This paper considers the narrative structure of clinical action. I argue that clinical encounters involve clinician and patient in the creation and negotiation of a plot structure within clinical time. This clinical plot gives meaning to particular therapeutic actions by placing them within a larger therapeutic story. No therapeutic plot is completely pre-ordained, however. Improvisation and revision are necessary to its creation. In making a case for the narrative construction of lived time, of narratives that are created before they are told, this paper departs from the predominant mode of narrative analysis within medical anthropology that has focused on narrative discourse. Therapeutic emplotment is concretely considered through an interpretation of a single case, a clinical interaction between an occupational therapist and a head-injured patient.


Narrative inquiry is gaining momentum in the field of nursing. As a research approach it does not have any single heritage of methodology and its practitioners draw upon diverse sources of influence. Central to all narrative inquiry however, is attention to the potential of stories to give meaning to people’s lives, and the treatment of data as stories. This is the first of two papers on the topic and addresses the theoretical influences upon a particular narrative inquiry into nursing scholars and scholarship. The second paper, Conducting a narrative analysis, describes the actual narrative analysis as it was conducted in this same study. Together, the papers provide sufficient detail for others wishing to pursue a similar approach to do so, or to develop the ideas and procedures according to their own way of thinking. Within this first theoretical paper, perspectives from Jerome Bruner (1987) and Wade Roof (1993) are outlined. These relate especially to the notion of stories as ‘imaginative constructions’ and as ‘cultural narratives’ and as such, highlight the profound importance of stories as being individually and culturally meaningful. As well, perspectives on narrative inquiry from nursing literature are highlighted. Narrative inquiry in this instance lies within the broader context of phenomenology.

Special education in Russia is undergoing major change. It is shifting from a system that was first established under the Soviet communist regime over 70 years ago to one that reflects a more humanistic view of children with disabilities. To describe special educationin Russia, this article (a) explains the background information on the formation of a Russian-American partnership, (b) offers an historical perspective of special education in Russia, (c) reviews the current status of special education in Russia and in particular the Sverdlovsk Oblast, and (d) forecasts future directions of Russian special education. In considering new goals and future directions for special education in Russia, the authors suggest that the policies and legislation developed by the Provinces in Canada may offer a workable model for a Russian special education system.

This article is the outcome of a working partnership between two universities–one in Russia and the other in the United States. The two universities have in common large departments of special education and a curriculum that prepares teachers to work with students with disabilities.