When you have been depressed for a while, it can start to feel like part of who you are. "I'm a depressed person." "I've always been like this." "This is just me." Narrative therapy offers a different way of looking at it. Instead of treating depression as your identity, it treats depression as a problem that has been influencing your life, one you can study, push back against and gradually loosen. This post explains how narrative therapy works with depression, a few common techniques, how it compares with CBT and what research does and doesn't show.
This post is general information, not a diagnosis or medical advice.
Narrative therapy for depression, the short answer
In narrative therapy, depression is seen as the problem, not as who you are. Your therapist helps you notice how depression has shaped the story you tell about yourself, then looks for the parts of your life that don't fit that story. Over time, the goal is to strengthen a fuller, more accurate account of who you are and what you value.
When people ask how narrative therapy and depression fit together, the simplest answer is this: depression tends to tell a narrow, harsh story. Narrative work helps you notice the rest of the story.
What is narrative therapy?
If you're wondering what is narrative therapy more broadly, it is a collaborative, conversational approach built on the idea that people make sense of their lives through stories. Those stories shape how we see ourselves, our relationships and our options.
The therapist acts less like an expert on your life and more like a curious partner, asking questions that help you see your experiences from new angles. You remain the expert on your own life. For a fuller introduction to the approach, see our narrative counselling page.
Externalizing depression in plain words
One of the core ideas in narrative work is externalizing. Instead of saying "I am depressed," you might say "the depression has been really loud this week" or "the heaviness talked me out of seeing friends again."
Externalizing depression can sound like a small shift in language, but many people find it surprisingly freeing. It creates a little distance. From that distance, you can ask questions like:
When does the depression show up most?
What does it tell you about yourself?
What does it want you to do, or avoid doing?
When have you resisted it, even a little?
Those questions turn depression into something you can observe and respond to, rather than something you simply are.
Re-authoring when low mood has taken over the story
Depression often edits out the good parts. It highlights failures and rejections, and hides moments of strength, care and connection. Narrative therapy pays close attention to those hidden moments, sometimes called unique outcomes: times when the problem didn't win.
Maybe you got out of bed on a hard morning to help a friend. Maybe you finished a project even though everything felt pointless. In narrative work, those moments aren't brushed aside. They become the starting point for a different story, one that includes your values, your effort and the people who see you clearly.
Your therapist may also invite you to think about who in your life would recognize this preferred version of you, and how to keep those relationships close.
Narrative therapy techniques you might use
A few common narrative therapy techniques include:
Naming the problem. Giving depression a name or description that fits your experience, such as "the fog" or "the critic."
Mapping its influence. Exploring how depression affects your work, relationships, energy and sense of self.
Searching for exceptions. Looking closely at times when the problem was weaker or absent.
Thickening the alternative story. Adding detail and meaning to those exceptions so they carry more weight.
Letters or documents. Some therapists write short summaries or letters that capture new insights between sessions.
You don't need to use all of these. Your therapist will adapt the approach to what feels natural for you.
What a session might look like
Narrative sessions usually feel like a thoughtful conversation. Your therapist might ask how the depression has been affecting your week, then follow up with curious questions about moments that went differently. They may summarize what they're hearing in your own words, and check whether it fits.
Over several sessions, you may notice the conversation shifting from what depression has taken from you to what you want to reclaim. Some people bring photos, journal entries or stories about people who matter to them. Others prefer to just talk. There's no single right way to do it, and you set the pace.
How it differs from CBT, briefly
Cognitive behavioural therapy (CBT) tends to be more structured. It often uses skills, worksheets and thought records to identify and change unhelpful thinking patterns and behaviours. Narrative therapy is more exploratory, focused on story, meaning and identity.
Both can help, and they aren't mutually exclusive. Some people like the clear tools of CBT. Others connect more with the reflective, values-based feel of narrative work. Many therapists blend approaches. The National Institute of Mental Health notes that therapists may use one primary approach or draw on several, depending on their training and the needs of the person they're working with.
What the research says so far
Here is the honest picture: the evidence specific to depression is thin.
A 2024 systematic review and meta-analysis looked at narrative therapy for depressive symptoms in adults living with physical health conditions. It found that narrative therapy appeared to reduce depressive symptoms in that group. But the authors rated the evidence as low quality, noted that most studies came from one country, and pointed out that only 2 of the included studies looked at people with depression specifically. They called for more research.
So narrative therapy is promising, and many people find it meaningful, but it doesn't yet have the large body of depression-specific research that some other approaches do. A good therapist will be upfront about that and talk with you about what fits. According to the Centre for Addiction and Mental Health, counselling is one of several forms that depression treatment can take, so picking an approach that feels right to you is reasonable.
Starting in person or online in Ontario
You can see us in Kitchener, Waterloo, Cambridge or Ottawa, or by secure video from anywhere in Ontario, and every location offers every service. If narrative work appeals to you, mention it in your free consultation so our admin team can suggest a therapist who uses narrative approaches.
Cost, billing and your first step
Sessions with our therapists range from $130 to $200, depending on the clinician.
Depending on your plan, insurance may cover up to 100% of the cost. Our insurance page explains what to check.
We accept Health Spending Accounts (HSAs).
We can direct bill many insurers, including for sessions with an RP (Qualifying). Desjardins is the exception: through TELUS eClaims, we can direct bill Desjardins for sessions with an RSW, RP or psychologist, but not for an RP (Qualifying).
Book a free 15-minute consultation with our admin team to share a little about your situation and ask whether narrative therapy might suit you.
If you're in crisis: if you or anyone else is in immediate danger, call 911. If you're having thoughts of suicide, call or text 9-8-8 any time.
Depression may have been writing much of your story lately. It doesn't get the final word.
Last reviewed: October 2026
Sources
Hu G, Han B, Gains H, et al. Effectiveness of narrative therapy for depressive symptoms in adults with somatic disorders: A systematic review and meta-analysis, International Journal of Clinical and Health Psychology, 2024
National Institute of Mental Health, Psychotherapies
Centre for Addiction and Mental Health, Depression