Using Narrative Family Therapy to address discontinuity narratives in couples living with brain injury

BackgroundBrain injuries can put marriages/partnerships under considerable strain. Previous papers have reported on the use of narrative family therapy to address this, but they describe general principles rather than give structured guidance. This makes the therapy dependent on the availability of skilled family therapists, which means it is not accessible to most brain injury rehabilitation services. AimsThe aim of this paper was to provide more structured guidance about what issues to explore and how to deliver the therapy, so that the therapy can be delivered by a wider range of professionals. MethodIn exploring problem-focused narratives, the therapy focuses on narratives of discontinuity and rupture between life before and after the injury that previous research has shown to be frequent responses to brain injury. In terms of delivery, session-by-session guidance is provided that translates the general principles into specific practice. Individual and couple trees of life are also used to provide more structure. OutcomeThree case examples are described. Couples showed improvements on questionnaires about their relationship and wellbeing completed before and after the therapy. Narrative family therapy, with its emphasis on empowerment and helping couples develop a richer and more rounded narrative to replace problem-focused narratives, may be particularly potent in a brain injury context where couples often feel helpless in the face of a brain injury that takes over how they think about themselves, their relationship and their life together.