The Therapeutic Use of Narrative Therapy With Oncology Patients Paper Example

1.0 Introduction

Group therapy is an essential part of counseling where guidelines and techniques are tailored to improve the experience of the targeted group. Effective group counseling depends on the nature of planning, recruitment, and management of the group session. The use of group therapy in counseling is necessary because members interact, which improves how they perceive their experiences. While leadership and diversity issues in group therapy are critical, other aspects such as the recruitment of members, ethical considerations, and planning for termination are equally essential. This paper provides a critical analysis of the therapeutic use of narrative therapy with oncology patients.

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2.0 Narrative Therapy Theoretical Framework

Narrative therapy is a counseling approach that focuses on the experience of the patients as the baseline for the establishment of new insights and perspectives. In the 1980s, Michael White and David Epston postulated the essence of focusing on the experience of the patients where narrative and situated concepts are used to segregate the negative perceptions from the positive ones (Paterson et al., 2005). In this case, the therapist collaborates with the client and works together to identify the 'thicker' narratives emanating from the different descriptions of the events that characterized the experience of the client (Payne, 2006). In this case, the role of the therapist is to assist the patient in influencing their perspectives, which destabilizes the negative narrative that the client holds. Moreover, narrative therapy is built on the idea that people have perspectives that are based on stories that impact their lives. People construct these stories that define who they are and what their lives entail (Payne, 2006; Paterson et al., 2005). Sometimes the stories could include what they expect their lives to be, which contributes towards the negative or the positive narratives that an individual is holding. The therapist, therefore, builds on these stories while working closely with their client to establish the 'thicker' narrative while suppressing the 'thin' ones.

Moreover, according to the postulates of narrative therapy, stories become the lenses that people use to shape their understanding of their situation. An individual will end up filtering different stories that do not fit the main narrative defining current situation one is facing (Paterson et al., 2005). When a person gets stuck to a negative story to the extent that it influences how they perceive life and self, then the need for counseling emerges. At this point, the therapist focuses on the stories that their client will bring (Payne, 2006). The stories constitute the negative experiences about the client and the situation defining his/her life. The role of the therapist is to collaborate with the client to reshape the new lenses and stories while fostering new experiences and positive future perspectives (Paterson et al., 2005). Narrative therapy is, therefore, a non-blaming approach that separates the problem from the people facing it and explores the skills of an individual in reshaping a narrative. The values, beliefs, commitment, and abilities define the extent to which the client will be in a position to suppress the adverse influence emanating from problems one is facing (Payne, 2006). Two principles, that is the effect of curiosity and asking questions, inform how narrative influence perceptions.

3.0 Oncology Patients and Narrative Therapy

Oncology patients require advanced care and symptom management; however, based on their condition, they also require emotional support through counseling (Zamanzadeh et al., 2010). While the nurses are keen to ensure that the reccovery of oncology patients is geared towards effective symptom management, emotional support guarantees a positive perception, which is central to coping with a terminal or advanced health condition. Appropriate mental behavior is a crucial factor in enhancing the treatment, recovery, and emotional stability (Zamanzadeh et al., 2010). Oncology patients have experiences that define their life stories. In such a case, the use of storytelling is part of the nursing and counseling intervention that is incorporated in risk management framework for patients with chronic illness.

A critical evaluation of the narratives of oncology patients such as those battling post-surgical complication, undergoing radiotherapy, or under chemotherapy treatment recommendations indicates how their perceptions could adversely affect the mental stories and narrations they develop and build as they undergo treatment. Therefore, interventions that seek to unravel these perceptions and determine their respective implication could assist these patients to develop positive emotional health that could enhance their treatment, recovery, and symptom management (Crogan, Evans, & Bendel, 2008b). The use of narrative therapy with oncology patients present the opportunity to collaborate with the psychologist to suppress the adverse insights and focus on positivity. The focus of storytelling is to reduce the high level of anxiety and stress associated with cancer patients. Since the use of narration is inexpensive and noninvasive, the focus could be channeled to the approach to group formation, management, participation, and termination to guarantee quality outcome among patients. Moreover, the evaluation of the outcome is central to the use of narrative therapy, which outlines the extent that the objectives have been met. A combination of both the treatment intervention and psychological help though storytelling ensures that the emotional sufferings of patients are included in the recovery framework (Crogan, Evans, & Bendel, 2008b).

4.0 Group Planning, Implementation, and Evaluation

One of the essential considerations in narrative therapy is the formation of the group. Different stages are included for the success of the intervention (Paterson et al., 2005). The planning stage defines the nature of activities that will be carried out to assist the patients to achieve their wellness and symptom management goals. However, for group therapy, it is essential to consider the recruitment and selection criteria based on the experiences of the patient. Leadership and management of diversity, which is a challenge for most of group therapy sessions, is equally essential and require professional consideration. At each of these stages, the therapists could face significant challenges; however, having a strategic approach to group management could be used to overcome the limitation and improve outcomes (Crogan, Evans, & Bendel, 2008b).

4.1 Planning

Based on the needs of oncology patients and the complexity of narrative therapy, planning is an essential process before undertaking a group therapy. At this point, it is important to focus on the objective of the group by scaling down the goals of the targeted members. The goal of the oncology patients is to overcome the implications associated with the negative experiences associated with their narratives. For example, the cancer patients undergoing chemotherapy are emotionally affected because of the financial costs associated with the processes as well as the struggle of managing the symptoms. When these factors combine they affect the perceptions that these patients have regarding their recovery process. When planning for a group therapy, the therapist should consider the centricity of identify the goals of the oncology patients to be included in the group session, which assists in establishing the shared needs. The focus of narrative therapy for oncology patients is tailored to assist the clients to manage the negative automatic thoughts that build their narratives, acquire skills that will enable them to dispute these thoughts and focus on improving their social skills. Another essential consideration during group planning that the therapist should consider is the identification of the strategy and techniques that will be used to assist the clients to overcome their limitations. In this case, the use narrative therapy is an inexpensive strategy that is patient-centered and guarantees positive results.

4.2 Recruitment and Selection

Recruitment and selection of clients prior to joining a group therapy session requires several considerations (Baker, 2010). Once the needs of the patients have been identified, it is important to work with a strategy that will determine the readiness of the potential member to join a group. In narrative therapy, the facilitator should consider the client's ability to participate as the criteria for selection. Oncology patients, for example, the cancer patients undergoing chemotherapy, are at different stages of treatment or emotional imbalance. It is, therefore, essential to determine the capacity of a potential client and their willingness to participate in a group session. Some categories of clients could affect the nature of outcomes associated with group therapy. For example, clients with a tendency to some adverse group experience, whose defenses conflict with group dynamics, and those who regularly withdraw from group sessions before termination affect the success of group therapy (Baker, 2010). In such a case, the therapist is expected to consider the use of reviews as a critical source of insights to determine the suitability of client-specific narrative therapy groups based on their needs and the objective of group therapy. Using Group Selection Questionnaires will contribute towards identifying the fitness of a client to a specific therapy group (Baker, 2010). A list of factors defines the appropriateness of oncology patients to be included in a narrative therapy group as outlined below.

• Patients with the regular emotional challenge because they dwell on the negative experience
• Patients willing to share their story with other people as a way of expressing their pain and adverse experiences
• Patients who show a significant level of commitment when working with peers
• Patients who are not at the extreme stages of a life crisis
• Patients who show a notable degree of honoring group commitments
• Patients who can tolerate strong emotions and they do not let their defenses clash with the tenets of social interaction

4.3 Type of Group

Five models have been used in therapeutic groups where the choice depends on the objectives and the nature of issues be...