Yesterday I received an email from Dr. Andrew Cashin who resides and works in Australia. I had first contacted Dr. Cashin a couple of years ago when I found myself tasked to work with a young boy whom had been diagnosed with Autism. I immediately went searching for articles or sources for how to work from a narrative approach with people diagnosed with Autism. I found only one article and it was Dr. Cashin's. I used his article as a guide for my work and found it to be quite successful. The mother of the child was quite pleased with the work we did together and toward the end of our time together (they moved) told me that my client "had his best IEP meeting ever." After that I reached out to Dr. Cashin to ask him if he knew of other sources for my work and he was quite helpful and told me that they were starting some new work and that he would keep me informed.
Yesterday in his email he sent a new article that he authored with Graeme Browne, Joanne Bradbury, and Ann Mulde that was published in the Journal of Child and Adolescent Psychiatric Nursing titled The Effectiveness of Narrative Therapy With Young People With Autism. The aim of this pilot study was to be the first step toward empirically determining whether narrative therapy is effective in helping young people with autism who present with emotional and behavioral problems. Being a pilot study the authors used a convenience sample of 10 young people with autism (10–16 years) to evaluate the effectiveness of five 1 hr sessions of narrative therapy conducted over 10 weeks. In the study the primary outcome measure was the parent-rated Strengths and Difficulties Questionnaire (SDQ) but the study also used as secondary measures the Kessler-10 Scale of Psychological Distress (K-10), the Beck Hopelessness Scale, and a stress biomarker, the salivary cortisol to dehydroepiandrosterone (DHEA) ratio.
Well guess what he results were? Significant improvement in psychological distress identified through the K-10 was demonstrated. Significant improvement was identified on the Emotional Symptoms Scale of the SDQ. The cortisol:DHEA ratio was responsive and a power analysis indicated that further study is indicated with a larger sample. Leading to the conclusion Narrative therapy has merit as an intervention with young people with autism and of course further research is indicated.
No matter where you fall on the narrative therapy and research question there are some realities to doing the work we do in North America, evidence based practice is king. However there is some hope for those that want to continue to practice narrative therapy in certain settings. There's John Stillman in Minnesota and his work with the Veterans Administration researching narrative therapy and trauma and now Dr. Cashin and his fellow authors providing promising results with narrative therapy and autism. Who knows, with me starting a PhD program next month, I might throw my name into that research hat as well.