The evolution of the narrative metaphor when chemical dependency is the dominant plot
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Abstract
Over the past 30 years many approaches have been developed to work with chemically dependent individuals. Of those approaches the disease model (12 step) is the most prevalent. However, research has indicated that the 12 step model has limited effectiveness (Selekman, 1991);As treatment centers looked for ways to increase their effectiveness with the problem of chemical dependency, interest turned toward the family's influence with the problem. Consequently, systems therapists started working with the chemically dependent population and their families;Both the 12 step model and family systems therapy tend to de-emphasize the individual's story about the experience with chemicals. This often leads to a struggle between the individual's worldview and the therapist's theoretical orientation. When this happens the individual does not feel understood or that the therapist has a predetermined agenda. As such, there is a growing interest in goodness-of-fit models for understanding the interplay between individuals, family and environment (Steinglass, 1990);The narrative metaphor is a therapeutic model that uses ethnographic information from each individual to further the therapeutic process. The information from the individual allows the individual and therapist to co-create a narrative about chemical dependency that is unique and non-problematic for the person. The narrative metaphor, will move beyond the current tug-of-war between systems theory and the disease model and the struggle between individual and therapist;The research is designed to evolve a treatment model. The interest is in how the narrative metaphor unfolds in the therapeutic process with individuals presenting chemical dependency as their dominant plot. Moreover, it looks at how the metaphor provides a better therapeutic fit for individuals;The articles are based on a qualitative study using the narrative metaphor with clinical cases presenting chemical dependency as their dominant plot. Qualitative research was chosen because of its focus on process, meaning given to lived experiences, multiple perspectives and attention to context (Marshall & Rossman, 1989). By directly interacting with the individual, the researcher has the ability to clarify information that would have otherwise escaped the standard paper-pencil questionnaire.