Anita Santos

Narrative Therapy and the Nature Of “Innovative Moments” in the Construction of Change

In the narrative metaphor of psychotherapy, clients transform themselves by changing their life stories. According to White and Epston (1990), the construction of change occurs from the expansion of unique outcomes—or innovative moments, as we prefer to call them—that is, the development of episodes outside the problem-saturated narrative. Unique outcomes operate as exceptions to the rule (i.e., to the problem-saturated story) that can be changed to a new rule (i.e., a new narrative). We suggest that some forms of unique outcomes can operate as shadow voices (Gustafson, 1992) of the problem-saturated story, allowing a temporary release from the problem, but facilitating a return to it. In our view, there is a particular type of unique outcome—reconceptualization—that facilitates sustained change. This kind of innovation facilitates the emergence of a meta-level perspective about the change process itself and, in turn, enables the active positioning of the person as an author of the new narrative.

Innovative moments and change in narrative therapy

Abstract Narrative therapy suggests that change happens by paying close attention in therapy to “unique outcomes,” which are narrative details outside the main story (White & Epston, 1990). In this exploratory study, unique outcomes were analyzed in five good-outcome and five poor-outcome psychotherapy cases using the Innovative Moments Coding System (Gonçalves, Matos, & Santos, 2008). Across 127 sessions, innovative moments were coded in terms of salience and type. In accordance with the theory, results suggest that innovative moments are important to therapeutic change. Poor- and good-outcome groups have a global difference in the salience of the innovative moments. In addition, results suggest that two particular types of innovative moments are needed in narrative therapy for therapeutic change to take place: re-conceptualization and new experiences. Implications for future research using this model of analysis are discussed.

Tracking novelties in psychotherapy process research: The innovative moments coding system

Abstract This article presents a method for the assessment of innovative moments, which are novelties that emerge in contrast to a clients problematic self-narrative as expressed in therapy, the innovative moments coding system (IMCS). The authors discuss the theoretical background of the IMCS as well as its coding procedures. Results from several studies suggest that the IMCS is a reliable and valid coding system that can be applied to several modalities of psychotherapy. Finally, future research implications are discussed.

Innovative moments and change pathways: A good outcome case of narrative therapy

OBJECTIVES Our aim was to explore the development of innovative moments (i-moments) in therapeutic conversation and to study how they match our heuristic model that accounts for the development of change, drawn from previous empirical research. DESIGN In this therapeutic process research, we analysed a good outcome case of narrative therapy with a woman victim of intimate violence. METHODS This case, composed of 12 sessions, was analysed with the Innovative Moments Coding System: Version 1. This coding system allowed the identification of five different types of innovations (i-moments) that appeared during the therapeutic process: action, reflection, protest, re-conceptualization, and performing change. For each session, an index of temporal salience was computed, as the percentage of the time in the session that client and therapist spent talking about each i-moment. Our analysis procedures provided a quantitative and also a complementary qualitative approach. RESULTS Data showed that the types of i-moments emerged differently throughout the process. Early sessions were characterized mainly by action and reflection (low temporal salience), middle sessions were found to have mainly protest i-moments (low or middle temporal salience), and final sessions were characterized by the combination of high salient re-conceptualization and performing change i-moments. CONCLUSIONS Findings suggested that narrative change seems to develop in a cyclical way, in which different types of i-moments contribute to the development of a new self-narrative in different phases.

The role of mutual in-feeding in maintaining problematic self-narratives: Exploring one path to therapeutic failure

Abstract According to the authors narrative model of change, clients may maintain a problematic self-stability across therapy, leading to therapeutic failure, by a mutual in-feeding process, which involves a cyclical movement between two opposing parts of the self. During innovative moments (IMs) in the therapy dialogue, clients’ dominant self-narrative is interrupted by exceptions to that self-narrative, but subsequently the dominant self-narrative returns. The authors identified return-to-the-problem markers (RPMs), which are empirical indicators of the mutual in-feeding process, in passages containing IMs in 10 cases of narrative therapy (five good-outcome cases and five poor-outcome cases) with females who were victims of intimate violence. The poor-outcome group had a significantly higher percentage of IMs with RPMs than the good-outcome group. The results suggest that therapeutic failures may reflect a systematic return to a dominant self-narrative after the emergence of novelties (IMs).

Innovative moments and poor outcome in narrative therapy

Abstract Aims: To analyse a poor outcome case of narrative therapy with a woman victim of intimate violence. Method: The Innovative Moments Coding System: version 1 was applied to all sessions to track the innovative moments (i-moments) in the therapeutic process. I–moments are the narrative details that occur in psychotherapeutic conversations that are outside the influence of the problematic narrative. This research aims to describe the processes involved in the stability of meanings in psychotherapy through a dialogical approach to meaning making. Findings: Contrarily to what usually occurs in good outcome cases, re-conceptualization i-moments are absent. Moreover, two specific types of i-moments emerged with higher duration: reflection and protest. Qualitative analysis showed that the potential meanings of these i-moments were surpassed by a return to the problematic narrative. Conclusion: The therapeutic stability seems to be maintained by a systematic return to the problematic narrative after the em...

Innovative Moments and Change Processes in Psychotherapy: An Exercise in New Methodology

Psychotherapy is a field where development of dynamic methodologies is a conceptual imperative. In this chapter we present an analysis of the Innovative Moments (i-moments) emergence in psychotherapeutic process, through a dialogical lens. I-moments are the novel ways of thinking, interacting, and behaving that the client narrates in the therapeutic conversation, which is different from the rule he or she usually applies to his or her life. This rule is composed of general meanings over the world that guides their behaviors and understandings about it. Using Josephs’ and colleagues dialectical framework (Josephs & Valsiner, 1998; Josephs, Valsiner, & Surgan, 1999) we can conceive this rule as a macro organizer of meaning.

Effectiveness of a Group Intervention Program for Female Victims of Intimate Partner Violence

Group intervention has been widely used with female victims of intimate partner violence (IPV). However, efficacy studies are scarce due to several research limitations. This study evaluates the effectiveness of an 8-week group intervention program, with a cognitive-behavioral orientation and attended by 23 female victims of IPV. Self-report psychological assessment was conducted at pre-test, post-test, and follow-up. Results revealed that the group intervention had a positive impact on participants, showing a decrease in re-victimization and in beliefs toward legitimizing IPV. A decrease in levels of depression and a significant improvement in general clinical symptoms were also evident. Self-esteem and social support were enhanced throughout group intervention. The changes were confirmed through follow-up after 3 months, suggesting that this group intervention has important effects on female victims. The implications of the findings for practice are also discussed.

Multiple Victimization and Social Exclusion A Grounded Analysis of the Life Stories of Women

This work explores life stories of socially excluded women who experienced multiple victimization. It seeks to understand the existential dimension of victimization experience, particularly how victims integrate their victimization experiences in their meaning or sense that they give to their existence and their lives. The study included 12 participants who suffered multiple victimization and who were in a situation of social exclusion. Individual interviews were conducted about their life stories, adapted from McAdams interview. The qualitative methodology used was grounded analysis. The results highlighted the focus of their life stories in violence suffered in adulthood, specifically, in intimacy. It was found that being from Black race, having a low socioeconomic status, and being unemployed, seemed to increase victimization vulnerability. Despite the several types of violence, participants do not describe and give meaning to the “multiple” feature of victimization. However, victimization is the matrix of their life story, expressing itself in a discourse of vulnerability/fragility. Furthermore, some women revealed discourses of resistance that may reflect the concept of “postvictimization growth,” in which they conceptualize positive changes arising from victimization experiences. From a humanistic and existentialist perspective, victimization might provide some sense of personal unity to these women’s troubled lives.

Exploring Help Seeking Experiences of Male Victims of Female Perpetrators of IPV

Intimate partner violence (IPV) is a common phenomenon worldwide. However, there is a relative dearth of qualitative research exploring IPV in which men are the victims of their female partners. The present study used a qualitative approach to explore how Portuguese men experience IPV. Ten male victims (aged 35–75) who had sought help from domestic violence agencies or from the police were interviewed. Transcripts were analyzed using QSR NVivo10 and coded following thematic analysis. The results enhance our understanding of both the nature and dynamics of the violence that men experience as well as the negative impact of violence on their lives. This study revealed the difficulties that men face in the process of seeking help, namely differences in treatment of men versus women victims. It also highlights that help seeking had a negative emotional impact for most of these men. Finally, this study has important implications for practitioners and underlines macro-level social recommendations for raising awareness about this phenomenon, including the need for changes in victims’ services and advocacy for gender-inclusive campaigns and responses.