Narrative Therapy Role-Play – Externalizing the Problem – Excessive Worry

hey bro hey doing today okay okay a
little bit anxious lately I’ve got a lot of pressure coming up at work and as we
talked about before work is kind of a struggle for me because of all the
pressure I’m under so so you feel a bit anxious and it’s work-related yeah so
what’s going on there well I’m a member HR and I’m part like we have hiring
fairs and other things where we need to hire people and there’s only like like
two or three of us to do the job and next week we have something event where
we need to hire some people and I’m just really worried about hiring the right
people and and when making these tough decisions about like the future of our
company all right so you’re worried that show select people that aren’t ideal for
the positions right like that’s happened before where someone’s done that and
hired some wrong people and like some things happen in the company and then
that person got in trouble for it so I just want to make sure I hire like
people who are gonna be good for our company and there’s a lot that rests on
like my judgment and the worrying it’s in a way of the judgement yeah because I
kind of second-guess my instincts on you know people and if they’re oh they will
be good how long has the worrying been part of your life first of all cuz I can
remember I’m just like warrior like I worry about everything we’re but
everything so not just not just interviewing people but other areas as
well yeah definitely but this is reviewing people this worry is more
intense right now this is what you’re thinking about now right like I don’t
want to be fired for you know hiring the wrong people
I don’t want my company to not do well because I hired the wrong people like
it’s a lot of pressure for me I feel like so I’m really nervous all right so
it sounds like you’re really struggling with this you’re worried about your the
company you work for in your own job yeah in performance and you mentioned
that you’re a worrier yeah yeah I feel like I worry about everything it’s kind
of how you view yourself definitely so what if we reframe this another way and
think about the worry as a separate entity I see you’re kind of identifying
as a warrior now it’s like it’s part of you right like it’s Who I am
like it’s who you are max you allottee the worry is external to a degree right
so so let’s have you here let’s move the worry over here a bit and
think of the worry it’s almost a separate entity okay so what’s the worry
trying to do to you what’s the separate entity of worry trying to do the worry
seems like it’s trying to make me doubt myself and you know question my own
judgment and not have faith that I’ll make the right choice all right so it’s
generally disrupting you from here yeah I don’t have as much confidence all right so the worry is over here
sori is over here and it’s making his attempts to lower your confidence make
you question how good you are your job right in a way it’s trying to manipulate
you into believing those things right what is evidence suggest in terms of
your history in this particular function is a function of interviewing people
have you performed I mean I think I’ve done it okay so far like I’ve been doing
this particular job for a while now and I’m one of the people they rely on to do
it the most like to hire the most people so I mean I would say I’m doing a pretty
good job um right now but it’s kind of like you
know seeing what happened to somebody else I’m kind of like worried about that
so the evidence tells you that your evaluate the evidence approach that
you’re doing you’re doing okay in that job but you see other people that
haven’t done this well right and that’s when that worry comes back and tries to
convince you that you’re right you’re not going to do well so what what do you
say to the worry the next time it comes in like what can you what can you
communicate to the worried I mean I guess I could say that so far I’ve hired
some people who have been worthwhile to the company and you know they trust me
to do this job my bosses trust me to this job so new chances are I’ll make an
informed decision based on my experience that’s the that’s the challenge that you
can put up against worry when it comes to right to try to influence you
right is that something you feel you can do the next time you have thoughts of
worry it’s hard sometimes yeah because I feel like the worried voice is really
loud sometimes so strong too strong boy yeah try to think of it when when that
voice is audible try to think of it as something external
not necessary something internal like you’re a warrior like that thought but
more like worries outside of me and worries trying to come in like trying to
influence or manipulate me exactly okay yeah try to try to reframe
it in that way rather than identifying as a worry I know that’s real for you
and that’s how you identify but let’s let’s try this experiment we’ll retreat
the worry is kind of an outsider that’s encroaching in on your territory
and disrupting okay your job a bit and then your your job then would be to
challenge the the thoughts of that worry tries to introduce okay that make sense
so when is the next time you’ll be interviewing people for your job next
Wednesday X Y Z so you feel like next Wednesday you can apply that kind of
reframe yeah I think so all right give that a try and I’ll see
you in a week and we’ll we’ll build from there okay thank you thanks April

74 comments

  1. I really like how this approach externalized the worry that the client felt. Once she took a step back and looked at the problem from the outside she was able to see what it was doing to her. She than could realize the good that she had done for the company and ease the worry she had.

  2. This one was interesting for me. I can relate to the client's excessive worry. I think it is interesting to think of the worry itself as an external entity instead of being something that's inherent. I am not sure how effective the technique would be however, especially when the voice of the worry gets really loud, like the client stated. Interesting!

  3. I found this technique to be very interesting. I like how Dr. Grande was able to get her thinking that worry could be seen outside of her, but did acknowledge to her at the end that he realizes that worry is a real part of her. I think reframing worry as it was done in this video is something that would be useful for many people.

  4. I like how Dr. Grande re-frames the worry as an external entity, and got the client to see the worry as an outsider. This technique would be really effective especially for client's who internalize things and are constantly anxious and worried. This was almost like the empty chair technique in a way.

  5. I wonder how easily a client who has crafted their identity around problems such as anger, worry, temper, and depression would take to this technique of externalizing the problem. These individuals may believe the problem is inherent in them and their personality and may not be receptive to this or any reconstruction of their narrative. In that case, would narrative therapy be the best approach?

  6. Making the worry it's own "thing" and separating it from the actual issue before he is a great technique. Worrying is not going to change her ability to choose the right person for the job. He separated the worry from her and gave it a face. It gave her the opportunity to change the story. I use this technique often for myself and others seeking empathy with worry.

  7. I thought that this therapy was really interesting. I liked that Dr. Grande got the client to see that the excessive worry wasn't exactly who she was as a person. Dr. Grande helped the client to take this worry and externalize it from herself. I think that this therapy could be helpful for clients that believe they are what they feel.

  8. I liked how Dr. Grande led the client to see that the worry is a separate piece of her and not who she is as a person. Through narrative therapy he was able to help the client rewrite the story by focusing on her actual experiences.

  9. I liked the approach, reminded me a lot of cognitive self talk technique. I think when the counselor separated the two from each other she was able to look at the situation with a different lens, without labeling herself. I feel she will be able to control those thoughts as they approach her with this strategy over time.

  10. I think this technique was helpful to the client because by externalizing the problem, she can change her perspective to be a worrier to recognize that worry is something out of her. Also she could explore how even she was worried of performing poorly at her job, experience proved that she was actually doing a good job.

  11. I thought that this was a great technique for someone who worries a lot. I can see how it could be used for other issues too such as shyness, anger, etc. It seemed to help the client with the issue because she identified herself as a worrier so taking that and making it separate from herself was a good strategy. It helped her to see that she was doing a good job at work and gave her a good way to combat that worry when it comes up again in the future.

  12. This technique helps the client take something that she has internalized, "I am a worrier", and externalizes it allowing her to take the label off of herself that she put there.

  13. Externalizing the worries of the client was a fascinating technique in helping the her gain more self-confidence. She needed to rely on the evidence of her job to challenge the worries. It was helpful.

  14. Narrative therapy has a lot of different techniques and when reading about them, it has been difficult to envision it. Here the description is put right into a step by step visual, where the client has to make the worry a separate entity, almost as a person. where the individual has to describe it and then talk to it to combat it (evidence and challenge).

  15. I really liked how Dr. Grande had the client think about how she has been successful in the past in an attempt to make her realize that she is worrying based on something that has happened to someone else and not to her. Dr. Grande did not discount that the client has always worried about things, but attempted to have her try reframing her thoughts when worrying.

  16. so the "narrative" refers to an internal narrative the person tells themselves about themselves? is that what I'm seeing there? goal is to pause that narrative long enough to make the person aware of it, then equip them with tools needed to counter the narrative of internal dialogue or preconception?

  17. This video is a very brief yet clear display of how Narrative Therapy would help a client. By introducing the process of externalizing the problem, which is the "worry", the counselor helped the client see the problem as it was from the outside of the client herself. That way, it made more sense and gave the client more motivation/reason to challenge or fight with the external strength. Great illustration!

  18. Though Narrative Therapy may use awkward techniques, it offers simplicity in finding a means with which to relate. Most people understand the elements of a story: Protagonist, plot, theme, etc. After assessing duration and severity of the anxiety, the counselor suggests that the client view the problem (worry) as an external factor, which seems unusual at first. However, the alternative narrative brings new meaning. The personal constructs become the client as a competent person and worry as the manipulator trying to sabotage her. The power of words such as describing worry as a "disruptor" and "manipulator," sets the stage so to speak. The act of challenging the manipulator is clear. This reframe not only makes sense for the client, but also is positive. The client's personal construct changes from a worrier to a competent individual able to challenge worry so that she can function as desired.

  19. This was a great role-play because I was easily able to recognize the techniques used. In helping the client to construct her narrative, the counselor asked questions about the client's past worrying and job performance to see how the problem influences the client. The counselor also attempted to help the client reframe her narrative by externalizing her worry as being separate from the client. The counselor and client gave the worry a separate identity with separate personality traits as being manipulative, doubtful, and having low confidence. They set a goal to have the client attempt to communicate to her worry in the future as a separate identity, and hopefully the client will begin to reconstruct a new narrative and form a new identity.

  20. This approach from narrative therapy allowed the client to explain her conflicts/ problems. The counselor sat and listened mostly in the beginning, and then started asking questions to get a further detailed description of the issue at hand. This was a great example of reframing within narrative therapy to show how the technique is utilized.

  21. I think it was a good idea to clarify if the client's current problem of worry was the most significant, because it seemed to help both the client and counselor focus on one problem at a time amongst all of the client's worries. I wondered if the counselor should have dug deeper to ask about other problems at first, but I was pleased to see that he did not, so that he could help the client focus on one problem at a time, rather than bringing up more problems and not addressing them at once. It was a good way to focus the conversation more. I also thought it was a good idea to have the client reflect on strengths and encouraged them to think about those strengths when they are presented with worry for the presenting problem, along with reframing their thoughts.

  22. I enjoyed watching this approach. I liked that the counselor could have the client see the excessive worry. I really think this type of therapy could help individuals that are encountering situations in their life. I like the re-framing idea.

  23. This is very interesting. I really like narrative therapy but when I think of it I think about story telling. I like how Dr. Grande used the technique externalizing the problem. I like how when using this technique he made the client desperate the worry from her life. This allowed her to see the worry as a culprit. This helps her to see how this worry can affect her life at work. Although this was super brief he was able to kind of deconstruct the problem in efforts to find a solution.

  24. She was having the experience of worrying. Dr. Grande showed her that re framing it as worry coming in. Rather than her being a worrier. She then was to challenge those thoughts which would help her re frame.

  25. I really like the externalizing technique used in narrative therapy. Most of us often identify ourselves with the problem, as if we are part of it and it effects how we respond. In separating the issue from ourselves and giving it its own life, it is a way to view it outside of ourselves and then objectively analyze its impact on us.

  26. I liked how he identified that worrying has been an ongoing issue for the client however he was able to identify the current problem. He was able to get her to separate herself from worrying and identifying how it causes her to question her judgment.

  27. I participated in a Narrative therapy role-play for test anxiety and with reinforcement this technique can work. Separating one's self from the issue and then re-framing the negative thoughts with positive thoughts can be beneficial in many ways.

  28. I enjoyed watching this role play. I didnt realize when Dr. Grande said externalize the worry that they literally were going to talk about worry as if it were a person and was no longer a part of the client. Also I think giving a homework assignment was a great way to close the session.

  29. I'm not as particularly fond of this theory. I struggle with the concept of externalizing feelings because it doesn't seem like it would be easy to accomplish. It's such an abstract thing to try to do with a client that it would almost have to be forced. However, that being said, I think Dr. Grande did a really good job at making this concept seem more smooth. I just don't think I would be able to accomplish the same in my own practice.

  30. This approach seems like it would be beneficial to the client. By identifying the worry as it's own entity and speaking to it as if it were another person, reminded me a bit of REBT with irrational thoughts and working through the thought process to eliminate the irrational thought. Being aware of how you're feeling in the specific situation is a great first step. Implementing this practice that Dr. Grande demonstrated could certainly be effective.

  31. I can see how externalizing the problem allows the client to separate the emotions tied to it so that she can deal with it more rationally or cognitively. It is a good idea in theory and may work for some, but it seems to me only a certain set of clients. In this case, the client is able to identify her strength against "worry." I would have liked to have seen a little more drama in the video. I think externalizing requires imagination and creativity. I think it would be helpful to have the client experience HOW she would talk to worry (perhaps sternly).

  32. The narrative role play helped the client detach from the worry and treat it as a separate entity. This was effective for the client to create a different picture and relationship with worry. She implied that it has been almost an excessive part of her life by worrying about everything. This reframe is a good start for her to replace a habit with something more positive.

  33. I really enjoyed this role-play. I felt that there was a good use of this technique. The counselor, Dr. Grande identified the client’s source of worry and focused on it. I like that he focused on one issue instead of a variety of issue. He then walked his client, April through the process of her worry. Together they identified how her worry was negatively impacting her life. Dr. Grande suggested that April challenge the worry and treat it as an external entity. I myself am I big worried and I really found this technique helpful on a personal level.

  34. This role play provided a great example of how to use this therapy in a counseling session. After the client expresses her worry and anxiety, the counselor gives her the floor to dive deeper into what is causing the worry. The counselor has the client separate herself from the worry to help her process why she was feeling anxious. I think it helped the client dive deeper into her struggles at work and how the thought of not doing well or being a failure was overpowering her work and how she can re-frame those thoughts to reduce her worry.

  35. This was a very interesting concept, trying to externalize "the worry". I liked how she got to see that the worry doesn't change who she is as a person and that she could stand up to "it". Rather than telling herself, this is who she is and will always be, she was able to look at it from a different point of view. She said gave examples as to why she shouldn't worry, such as her boss trusts her to do this job and she has done a good job in the past.

  36. Really straight-forward approach to externalising issues – would you be able to provide an example of narrative therapy with children?

  37. This exercise not only helps me with my schooling for professional counseling, but as a person, too. It is so easy to fall into the trap of, "I am depressed; therefore, I am a depressed person." This exercise puts some healthy distance between the person and their malady. Thank you for posting this.

  38. i'm pretty much eclectic in many areas – narrative therapy would be very useful to integrate into treatment. i think the separation of symptom and the individual is a good way to think about one's "problem".

  39. This is an interesting way to view worry and problems. Looking at it from an "outside" perspective can relieve the pressure and anxiety it causes when we view this from an internal perspective. I like how you guided the client to look back at previous experiences and how they worked out favorably for the client. I applied this view to some challenges I am having in my life and will work towards challenging my own thoughts and try to look at worry as an outsider.

  40. The counselor demonstrated skills good by allowing the client to differentiate the difference between the person she was and the worry she was experiencing. He allowed the client to discuss her story by asking good questions.

  41. Dr. Grande was effective in externalizing the excessive worry described by the client by saying "the worry" instead of "your worry". I liked how they collaboratively examined what impact the worry was having on her day to day functioning. I think narrative therapy would be a great to use in the first several sessions in order to understand the client's presenting concern and the history of it. As therapy continues, the client and counselor can continue to tell the story, but instead find new ways to address the issues and build resilience based on the client's own experiences. This is a theory that resonates with me and I can see myself implementing many of these concepts in my work with clients.

  42. I liked how separating the client from the worry helped her to see it in a different light. By doing that the client may be able to see it as something that she can manipulate rather than it manipulating her. Reframing technique was good to see in action.

  43. Thanks Dr.Grande for this demonstration. Nice to see how reframing the Worry can put the client back into power. Its no longer controlling me, I can chose how to feel. That's great. Also mentioning the client's past performances and how she shouldn't disregard them seemed influential.

  44. I really liked the externalizing technique because it contradicts the idea that excessive worry (or any other presenting symptomology) is an inherent part of a client. Dr. Grande further empowered the client by having her identify all of the good hires she has made for the workplace, therefore easing her fears by highlighting specific examples.

  45. I really liked how Dr. Grande helped the client see her worry as something outside of herself rather than a part of who she is. I think that this could help her to view her worry (or any other symptom she may experience) as something that she can change. I also liked how he helped her to see/remember times when she did perform well, to also help in alleviating some of her worry.

  46. I appreciated how the counselor in this role play was able to bring light to the client's past performances to ease her excessive worry she experiences now. The technique seemed to enlighten the client on the positives rather than the negatives she was facing prior to the session. When individuals experience negative emotions, they begin to feel as though the negatives define who they are as a person, and the counselor was able to remind the client that that is not the case.

  47. This role play of narrative therapy was very useful to me because I have no idea what this type of therapy should look like in a session. The way narrative therapy seems is that the client makes up a story and tells it, but in reality they just tell their story and the counselor helps to reframe it to develop alternative ways of being or acting. I wasn't expecting him to be so direct as the counselor but it was helpful in allowing the client to recreat her story and work to defeat the problem.

  48. I think that Dr. Grande, even in this short span of time, provided a highly valuable look into how narrative therapy can work for an individual to separate themselves from their concerns. I liked his questions "what is the worry trying to do to you?" as well as "what can you say to worry?" to help her better conceptualize the worry as a separate entity. I believe the discussion of seeing the worry as a manipulator vs. what evidence there is to support the worry was highly helpful to the client in providing empowerment to challenge her anxiety.

  49. It is evident that the client's worry is controlling her life and she can't even remember a time when she didn't worry about things in her life. I think that using Narrative Therapy's method of externalizing her worries, was very effective for this client. The client was able to understand how worrying effects her daily life by lowering her confidence and question her abilities. Instead of letting worrying be apart of her, the client successfully created solutions for how she can separate herself from her worrying. This use of therapy seemed to truly empower the client and help her take back her confidence.

  50. I appreciate how Dr. Grande presented the idea of viewing “worry” as a separate entity. It allows the client to disconnect from the concept, therefore preventing herself from identifying as a worrier, but rather seeing how “worry” can affect her thoughts and view of self. By using such a technique the client is able to have awareness of when “worry” is approaching, and work to challenge the effects that “worry” brings. In this respect, the client may alter the effects to become positive, therefore allowing the client to have confidence in her abilities and prevent “worry” from taking form and manipulating her mindset.

  51. Dr. Grande did a great job illustrating how to speak to a client in a way that separates their issue from them. In this case the clients worry needed to be externalized. I think that this technique would be helpful in getting people to address their issues without feeling plagued by it since they are being taught to see it as separate from themselves. Externalizing also allows the client to examine the issue without feeling attacked.

  52. I like how Dr. Grande took the client's narrative of excessive worry and helped the client challenge those thoughts. He took the client's perception of her worries with hiring qualified candidates at her workplace and reinterpreted them into an easily understandable way for the client. She was challenged to be in control of the worry rather than allowing the worry to control her since she was using false evidence of why she may do poorly. Dr. Grande ended on a positive note of reflecting the strengths of the client in her previous performances which I found beneficial to the client.

  53. Dr. Grande- I enjoyed watching this session about helping the client manage how she worries. The technique you used allowed the client to be calm, comfortable and more open. The appropriate use of challenging the client and externalizing the worrying. It was important that you talked to her what the entities of her worries. Importantly, this type of therapy allowed the client to think and come to her own conclusions in what her worries mean to her. Great job!

  54. Dr. Grande was specific to encourage the client to create a narrative and ultimately externalize the problem. Using questions to gather more information and reframing the client's worry regarding various aspects of her job, the clinician was successful in rewriting the client's narrative more positively/from a different point of view. I personally like this technique and feel as though it can be productive for clients in session.

  55. i thought it was cool to watch this technique in action. Until my readings and viewing this video, i did not know much about narrative therapy or techniques used in it. It was interesting to watch how Dr. Grande had the client view her worry as something outside of herself and a separate entity. It seemed as if it was useful for her to disassociate from it and not label herself as a worryer

  56. Dr. Gande did a great job helping the client separate herself from her worry and externalize the problem. The client was able to realize that being worrisome is not "who she is." Like she had said prior to the technique being used.

  57. Thank you for the role play. I liked the use of externalization to separate the worry from the individual. The reframing techniques seemed helpful to offer an alternative narrative for the client. The exercise seemed practical and offered skills that the client can use immediately to improve functioning.

  58. Narrative therapy seems like a great way for clients to externalize issues so that they can directly communicate to them. Treating worry as a separate entity gave the client power of her worry, feeling that she could make a change since it no longer lived internally. It can seem easier to address external forces rather than internal ones. Dr.. Grande used the word reframe as means to give the client a new way to look at her issue and draw it from within. I like this particular therapy since many individuals deal with internal forces of which they feel they have no control.

  59. The video was helpful in showing how Narrative therapy works. This is not a therapy I would use very often, however because it does not seem like it would be very effective in long term healing. I think it is a good short term therapy style and can be useful in situations that are not very severe.

  60. I actually really like this type of therapy and the technique of externalizing. I personally work in addictions counseling and to use externalizing on an addiction would really help the individuals feel rid of the stigmas that are associated with addiction and the label of "addict." It was helpful in this role play that the therapist helped the client recognize that her worry is more or less an outside entity and not who she is.

  61. I have found a lot of interest in narrative therapy and seeing Dr Grande utilize the technique of externalizing the worry from the client was very helpful in my understanding of the therapy type. Dr Grande used simple language where the client could understand what was going on but told the client what was happening so she could still tell her story and find clarity

  62. I like how Dr. Grande pushes the client to externalize her troubles she is having with some stress in her life. I also enjoyed the question of, "What is this anxiety trying to do to you?" I really like how that question is used here.

  63. Externalizing the client's feelings and challenges is really beneficial for all involved. While I don't feel like this would be a type of therapy that I would use often, it was still interesting to watch in action. As a result, it assisted me in gaining a better understanding of the theory as well as how it would play out in an actual therapy session. Dr. Grande did a really good job and I appreciate watching his role plays because they really help me to better understand the theory in addition to how the therapist can implement it into a therapy session.

  64. Dr. Grande, thank you for this role play as it helped me deepen my understanding of Narrative therapy. Externalizing the "problem" is an effective tool in bringing the client autonomy. Seeing how separating the problem, in this case being the client worry, from the client is effective in giving the client the strength to view the worry and be able to address it in a way that does not cause stress. Thank you for sharing.

  65. I really enjoyed this role-play. Narrative therapy is very interesting and I can see myself using it in the future with my clients (being as though I wish to work with children). The way Dr. Grande externalizes the client's excessive worrying seemed to benefit her. She stated that the "worry voice" is too loud, but Dr. Grande tries to remind her of different ways she can continue to externalize this worry voice.

  66. I really appreciate the demonstration of narrative therapy in action. I did some research on this form of therapy but actually seeing the therapist remove the worry from client instead of making or allowing the client to feel like it is apart of them was very useful.

  67. This was a really great video! I think I may try to think this way myself! I've never heard of this or thought this way before! Thanks Dr. Grande!

  68. This intervention puzzled me a little. Not because it wasn't good, but because I couldn't see why it's called "narrative therapy". I saw clear elements of traditional cognitive therapy (challenge your thoughts), and maybe something of ACT (distance yourself from your thoughts), but where is the narrative itself? I have the feeling that the kind of data that supports narrative therapy should give room to a completely different type of intervention.

  69. am new to this channel and Todd's body of work. appreciate the demo but also found myself put off by his body language — other than at 3'50" for few minutes, it's so closed off.

  70. Good demonstration. Maybe we should give the actress's character some better problems to worry about while we're at it. Worry getting in the way of hiring the right people at work? Snoooooooooze. How about I write your scripts for these demonstrations. For this one, let's give her a specific phobia: gerascaphobia – fear of aging. Now, let's give her a job next to an old person home. She can worry about having a panic attack every time she commutes to/from work. She can worry about how people perceive her when reacts to the sight of old people. She can worry about her relationship with her aging parents, deteriorating. And most of all, let's give her a pathological preoccupation with looking for any slight hint of a wrinkle every time she sees herself in the mirror or gets in/out of the bath.

    Now, that's a much more interesting case, right? Terrible for the character – so much so, one HAS to feel for her and want her to get well. Narrative Therapy externalizing this fear of age, aging, and old people – ready set go!

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