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Demystifying Therapy II

Collins Nwabunike

Social Work 699

Family Therapy II: Post Structural Approaches

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Introduction

Collectively we participate in dominant discourses, and each shape our beliefs, intentions,

and actions (Combs & Freeman, 2013). It is therefore important for us to critically reflect on the

approaches that guide our therapy sessions, as they play a major role in challenging or

reproducing dominant discourses. Further, therapeutic approaches can affect the ways in which

our clients heal and view their presenting issue. In choosing approaches, we should be striving to

observe if they adopt a critical lens that considers a social justice approach. If we neglect to

purposefully bring a social justice lens into our therapeutic work, we do a harmful disservice to

our clients and disable our assumed position as social workers meant to be social justice

warriors. In my reflection on various therapies, I recognized both narrative therapy and just

therapy as holding important social justice concepts. For this paper, I will further delve into the

justice-oriented aspects of these theories as well as their implications for practice.

Defining Narrative Therapy

Narrative therapy works collaboratively with clients to construct alternative stories that

challenge dominant labels and discourses which often maintain a presenting issue for a client

(Carr, 1999). This therapy believes that people give meaning to their lives through stories and

assumes people carry with them various skills, competencies, abilities, beliefs, and values

(Morgan, N.D.; Combs & Freedman, 2012). Further, a narrative approach sees the client as the

expert in their own life and takes on a respectful and non-blaming perspective (Morgan, N.D).

Narrative therapy follows a post-structuralist view believing that there are no universal truths and

culture, language and discourse are integrated into the identity and experience of people in their

context (Combs & Freedman, 2012). These perspectives are especially important in social justice
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work, as they take the therapist away from the expert position, leaving room for often unheard

voices and stories to be brought forward. Further, they bring forth dominant structural discourses

that can negatively impact marginalized groups identities and realities.

Defining Just Therapy

Just therapy is a therapeutic approach that works to adequately address issues of culture,

gender, and socioeconomic disadvantage in therapy (Waldegrave & Tamasese, 1994). It was

pioneered by the Just Therapy Team, from The Family Centre in Wellington, New Zealand,

which consists of Warihi Campbell, Kiwi Tamasese, Flora Tuhaka and Charles Waldegrave

(Cambell, et.al 2001).

According to Waldegrave & Tamasese (1994), just therapy was never planned to be

developed. This therapy came about from working with the community and engaging in dialogue

that posed a variety of questions. By asking different questions, it led the team into working with

a broader range of colleagues, families, cultures and socioeconomic groups (Waldegrave &

Tamasese, 1994). This diversity was brought into therapy and resulted in a better awareness to

understand people’s problems in alternative ways (Waldegrave & Tamasese, 1994).

The Just Therapy team also noticed that families in crisis were often coming to them for

assistance with their mental health while experiencing ongoing social injustices such as poverty,

racism, and sexism (Cambell, et al. 2001). These were people marginalized by dominant

discourses, which resulted in their current state of crisis. Upon reflecting on this, the team

noticed how they may have been trained to only deal the immediate presenting clinical concerns

and had simply been adjusting people to problems made by social injustices (Cambell, et al.

2001).
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Challenging our Dominant Stories

Narrative and just therapy offer a strong window to social justice as they both work to

help clients challenge harmful dominant discourses and ideals, that infiltrate their own realities

and identities. Narrative therapy challenges dominant discourses by first deconstructing how the

client understands their life, the language practices they use, and power that resides in

relationships they are a part of (Carr, 1999). This first initial step means both client and therapist

can critically reflect on how realities and experiences can be constructed as they abide to

society’s dominant discourses and ideas. As narrative therapy recognizes there is no universal

truth, local, personal and contextualized stories are able to be brought forward (Combs &

Freeman, 2012). The therapist is also able to challenge their own internalized understanding of

dominant discourses as they privilege the language of the client, and work at the client’s pace

throughout the process (Carr, 1999). These dominant discourses are once again challenged in the

creation of alternative narratives or stories created with the client (Carr, 1999). This openness to

the therapeutic relationship also in itself challenges the dominant understandings of therapy as

being time restrictive and the therapist holding expert knowledge.

As a therapist, we are trained to resolve conflict and encourage harmony in families and

within individuals. In our effort to resolve conflict in therapy, we can indirectly silence the

experience of victims/survivors and make them feel resentful and even betrayed. By listening to

our client’s stories, we get a better understanding of the presence of dominant discourses and can

help to deconstruct their effect. Like in the case of intimate partner violence, when we listen to

the victim of IPV we see the role patriarchy plays toward violence against women (Waldegrave

& Tamasese, 1994). In just therapy, we are accountable to our clients and families and they

reserve the right to decide if a therapy session is just (Cambell, et al. 2001). “The values of
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humility, sacredness, respect, justice, love, trust and co-operation are absolutely central to our

processes of accountability and our processes of accountability are central to our efforts in

creating a just therapy” (Pg. 199-200, Cambell, et al. 2001).

With accountability comes appreciating and valuing our clients’ stories. This concept ties

into another core principle of just therapy, the concept of sacredness. As therapists, our client’s

stories are given to us in vulnerability and trust and it is up to us to cherish it as a sacred gift.

According to Cambell et al. (2001), by “using sacredness and spirituality as our central image for

an exchange within the therapeutic process we believe we are much more likely to treat people

with greater respect than if we applied the more commonly used mechanistic descriptions of

casework”. This idea of sacredness challenges common discourses of clients' stories being

problems to be fixed and addressed and instead honors their presence.

The Movement Towards Social Justice

Another valuable aspect of both just and narrative therapy is the impact they have on

bringing social justice beyond the therapy room.

To understand how narrative therapy can bring out social justice, we must first look

within the therapy room. Firstly, the relationship that is co-constructed with the client creates an

environment for the sharing of power, and an opportunity for often silenced voices to be heard.

This relationship is crucial in setting the stage for empowerment once the client leaves, as it

creates an opportunity for them to see the power in their voice. This is something that may often

be missed by our clients due to structural discrimination or oppression. This sharing of power

can be seen in the significant role that the client plays in determining the direction that the

process takes (Morgan, N.D). After this relationship has been established, clients are able to

share and recreate their own narrative and story. These stories, sometimes layered with
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injustices, can be shared beyond the therapy room and give voice and power to those who speak

them in the process (Denborough, 2013).

In a narrative therapy approach with survivors of the Rwandan genocide, Denborough

(2013) describes the impact of stories in which he says

In seeking healing and justice together, perhaps we can enable those who have experienced

injustices to come to feel, to know and to experience that their hard-won knowledge is

contributing towards the generation of a differently just world for other survivors and perhaps the

next generation (p. 15-16).

This meaningful quote shows the healing capabilities of a narrative approach, but also the

impact it can have on feelings of justice for the individual and impact on the larger community.

Another one of the core principles of just therapy is that it requires us to work with families and

clients in the therapy room, while getting involved in community development projects, social

policy research, and education to address social justice issues related to race, culture, gender, and

employment (Cambell, et al. 2001). This dual approach to supporting our clients, allows us to

bring issues of justice into action, advised by those living the injustice themselves.

An important principle of just therapy is the concept of liberation. Clients share their stories to us

as therapists and we are tasked to honor these stories, analyze the web of meaning that has

created the problem, and then facilitate new and transformative meanings that inspire hope and

reconciliation (Cambell, et al. 2001). This liberation was found through the sharing of stories and

was described by Combs & Freedman (2012) who explain:

As people develop and live out preferred stories, narrative therapists look for ways to link

them with other people who have struggled with similar problems. This allows people to

both contribute to and partake of a growing body of insider knowledge. Also, as people
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join their voices together, they are more likely to be heard in the larger society. They are

less marginalized (p. 1035).

The power and sharing of stories and dialogue are evident in both just therapy and

narrative therapy. Both approaches hone in on the client’s perspective as the expert position and

in this support the amplification of marginalized voices to move to a more just society.

Externalizing the Problem

An important part of social justice is the recognition of larger societal discrimination and

oppression. Both narrative therapy and just therapy externalize the problem from the individual

and recognize the impact of larger structures. By not ‘blaming’ the client, both these therapies

allow social justice issues to be brought forward, as the focus is not on fixing the client, but on

social inequalities that create the problem in the first place. Within narrative therapy, for

example, problems are seen as coming from dominant oppressive stories, that have taken over

the client’s life (Carr, 1999).

Further, in family therapy for example, symptoms are treated as though they were the

symptoms of family dysfunction. Families come to us with a range of mental health concerns as

a result of society’s injustices, and we treat these concerns as though the client or the family is

the problem that needs to be fixed (Waldegrave, 2005). Just therapy recognizes that these

symptoms can stem from larger structural issues including poverty, racism, and sexism

(Waldegrave & Tamasese, 1994). For example, if a person is living in poverty and as a result,

becomes depressed, they are often sent away undepressed. In this sense, we have unintentionally

adjusted them the injustice of being happy in poverty (Waldegrave, 2005). Just therapy acts as an

important tool as it acknowledges that we are political agents of the dominant discourse, which
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can work to silence the victims of unjust social policies (Waldegrave & Tamasese, 1994). Just

therapy not only acknowledges this but also proposes that we need to cease engaging in clinical

practices that collide with flawed social policies while failing to challenge them (Waldegrave,

2005).

In narrative therapy, a pathologizing discourse is also avoided, as the role of pieces such

as gender, class, race, culture and sexual identity and powerful contributors to the personal

stories that are created (Carr, 1999; Morgan, N.D). By externalizing the issue, clients are able to

see their problem from the outside, giving them the opportunity to construct resilience.

Resilience is an important part of social justice, as we must recognize the capabilities and

strength of our clients in the face of their adversities. Denborough (2013) discusses this aspect in

his work with Rwandan genocide survivors in noting that “our colleagues in Rwanda have been

very clear about what was destroyed by the injustices of the genocide in Rwanda in 1994, and

how the effects of this are continuing. At the same time, however, they have also been very clear

about what has survived” (p.15).

In order to recognize marginalized groups as part of the social justice movement, it is as

equally important to avoid patronizing them, and instead acknowledging their contribution.

Narrative therapy allows an opportunity for this side to become apparent to the therapist, and

also to the broader audience to which the story is shared.

Ethics, Implications and Emerging Practice

The principles and ideals of just and narrative therapy that have been discussed in this

paper are very much aligned with social works core values and principles, these include anti-

oppressive practice, our pursuit of social justice and service to humanity (CASW, 2005).
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However, as with any therapy, both narrative and just therapy carry ethical considerations and

challenges for implementation.

Narrative therapy offers an opportunity for the client to disrupt their common narrative,

with one of the first steps being to pinpoint times in their lives when they were not oppressed by

their presenting problem (Carr, 1999). While this could be an empowering approach, it could

also be challenging for the client to identify and could result in the therapists brushing over the

true impact of discrimination that is infused in our society. Additionally, the narrative approach

may become difficult to sustain once the client has finished their sessions with the therapist.

While this approach allows for new narratives to be built, it does not account for the ongoing

structural discrimination and oppression that will continue to affect the client’s life after they

leave.

Language acts as an important aspect of both therapies that believe it constructs

individuals’ realities. While this is a powerful notion and helps to break down dominant

discourses, it does not account for interactions with a client whose first language is not the same

as the therapist. Since the meaning of words may differ across languages, the creation of

alternative meanings may quite literally be lost in translation and result in the therapists and

client not being on the same page of understanding. Further, the notion of aspects such as gender,

sexual orientation or race as negatively impacting a person’s reality, may not be relevant across

all cultures and could reproduce eurocentric or colonial ideals in the therapy room.

While some may argue that in our fight for social justice that sometimes we need to

compromise in order to create change. However, where is the line on compromise when it comes

to justice? In Cambell, et al.’s (2001) article on just therapy, they talked about how in their effort

to bring about social justice; they decided to become involved in social policy research. They
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found policymakers were not moved by narratives, but they were moved by numbers. This

moved the authors to convey the social injustice they saw in numbers, rather than their clients’

stories. Today the organization is one of the leaders of the New Zealand poverty measurement

project. While this had a positive outcome for the authors’ organization, it bears the question of

succumbing to oppressive tools to be successful. Can we truly engage in these social justice

aspects of just and narrative therapy, if we are forced to work within dominant discourses that

ask for scientific measurements such as number? This was the compromise that the authors saw

had to be made in order to create change. I would question if these actions lead to a meaningful

change if it fails to validate alternative ways of knowing outside the dominant discourse.

Another one of the challenges I foresee with these approaches is when we decided to

bring forth the stories shared by our clients to the dominant sphere to enact change. In this

process, we run the risk of violating our clients’ confidentiality and disrespecting their stories

(Waldegrave, 2005). This may at times mean finding the balance between confidentiality and

social justice to be tricky.

Finally, both of these therapeutic approaches raise the question of social justice for whom

and on whose terms? Who gets to decide what constitutes injustice? Is it our role as therapists to

point out the oppression we perceive our clients to be experiencing? These thoughts raise

concern about the implementation of these therapies to our society. And the implications they

can have on our clients’ lives.

Conclusion

This paper has worked to offer a meaningful look into the powerful social justice aspects

of just and narrative therapy while recognizing the practical limitations. As we move forward as

practitioners, we should be deeply acknowledging and reflecting on our roles in reproducing

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injustices for our clients. Whether through our therapeutic practices, social policy action or work

in communities, our actions need to closely match our justice words such as anti-colonial, anti-

racist, and anti-oppressive practice. One starting point for this is drawing upon social justice

oriented approaches such as just and narrative therapy. Building upon these approaches means

thinking about justice critically or as Denborough (2013) so eloquently explains

“...... one starting point might involve beginning to notice, sometimes resurrect, and sometimes

co-create, a great diversity of forms of justice–processes in which justice and healing are not

separated. This is something that I think we, as counselors and community workers, can

participate in," (p.17). This means without doubt that, if we are to reach an equitable and just

society, it will take all of us looking within ourselves and towards others in inflicting change we

wish to see.
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References

Cambel, W., Tamasese, K., & Waldegravel, C. (2001). Just therapy. In Denborough, D (2001),

Family therapy: Exploring the field's past, present, and possible futures. Dulwich Centre

Publications.

Canadian Association of Social Workers. (2005). Code of ethics. Ottawa, ON: Author.

Carr, A. (1998). Michael White’s narrative therapy. Contemporary Family Therapy, 20(4),

485-503.

Combs, G., & Freedman, J. (2012). Narrative, poststructuralism, and social justice: Current

practices in narrative therapy. The Counseling Psychologist, 40(7), 1033-1060.

Denborough, D. (2013) Healing and justice together: Searching for narrative justice.

International Journal of Narrative Therapy and Community Work, 3, 13-17.

Morgan, A. (n.d.). What is narrative therapy? Dulwich Centre. Retrieved from

https://dulwichcentre.com.au/what-is-narrative-therapy/

Waldegrave, C. (2005). " Just therapy" with families on low incomes. Child Welfare, 84(2), 265.

Waldegrave, C., & Tamasese, K. (1994). Some central ideas in the" Just Therapy" approach. The

Family Journal, 2(2), 94-103.