Using Photographs in Narrative Therapy to Externalize the Problem: A Substance Abuse Case

Using a substance abuse case in a hospital in Hong Kong, this article discusses the potential of using photographs to externalize the problem in Narrative Therapy (NT). One of the key principles underlying NT techniques is externalizing. According to White, externalizing can be understood in terms of scaffolding, which begins with low-level distancing tasks, such as naming and characterizing the problem, and builds to high-level distancing tasks that have clients making plans to act upon the newly understood concepts they have formed. The clinical account recorded the utterances in the consultation process and plot changes throughout the consultation. The key observations were that: (i) the proportion of higher-level distancing utterances increased with the progression of the consultation, in line with the intended process of NT; (ii) among the client's utterances reflecting distancing tasks, most of them were associated with the photographs selected by the client; (iii) the consultation dialogues intended to induce distancing tasks were facilitated by the use of photographs. The use of photographs in NT opens up possibilities for future research and practice.