TOPIC: The intent of this article is to explore the efficacy of both the literal 
and concrete externalization aspects within narrative therapy, and the 
implementation of interactive metaphors as a combined psychotherapeutic approach 
for decreasing anxiety with people who present with high-functioning autism.
PURPOSE: The purpose of this exploratory article is to propose the use of 
externalizing metaphors as a treatment modality as a potentially useful way to 
engage clients. Specifically, a three-step process of change is described, which 
allows for concretizing affective states and experiences, and makes use of 
visual strengths of people presenting with an autism spectrum disorder.
SOURCE: A selective review was conducted of significant works regarding the 
process of change in narrative therapy, with particular emphasis on metaphors. 
Works were selected based on their relevance to the current paper and included 
both published works (searched via Psyc-INFO) and materials from narrative 
training sessions.
CONCLUSIONS: Further research is needed to address the testable hypotheses 
resulting from the current model. This line of research would not only establish 
best practices in a population for which there is no broadly accepted treatment 
paradigm, but would also contribute to the larger fields of abnormal psychology, 
emotion regulation, and cognitive psychology by further elucidating the complex 
ways these systems interact.