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Similarities & Differences Between CBT & Narrative

Clients often seek therapy because they are stuck in a positive feedback loop and cannot break a cycle of negative thinking. Negative thinking typically leads to poor choices, negative coping strategies, identity issues and relationship problems. Both cognitive-behaviour therapy (CBT) and narrative therapy techniques help a client break out of these negative patterns and find positive ways of viewing themselves and their world, which reduces symptoms of mental disorder and increases positive behaviours.

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How Problems are Formed

Both CBT and narrative therapy seek to change a client's negative thought patterns. It is the belief of practitioners of both of these therapy techniques that negative thought patterns lead to negative behaviours and a self-defeating attitude toward life. Therapists using CBT take an educational approach to therapy and work with the client to assist him in recognising negative patterns of thought, behaviour and mental imaging. Narrative therapists focus on the stories people tell about their lives and assist clients in finding the positive, often untold, stories that are also true for their lives.

Restructuring and Reframing

CBT practitioners seek to restructure their clients' thought processes through goal-oriented assignments. These assignments are aimed at self-knowledge and recognition of counterproductive thinking patterns. CBT operates on the premise that thoughts, behaviours and feelings are three points on a triangle, and changing either one of these points will change the other two. Narrative therapists seek to reframe the problem by exploring with the client the client's stories about their lives and finding positive and unexcavated perceptions of the events of the stories.

Externalising the Problem

Narrative therapy and CBT both externalise the problem, defining the problem behaviours or symptoms as separate from the client. This approach takes the blame and guilt away from the client and allows her to develop a more positive self-identity. When self-esteem is low and a client feels like she faces monumental oppression or opposition, she often identifies herself as the problem. For instance, society often refers to an individual who is dependent upon alcohol as an alcoholic. CBT practitioners help clients overcome the problem through skill-building. Narrative therapists externalise the problem so it can be explored in context of culture and personal life stories and changed by rewriting the stories.

Therapist as Co-creative of a New Reality

Narrative therapists and CBT practitioners use Socratic questions to assist the client in discovering a new reality. The CBT practitioner asks questions to probe, clarify and explore implications of the client's current way of thinking. Through this type of questioning, often presented as homework assignments, the CBT practitioner seeks to help the client change his thought patterns and reach his stated goal of therapy. Narrative therapists use Socratic questions to help the client find alternative ways of viewing an event, leading to reframing and creation of new -- and positive -- stories.

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About the Author

For Judy Kilpatrick, gardening is the best mental health therapy of all. Combining her interests in both of these fields, Kilpatrick is a professional flower grower and a practicing, licensed mental health therapist. A graduate of East Carolina University, Kilpatrick writes for national and regional publications.

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