Therapeutic documents
Therapeutic documents
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Short definition
Therapeutic documents are written, visual or symbolic records created in therapy to support preferred stories, values, commitments, changes and reflections.
Level
Expanded definition
Therapeutic documents are commonly associated with narrative therapy, especially the work of Michael White and David Epston.
They can include letters, certificates, declarations, lists, drawings, timelines, maps, poems, stories, agreements, invitations or other documents that preserve and develop meanings from therapy.
A therapeutic document is different from a clinical report. It is not mainly about recording symptoms, risk or intervention. Its purpose is to support the person or family to remember, strengthen and live closer to preferred stories.
Therapeutic documents can help make change more visible and portable. They allow the therapeutic conversation to continue outside the room.
Purpose of this method
The purpose of this method is to give preferred meanings a form that can be revisited.
Therapeutic documents can:
- preserve important conversations
- strengthen alternative stories
- honour values and commitments
- record acts of resistance
- support identity development
- mark endings, transitions or achievements
- help families remember new understandings
- create a witness to change
When to use this method
Use this method when:
- a preferred story is emerging
- a young person or family wants something to remember
- therapy is ending
- a significant moment needs marking
- a person has taken a meaningful stand against a problem
- values or commitments need strengthening
- the family may benefit from a shared written reflection
- the therapist wants to extend the conversation beyond the session
How this method works
The therapist creates or co-creates a document that captures important meanings from therapy.
The document may include:
- the person’s own words
- values that became visible
- moments of change
- acts of resistance
- preferred identity descriptions
- questions for reflection
- commitments or hopes
- names for emerging stories
- acknowledgements from witnesses
Therapeutic documents should feel personal, respectful and meaningful to the person or family.
Non-clinical example
A mentor creates a short written note for a student after a difficult year.
The note records how the student kept going, asked for help, repaired relationships and continued to care about their future.
The document helps the student remember a story of persistence rather than only struggle.
Clinical example
A young person has been working on standing up to anxiety.
The therapist creates a certificate or letter that names the young person’s acts of courage, the tricks anxiety uses, and the ways the young person has begun to respond differently.
The document can be kept, shared with carers, or used as a reminder during difficult moments.
Step-by-step process
- Identify the purpose of the document.
- Decide whether it will be written by the therapist, co-written, or created by the person or family.
- Use the person’s own language where possible.
- Name the preferred story or value being supported.
- Include specific examples from therapy or daily life.
- Avoid clinical jargon unless it is meaningful to the person.
- Keep the tone respectful and dignifying.
- Ask whether the person wants to keep, share or revise the document.
- Consider who might witness or support the document.
- Review its usefulness later if appropriate.
Questions before using this method
- What preferred story needs preserving?
- Who is the document for?
- What form would be meaningful?
- What words or phrases did the person use?
- What values should be honoured?
- Could the document be experienced as too formal, too certain or too exposing?
Questions during use
- What would be useful to remember from today?
- What words should we use for this story?
- Who might appreciate knowing about this change?
- Would you like this written down?
- What should be included?
- What should be left out?
- How would you like to use this document?
Questions after use
- Did the document feel meaningful to the person or family?
- Did it preserve their language and dignity?
- Did it support the preferred story?
- Did it avoid professional over-interpretation?
- Was it shared only with consent?
- Did it continue the therapeutic conversation outside the session?
Related epistemologies
Narrative epistemology Social constructionism Poststructuralist epistemology Postmodern epistemology Relational epistemology
Related schools and models
Narrative Systemic Therapy Conversational Dialogic
Related concepts
Alternative story Preferred story Unique outcomes Thickening the plot Absent but implicit Stories lived vs stories told Identity construction Meaning-making Relational responsibility Witnessing
Related techniques
Therapeutic letter questions Witnessing questions Re-authoring questions Unique outcome questions Thickening questions Preferred story questions Reflective comments
Related pathways
Narrative pathway Conversational pathway Dialogic pathway Family and relational dynamics pathway Power and culture pathway
Key theorists / contributors
Michael White David Epston Alice Morgan Jill Freedman Gene Combs David Denborough
Key texts / references
- White, M., & Epston, D. (1990). Narrative Means to Therapeutic Ends. Norton.
- White, M. (1995). Re-authoring Lives: Interviews and Essays. Dulwich Centre Publications.
- Epston, D. (1994). Extending the conversation. Family Therapy Networker, 18(6), 31–37.
- Morgan, A. (2000). What Is Narrative Therapy? An Easy-to-Read Introduction. Dulwich Centre Publications.
- Denborough, D. (2008). Collective Narrative Practice. Dulwich Centre Publications.
Notes / source material
Therapeutic documents should be created ethically and collaboratively.
They should not become hidden clinical interpretations. They should support the person’s own meanings, values and preferred stories.
Review status
Status: Open for review
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