Narrative transformation as an outcome in the psychotherapy of schizophrenia

Assertions that changes or transformations in narratives contribute significantly to recovery from schizophrenia persist as a cornerstone of some psychotherapies. Yet when narrative transformation occurs in schizophrenia, what is there about the client's story that tangibly changes, and how might that be measured? To address this issue, we review literature on the importance of narrative transformation and identify narrative qualities that might theoretically change. We then report content and thematic analyses of the qualities of narratives that might potentially change over 14 months of psychotherapy. These analyses suggest that narratives in schizophrenia may gain complexity and dynamism, but the changes do not entail the creation of a new story or the ‘awakening’ of an ‘old’ self. From these analyses, the hypothesis that narrative transformation may occur in terms of growth in the richness of the internal dialogue that produces narrative is posed for future research.