Avoid Using Metaphors Like a Medical Prescription

One option I explored in structuring this book was to list the sections in Part Two under diagnostic categories relevant to children such as depression, anxiety, fear, conduct disorders, relationship issues, and so on. I chose not to do that, first, because I consider it more helpful for the therapist to be mindful of the outcome than of the problem and, second, to avoid the temptation to use healing stories prescriptively. I wanted to avoid the formula that says "diagnose depression, prescribe Prozac," "think abuse, analyze repressed memories," or "see conduct disorders, do cognitive-behavior therapy." Such prescriptive thinking may work, at times, but it runs the risk of being inappropriate and even dangerous if it does not allow the therapist to acknowledge or adapt to the client's individual needs and resources.

For these reasons I have sought to avoid such prescriptive use of stories, though again there have been some exceptions to this. Story 89, "Facing Thoughts of Suicide," presents a message that suicide may not be a wise option and that in the future things may look different. Such stories may work for some adolescents at some times—and this is the very issue about using stories too prescriptively. They work best when most applicable and relevant for the listening child or adolescent. One story about not enacting suicidal thoughts does not fit all clients. Our stories are likely to be most beneficial if they are directed toward enhancing the things in that individual adolescent's life that will serve as preventatives to suicide. Is the client feeling suicidal because of the lack of friends? Are these feelings related to conflicts in their relationship with parents? Do they lack self-confidence and self-fulfillment? Do they have negative, helpless, hopeless, depressive cognitions? Metaphor therapy may be better directed to building those preventative skills rather than just saying, "Don't do it." Like any therapeutic intervention, it will be most effective when specifically geared to the needs and objectives of that individual client rather than offered prescriptively on the basis of the defined problem.

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