Published: October 2026

Keywords:
Lorenzo Atti, Cronen & Pearce, Micro-change; Chronicity; Immobility; Systemic-relational psychotherapy; Narrative practices; Coordinated Management of Meaning; Agency.

Lorenzo Atti

Lorenzo Atti is an Italian psychologist and psychotherapist trained in systemic-relational, dialogical and social constructionist approaches at the Centro Bolognese di Terapia Familiare.

He works in private practice and has collaborated with Insieme a Noi ODV, a voluntary organisation dedicated to social inclusion and mental health, since 2020. He has served as its coordinator since 2024.

His professional work includes individual and family psychotherapy, psychological support for family caregivers, and the development of community-based interventions. He also provides supervision to multidisciplinary teams working in day-care and residential services for people with disabilities. His interests include systemic practice in community settings, relational processes in mental health care, and the role of small-scale changes in opening up new possibilities for meaning and transformation in contexts characterised by chronicity.

Abstract

This article explores micro-change as a meaningful therapeutic process in the context of chronic mental health conditions, challenging the view of chronicity as an exclusively individual and diagnostic phenomenon. Drawing on systemic-relational and social constructionist perspectives, it conceptualises chronicity as a stabilised relational and narrative configuration maintained through interactions among individuals, families, professionals, and institutions. Building on Pearce and Cronen’s Coordinated Management of Meaning (CMM) model and Sluzki’s narrative framework, the article examines how subtle shifts in language, everyday actions, and relational positioning can generate new meanings and possibilities for agency. Through clinical examples drawn from community-based third-sector settings and private psychotherapy practice, it illustrates how recognising and supporting these micro-changes can challenge dominant narratives of incapacity and facilitate alternative identity positions. Rather than focusing solely on dramatic transformations or symptom reduction, the proposed approach emphasises the therapeutic potential of small differences to reopen possibilities for participation, autonomy, and change within seemingly immobilised systems.