Narrative Therapy as an
Alternative Treatment for
Older Adults Coping with Addictions
By Andrew Small
Researchers at the New York Academy of Medicine conducted an ethnographic study exploring the use of narrative therapy with older adults coping with addictions. Their goal was to “[identify] what practitioners and participants found helpful (or not) about this therapeutic approach…and provide new insights on using this approach with older adults.”
Increased social isolation, physical illness, and financial worries may all contribute to the development of alcoholism, drug use, or other addictions, and while such problems are not unique to older adults, their experiences with them can differ significantly from those of younger age groups. And aside from the serious repercussions that addictions present to people who may already be managing complex medical conditions, older adults are less likely to seek help, and problems with addiction are often unreported.
Generally speaking, current reports indicate that older adults are not served sufficiently by clinicians and that this field of practice remains relatively narrow and limited to traditional therapeutic approaches that may not be optimally effective with an older population.
Narrative therapy has been used to great extent in work with children and in family therapy, people suffering from depression and other illnesses, with survivors of violence, and in cross-cultural and multicultural counseling. Researchers describe it as “a collaborative process predicated on the belief that identity is co-created in social, cultural, and political contexts and revealed through stories and narratives.” In practice, the role of the therapist is to “support individuals to critically view their lives and experiences as embedded within larger social, cultural, and political contexts.” For the individual, this process entails “unearthing dominant or ‘problem’ stories in people’s lives (i.e., the addiction story), understanding them, and retelling them in alternative and more empowering ways.”
Working with Centre for Addiction and Mental Health therapists, researchers coordinated a series of eight two-hour weekly therapy sessions for a group of 12 older adults, all of whom were otherwise seeking help with addictions or other mental health issues. At the conclusion of the eight-week program, researchers interviewed the therapists who conducted the group sessions. Using extensive field notes compiled from their observations of participant behavior as well as the material gathered in interviews, the researchers organized data into broad conceptual categories. Gradually, key terms and ideas emerged, which the team “explored to generate meaning by looking for patterns, themes, contrasts, contradictions, paradoxes, similarities, and differences.”
Participants revealed their shared feeling that advanced age brings forth a sense of urgency, and that for those managing addiction issues, there is an added “recognition of the toll that the years of addiction had taken on their bodies and the need to make a change.” With similar cohesiveness, the data suggest “many examples of shared cohort experiences that served to connect individuals with other members of the group…providing a common ground on which to share stories.” All participants indicated “an increased personal wisdom and understanding of themselves as a result of their age, which was helpful to their narrative therapy experience.”
Overall, the authors state that their findings “suggest that narrative therapy is a helpful therapeutic approach for older people,” and that “[a]ll of the participants described their experience as positive.” Furthermore, results indicate that addiction or substance abuse is a problem well suited to mediation through narrative therapy. Concerning the unique characteristics and needs of the older adult population, the researchers found that “[a]ge was revealed as a key determinant of both individual as well as group experience,” contributing to their experience in three key ways: “time—a sense of urgency, cohort experience, and wisdom and understanding.”
For a therapeutic technique that is built around the essential core of storytelling, the authors concede that there is a troubling imbalance at work in a situation where, as research suggests, “older persons have numerous stories to tell,” but due to myriad social and medical factors, older people might have fewer chances to share these stories. Nevertheless, researchers remain optimistic that “narrative therapy may be particularly well suited to this age group.”
Source: Gardner, Paula J., and Poole, Jennifer M. 2009. One Story at a Time: Narrative Therapy, Older Adults, and Addictions. Journal of Applied Gerontology 28(5): 600-620
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