Conference Agenda

This article presents qualitative research on ten short narrative psychotherapy sessions and five group discussions. The study examined co-writing as a therapeutic approach for patients with drug-resistant schizophrenia. It examines the dominant narratives in collaborative writing sessions between therapist/researcher and patient, as well as the most conflictual narratives and the I-positions that express them. A reflexive thematic analysis combined with a descriptive phenomenological analysis was carried out to explore the most representative themes and the meanings, experiences, and life worlds of people with this diagnosis. Central to this process is the co-construction of a meta-position that can manage the various internal and external I-positions and facilitate collaboration while avoiding power imbalances between clinician and patient. Overall, co-writing emerges as a promising relational and meaning-building intervention in psychotherapy and mental health services. It fosters a collaborative and relational approach by reconfiguring the power dynamics between therapists and clients, creating a more equitable and shared meaning-building process. From a practical standpoint, co-writing necessitates revising the clinical and ethical approaches. Therapists must develop technical, ethical, and dialogical skills related to negotiating co-authorship, managing disagreements, and shared reflexivity.

Long‑term narrative and dialogical therapies are fundamentally mismatched with classical randomized controlled trials (RCTs). Healing is multi‑component and contextual, including narrative groups, dialogical meetings, community and family involvement, shifts in staff culture, and attention to spirituality and Indigenous or local meanings, all of which occur together. Trying to isolate a single manualized “active ingredient” for an RCT, in their view, distorts what actually helps people. Work that is genuinely dialogical and evolving in response to participant feedback clashes with fixed protocols and tight fidelity demands. Ethically, it is questionable to randomize people in severe distress (psychosis, suicidality, chronic coercive care histories) away from a recovery‑oriented milieu to a fixed and rigid protocol. Outcomes like identity change, agency, and community participation are poorly captured by symptom‑only scales. Instead of classic RCTs, we favor mixed‑methods and naturalistic designs: pre–post quantitative measures, comparison with treatment‑as‑usual, intensive case series, and phenomenological descriptions of change. On locked inpatient units, they reported that adding a daily narrative group produced significantly greater improvement on measures such as BASIS‑32 than comparison units, with changes they interpret as clinically meaningful. In longer‑term dialogical and largely non‑pharmacological work with psychosis, we describe reductions in hospitalization and crises, diminished suicidality, and return to education, work, and relational roles—“recovery of function in the ordinary world”—even when some symptoms persist. There is a modest but growing body of literature showing that narrative‑based psychotherapies produce statistically significant improvements in symptoms and functioning, sometimes comparable to or superior to conventional CBT, though studies are usually small and methodologically limited. Narrative/dialogical approaches have enough empirical and experiential support to be considered reasonable alternatives or adjuncts to standard care, and future research must find creative designs that preserve the relational, cultural, and community context rather than stripping it away for the sake of methodological purity.

Background and Aim: People living with brain tumors face enduring uncertainty and a lack of understanding from others (Janda et al., 2006). Drawing on Dialogical Self Theory (Hermans, 2001), this study examines how "being understood" is interactionally achieved during life-story interviews and how these dialogical processes reshape illness narratives.

Method: Five cases were selected from life-story interviews with fifteen Japanese adults with diverse brain tumor histories. Using Dialogical Narrative Analysis (Frank, 2011), interview data were analyzed as multivoiced performances, focusing on turn-by-turn positioning and the evolving interviewer–interviewee relationship. A distinctive analytic feature was the interviewer's partial "insider" positioning—as a bereaved family member of a father who died from glioblastoma—alongside researcher and trainee clinical psychologist positions. This positionality was treated as both an analytic resource and an ethical challenge.

Results: Findings reveal that "being understood" is co-constructed through layered relational frames. Interviewees and the interviewer navigated multiple positions (e.g., patient–family member, friend-like, client-counselor), collaboratively generating new narrative possibilities. In this dialogical space, re-telling reopened previously closed experiences, rendering unmet psychosocial needs more speakable. Intertextual traces (e.g., blogs, SNS, mails) further supported ongoing self-reinterpretation beyond the interview encounter. Crucially, moments of recognition—when interviewees experienced being received—were linked to deeper reflection and a renewed sense of self-coherence. While the interviewer's partial insider stance fostered safety and depth of disclosure, it also required careful management of potential invasiveness.

Conclusions: This study suggests that dialogical interviewing can function as a care-like moment that facilitates narrative reconstruction. Methodologically, integrating shifting I-positions and wider interactional trajectories (including pre/post-interview exchanges and intertextual traces) offers a way to enrich qualitative data and to connect DST with narrative approach in health research. Ethically, the strategic use of partial insider positioning invites deeper dialogue but necessitates sustained reflexivity to manage mutual bias.