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Using Visual and Narrative Methods to Achieve Fair Process in Clinical Care
Published on: February 16, 2011
Innovative moments and change pathways: a good outcome case of narrative therapy
Anita Santos1, Miguel Gonçalves, Marlene Matos
1Instituto Superior da Maia (ISMAI), Maia, Portugal.
Objectives:
Our aim was to explore the development of innovative moments (i-moments) in therapeutic conversation and to study how they match our heuristic model that accounts for the development of change, drawn from previous empirical research.
Design:
In this therapeutic process research, we analysed a good outcome case of narrative therapy with a woman victim of intimate violence.
Methods:
This case, composed of 12 sessions, was analysed with the Innovative Moments Coding System: Version 1. This coding system allowed the identification of five different types of innovations (i-moments) that appeared during the therapeutic process: action, reflection, protest, re-conceptualization, and performing change. For each session, an index of temporal salience was computed, as the percentage of the time in the session that client and therapist spent talking about each i-moment. Our analysis procedures provided a quantitative and also a complementary qualitative approach.
Results:
Data showed that the types of i-moments emerged differently throughout the process. Early sessions were characterized mainly by action and reflection (low temporal salience), middle sessions were found to have mainly protest i-moments (low or middle temporal salience), and final sessions were characterized by the combination of high salient re-conceptualization and performing change i-moments.
Conclusions:
Findings suggested that narrative change seems to develop in a cyclical way, in which different types of i-moments contribute to the development of a new self-narrative in different phases.
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