Cognitive narrative psychotherapy

Domain II · Behavioural & cognitive · Óscar F. Gonçalves · 1994 · Braga, Portugal

What it is

Cognitive narrative psychotherapy (CNP) is a structured, individual cognitive-constructivist therapy developed by Óscar F. Gonçalves at the University of Minho (Braga, Portugal) in the early 1990s. Its author frames it as hermeneutic and constructivist, in contrast to the rationalist cognitive…

Format

• Format. Individual talk therapy with a fixed phase sequence. The 1994 paper describes in-session exercise and practice sessions, guided imagery, and homework that applies each attitude to daily events. It treats homework as central to consolidating the work. The 1998 manual presents CNP as a brief…
• Recurring within-phase structure. Each phase has two objectives: developing the phase's attitude, then applying it to the prototype narrative. The work runs in four steps. (1) The therapist models the attitude, typically with excerpts from novelists and other writers or artists. (2) In-session…

Questions to explore with your client

• What drew you to it, and what are you hoping it will change?
• Is there physical contact? Was it explained beforehand, and do you feel free to say no or stop at any point?
• Does it involve any substance, plant preparation, remedy or supplement? Has your doctor or prescriber been told, especially about any medication you take?
• Does it involve intense or unusual breathing? Have you been told about the medical conditions for which that is not advised?
• How do you and the practitioner understand what is happening, in spiritual or cultural terms? Is that a source of comfort, worry, or both?
• Who runs it, and what training or registration do they hold?
• What actually happens in a session or meeting, and how often?
• What does it cost, and is there pressure to commit to more?
• How do you feel afterwards, in the hours and days that follow?
• Does it fit with, or clash with, the work we do here?

What practitioners of it watch for

• Ending anxiety; consider spacing the final sessions.
• Polite agreement. Ask for felt fit, not intellectual fit.
• The metaphor becoming a new stick to beat oneself with. Keep the stance curious.
• Over-reliance on informal ratings; supplement them with standard symptom measures.
• Strong grief or trauma reactions to objects; agree beforehand that the client can stop at any point.

Problems the guide addresses

• Stuck client: thin, generalised or absent episodes
• Emotional overwhelm or dissociation during objectifying or subjectifying
• Intellectualisation and over-control
• Resistance to the narrative frame
• Homework non-adherence
• Alliance ruptures
• Modality-specific difficulties

When to involve someone else

• New or worsening physical symptoms, or advice to stop or change prescribed medication: involve the client's doctor or prescriber.
• Signs of coercion, isolation from family and friends, escalating costs or secrecy: discuss openly and consider safeguarding.
• A crisis or thoughts of suicide: follow your crisis protocol. In the US, call or text 988; in the UK and Ireland, Samaritans on 116 123.

Drawn automatically from the guide's own sections. Stay curious: neither endorse nor dismiss what the client values, and check anything that matters against the full guide and its sources. Not medical advice.