Theories of Change Underlying Constructivist Therapies

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Table of Contents

Constructivism
Constructivist Theory
The Purpose of a Clinician in Constructivist Healing
Narrative Method
Narrative Therapy Philosophy
Criticism of Narrative-Focused Method
Solution-Focused Therapy
Use of Questions
Conclusion
References

Constructivism

Constructivism is an approach used to gain insight into an individual’s psychology and to initiate change in a person (Berg, 1994). Today, it influences many techniques of psychotherapy by concentrating on an individual’s inner and outer mechanisms of constructing meaning.

Constructivism is not based on a particular theory or method. Rather, it is a combination of several forms of psychotherapies and methods including existential-humanistic and cognitive-behavioral therapies, and psychoanalysis. It also includes other techniques used to transform family dynamics (Berg, 1994).

Today, many psychotherapy approaches are based on constructivism and they range from solution-focused approaches to narrative methods (Simon, 2009). Each of these methods utilizes different approaches and mechanisms to achieve healing (Simon, 2009).

Constructivist Theory

Constructivism is based on the notion that individuals will understand his environment well by contemplating the occurrences in their personal lives. Each individual has a clear set of dimensions and thought systems which they apply in their daily lives (Guteman, 1994). Constructivism healing is concerned with the sense-creating system which individuals utilize to comprehend occurrences in their lives (Guterman, 1994).

Each person who attends a therapy session harbors a distinctive set of life experiences. An individual’s response to these life experiences determine the emotions, beliefs and attitude that he or she will carry through life (Guteman, 1994). The belief behind constructivism is that our knowledge of our surroundings is not based on objectives but rather on constructions, feelings, and convictions that we attach to our life experiences (Guteman, 1994).

The Purpose of a Clinician in Constructivist Healing

The role of a clinician in constructivist treatment is to infer how an individual’s reaction to past life experiences have influenced his or her present circumstance that is troubling the individual (Fish, 1993). The clinician does not view the client’s story as a reality. Instead, he or she presumes that the client’s current problem resulted from prior constructions from the client’s life experiences (Doan, 1998).

The clinician, therefore, engages the client in order to generate the occurrence-thought-reaction chains formed by the client in the past and which are more likely to underlie his present or future conditions (Doan, 1998).

Narrative Method

Narrative approach is a kind of psychotherapy that utilizes narrative. This method was conceived between 1970 and 1980 mainly by Michael White from Australia and David Epston of New Zealand (White & Epston, 1990).

Narrative therapy involves the client working together with the therapist. During the process, the therapist will pose some questions to the client designed to generate positive and detailed stories of the client’s personal life experiences that do not form part of his or her problem.

The aim of the narrative method is to detach individuals from elements that are assumed to be essential part of the person but which are not in reality. This technique is known as externalization (Etchison & Kleist, 2000). The purpose of externalization is to enable people to figure out their association with their problems.

The maxim of narrative form of therapy is that ‘‘the person is not the trouble but rather the trouble is the trouble.’’ In the process, the positive qualities of an individual are externalized to enable him or her visualize an aspired identity.

Essentially, the narrative method entails deconstructing old meanings and constructing new ones in order to imagine what is considered as an individual’s ideal identity. This is achieved through quizzing and working with the client.

Narrative Therapy Philosophy

The perspective of narrative treatment is that our identities are built around our life stories as found in anecdotes. The goal of a narrative clinician is to aid clients in describing accounts in their lives and how they relate to them. The narrative method helps individuals to view problems as influences on their lives but not as intrinsic components of their lives (Fish, 1993).

This is useful for establishing distance between problems and the lives of individuals. By making problems an extrinsic factor, it becomes simpler to analyze the influence that problems have on our lives (White & Epston, 1990).

There is yet another form of externalization that takes place in narrative therapy. This kind involves mulling over one’s motives, values, allegiances, and hopes. Examination of these elements can help to re-write individuals’ life experiences making them more problem-resistant (Doan, 1998).

The word ‘‘narrative’’ refers to our identity complex as constructed from our life experiences. Some ways of reconstructing this complex is by rewriting our beliefs about values and reminiscing discussions with important people (White, 2007). These are just some of the ways of recovering our lives from problems.

Criticism of Narrative-Focused Method

Narrative therapy has been criticized on various grounds. First, it is viewed as being too theoretical and methodical as opposed to being a practical form of treatment, making its effectiveness questionable (Etchison & Kleist, 2000). Second, the healing approach has been accused of subscribing to the theme of social construction theory that there exist no absolute truths (White, 2007).

The therapy has also been accused of ignoring the fact that therapists themselves are subject to biases which could make the treatment ineffectiveness. Finally, there is lack of clinical and empirical evidence to support the contentions of the narrative method (White, 2007).

Solution-Focused Therapy

Solution-focused treatment is a kind of ‘‘talking’’ therapy (Berg, 1994). This form of therapy is based on social construction theory. The method concentrates on clients’ aspirations instead of the problems that drove them to seek treatment. The concern of this method is the present and future situation. In this approach, the clinician enquires about the client’s life accounts and perceived strengths (Simon, 2009). The aim of the therapist in making this inquiry is to help clients imagine their desired future (Guterman, 1996).

The philosophy of solution-focused therapy is that change is continuous (Thorana, 2007). The method helps individuals to determine elements in their lives which they would like to be changed and those issues in their lives that they would wish to continue as they are (Guteman, 1994).

This approach is concerned mainly with two issues: The first is aiding people to discover their aspired future while the second is to determine which parts of the desired ideal future are already taking place at present (Thorana, 2007). Social-focused therapy is largely practical and it does not require a theoretical background.

Use of Questions

Solution-focused therapy employs questions to help clients imagine how a problem-free future would look like (Simon, 2009). There are various types of questions used by therapists in this case. One form is scaling questions which are designed for establishing significant distinctions for the client as well as setting goals. Another form of questions used in this therapy is exceptions-searching questions (Thorana, 2007).

These are utilized to when the client exhibits no apparent problems but, nevertheless, wishes to improve on his current conditions. The third type of questions is coping questions. These are meant for generating information regarding the clients’ strengths. Lastly, there is the problem-free talk technique which is used to relax the client and also to identify strengths (Thorana, 2007).

Conclusion

Constructivism is a very significant approach used in counseling and psychotherapy today (Guteman, 1994). This method involves gaining insight into a person’s psychology in a bid to initiate positive change (Fish, 1993). The constructivist theory holds that problems are not real but instead they are psychological constructs created by one’s environment (White, 2007).

Some variants of this approach are the solution-focused and narrative-based therapies. Some critics of constructivism have argued that it is too theoretical and it lacks empirical evidence to support it (Doan, 1998). The major pioneers of this concept include Michael White, David Epston, and Michael Mahoney.

References

Berg,K. (1994). Family based services: A solution-focused approach. New York:Norton.

Doan, R. (1998). ‘‘The King is Dead: Long Live the King: Narrative Therapy and Practicing What We Preach’’. Family Process, 37(3), 379-385.

Etchison, M., & Kleist, D. (2000). ‘‘Review of Narrative Therapy: Research and Review’’. Family Journal, 8(1), 61-67.

Fish, V. (1993). ‘’Post Structuralism in Family Therapy: Interrogating the Narrative/Conversational Mode’’. Journal of Family Therapy, 19(3) 221-232

Guterman, J. T. (1994). ‘‘A social constructionist position for mental health counseling’’. Journal of Mental Health Counseling, 16, 226-244.

Guterman, J.T. (1996). ‘‘Doing mental health counseling: A social constructionist re-vision’’. Journal of Mental Health Counseling, 18, 228-252.

Simon, K. (2009). Solution focused practice in end-of-life and grief counseling. New York: Springer Publication.

Thorana, S. (2007). Solution-focused brief practice with long-term clients in mental health services: I’m more than my label. New York: Taylor & Francis.

White, M. & Epston, D. (1990). Narrative means to therapeutic ends. New York: WW Norton.

White, M. (2007). Maps of narrative practice. New York: W.W. Norton.

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