therapy
more useful to the client and influence the further evolu-
tion of ideas and practices (Andersen, 1997).
Narrative therapists (along with systemic therapists)
assert that positivist evidence-based methodologies over-
simplify the complexity of social phenomena, particularly
the application of psychotherapy in clinical settings (Roy-
Chowdhury, 2003).
Larner (2004) notes that social constructionist, narrative
and systemic approaches are widely practiced, have a
defined theory and practice and yet are less amenable to
manualization and replication. The reason suggested is
that narrative therapy, often included as one approach
within systemic practice, shares with systemic family
Clin. Psychol. Psychother. 18, 486497 (2011)
Q Methodology and Narrative Therapy
therapy an emphasis on the relational process, focusing
on the persons language and giving personal agency
priority (Larner, 2004). Highlighting personal narratives
and solutions means that it is difficult to apply a step-by-
step procedure that can easily be replicated and measured
(Larner, 2004). This highlights the politics of positivist
evidence-based practice, in particular the tension between
the science and research of therapy and its application in
clinical practice (Larner, 2004).
The political and social construction of evidence-based
practice may therefore contribute to a reluctance of some
systemic practitioners to engage with this discourse.
Thus, narrative outcome studies using a randomized
control trial (RCT) design, the gold standard of clinical
effectiveness research designs (Margison et al., 2000), are
sparse. Summarizing the evidence base for systemic prac-
tice, Carr (2009a, 2009b) notes that the bulk of systemic
interventions which have been evaluated in control trials
have been developed within cognitivebehavioural, psy-
choeducational and structuralstrategic psychothera-
peutic traditions. More research is required on social
constructionist and narrative approaches to systemic
practice, which are widely used in the UK, Ireland and
elsewhere (2009b, p. 64). One study identified as a RCT
involving narrative therapy is Beutler et al. (2003). This
study looked at a variety of treatment outcomes for people
who were depressed and had chemical dependencies.
Sixteen hours of training in narrative cognition therapy,
as developed by Goncalves (1995) and Mahoney (1991),
was provided; treatment was over 20 weeks and followed
up to 6 months. They concluded that prediction of
outcome was a function of treatment, but only as an
additive function of patient, relationship and patient
treatment variables. Other studies have been typical of
the exploratory, small-scale research described by Roth
and Fonagy (1996) and Salkovskis (1985) to develop
theory, practise techniques and investigate outcomes
(e.g., Besa, 1994; Coulehan, Friedlander, & Heatherington,
1998; DiLollo, Neimeyer & Manning, 2002; Elliot,
Loewenthal, & Greenwood, 2007; Kogan & Gale, 1997;
May, 2005; OConnor, Meakes, Pickering, & Schuman,
1997). Within such research, attention to process as well
as outcomes is important as it allows the identification of
the active ingredients of psychotherapy and the mecha-
nisms of change (Kopta, Lueger, Saunders, & Howard,
1999, p. 7). While the majority of these studies report posi-
tive outcomes, they also point to the wide diversity in
which narrative therapy is being defined (e.g., free asso-
ciation narrative, Elliot et al., 2007; family attachment
narrative therapy, May, 2005) and the ways it is being
integrated with other approaches (e.g., constructivist
control mastery, Lieb & Kanofsky, 2003; behavioural
monitoring, Besa, 1994; systemic therapy Coulehan
et al., 1998), thus giving further evidence to the eclectic
and integrationist nature of this therapy (Flaskas, 2002;
Copyright 2010 John Wiley & Sons, Ltd.
489
Pinsof & Wynne, 2000) and posing more challenges to a
research paradigm attracted to model fidelity. While it
is important to recognize that these researchers have been
bold enough to venture into a new area of psychotherapy
outcome research, their attempts can also be criticized for
many of the limitations so frequently encountered in such
initial research endeavours. Symptom severity is not
often assessed using standardized measures, which limits
comparability to other client groups. Studies used self-
report outcome measures that are noted for their subjec-
tivity (Barker, Pistrang, & Elliott, 1994) and unreliability
(Kazdin, 1982). The training of therapists is not always
described. In defining narrative therapy, some refer to the
key practices of narrative therapy (externalizing and
unique outcomes), but none have referred to all of the key
aspects mentioned in the Dulwich Centre Publications
(2009) definition. In summary, the conclusions of Etchison
and Kleists (2000) review still stand that, despite its
apparent appeal, a broader research base is yet to be
established. Interestingly, most advancement in this area
has been made in recent years not in evaluating the imple-
mentation of the therapeutic model, but in narrative as an
outcome measure of therapeutic success (France & Uhlin,
2006). Clearly, this is easier to define and hence measure,
but the evaluation of narrative therapy as a therapeutic
model to advance a better agreement about what narra-
tive therapy is and what it does needs to be reached.
Such agreement would enable researcher/clinicians to
position their particular approach to narrative therapy
and to describe what is important in applying their
approach in practice. This will further the endeavour of
defining or specifying narrative approaches to therapy,
allowing research to progress and an evidence base to be
established. While acknowledging that this project fur-
thers the scientific discourse in relation to psychological
therapies, it also could provide a form of accountability
of narrative approaches to both clients and managers of
services within a UK context. More specifically, consider-
ing the similarities and differences between narrative
therapy and other models or approaches to therapy, such
as family therapy, research should highlight the dis-
tinctiveness of White and Epstons (1990) approach to
narrative therapy as well as commonalities with other
approaches. This then allows future research into the
effectiveness of narrative therapy to be more focused on
the unique features of narrative therapy. Hence, it was the
aim of this study to explore current definitions of those
applying White and Epstons (1990) approach to narrative
therapy within UK practitioners and to distil the common
themes that characterize narrative therapy within this
context. Thus, the aims of this research study were
twofold: to explore (1) the commonalities and differences
in how narrative therapy is described and applied by
practitioners; and (2) the range of accounts or discourses
in relation to narrative therapy.
Clin. Psychol. Psychother. 18, 486497 (2011)
490 J. Wallis et al.

METHOD Association of Family Therapy (AFT) Journal; participants

in narrative therapy and AFT electronic mail discussion
The design consisted of two parts: a Delphi Poll and Q lists; trainers of narrative therapy; presenters at narrative
methodology. The combination of Q methodology and therapy conferences and trainers from key systemic/family
the Delphi Panel was unique to this study and provided therapy training courses, including the Tavistock Clinic,
a method for researching a relatively new approach to Kensington Consultation Centre, Brief Therapy Press and
therapy. The Delphi Poll involved identifying an expert the Institute of Family Therapy. Consequently, the Delphi
panel (see Table 1) of established practitioners trained in panellists included people from different training institu-
and knowledgeable about narrative therapy. The aim in tions reflecting the variety of training entry points into
recruiting the Delphi Panel was to maximize the diversity narrative therapy (see Table 1). The panel was asked to
of participants, while maintaining a high level of expertise. answer the following questions, in writing: What is narra-
The following criteria were applied to recruit the Delphi tive therapy and what is it not? and What do narrative
Panel of seven UK experts: contributors of articles about practitioners do and not do? Once these responses were
narrative therapy to Clinical Psychology Journals and the collected and analysed for recurring themes, the study pro-
gressed to the next, Q methodological stage.
Q methodology involves a number of phases (see also
Brown, 1980; Stainton Rogers, 1995; Watts & Stenner, 2005).
Table 1. Summary of participant details
First, a set (pack) of statements about the topic for study
Category Delphi Q-sort was developed from the Delphi Poll, relevant literature
Panel participants and electronic mail discussions. Second, they were piloted
to check for balance, comprehensiveness and clarity result-
Gender
Males 5 11
ing in a total of 55 statements. Third, a wider group of 40
Females 2 22 participants sorted or ranked the statements (Q-sort) on a
quasi normally distributed grid from most to least impor-
Specialty tant to their perspective. Delphi Panel participants were
Child and adolescent specialty 3 21
Adult 2 7
invited to participate in this second stage. A further 33
Other 2 5 participants were recruited. The main inclusion criterion
for the additional participants was if they identified them-
Years of experience selves as applying White and Epstons (1990) narrative
>10 7 23
<10 0 10
approach in their practice (see Table 1). Finally, the data
were subjected to principal components analysis and
Professional group Varimax rotation to identify shared patterns across the
Family therapist 2 12 sorts. The criterion for inclusion was an eigenvalue greater
Social worker 2
Clinical psychologist and family 3 6
than 1 to assure the patterns were shared (Tabachnick &
therapist Fidell, 2001). This produced an eight-component solution.
Clinical psychologist 11 The sorts correlating most highly with each of the com-
Clinical psychologist and academic 1 ponents were then weighted and merged to produce a
Other psychologist 1 2 representative sort for that component. These represen-
Training tative components were interpreted together with written
Diploma level training in family 3 open-ended comments made by participants about their
therapy (2 years) particular sorting.
Qualified as family therapist 5 17
International Diploma in narrative 4
therapy FINDINGS
Narrative therapy: 2-day workshops 7 22
Narrative therapy intensive 3 4 Bruners (1986) concept of two landscapes making a
training (5 days) good storya landscape of action and landscape of con-
Presented narrative therapy at 7 Not asked sciousness, incorporated by White (1995) into narrative
national or international therapyprovides a useful frame to describe and discuss
conferences and/or writing the results.
about narrative therapy The findings of the accounts are therefore organized
Informal trainingpeer groups 4 5
into the relative emphases reported to be placed on tech-
Total number of participants with 7 33 niques, practices or actions in therapy (reflecting a land-
data scape of action), an emphasis on the philosophy or

Most Delphi Panel members trained prior to introduction of International theories informing narrative therapy (reflecting a land-
Diploma in narrative therapy. scape of consciousness) or the interplay between these

Copyright 2010 John Wiley & Sons, Ltd. Clin. Psychol. Psychother. 18, 486497 (2011)
Q Methodology and Narrative Therapy 491

two landscapes. The findings of the commonalities identi-
fied by the Delphi Panel are first reported.
The Delphi Panel
The development of the statements through the Delphi
Panel pointed to unanimous agreement on a number of
key issues related to theory, politics and the practices
of narrative therapy. Theoretically, the proposition that
problem stories are socially, culturally and politically
formed, both interpersonally and through wider influ-
ences, was unanimously supported. Moreover, it was
acknowledged that narrative therapy deconstructs objec-
tive knowledge and privileges contextual, local knowl-
edge. There was agreement that ethics, particularly
accountability and transparency, is important, as well as
a social justice stance. Furthermore, Delphi Panel members
unanimously agreed that the role of the therapist could
be conceived as that of a conversational architect, and
that the therapists expertise lay in creating a context for
change. Narrative practices that were agreed to be impor-
tant were the following: seeking unique outcomes or
exceptions, making explicit peoples skills and knowl-
edge, enhancing connection with social networks, invit-
ing audiences to sessions, writing therapeutic documents,
listening to and acknowledging peoples experiences,
exploring identity through questions about landscape of
action (what people do) and landscape of consciousness
(identity and meaning) and focusing on the persons pre-
ferred outcomes. The results from the Delphi Panel seem
to indicate that there is agreement among a small group
of knowledgeable practitioners about the key features of
White and Epstons (1990) narrative therapy. The Q-sort
highlighted both convergence and divergence in the
accounts of the broader group of participants.
The Accounts of Narrative Therapy
The eight distinct accounts that emerged in relation to
White and Epstons (1990) narrative therapy are summa-
rized in Table 2.
Overall, a key issue distinguishing the different accounts
seems to be a difference in emphasis between a landscape
of consciousness rather than a landscape of action. Thus,
within a landscape of consciousness, narrative therapy
was seen as a political stance, a world view, and irreverent
to traditions, issues about integration with other approaches
and the influence of social constructionism were fore-
grounded. Contrasted with this, an emphasis on the land-
scape of action highlighted the relative importance of
different techniques and practices of narrative therapy and
integration with other approaches. Two accounts empha-
sized an interplay between practices and theories such as
social constructionism and systemic ideas. Thus, the ways
in which practices are selected (or not) and combined with
theoretical or philosophical understandings of narrative
therapy combine to create the different accounts of
narrative therapy.
The accounts of narrative therapy can be thought of as
a stance taken in relation to narrative therapy. Statements
that seem to typify the account are reported as well as
relevant comments made by participants. To compare
and highlight the debates around the topic, statements
that may be important to some accounts but not to others
are reported.
Of those participants whose sorts were highly corre-
lated with the accounts, information about their profes-
sion, work contexts, years of experience and training
is provided to contextualize the accounts. In addition,
the professional position chosen by these participants to
describe how they sorted the statements is reported.
Landscape of Consciousness Accounts
Three accounts illustrate different consciousness stances
taken in relation to narrative therapy: a political, social
justice stance (component 1), an irreverent stance to
traditions (component 6) and a critical/reflexive stance
(component 8).
Component 1: The Political/Social Justice Account
This component emphasizes the importance of address-
ing social, cultural and political issues in therapy and
avoids pathologizing and individualizing people. In this

Table 2. Q-sort components, titles and variance

Component Title Variance %

1 The political/social justice account 16.8
2 The distinctive, re-authoring account 15.5
3 Narrative practices are important 9.6
4 The flexiblesystemic account 8
5 The selective, non-purist account 6.9
6 The irreverent account 6.6
7 The integrationist account 6
8 The reflexive/critical account 5

Copyright 2010 John Wiley & Sons, Ltd. Clin. Psychol. Psychother. 18, 486497 (2011)
492
account, the emphasis on ethics, particularly accountabil-
ity and transparency, seemed important. Narrative
therapy is viewed more as a political position than a set
of techniques. Given that, deconstruction and identifica-
tion of unique outcomes are presented as important
techniques.
Three sorts were highly correlated with this account.
One participant sorted the statements from the position
of clinical psychologist, worked in an adult specialty,
had 3 years of experience and had attended a 2-day work-
shop in narrative therapy. The second participant sorted
the statements from a clinical psychologist and academic
position, worked in an adult speciality and had 11 years
of experience. This participant had attended many 2-day
workshops in narrative therapy, taught, presented at con-
ferences and had published articles about narrative
therapy. The third participant sorted the statements from
a clinical psychologist and family therapist position, was
a registered family therapist, worked in a child and ado-
lescent specialty and had over 20 years of experience. This
participant had attended a 4-day training in narrative
therapy, taught, presented at conferences and published
about narrative therapy.
Component 6: The Irreverent Account
The the irreverent account favoured the anti-patholo-
gizing approach of narrative therapy, enabling alternative
stories to emerge and making skills and abilities explicit.
This stance seemed irreverent to traditions, including
those of narrative therapy.
One sort correlated highly with this account. The partici-
pant sorted the statements from a social worker position,
had 16 years of experience and worked in both a child and
adolescent and adult specialty. This participant had attended
a 2-year training course in family therapy and had com-
pleted the International Diploma in Narrative Therapy.
Component 8: The Reflexive/Critical Account
This component regarded narrative therapy as a world
view that provided a critique of therapy generally and
emphasized the need to hold this position reflexively.
Thus, participant 18 commented: I see narrative therapy
as potentially a place of resistance and critique to
therapy in general. No specific techniques were associ-
ated with this account as narrative therapy should not be
technique driven (participant 18). While narratives were
seen as socially constructed, it was not important to this
account that narrative therapy integrate with other thera-
pies, or that it is seen as a type of family therapy.
One sort correlated highly with this account. The par-
ticipant sorted the statements from a clinical psycholo-
gist position, worked in an adult specialty, had 12 years
of experience and has attended 2-day workshops in
narrative therapy.
Copyright 2010 John Wiley & Sons, Ltd.
J. Wallis et al.
Landscape of Action Accounts
Three accountscomponent 3 (the narrative practices are
important account), component 5 (the selective, non-purist
account) and component 7 (the integrationist account)
illustrate different emphases taken with regard to the
actions taken in narrative practice.
Component 3: The Narrative Practices Are
Important Account
Component 3 highlighted narrative therapy as a cre-
ative and fun approach with children: Its not a Literary
emphasisbut great creative fun to make up triumphant
stories with kids (participant 26). Practices important to
this approach were unique outcomes and identifying
skills and abilities. It was important that techniques are
applied from a non-expert stance. From this perspective,
it is not important that narrative therapy is viewed as a
political position that one adopts; rather, the range of
techniques seems important.
The sort from one participant correlated significantly
with this account. The participant was an Educational
Psychologist working with children and families with 25
years of experience. The participant had attended 2-day
workshops in narrative therapy and many workshops in
systemic therapy.
Component 5: The Selective, Non-Purist Account
Component 5 incorporated the hallmark practices of
narrative therapy, e.g., unique outcomes and externaliz-
ing the problem, into established family therapy practice.
The tension within this approach is alluded to by partici-
pant 25 who wrote: I have a struggle between what nar-
rative therapy is in my practise and my understanding of
what a purist may argue. Social constructionism was
important in this account, while working from a non-
expert stance seemed less important. Another comment
from participant 25 about therapist expertise illustrates a
further difference between the accounts: Therapists need
expertise . . . [the idea of therapists not being experts] is
a red herring. Thus, from this perspective, therapist
expertise seems to be accepted as part of the process. This
is contrasted with accounts 2 and 3 where it seems impor-
tant that narrative therapists resist positioning themselves
as experts.
Two sorts were highly correlated with this account.
Both participants sorted the statements from a position of
a family therapist, and both were family therapists
working in child and adolescent specialties. One partici-
pant had over 20 years of experience as a social worker
and 10 years of experience as a family therapist and had
attended many 2-day workshops in narrative therapy.
The second participant had 1 year of experience as a
family therapist and had informal training in narrative
therapy.
Clin. Psychol. Psychother. 18, 486497 (2011)
Q Methodology and Narrative Therapy
Component 7: The Integrationist Account
This account strongly supported applying narrative
techniques along with other influences and a collabora-
tive, directive approach. From this position, participant
33 commented that it is unhelpful (for narrative thera-
pists) to take a completely oppositional stance and areas
of overlap are considerable with other therapies. This
account disagreed with the statement that narrative tech-
niques are less effective if used with therapies based on
different philosophical assumptions. Participant 33 com-
mented that techniques derived from different assump-
tions can be complementarybut this is an area of
discomfort and uncertainty for me. In this account, the
therapist seemed to be viewed as being able to be both
collaborative and directive, with the effect that the dif-
ferential power of roles remains.
One sort was highly correlated with this account. The
participant sorted the statements from a clinical psychol-
ogist using narrative therapy and cognitivebehaviour
therapy position, worked within an other specialty and
on a clinical psychology training course, has 5 years of
experience and has attended 2-day workshops in narra-
tive therapy.
Accounts Emphasizing an Interplay between
Landscapes of Consciousness and Action
Two accountscomponent 2 (the distinctive, re-author-
ing account) and component 4 (the flexible-systemic
approach)seemed to integrate theoretical aspects
(landscape of consciousness) with practices (landscapes
of action).
Component 2: The Distinctive, Re-Authoring Account
This emphasized the unique contribution of narrative
therapy to re-authoring: I do re-authoring (participant
10). Techniques highlighted by the re-authoring account,
were also important to other accounts and included iden-
tifying unique outcomes or exceptions; centring the per-
sons intentions, values and dreams; making skills,
abilities and knowledge explicit through techniques that
centre the person and explore meaning (identity). Social
constructionism is an important basis (participant 10),
and the notion that narratives are constructed socially is
key to this account, as well as to accounts 2, 4, 5 and 8.
The therapist is viewed as a conversational architect,
applying techniques from a non-expert position.
Three sorts correlated highly with this account. All of
the participants sorted the statements from a narrative
therapist perspective. One participant was a clinical psy-
chologist who had worked in a child, adult and eating
disorder specialty and had 20 years of experience. This
participant was a registered family therapist and was
enrolled for the International Diploma of Narrative
Copyright 2010 John Wiley & Sons, Ltd.
493
Therapy. The second participant was a social worker with
26 years of experience, who worked in a child and ado-
lescent specialty and had attended many 2-day work-
shops in narrative therapy. The third participant was a
clinical psychologist with 6 years of experience who had
gained intensive experience in narrative therapy while
working in Australia and facilitated a peer training group
in narrative therapy.
Component 4: The FlexibleSystemic Account
This component regarded systemic ideas, along with
social constructionism, as important in narrative therapy.
Centring the abilities of people as well as addressing
social, cultural and political issues were important prac-
tices. Commenting on the statement about narrative tech-
niques being less effective if used with therapies based on
different philosophical assumptions, participant 13 wrote:
Possibly, but in my work I need the flexibility to do both
narrative therapy and cognitive therapy. This seemed to
reflect a pragmatic, flexible approach rather than holding
a theoretical stance. Thus, in this account of narrative
therapy, practitioners seem to integrate systemic and
social constructionist ideas with narrative practices.
Two sorts correlated highly with this account. One of
the participants sorted the statements from the position
of a clinical psychologist, had 2 years of experience,
worked in adult mental health and attended a peer train-
ing group in narrative therapy. The second participant
sorted the statements from the position of a family thera-
pist, worked in a child and adult specialty, worked as a
nurse for 20 years and as a family therapist for 5 years
and attended many 2-day training courses in narrative
therapy.
DISCUSSION
An interesting finding of this study was that there
appeared to be no clear clustering of demographics
around the different accounts; thus, years of experience,
specialties, profession or training in narrative therapy did
not appear to differentiate the accounts of narrative
therapy. The position participants choice from which to
sort the statements was interesting in that it seemed to
highlight their self-identity.
Defining Narrative Therapy: Commonalities
A core of narrative practitioners (the Delphi Panellists)
were able to agree on a range of techniques key to narra-
tive therapy. Moreover, theoretical issues informing prac-
tice, such as the socio-cultural and political context of
problems, were noted as important. There seems to be
broad agreement among Q-sort participants on the social
construction of narratives and techniques contributing to
Clin. Psychol. Psychother. 18, 486497 (2011)
494
a re-authoring approach and enabling alternative stories
to emerge. Pote, Stratton, Cottrell, Shapiro, and Boston
(2003) noted the importance of social constructionism as
a guiding principle of systemic practitioners in the UK.
Social constructionism may therefore constitute one of the
known (familiar) influences on narrative therapists, con-
tributing to therapists landscape of consciousness. The
appeal of narrative therapy for clinicians may be that nar-
rative techniques facilitate an implementation of social
constructionist ideas in practiceconnecting the land-
scape of consciousness with landscape of action. The dis-
tinctive, re-authoring account (component 2) highlights
specific narrative practices that can be thought of as con-
tributing to a re-authoring process. Techniques high-
lighted by the distinct, re-authoring account, were also
important to other accounts. Although re-authoring has
been described as a clich (Blow & Daniel, 2002), there
seems to be some agreement on the substance of re-
authoring. It may be that techniques associated with re-
authoring provide a contrast to the deficit approach
(Gergen, 1990), i.e., the focus on problems and the need
to fix people, common in therapeutic discourse. It may
be that these techniques contribute to outcomes and a
shift to hope by developing personal agency (OConnor
et al., 1997) and focusing on the exceptions and strengths
of family members (Coulehan et al., 1998). However, it is
the areas of debate and difference identified that may
have the greatest influence in how practitioners apply
narrative approaches in practice, hence contributing the
most variance when trying to establish the efficacy of the
approach.
Differences: Areas of Contestation
The Q-sort highlighted the following areas of contesta-
tion: (1) conceptions of therapy as a political stance con-
trasted to a focus on techniques; (2) the therapist as expert
and (3) the relationship between narrative therapy and
other therapies, specifically systemic therapy. The politi-
cal/social justice account of narrative therapy (compo-
nent 1) may indicate that part of the appeal of narrative
therapy is its political, social justice approach and decon-
struction of social norms. This may reflect the influence
of the post-structuralist philosopher Foucault on White
and Epstons (1990) ideas. Foucaults theorizing of power
and knowledge and the importance of this for everyday
social practices are applied to individual experience
(Flaskas, 2002; White, 1992). Thus, certain knowledge
positions (or dominant discourses) become more power-
ful than others, marginalize alternate discourses and
shape everyday social practices. Although White has been
criticized for applying Foucaults ideas highly selectively
(Leupnitz, 1992; Redekop, 1995), the Foucauldian influ-
ence is important. Flaskas (2002) argues that there has
Copyright 2010 John Wiley & Sons, Ltd.
J. Wallis et al.
been little recognition of the differences between the ideas
of social constructionism (privileging language construc-
tion) and Foucaults theorizing of social context and
relationships where social practices are privileged. The
political/social justice account of narrative therapy may
have different implications in practice to other accounts
that emphasize narratives as social constructions. While
the political/social justice account emphasizes a land-
scape of consciousness, other accounts focus more on
techniques or a landscape of action. Thus, in this account,
narrative therapy is seen as a political position that one
adopts rather than a set of techniques that can be applied.
However, this positioning did not seem to be important
to component 3 (the narrative practices are important),
component 5 (the selective, non-purist account) or com-
ponent 7 (the integrationist account). These results epito-
mize two different positions: (1) the resonance of the
value and philosophical base of the therapy for the thera-
pistemphasizing a landscape of consciousness and (2)
a set of useful techniquesemphasizing a landscape of
action. These different positions may lead to different
therapeutic outcomes. They may also characterize differ-
ent sorts of practitioners: those who hold to narrative as
their core model and have chosen this as a result of a more
fundamental set of values, compared with more eclectic
practitioners who see it is as one of a set of tools. Griffith
and Griffith (1992) argue that the epistemological
approach taken is more important to the effectiveness of
narrative therapy than the techniques applied. Thus, for
practitioners, this dimension highlights the importance
of clarifying ones approach as it informs method or
technique (Burnham, 1992).
Ranking of statements relating to the role of the therapist
and comments made by participants during the sorting of
statements seem to indicate differences about the notion of
therapist expertise. In some accounts, it seemed important
that therapists resist positioning themselves as experts
(components 2 and 3), whereas this seemed less important
to others. The notion of therapist expertise seemed a red
herring to participant 25 (component 5). This may reflect
different positions related to the power of the therapist.
The significance of this distinction is underlined by
Guilfoyle (2003) who warns that power comes from expert
knowledge, and that power can be concealed if therapy is
detached from the socio-political/cultural context. Kogan
and Gales (1997) analysis of a session of Michael Whites
notes that the therapist is both de-centered and yet inter-
ventive. Thus, Whites approach has been described as
purposefully interventive with the power issues involved
mediated by an ethical commitment to practices of trans-
parency (Flaskas, 2002). The relationships between narra-
tive therapy and other therapies emerged as an area of
debate. The range of accounts included the following
views: that narrative therapy is a distinct therapy that
cannot be integrated with other therapies (component 2);
Clin. Psychol. Psychother. 18, 486497 (2011)
Q Methodology and Narrative Therapy
that narrative therapy could be used flexibly with systemic
and other therapeutic approaches (component 4); that nar-
rative therapy could be integrated with other approaches
(component 7). However, the integration of narrative
therapy with other therapies did not seem to be important
to accounts emphasizing the landscape of consciousness.
This perhaps highlights that narrative therapy might be
easier to integrate with other therapies at the level of tech-
nique or landscape of action rather than at the level of
theory or landscape of consciousness.
The distinction of narrative therapy from other
approaches, reflected in account 2 (the distinct, re-author-
ing account), may have been important in the early
development of the approach to clarify the uniqueness of
this development. From this perspective, narrative
therapy seems to be applied as a distinct approach without
integration with other approaches. In only the flexible
systemic account (component 4) did a strong link between
narrative therapy and systemic ideas appear important.
This finding was surprising, as White and Epstons (1990)
narrative therapy emerged from systemic approaches in
the 1980s (Hart, 1995; Tomm, 1993). It seems that practi-
tioners may have different views on the importance of the
relationship between narrative therapy and systemic
therapy. Harper (2009), commenting on a plenary held at
the Association of Family Therapy Annual Conference in
2008, noted that contributors seemed keen to avoid a split
between narrative therapy and the broader family therapy
field, and instead, to find connections but this issue
seemed difficult to negotiate (p. 17). Vetere and Dowling
(2005), in their book on narrative therapies with children,
specifically aimed to make narrative therapy more sys-
temic and to put the family back into systemic/narrative
therapy. It was interesting, therefore, that a key systemic
practice, that of involving audiences or reflecting teams,
was not rated as very important in any of the accounts.
Thus, the relationship between narrative therapy and
other therapies, specifically systemic psychotherapy
remains unclear and requires further exploration.
Moreover, how practitioners integrate narrative therapy
at the levels of landscape of consciousness (theory) and
landscape of action (practice) could be further described.
Integrating ideas from different therapeutic models
(reflected in account 7, the integrationist account) can be
argued to be a logical outcome of the post-modern debate
(Hart, 1995). As Hoffman (1990) argues, our theories may
become lenses rather than truths. However, at least within
a UK context, this move towards integration of therapeu-
tic approaches does not fit with the National Health
Service context where the discourse of evidence-based
practice requires specification, manualization and strict
adherence to models (Layard, 2006). In this context, family
therapy could be positioned as a systemic science of
context, narrative and relationship (Larner, 2004, p. 35).
However, developing evidence that reflects clinical prac-
Copyright 2010 John Wiley & Sons, Ltd.
495
tice and practice-based evidence could be an alternative
way forward (Margison et al., 2000).
CONCLUSION
If therapists are to demonstrate the effectiveness of models
of therapy, specifying what we do and how we do it is
vital. The accounts identified in this study may assist
practitioners in identifying an approach to narrative
therapy that reflects their values and practice. This study
also illustrates a pluralism that has influenced the debate
around what is narrative therapy for some time.
Furthermore, it has contributed the identification of a set
of core concepts, values and techniques over which there
is some consensus. For therapists, the various accounts
indicate that narrative therapy provides therapists with
the following: a social justice, political and ethical stance
to therapy; a re-authoring approach and practices that
facilitate the application of social constructionist ideas.
Together, these seem to compose the unique contribution
of narrative therapy. This study has also identified the
different positionings of narrative therapy that have con-
tributed to its opacity and highlighted the diversity in
therapist practice. Only by acknowledging both the core
constructs of narrative therapy and the differences held
theoretically and in practice can we make it possible to
develop research evidence for the effectiveness of this
approach, essential in the current healthcare delivery
context.
REFERENCES
Andersen, T. (1997). Researching clienttherapist relationships:
A collaborative study for informing therapy. Journal of Systemic
therapies, 16, 125133.
Anderson, H. (2003). Postmodern social construction therapies.
In T.L. Sexton, G.R. Weeks, & M.S. Robbins (Eds), Handbook of
family therapy. The science and practice of working with families
and couples. New York: Brunner-Routledge.
Anderson, H., & Goolishian, H.A. (1992). The client is the expert:
A not-knowing approach to therapy. In S. McNamee, & K.J.
Gergen (Eds), Therapy as social construction. London: Sage.
Angus, L.E., & McLeod, J. (Eds). (2004). The handbook of narrative
and psychotherapy. Practice, theory and research. London: Sage.
Barker, C., Pistrang, N., & Elliott, R. (1994). Research methods in
clinical and counselling psychology. New York: Wiley.
Besa, D. (1994). Evaluating narrative family therapy using sin-
gle-system research designs. Social Work Practice, 4(3),
309325.
Beutler, L.E., Moleiro, C., Malik, M., Harwood, T.M., Romanelli,
R., Gallagher-Thompson, D., & Thompson, L. (2003). A com-
parison of the dodo, EST, and ATI factors among co-morbid
stimulant dependent, depressed patients. Clinical Psychology &
Psychotherapy, 10(2), 6969.
Blow, K., & Daniel, G. (2002). Frozen narratives? Post-divorce
processes and contact disputes. Journal of family therapy, 24,
84105.
Clin. Psychol. Psychother. 18, 486497 (2011)
496
Brown, S.R. (1980). Political subjectivity: Applications of
Q-methodology in political science. New Haven: Yale University
Press.
Bruner, J. (1986). Actual minds, possible worlds. Cambridge, MA:
Harvard University Press.
Burnham, J.B. (1992). Approach-method-technique: Making dis-
tinctions and creating connections. Human Systems, 3, 326.
Byng-Hall, J. (1998). Evolving ideas about narrative: Re-editing
the re-editing of family mythology. Journal of Family Therapy,
20(2), 133142.
Campbell, D. (1999). Family therapy and beyond: Where is the
Milan systemic approach today? Child Psychology & Psychiatry
Review, 4(2), 7684.
Carr, A. (1998). Michael Whites narrative therapy. Contemporary
Family Therapy, 20(4), 485503.
Carr, A. (2009a). The effectiveness of family therapy and sys-
temic interventions for child-focused problems. Journal of
Family Therapy, 31, 345.
Carr, A. (2009b). The effectiveness of family therapy and sys-
temic interventions for adult-focused problems. Journal of
Family Therapy, 31, 4674.
Clare, D. (2001). What is narrative therapy? A project with many
solutions. Gecko, 2, 9799.
Combs, G., & Freedman, J. (2004). A poststructuralist approach
to narrative work. In L.E. Angus, & J. McLeod (Eds), The hand-
book of narrative and psychotherapy. Practice, theory and research.
London: Sage.
Coulehan, R., Friedlander, M.L., & Heatherington, L. (1998).
Transforming narratives: A change event in constructivist
therapy. Family Process, 37(Spring), 1733.
Crossley, M.L. (2000). Narrative psychology, trauma and the
study of self/identity. Theory & Psychology, 10(4), 527546.
Dallos, R. (2001). Attachment narrative therapy: Narrative and
attachment theory approaches in systemic family therapy with
eating disorders. Journal of family Psychotherapy, 12(2), 4372.
de Shazer, S. (1982). Patterns of brief family therapy: An ecosystemic
approach. New York: The Guilford Press.
DiLollo A., Neimeyer, R., & Manning, W. (2002). A personal
construct psychology view of relapse: indications for a narra-
tive therapy component to stuttering treatment. Journal of
Fluency Disorders, 27, 1942.
Dulwich Centre Publications. (2004). Narrative therapy and
research. The International Journal of Narrative Therapy and
Community Work, 2, 2936.
Dulwich Centre Publications. (2009). Commonly asked ques-
tions about narrative approaches to therapy, community work
and psychosocial support. Retrieved July 25, 2009, from
http://www.dulwichcentre.com.au/questions.html
Elliott, S., Loewenthal, D., & Greenwood, D. (2007). Narrative
research into erotic countertransference in a female therapist
male patient encounter. Psychoanalytic Psychotherapy, 21(3),
233233.
Epston, D. (2001). Anthropology, archives, co-research and
narrative therapy. In D. Denborough (Ed.), Family therapy:
Exploring the fields past, present and possible futures. Adelaide:
Dulwich Centre Publications.
Etchison, M., & Kleist, D.M. (2000). Review of narrative therapy:
Research and utility. The Family Journal: Counselling and Therapy
for Couples and Families, 8(1), 6166.
Flaskas, C. (2002). Family therapy beyond postmodernism. London:
Brunner-Routledge.
Fox, D., & Prilleltensky, V. (Eds). (1997). Critical psychology: An
introduction. London: Sage.
Copyright 2010 John Wiley & Sons, Ltd.
J. Wallis et al.
France, C.M., & Uhlin, B.D. (2006). Narrative as an outcome
domain in psychosis. Psychology and Psychotherapy: Theory,
Research and Practice, 79(1), 5353.
Fredman, G. (2004). Transforming emotion. Conversations in coun-
selling and psychotherapy. London: Whurr Publishers.
Freedman, J., & Combs, G. (1996). Narrative therapy: The social
construction of preferred realities. New York: W.W. Norton.
Gaddis, S. (2004). Re-positioning traditional research: Centring
clients accounts in the construction of professional therapy
knowledges. The International Journal of Narrative Therapy and
Community Work, 2, 3748.
Gergen, K. (1990). Therapeutic professions and the diffusion of
deficit. The Journal of Mind and Behaviour, 11(3 & 4), 107
122.
Goncalves, O.F. (1995). Cognitive narrative psychotherapy: The
hermeneutic construction of alternative meanings. In M.J.
Mahoney (Ed.), Cognitive and constructive psychotherapies (pp.
186245). New York: Pergamon Press.
Goncalves, O.F., & Machado, P.P.P. (1999). Cognitive narrative
psychotherapy: Research foundations. Journal of Clinical
Psychology, 55(10), 11791191.
Greenhalgh, T., & Hurwitz, B. (1999). Narrative based medicine:
why study narrative? British Medical Journal, 318, 4850.
Griffith, J., & Griffith, M. (1992). Owning ones epistemological
stance in therapy. Dulwich Centre Newsletter, 1, 511.
Guilfoyle, M. (2003). Dialogue and power: A critical analysis of
power in dialogical therapy. Family Process, 42(3), 331343.
Harper, D. (2009). Narrative therapy, family therapy and history.
Context, 102(April), 1718.
Harper, D., & Spellman, D. (2002). Under the influence: The story
of two clinical psychologists interest in narrative approaches.
Clinical Psychology 17(17), 811.
Hart, B. (1995). Re-authoring the stories we work by. Situating
the narrative approach in the presence of the family of thera-
pists. Australian and New Zealand Journal of Family Therapy,
16(4), 181189.
Hoffman, L. (1990). Constructing reality: An art of lenses. Family
Process, 29(1), 212.
Hoffman, L. (2002). Family therapy: An intimate history. New York:
Norton.
Kazdin, A.E. (1982). Single-case research designs: Methods for clini-
cal and applied settings. New York: Oxford University Press.
Kogan, S.M., & Gale, J.E. (1997). Decentering therapy: Textual
analysis of a narrative therapy session. Family Process, 36(June),
101126.
Kopta, S.M., Lueger, R.J., Saunders, S.M., & Howard, K.I. (1999).
Individual psychotherapy outcome and process research:
Challenges leading to greater turmoil or a positive transition?
Annual Review of Psychology, 50, 441469.
Larner, G. (2004). Family therapy and the politics of evidence.
Journal of Family Therapy, 26, 1739.
Launer, J. (1999). Narrative based medicine: A narrative approach
to mental health in general practice. British Medical Journal,
318, 117119.
Layard, R. (2006). The case for psychological treatment centres.
British Medical Journal, 332, 10231032.
Lieb, R.J., & Kanofsky, S. (2003). Toward a constructivist control
mastery theory: An integration with narrative therapy.
Psychotherapy: Theory, Research, Practice, Training, 40(3),
187187.
Luepnitz, D.A. (1992). Nothing in common but their first names:
The case of Foucault and White. Journal of Family Therapy, 14,
281284.
Clin. Psychol. Psychother. 18, 486497 (2011)
Q Methodology and Narrative Therapy
Madigan, S., & Law, I. (Eds). (1998). Praxis. Situating discourse,
feminism & politics in narrative therapies. Vancouver: The
Cardigan Press.
Mahoney, M.J. (1991). Human change processes: The scientific
foundations of psychotherapy. New York: Basic Books.
Margison, F.R., Barkham, M., Evans, C., McGrath, G., Mellor-
Clark, J., Audin, K., & Connell, J. (2000). Measurement and
psychotherapy: Evidence-based practice and practice-based
evidence. British Journal of Psychiatry, 177(August): 123130.
May, J.C. (2005). Family attachment narrative therapy: Healing
the experience of early childhood maltreatment. Journal of
Marital & Family Therapy, 31(3), 221221.
McLeod, J. (1997). Narrative and psychotherapy. London: Sage.
Minuchin, S. (1998). Where is the family in narrative family
therapy? Journal of marital and Family Therapy, 12, 397404.
Monk, G., & Gehart, D.R. (2003). Sociopolitical activist or
conversational partner? Distinguishing the position of the
therapist in narrative ad collaborative therapies. Family
Process, 42(1), 1930.
Morgan, A. (2000). What is narrative therapy? An easy-to-read intro-
duction. Adelaide: Dulwich Centre Publications.
OConnor, T., Meakes, E., Pickering, R., & Schuman, M. (1997). On
the right track: Clients experience of narrative therapy.
Contemporary Family Therapy, 19, 470496.
Papadoupoulos, R.K., & Byng-Hall, J. (Eds). (1998). Multiple
voices: Narrative in systemic family psychotherapy. London:
Routledge.
Parker, I. (Ed.). (1999). Deconstructing psychotherapy. London: Sage.
Parry, A., & Doan, R.E. (Eds). (1994). Story re-visions. Narrative
therapy in the postmodern world. New York: The Guildford
Press.
Pinsof, W.M., & Wynne, L.C. (2000). Towards progress research:
closing the gap between family therapy practice and research.
Journal of Marital and Family Therapy, 26(1), 18.
Polkinghorne, D.E. (1988). Narrative knowing and the human sci-
ences. Albany: State University of New York Press.
Polkinghorne, D.E. (2004). Narrative therapy and postmodern-
ism. In L.E. Angus, & J. McLeod (Eds), The handbook of narrative
and psychotherapy. Practice, theory and research. London: Sage.
Pote, H., Stratton, P., Cottrell, D., Shapiro, D., & Boston, P. (2003).
Systemic family therapy can be manualised: Research process
and findings. Journal of Family Therapy, 25, 236262.
Redekop, F. (1995). The problem of Michael White and Michel
Foucault. Journal of Marital and Family Therapy, 21(3),
309318.
Roberts, G., & Holmes, J. (Eds). (1999). Healing stories. Narrative
psychiatry and psychotherapy. Oxford: Oxford University Press.
Roth, A., & Fonagy, P. (Eds). (1996). What works for whom? New
York: Guildford.
Roy-Chowdhury, S. (2003). Knowing the unknowable: What
constitutes evidence in family therapy. Journal of family therapy,
25, 6485.
Salkovskis, P.M. (1985). Obsessionalcompulsive problems: A
cognitivebehavioural analysis. Behaviour Research & Therapy,
23(5), 571583.
Copyright 2010 John Wiley & Sons, Ltd.
497
Sarbin, J. (1986). Narrative psychology: The storied nature of human
conduct. New York: Praeger.
Schafer, R. (1992). Retelling a life: Narration and dialogue in psycho-
analysis. New York: Basic Books.
Smith, L.T. (1999). Decolonising methodologies: Research and indig-
enous peoples. Dunedin: University of Otago Press.
Smith, C., & Nylund, D. (Eds). (1997). Narrative therapies with
children and adolescents. New York: The Guilford Press.
Smith, B., & Sparkes, A.C. (2006). Narrative inquiry in psychol-
ogy: Exploring the tensions within. Qualitative Research in
Psychology, 3, 169192.
Spence, D. (1982). Narrative truth and historical truth: Meaning and
interpretation in psychoanalysis. New York: Norton.
Stainton Rogers, R. (1995). Q methodology. In J.A. Smith, R.
Harre, & L. Van Langenhove (Eds), Rethinking methods in
psychology. London: Sage.
Tabachnick, B.G., & Fidell, L.S. (2001). Using multivariate statistics
(4th ed.). Boston: Allyn and Bacon.
Tomm, K. (1989). Externalising problems and internalising per-
sonal agency. Journal of Strategic and Systemic Therapies 18(1),
1632.
Tomm, K. (1993). The courage to protest: a commentary on
Michael Whites work. In S. Gilligan, & R. Price (Eds),
Therapeutic Conversations. New York: Norton.
Vetere, A., & Dowling, E. (Eds). (2005). Narrative therapies with
children and their families. A practitioners guide concepts and
approaches. London: Routledge.
Wallis, J.M., Burns, J., & Capdevila, R. (2009). Q methodology
and a Delphi Poll: A useful approach to researching a narra-
tive approach to therapy. Qualitative Research in Psychology, 6,
118.
Watts, S., & Stenner, P. (2005). Doing Q methodology: Theory,
method and interpretation. Qualitative Research in Psychology,
2(1), 6791.
Weingarten, K. (1998). The small and ordinary: The daily prac-
tice of a postmodern narrative therapy. Family Process, 37(1),
315.
White, M. (1992). Deconstruction and therapy. In D. Epston, &
M. White (Eds), Experience, contradiction, narrative & imagina-
tion: Selected papers of David Epston & Michael White 19891991.
South Australia: Dulwich Centre Publications.
White, M. (1995). The narrative perspective in therapy. In M.
White (Ed.), Re-authoring lives: Interviews & essays. Adelaide:
Dulwich Centre Publications.
White, M. (2001). The narrative metaphor in family therapy. In D.
Deneborough (Ed.), Family therapy: Exploring the fields past,
present and possible futures. Adelaide, South Australia: Dulwich
Centre Publications.
White, M. (2007). Maps of narrative practice. New York, NY: WW
Norton & Co.
White, M., & Epston, D. (1990). Narrative means to therapeutic ends.
New York: Norton.
Zimmerman, J.L., & Dickerson, V.C. (1994). Using a narrative
metaphor: Implications for theory and clinical practice. Family
Process, 53, 233245.
Clin. Psychol. Psychother. 18, 486497 (2011)