Narrative process modes as a bridging concept for the ...

r The Association for Family Therapy 2005. Published by Blackwell Publishing, 9600 Garsington Road, Oxford OX4 2DQ, UK and 350 Main Street, Malden, MA 02148, USA. Journal of Family Therapy (2005) 27: 202–216 0163-4445 (print); 1467-6427 (online)

Narrative process modes as a bridging concept for the theory, research and clinical practice of systemic therapy

Aarno Laitila,a Jukka Aaltonen,b Jarl Wahlstro ¨ mc d and Lynne Angus This article is concerned with the relationships which hold between the clinical practice and the theory of family therapy; and between these and academic research. These relationships are seen as tenuous and thin because, in the first place, there is a lack of rigorous theoretical underpinning; and second, the research methods employed do not fit in with current family therapy practice, and with the theory that underlies this practice. The role of the concept of narrative process modes is proposed as a bridging and mediating one. The external, internal and reflective narrative process modes are seen as relevant from the point of view of family therapy process research, and the clinical practice of marital and family therapy.

Introduction A repeated subject of concern in family therapy is the thin relationship between theory research and clinical practice (Pinsof and Wynne, 2000; Sprenkle and Ball, 1996; Wynne, 1988). None of these areas has been able to benefit very much from either of the others. The reasons for this situation, and possible solutions for it, should be sought from all three of these sources. We will begin this article by discussing the question of the thin relationship between theory and practice; and we will explore various aspects of theory, research and clinical practice. Second, we will a Lecturer at the University of Jyva¨skyla¨, Department of Psychology, PO Box 35, FIN40014 University of Jyva¨skyla¨, Finland. E-mail: [email protected]. b Professor of Family Therapy at the University of Jyva¨skyla¨, Department of Psychology. c Professor at the University of Jyva¨skyla¨, Department of Psychology. d Associate Professor at York University, Department of Psychology, North York, Ontario, Canada.

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discuss the advantages that we believe the narrative process theory of therapeutic change can provide. Finally, we discuss research opportunities providing a case study as an example, and suggest the direction clinical practice might take in the future. The thin relationship One possible source of the above-mentioned tenuous relationship between theory and practice is the eagerness of therapists to seek guiding metaphors from very far-removed areas of science such as biology, mechanics or physics. This was already apparent in the 1960s in Minuchin’s early work, and his fascination with Zen Buddhism and aesthetics (Minuchin, 1966). In the field of psychology this tendency had already been criticized in the 1920s by Vygostky (1997), who also noted the complicated relationship between theory and practice: ‘Every natural-scientific concept, however high the degree of its abstraction from the empirical fact, always contains a clot, a sediment of the concrete, real and scientifically known reality . . . even the most immediate, empirical, raw, singular natural scientific fact already contains a first abstraction’ (1997, pp. 248–249). It has also been popular to adopt the theoretical concepts of philosophy, and to use them in the context of clinical practice to describe family interaction. Thus the empirical basis of family therapy research and clinical practice of family therapy have been marginalized, and clinically informed concepts have remained secondary: ‘It is no secret that theory (often ‘‘armchair’’ theory) has far outstripped the field’s ability to authenticate it’ (Sprenkle and Ball, 1996, p. 392). Pinsof and Wynne (2000) similarly discuss the situation of outcome research. The problem with outcome research is, according to Pinsof and Wynne, that it has very little to offer practising clinicians: the clinicians cannot take advantage of the research findings since they are not presented in a way that is close to the clinicians’ experience. The research findings (e.g. the finding that two-thirds of all clients can benefit from a certain treatment) are too general to be applied in clinical practice. Their recommendation is to study eclectic, integrative and multimodal therapies in the clinical context in order to move effectiveness research closer to reality of couple and family therapy practice. They claim that the problem is in the way change is conceptualized in family therapy. Different aspects of change (first and second order, interaction/behaviour and semantic) have not been grounded empirically. They suggest that therapy should be seen as r 2005 The Association for Family Therapy and Systemic Practice

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a joint learning process, and no longer as a scientific experiment. A typical guiding metaphor in (experimental or quasi-experimental) outcome research is the drug metaphor (Stiles et al., 1995). Pinsof and Wynne argue for the need of process research to develop the rigour of the experimental method. Another possibility is to search for new guiding metaphors for research (e.g. learning) (Pinsof and Wynne, 2000), or developmental process (Leiman, 2004; Stiles et al., 1995). The theory of narrative and reflective therapy, as well as other postmodern approaches, claims to emphasize contextual, local, unheard, unvoiced or marginalized knowledge, minimal exceptions to rules and/or unique outcomes (e.g. Andersen, 1997; Anderson, 1996, 1997; de Shazer, 1985; Goolishian and Anderson, 1992; Smith and Nylund, 1997; White and Epston, 1990) instead of the grand narrative, or scientific, universal knowledge. In this the theory adapts the perspectives of expertise research, and the idea of new or second expertise (e.g. Gibbons et al., 1994). The project of dissolving the grand narrative, however, seems to have become a grand narrative in itself (Alvesson and Sko ¨ldberg, 2000; Lawson, 1985). This same problem has been visible in the field of philosophy, and in other fields of enquiry involving reflectivity – discourse which selfconsciously refers to itself – and which may even demand reflectivity, as is obvious in the cases of Nietzsche, Heidegger and Derrida (Lawson, 1985). In this connection, Latour (1988) ends by asking whether social scientists are not sawing the branch upon which they sit. This claim is not valid in the entire field of family therapy (e.g. attachment theory has been adapted to a guiding theory in some approaches (Byng-Hall, 1995)). This provides more possibilities to operationalize theory in a more straightforward way in the context of research. This however does not eliminate the uniqueness of the process of each therapy. The way in which case histories are presented in scientific writing also favours macro-level knowledge and the possible challenge to grand narratives. Minuchin (1999) strongly criticizes narrative therapies for abandoning family and family interaction for the political aims of therapy. This also emphasizes the meaning of a more general level of knowledge. The reauthored identity story challenges general (scientific or logico-scientific knowledge, according to White and Epston, 1990) knowledge with its predictive value and the idea of therapeutic liberation has clearly a political (or even ‘messianic’) connotation (Alvesson and Sko ¨ldberg, 2000; Johnson, 2001; r 2005 The Association for Family Therapy and Systemic Practice


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Minuchin, 1999). The meaning and value of locality is questioned. ‘Thinking globally’ seems to overshadow ‘acting locally’. For example, the Beck Depression Inventory (BDI) (Beck et al., 1979) is a measure used widely for outcome research with different therapeutic orientations. It is a measure which was developed with the cognitive theory of depression in mind. The questions included in the inventory deal with cognitions, beliefs, emotions and behaviours connected with depression as it is conceived of by cognitive therapy. There is a unity of theory, clinical practice and research apparent here. In the area of family therapy there is a need for research tools of this kind. This is where Pinsof and Wynne (2000) hit the nail on the head: even therapeutic change is conceptualized so vaguely that it is very difficult to do research that is congruent with the theory of family therapy. There remains the need to elaborate different dimensions of change, namely interactive/behavioural, emotional and semantic. It is also possible to see through more partial change processes instead of the global therapeutic change, as it is done in the assimilation model (Laitila and Aaltonen, 1998; Stiles et al., 1995). Many of the micro-level methods of analysis have been developed within traditions other than family therapy research, or even psychotherapy research. Conversation analysis, for example, has an interpretation frame of its own. It cannot be taken for granted that all the research traditions of the social sciences can be usefully transferred to the domain of family therapy research. Clinical practice may also sometimes be described in terms which are extremely hard to verify. Sprenkle and Ball (1996) even claim that the field of family therapy is still too often dominated by charismatic clinicians: teachers whose ideas have rarely been empirically tested with anything approaching scientific rigour. A new way of thinking in family therapy research may be seen in certain ethnographic approaches. In ethnography it is common to use an approach which takes as its starting point the processes seen from within (Latour and Woolgar, 1986). These researchers have a good knowledge of family therapy and are familiar with the use of empathy as a research strategy. This adds something to ethnography and ethnomethodology (Heritage, 1984). The need for information based on firm evidence of the effectiveness of the various forms of clinical practice is important to those who send their clients for therapy, fund therapies, and make political decisions on the importance of different therapies, and on health policy (Dallos and Draper, 2000; Gingerich and Eisengart, 2000). The r 2005 The Association for Family Therapy and Systemic Practice

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role of this audience for research findings has dominated the entire field of outcome research. The main answer from the clinicians’ perspective does not lie in the development of outcome research, however. Concentrating on only this would be a first-order change, ‘more of the same’-type solution. There is a need for second-order change (i.e. a different understanding of the research). The development of outcome research on its own leads nowhere. Narrative process modes The question arises as to what kind of research meets the needs of clinicians and therapists involved in family therapy training. What is needed to promote evaluation during the therapy process? In this article we suggest that one possible solution is in the development of tools and concepts which promote dialogue between researchers, theorists and clinicians. The term ‘narrative process modes’ is used in this article to refer to ‘ways or modes of inquiry or cognitive/affective processes through which a) clients strive to understand themselves and b) clients and the therapists co-construct understanding during therapy sessions’ (Laitila et al., 2001, p. 310). From the viewpoint of narrative processes, productive therapy consists of three different kinds of narrative sequences (Angus et al., 1999; Laitila et al., 2001): internal, external and reflexive. 1 External narrative sequences consist of different descriptions of life events, and provide descriptions of current events (e.g. ‘Today, as I left home for therapy, I forgot the keys inside’). 2 Internal narrative sequences undertake a detailed unfolding and exploration of associated perceptions, sensations and emotions such that the lived experience of the events may be engaged and perhaps articulated for the first time (e.g. ‘As I noticed what had happened I felt totally helpless, and outraged at the same time, like a little child’). 3 Reflexive narrative sequences refer to the client and therapist’s shared, mutual and reciprocal analysis of experiences and the generation of meanings. This is done in order to generate new meanings which either support or challenge previously held beliefs about the self and others (e.g. ‘In the bus I found myself wondering what’s happening in me: I forget things, I become totally overwhelmed by feelings I never knew existed in me, and wonder what’s next’). r 2005 The Association for Family Therapy and Systemic Practice


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From the point of view of narrative family therapy and research, it is other types of narrative (Angus and Hardtke, 1994) rather than narrative processes which are dominant: in particular the macronarrative and micro-narrative. The macro-narrative (1), as an autobiography-like identity story; and even micro-narrative (2), as the description of a single event (e.g. with a unique outcome) given during a therapy session are easier to integrate into narrative thinking as whole. Identity stories tend to become macro-narratives. The narrative process modes (3), which characterize the interaction between therapist and client, tend to be ignored in the research results. Narrative in the first and second meanings is mentioned in the literature in the context of case reports and case studies. Epston (1997) gives an example of a case where the therapist takes a detail, the boy’s name, and uses this as the starting point of a new macronarrative, with a totally new perspective compared to the former identity story. The unique outcome, one key concept of the original narrative model, is typically embedded in a micro-narrative (White and Epston, 1990). This unique outcome is first located (usually in a very therapist-driven way) in the larger context of a macro-narrative in order to give the opportunity for a new identity story. This approach has also been used in family therapy research (e.g. Holma, 1999). However, family therapy researchers do not describe the concept of narrative processes, even though it would be helpful to show how different therapeutic actions and different descriptions of events are dealt with (or processed) in therapy sessions in order to become a part of the identity or the macro-narrative. Where do these narrative process modes – external, internal and reflective – come from, and what is their relevance in the context of family therapy? Behaviour, experience and meanings are more or less available in a family therapeutic interview. These clinically informed dimensions are present, e.g. in Brown (1997): behaviours, feelings, beliefs, meaning and relationship, and in White (1993): landscape of action and landscape of consciousness. The bridging or mediating role of the narrative processes is in the possibility of analysing therapeutic conversation, its contents, its quality, its dialogical aspects, as well as the conversational context. These differing aspects of therapeutic conversation are also the basic dimensions in family therapy. They deal with verbal descriptions of actual behaviour; with feelings and emotions as well as with the reflective processing of the previously named dimensions. They are a pathway to knowledge of the third kind (i.e. knowing from the r 2005 The Association for Family Therapy and Systemic Practice

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relationship) (Shotter, 1986). For a beginning therapist they provide a handy tool to differentiate some basic aspects of conversation regardless of the therapeutic orientation. For example, Minuchin et al. (1996) emphasize in the context of supervision the importance of being able to differentiate the content and process aspects of therapy. The therapeutic context allows the researcher to be sensitive (e.g. to shifts in therapeutic dialogue). Is the therapist introducing a new way of processing in order to create reflective space, or is she too eager to move on while the client/s might still be describing the situation itself? Clinicians can be sensitive to the interactional process whether this takes the form of a dialogue or turns into a monologue (Seikkula, 2002). The researcher can derive theoretical concepts from the data (i.e. the conversational level of therapeutic interaction), so that these concepts may be both clinically informed and grounded in data. To do this it is useful to apply the principle of constant comparison of data-oriented methods (e.g. grounded theory) (Alvesson and Sko ¨ldberg, 2000; Glaser and Strauss, 1967). Thus the adopted theory may be used to test and challenge existing theory. To illustrate some of the developments that may come from these views we shall describe a particular case. The aim is to study (1) the therapeutic dialogue, (2) the research into the dialogue, and (3) the usefulness and potential of the concept of narrative process modes as a bridging concept, as a tool of research, as an organizing tool of clinical practice, and as a basis of orientation for the therapist as she interviews a couple, a family, or the members of a social network.

An illustrative case Therapy, therapists and the case material The data for this case example were collected during a training process for advanced specialist level in marital and family therapy. A more detailed description of the study may be found in Laitila (2004). The interviewing therapist in the session analysed was a male child psychiatrist in his late forties. In all the sessions included in the overall study, the therapy team discussion was organized as a mixture of the principles of the Milan style and open reflective discussion (Friedman, 1995). In this context the therapist in charge worked according to his personal style and preferences. The material involved in this illustration was abstracted from data used first in discourse analytic study designed to investigate r 2005 The Association for Family Therapy and Systemic Practice


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semantic change in family therapy (Wahlstro ¨m, 1992). The data used consisted of the first therapy session with a couple who had marital problems, including the threat of divorce. They had been married for five years. The couple and all the therapists gave their informed consent for the data to be used as the research material. The raw data consisting of transcripts of the initial interview amounted to seventeen pages. The transcription was carried out in order to meet the requirements of the Narrative Processes Coding System (NPCS) methodology, which is not as detailed as the transcription required for conversation analysis. This marital therapy session was coded using the NPCS methodology (Angus and Hardtke, 1994; Angus et al., 1996, 1999; Laitila et al., 2001). The transcripts were first categorized according to their content areas, or more precisely according to the detailed elaboration of the aspects of a content area known as topic segments. Second, these topic segments were divided according to narrative sequence type into external, internal and reflective modes. The first author was trained to use the coding system in an intensive two-week seminar and through continuous personal consultations with the author of the method (Angus). The analysis concentrated on the therapist’s role in initiating shifts to the reflective mode into the conversation. The principle of constant comparison of the data-oriented qualitative methodology was applied, and we present the samples of analysis in the order in which the analysis was originally carried out. We have chosen the very first segment of the therapy session for our micro-analysis, because the importance of beginning the therapy process in the context of family therapy has been overlooked in family therapy research. Our conclusions apply only to the formation of joint reflection and to the questions arising from this; not to the entire therapy process, or to the outcome. An illustration of the application The following examples show a therapist trying to get a married couple to reflect on the meaning of the wife’s idea that their entire marriage is in a constant state of crisis. The shift of narrative process mode is showed with/. Family nr 5/1st session/lines 57–85 M: We’ve been thinkin’ about the divorce and neither of us seems to know if we should get it or not. Should we stay together. r 2005 The Association for Family Therapy and Systemic Practice

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Th: And that’s . . . is it because of it that you’re now here, considering the divorce. Umm. Is this a new situation, or have you been thinkin’ about it a longer time, has there been a crisis? M: Since the turn of the year. W: I guess it’s been kind of crisis all the time. Th: Uhm, and how long have you now been married. M: It’ll be five years this autumn. Th: That means that you were 20 years old when you got married. W: Actually I was 19 then. Th: And you were been about 27? All right./She says it’s been a kind of crisis all the time. What do you think she means by that? M: Well I don’t think so. That’s not how I see it. Th: You don’t agree. What is it . . . . What do you think then that she means when she says that hasn’t this been a kind of crisis all the time? M: I don’t know. Th: What do you imagine she means? M: I can’t tell. Th: You can’t tell. What do you think then, is it true that your husband doesn’t really know what you mean when you say that it’s crisis all the time? W: I don’t know, it’s been almost continual fightin’.

The therapist is asking about the reasons for the couple’s attending therapy (content and plot). All this is done in the external narrative process mode. As the therapist comes back to the idea of crisis, using the wife’s exact words for it, he makes a shift to the reflective mode for the first time (line 71). The end of this effort is the wife’s referring to the fighting and the conversation shifts back to the external mode. The therapist’s effort may be seen as a suggestion to the couple as to how the issue could be discussed differently. For some reason the couple are not ready to do this yet, and the therapist is sensitive enough to listen to the line the couple are ready to follow. This brief example shows how the therapist’s effort to bring novelty into the conversation with an open question (in the form of a change of perspective: from description to reflection) leads to a narrowing of it. The concept of narrative process mode makes visible the quality of the therapist’s invitation, and the couple’s response. What emerges if we take alternative theoretical perspectives? It is at least possible, without the danger of overinterpretation, to say that this quite orderly therapeutic conversation was in danger of turning into unfruitful argument. This may be described as a monologue in which every participant of the conversation follows only the lead of r 2005 The Association for Family Therapy and Systemic Practice


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her or his own, without listening to the others. This danger was present in spite of the fact that the therapist was making a linguistic link, as a means of structural coupling, between the wife’s utterance and his own initiative (‘She says it’s been a kind of crisis all the time’). The previously discussed episode also shows how the technically and theoretically correct ‘intervention’ was both informative and formative (Andersen, 1995). The therapist is informed of the couple’s hesitation over moving towards analysing their communication and reflecting on it, as well as of the premature nature of his own initiative: the issue of timing is thus highlighted, both in the plot and in the process. The therapist chose the time definition of the wife to move into reflection (line 65) instead of the husband’s (line 64). Thus he chose to consider eternity instead of a time period shorter than a year. This emphasizes the complexity of a client-centred focus and orientation. The conscious choice of collaborative practice to discuss with one person at a time without encouraging interaction, as Anderson (1997) recommends, is, in fact, an intervention. This meant that while responding to, confronting and challenging the wife’s abstract definition the therapist lost the opportunity to search for sequences, changes, different punctuations, exceptions and unique outcomes from the period of less than a year. The formative process acts to move the therapist in a symmetrically escalating position towards the couple: distance was thus restored to a level tolerable from the couple’s point of view, and more acts of joining are needed from the therapist’s side. The question of timing is in itself quite an abstraction. By making constant comparisons within the data it was possible to gain an idea of the issues involved even at the very beginning of the session. If we move back in the transcripts and look at the conversational context of the previous illustration, we can investigate the question in a more practical way. Family nr 5/1st session/lines 25–43 Th: You had also . . . . You managed to make contact, but then you had some difficulties finding this place. How did it happen? M: We visited this place once and they didn’t know about this (clinic). They told us to go to X street. Th: All right umm, did you go to this floor, or was it downstairs where you were advised to go or? M: It was at the other end (of the block). Th: So it wasn’t here in this building?


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M: No, it was there in the white one. Th: Umm, yes, all right. And then you drove to x street and . . . . W: And then we came back again. Th: And so what happened was you kind of lost half an hour with this kind of cruisin’ around./How did it feel, what kind of feelings did you have as you noticed that here we are drivin’ around? M: No,/we just thought that it was wrongly marked on the map, the place on it.

This sample from the earlier phase of the session shows how the subject of timing had been present in the session during the first minutes of discussion. The conversation proceeds in external narrative process mode nearly all the time. At the end (line 39), the therapist makes an effort to reflect on the couple’s feelings by asking an internal process mode-oriented question. These two efforts (in lines 39 and line 71) to shift the conversation into a different mode are therapeutic movements which failed to lead to joint reflection on the issue. They show how the plot of timing, which started from the delayed beginning of the session, is central, and has continued significance throughout the lines that follow. Family nr 5/1st session/lines 145–163 Th: And how new is this idea of divorce exactly? When was it said aloud for the first time? M: I guess it’s about a year . . . for one year. Th: Which one of you said it aloud first? W: It was me. Th: /Was it a surprise for you when she said that . . . M: Actually yes. Th: By saying, let’s get divorced, you surprised your husband. W: I really can’t believe it. Th: Umm, but he says however that it was a kind of surprise . . . had you been thinking it over for a long time before you said it aloud? W: I looked at that jerk for a while and thought that this is not gonna work. Th: What does it mean that we just keep on fightin’ and nothing is gonna work . . . describe a little . . . how, about what.

In this third sample the conversation has continued for a little longer. From line 150 there is visible for the first time some joint reflection on the idea of the couple’s marital crisis and the idea of divorce. Now it is the husband’s definition of time which dominates. Thus the couple’s quarrelling becomes more central, instead of the symmetrical escalation in relation to the therapist. r 2005 The Association for Family Therapy and Systemic Practice


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The repeating topic of time sequences forms a conversational context for the presentation of the couple’s marital difficulties. This context was already established before the session began, as the couple arrived late and the beginning was delayed.

Discussion According to the authors (Angus and Hardtke, 1994; Angus et al., 1996, 1999) of NPCS, NPCS coding may be applied both quantitatively and qualitatively. The validity of the coding has been tested and found to be quite high. In our study the system was applied in a single-case context in order to show, in a data-informed way, that it was possible to establish connections between the actual analysis and the theory of family therapy, as well as clinical practice. The actual interest is theoretical and methodological, and thus this issue of validity is not highlighted. In spite of this, the validity may be evaluated by procedures which follow the standard principles of qualitative research, and will be found to be trustworthy (Lincoln and Guba, 1985). Thus the reader may be able to ask whether, in the light of the data, the theme of ‘timing’ was a credible reconstruction of actual data and if it meets the need for credibility. The interpretive process has been presented as openly as possible in order to allow the reader to make her own judgement on this point (Stiles, 1993). The components of transferability, dependability and confirmability are more theoretical in this study, since the focus of the study is not on generalizing the results to the overall theory of family therapy. The bridging and mediating role of the narrative processes became visible in this study. The study actualizes the various possibilities for moving between the micro- and macro-analytic levels of analysis; and in this particular case, between the level of action and the conversational level: one theme of the therapeutic conversation was highlighted in this study. This was done in a data-informed way, in a way which is close to the experience of clinicians (and, in many cases, close also to therapeutic orientation). Narrative process modes allow analysis both in micro-analytic level when the narrative process type is recognized, and in macro-analytic level when the development of specific narrative themes (i.e. topic segments) is followed through the entire therapeutic process. This shifting between different levels of analysis also allows us to follow both the role of the therapist and that of the clients in this development. r 2005 The Association for Family Therapy and Systemic Practice

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For research purposes it is possible to select further levels of abstraction in a clinically informed way, and to ‘consult the data’ with conclusions. Thus the focus of this choice can be the purpose of analysis, whether it is feedback in a supervision or training situation, or the forming or questioning of theory. The therapist or the supervisor can orient himself to listen more carefully to the direction being taken by a conversation, whether all the participants are in the same narrative process mode or not. In the training context this serves the trainee in order to differentiate the content aspect and the meaning aspect as well as the position of the therapist in the interaction.

Acknowledgements The Nordic Academy for Advanced Study (NORFA) and the Finnish Academy made it possible for the first author to participate in the Semiosis in Psychotherapy seminar held in Valamo Monastery, Finland, in 1996, and thus to learn the course and contents of the NPCS. Our thanks to them. We also wish to acknowledge the contribution of the reviewers of the Journal of Family Therapy for their helpful comments concerning the manuscript. Parts of the analysis were presented to the annual meeting of the Society for Psychotherapy Research, June 2003, Weimar, Germany.

References Alvesson, M. and Sko ¨ldberg, K. (2000) Reflexive Methodology: New Vistas for Qualitative Research. London: Sage. Andersen, T. (1995) Reflective processes; acts of informing and forming: you can borrow my eyes, but you must not take them away from me! In S. Friedman (ed.), The Reflecting Team in Action. Collaborative Practice in Family Therapy. New York: Guilford Press. Andersen, T. (1997) Miserere nobis: a choir of small and big voices in despair. In C. Smith and D. Nylund (eds) Narrative Therapies with Children and Adolescents. New York: Guilford Press. Anderson, H. (1996) A reflection on client–professional collaboration. Families, Systems & Health, 14: 193–206. Anderson, H. (1997) Conversation, Language, and Possibilities; A Postmodern Approach to Therapy. New York: Basic Books. Angus, L. and Hardtke, K. (1994) Narrative processes in psychotherapy. Canadian Psychology, 35: 190–203. Angus, L., Hardtke, K. and Levitt, H. (1996) The Narrative Processes Coding System: A Revised Manual. North York: York University, Department of Psychology. r 2005 The Association for Family Therapy and Systemic Practice


215

Angus, L., Levitt, H. and Hardtke, K. (1999) The Narrative Processes Coding System: research applications and implications for therapy. Journal of Clinical Psychology, 55: 1255–1270. Beck, A. T., Rush, S. J., Shaw, B. F. and Emery, G. (1979) Cognitive Therapy of Depression. New York: Guilford Press. Brown, J. E. (1997) The question cube: a model for developing question repertoire in training couple and family therapist. Journal of Marital and Family Therapy, 23: 27–40. Byng-Hall, J. (1995) Rewriting Family Scripts: Improvisation and Systems Change. New York: Guilford Press. Dallos, R. and Draper, R. (2000) An Introduction to Family Therapy. Systemic Theory and Practice. Buckingham: Open University Press. de Shazer, S. (1985) Keys to Solution in Brief Therapy. New York: W.W. Norton. Epston, D. (1997) ‘I am a bear’: discovering discoveries. In C. Smith and D. Nylund (eds), Narrative Therapies with Children and Adolescents. New York: Guilford Press. Friedman, S. (ed.) (1995) The Reflecting Team in Action. Collaborative Practice in Family Therapy. New York: Guilford Press. Gibbons, M., Limoges, C., Nowotny, H., Schwartzman, S., Scott, P. and Trow, M. (1994) The New Production of Knowledge. The Dynamics of Science and Research in Contemporary Societies. London: Sage. Gingerich, W. J. and Eisengart, S. (2000) Solution-focused brief therapy: a review of the outcome research. Family Process, 39: 477–498. Glaser, B. G. and Strauss, A. L. (1967) The Discovery of Grounded Theory: Strategies for Qualitative Research. New York: Aldine de Gruyter. Goolishian, H. A. and Anderson, H. (1992) Strategy and intervention versus nonintervention: a matter of theory. Journal of Marital and Family Therapy, 18: 5–15. Heritage, J. (1984) Harold Garfinkel ja etnometodologia (Garfinkel and Ethnomethodology). Jyva¨skyla¨: Gaudeamus. Holma, J. M. (1999) The Search for a Narrative – Investigating Acute Psychosis and the Need-adapted Treatment Model from a Narrative Viewpoint. Jyva¨skyla¨ Studies in Education, Psychology and Social Research, 150. Jyva¨skyla¨: University of Jyva¨skyla¨. Johnson, S. (2001) Family therapy saves the planet: messianic tendencies in the family systems literature. Journal of Marital and Family Therapy, 27: 3–11. Laitila, A. (2004) Dimensions of Expertise in Family Therapeutic Process. Jyva¨skyla¨ Studies in Education, Psychology and Social Research, 247. Jyva¨skyla¨: University of Jyva¨skyla¨. Laitila, A. and Aaltonen, J. (1998) Application of the assimilation model in the context of family therapy – a case study. Contemporary Family Tharapy, 20: 277– 290. Laitila, A., Aaltonen, J., Wahlstro ¨m, J. and Angus, L. (2001) Narrative process coding system in marital and family therapy: an intensive case analysis of the formation of a therapeutic system. Contemporary Family Therapy, 23: 309–322. Latour, B. (1988) The politics of explanation: an alternative. In S. Woolgar (ed.), Knowledge and Reflexivity. New Frontiers in the Sociology of Knowledge. London: Sage.


216


Latour, B. and Woolgar, S. (1986) Laboratory Life. The Construction of Scientific Facts. Princeton, NJ: Princeton University Press. Lawson, H. (1985) Reflexivity – The Post-modern Predicament. London: Hutchinson. Leiman, M. (2004) Vaikuttavuustutkimuksen pulmallisuus psykoterapiassa (The complexity of effectiveness research in psychotherapy, in Finnish). Duodecim, 120: 2645–2653. Lincoln, Y. S. and Guba, E. G. (1985) Naturalistic Inquiry. Beverly Hills, CA: Sage. Minuchin, S. (1966) Conflict-resolution family therapy. In G. E. Stollak, B. G. Guerney and M. Rothberg (eds), Psychotherapy Research. Selected Readings. Chicago, IL: Rand McNally. Minuchin, S. (1999) Where is the family in the narrative family therapy? Journal of Marital and Family Therapy, 24: 397–403. Minuchin, S., Lee, W-Y. and Simon, G. M. (1996) Mastering Family Therapy. Journeys of Growth and Transformation. New York: John Wiley & Sons. Pinsof, W. M. and Wynne, L. C. (2000) Toward progress research: closing the gap between family therapy practice and research. Journal of Marital and Family Therapy, 26: 1–8. Seikkula, J. (2002) Open dialogues with good and poor outcomes for psychotic crises: examples from families with violence. Journal of Marital and Family Therapy, 28: 263–274. Shotter, J. (1986) Speaking practically: Whorf, the formative function of communication, and knowing of the third kind. In R. L. Rosnow and M. Georgoudi (eds), Contextualism and Understanding in Behavioral Science. New York: Praeger. Smith, C. and Nylund, D. (eds) (1997) Narrative Therapies with Children and Adolescents. New York: Guilford Press. Sprenkle, D. H. and Ball, D. (1996) Research in family therapy. In F. P. Piercy, D. H. Sprenkle and J. L. Wetchler (eds) Family Therapy Sourcebook, 2nd edn. New York: Guilford Press. Stiles, W. B. (1993) Quality control in qualitative research. Clinical Psychology Review, 13: 593–618. Stiles, W. B., Shapiro, D. A., Harper, H. and Morrison, L. A. (1995) Therapist contributions to psychotherapeutic assimilation: an alternative to the drug metaphor. British Journal of Medical Psychology, 68: 1–13. Vygostky, L. S. (1997) The historical meaning of the crisis in psychology: a methodological investigation. In R. W. Rieber and J. Wollock (eds), The Collected Works of L. S. Vygostky. Volume 3, Problems of the Theory and History of Psychology. New York: Plenum Press. Wahlstro ¨m, J. (1992) Merkitysten muodostuminen ja muuttuminen perheterapeuttisessa keskustelussa (Semantic Change in Family Therapy. English abstract and summary). Jyva¨skyla¨ Studies in Education, Psychology and Social Research, 94. Jyva¨skyla¨: University of Jyva¨skyla¨. White, M. (1993) Deconstruction and therapy. In S. Gilligan and R. Price (eds), Therapeutic Conversations. New York: W.W. Norton. White, M. and Epston, D. (1990) Narrative Means to Therapeutic Ends. New York: W.W. Norton. Wynne, L. C. (ed.) (1988) The State of the Art in the Family Therapy Research. Controversies and Recommendations. New York: Family Process.
