Narrative is an emerging adjunct in psychiatric communication allowing a meaning-centred interpretation of patient experiences. Despite this fact the philosophical framework for such an approach remains largely unknown. This article builds on an earlier article and aims to set out the underlying principles allowing the establishment of a practical and expedient use of this technique to aid patient–physician interaction and therefore improve the quality of that encounter. It will give a philosophical overview of this technique, describe its practical use in a worked example and finally expand the discussion with an argument for its integration in routine clinical consultation.

Psychiatric training in all European Union (EU) Member States complies with the relevant Council Directive 93/16, permitting free movement of specialists within EU borders. This assumes that the training offers similar experiences, and produces specialists fit for purpose in all EU countries. Surveys demonstrate that, although all countries adhere to the conditions of the Directive, the diversity of training is striking on all but the most fundamental aspects. An added complication is that psychiatric practice has become increasingly diversified, even between neighbouring countries, and psychiatric training will have evolved to meet national service requirements. Questions about how to safeguard competence of psychiatric specialists to practice across the EU are therefore pertinent, and introducing systems to regulate quality control of training should be considered.

Solution-focused brief therapy (SFBT) can be widely implemented in psychiatric practice as a short form of psychotherapy that reinforces the client's autonomy and focuses on what the client wants instead of on the problem. It was developed by an iterative process of removal from existing therapy of any features not found to promote good outcomes for the attenders. Research indicates that SFBT is effective and cost-efficient, and when used in practice makes the psychiatrist's work more satisfying. It can be used as a primary intervention, for example during crisis intervention, as a formal psychotherapy and as an addition to pharmacotherapy.