Narrative, Identity, and Meaning Making: Young People’s Experiences of Psychotherapy

Abstract

This research addresses the relative paucity of research on adolescent clients’ experiences of psychotherapy. It uses a narrative methodology to provide insight into the way in which young people make meaning of their psychotherapy experiences in the context of their own priorities and concerns. It is based on interviews with eleven young people, aged between thirteen and eighteen years old, who had been to therapy in a child and adolescent mental health service within the last year. Open-ended narrative interviews were conducted, where the participants were asked to tell a story of their experiences. The narrative analysis identified patterns of meaning making in individual narratives, which were then collated into an overarching analysis that describes the different narrative patterns present in the data. Three overarching narrative themes were identified. These included stories of identity, of the therapeutic relationship, and of how therapy works. Within each of these narrative themes were a number of subthemes that comprised the major ideas that emerged in the young people’s stories. The young people described using therapy as a site for identity work, wherein they experienced changes to their identity. Through the therapy process they explained how they moved from a place of feeling different and unacceptable, to developing a more positive, meaningful, and coherent sense of themselves. They described prioritising the emotional and relational aspects of therapy (i.e., a relationship that was genuine, where they felt understood, safe, and able to access support) over the more professionalised characteristics of their therapists or the therapy process, such as specific interventions or modalities. In terms of therapy itself, the young people produced narratives in which they positioned themselves as being highly active in the process. They explained how they used therapy in their own way, actively accepting and/or rejecting aspects of therapy based on their needs and circumstances at the time. Overall the young people produced thoughtful and articulate narratives of their experience which can provide therapists with valuable insights into how to make their practice more relevant and useful. In particular, clinicians need to be aware that questions of identity are at the forefront for young people, and that they consider developing a positive sense of self as more critical to recovery than the resolution of symptoms. Furthermore, young people value the relational aspects of therapy, in particular therapists who are understanding and genuine.