This chapter explores how an adoption of the narrative metaphor challenges our understanding of psychotherapy as a professional and social activity, and how a reframed understanding could form a platform for new kinds of discussion on differences and convergences among the therapeutic orientations. Different psychotherapeutic approaches give different descriptions and understandings of how such change-facilitating conversational formats can be created. There are a large variety of life situations that invite a person, or somebody in a person’s close environment, to seek help from conversational therapies. Such situations can be seen as having in common the experience of a disturbed sense of agency on the part of one or more persons. When one is approaching the question of comparison and integration of psychotherapeutic modalities from a narrative and constructionist point of view, one possibility is to look at how different therapeutic practices contribute to the re-negotiation and re-formation of identity projects and individuality.