Themes in Nested Stories: A Case in Family-Oriented Synthetic Therapy

Abstract

This paper presents an example of clinical practice using a family-oriented approach which allows for a personal—but guided synthesis—of theoretical ideas, interventions, types of sessions (individual, family and group), and contracts (short and long). The approach is re-conceptualized in narrative terms. Therapy phases are marked by a process of collaboratively revising a central theme. All story types are seen as “nested” one within another, an idea which helps organize a vast amount of therapy material. The case presented provides an illustration of these ideas and follows the progress of a woman and her family who struggle to change a central theme from one that excludes loved ones to one which includes loved ones and many others. We conclude by summarizing key issues and pointing out how the approach helps make a distinction between drop-out and termination in the various phases of short and long term therapy.