Family Focused Session mft


Question Description

These are two different questions and should be answered separately with a minimum of 200 words each, and each must include 1 in text cite. Please use reading attached to answer questions

Question 1-Reading attached

Let’s discuss chapter 9 in Taffel, R. (2014). Breaking Through to Teens. Starting on page 216, he outlines the goals you should have for the family focused session. He spends the rest of the chapter discussing these points as well as what else may come up in the session.

Please elaborate on the steps he suggests in preparation for the family focused sessions, the goal of the family focused session, and what he states to look out for in these sessions.

Question 2 Video Transcript is second attachment

After reviewing the video please answer the following questions on how the therapist was engaging during the therapy session

How do you see the parents viewing the daughter?

How does the therapist join with the family?

How is the daughter engaged in the therapy?

How does the therapist help this family communicate?

Unformatted Attachment Preview

9 STUCK How to Conduct a “Focused Family Session” Ron, I don’t understand it. I’m trying to find a referral for a friend’s teenage daughter. Either they only see kids and won’t involve the parents, or they only see families and won’t see the kid alone. I thought we’d gotten further than this in the field. —An extremely experienced professional in a major, urban–suburban hub Slowly you turn yourself from a bridge into a well-worn path. Your office has become the town’s center, a place where park benches still exist. Copyright © 2005. Guilford Publications. All rights reserved. D uring the course of work with adolescents, there are times when it is absolutely essential to meet with the family, instead of with the child or parents alone. This is troublesome for many therapists. For the most part, we are trained to work individually with children or do guidance with parents or see families as a whole. Our narrow specialization drives families crazy. Having personally done and supervised thousands of initial interviews, I’ve learned that one of the biggest complaints patients have is a sense they are being forced into the teaching model of a training facility or the orientation of a private practitioner. This is maddening to prospective clients—approximately half terminate prematurely and find what they want elsewhere. Within many agencies, the family Taffel, Ron. Breaking Through to Teens : Psychotherapy for the New Adolescence, Guilford Publications, 2005. ProQuest Ebook Central, Created from touromain-ebooks on 2020-02-17 19:29:27. 213 214 BREAKING THROUGH TO TEENS is divided according to modality. When assigned as a “family” case, few of the treating therapists are equipped to see kids alone; if it is considered a “child” case, few of these therapists can handle the family in a room together. Almost none can move between modalities, keeping all relationships intact. What a perfect metaphor: Fragmented homes, already pulled between first and second families, now find themselves in a field that replicates the disconnection that got kids into trouble in the first place. The relational–behavioral approach is a way to address this fragmentation, challenging the distance between parents and kids while strengthening both kids’ and parents’ competence. Paraphrasing Winnicott, the 21st-century helping professional must create a flexible container: see kids alone, see parents alone, and feel competent to conduct what I call “focused family sessions” when needed. This is a difficult balancing act. In a disconnected world, however, it is necessary to integrate modalities. The information you receive from parents and kids and the way you use this information in conjoint meetings challenges family members to make significant changes in their behavior. This creates connections and family relationships previously considered impossible. Copyright © 2005. Guilford Publications. All rights reserved. Why a Focused Family Session? Talking in individual meetings is not enough. Dylan complains about his “crazy” mother. He describes to me how they get into fights over his grades and increasingly strident demands to go out with friends during the week. Interactions at home escalate, sometimes into physical standoffs. Recently, Dylan loomed over his mother with a baseball bat in hand, screaming he’d use it (not a real threat) if she pressed on. They are obviously stuck. When I work with Dylan alone I challenge him to make concrete changes around the house. His mother might not be so hysterical if he approached her less provocatively, or in a respectful way that eased her mind, at least slightly, about the kind of privileges he was demanding. At the same time, parent sessions did not lead to changes either. Dylan’s Taffel, Ron. Breaking Through to Teens : Psychotherapy for the New Adolescence, Guilford Publications, 2005. ProQuest Ebook Central, Created from touromain-ebooks on 2020-02-17 19:29:27. 9. Stuck 215 Copyright © 2005. Guilford Publications. All rights reserved. mother,Yvette, still pounced like a tigress when he was slow to cooperate. She couldn’t stop focusing on his disorganized room. Yvette exploded almost every time he pushed for a later curfew, once rushing from the bathtub naked to block him at the front door. Often, child and parent are like a dysfunctional couple who can’t transfer what is discussed in the room to acting differently at home. The inability to create individual or systemic change leads kids down a dangerous path. For example, Frederick, 14, talked at length in our sessions about his father’s ferocious temper, his mother’s attempts to play peacemaker, and his own efforts to stand up for himself. Frederick and I tried to figure out how he might handle these scenes in a better way. I also met with Mom and Dad, as I regularly do, to try to get them to manage anger differently. Very little shifted—family life was temporarily quiet, then new explosions always flared up. Meanwhile, outside the house, Frederick spent more time playing at the edge of danger. Pushing the envelope, he slept around, stayed out later, drank more, and went to after-hour clubs and extremely sketchy areas of town. Frederick became unmotivated in school, which had always been a sustaining involvement. The situation was stuck. The cycle of explosion, peacemaking, remorse, truce and explosion kept recurring. In such mired-down cases—after I have met with an adolescent for some time alone and with parent(s), separately—it is necessary to have a “focused family session” before a major crisis occurs. What Are Focused Family Sessions? Focused family sessions, as I have developed them, synthesize family systems theory, even as most sessions are individual ones with the adolescent or parents. The “focus” in focused family sessions is essential, so that the therapist can maintain control of family meetings and protect empathic connections with both teen and parent. Fears of unmanageable eruptions during conjoint sessions, stony Taffel, Ron. Breaking Through to Teens : Psychotherapy for the New Adolescence, Guilford Publications, 2005. ProQuest Ebook Central, Created from touromain-ebooks on 2020-02-17 19:29:27. 216 BREAKING THROUGH TO TEENS silence on a teen’s part, and vicious scapegoating in all directions discourage therapists from entering into this territory. In hundreds of consultations with families of adolescents, I have heard complaints by both parents and teens who say past family sessions were episodes of unprocessed venting, huge disappointments or events that shook their faith in the entire change process. It is such a difficult balancing act to manage individual as well as family sessions, it’s no wonder few training facilities offer this approach (check the brochures or websites of programs around the country). To begin, use the following guidelines for focused family sessions: ♦ The frame of the session is extremely specific—to shift a single stuck interaction or issue. Success is more attainable when the frame is limited. ♦ Goals are defined ahead of time, thereby lessening surprises for kids and parents. ♦ The fact that you will temporarily ally with the other “side” is predicted. This is done in order to protect empathic connections for future individual meetings. Copyright © 2005. Guilford Publications. All rights reserved. The overarching purpose of a focused family session is to help parent(s) and teen shift one troublesome, repetitive interaction between them. That’s it! The goal is not to figure out how the entire family dynamic needs to change or how each member might improve communication or how to resolve transgenerational issues, and so on. The Choreography of Change My narrow definition of a family session evolved from work I originally did over 20 years ago at the Philadelphia Child Guidance Clinic. I was then trained in structural family therapy with Salvador Minuchin and Virginia Goldner, and later in family systems therapy with Betty Carter. Structural family therapy teaches us that Taffel, Ron. Breaking Through to Teens : Psychotherapy for the New Adolescence, Guilford Publications, 2005. ProQuest Ebook Central, Created from touromain-ebooks on 2020-02-17 19:29:27. Copyright © 2005. Guilford Publications. All rights reserved. 9. Stuck 217 changing the interaction in one area of family life allows individuals to move beyond symptomatic behaviors; they begin to differentiate in healthier ways. Structural family therapy had its most profound impact in the ’70s and ’80s. It produced dramatic videotapes of sessions so charged that reestablishing empathetic connections in subsequent individual meetings would be quite a challenge. For example, in one famous videotaped session, Mother and Father became sufficiently frustrated with their anorexic teen that they literally shoved a frankfurter down her throat—at the therapist’s urgings that Mom and Dad take charge. This shocking intervention, a kind of therapeutic performance art, restructured the entire hierarchy: The sick child was no longer in charge of her parents. This girl could now begin to eat for herself, according to what these family therapists believed. Another dramatic videotape involved a family in which the two adolescent boys were out of control—defying their parents and in trouble with police. In the taped session (considered then to be a breakthrough), Dad physically wrestled one of his teenage sons to the floor. From that session, as was the case with the anorexic girl, the family pattern significantly shifted. Kids reconstituted because parents were now in charge and the children were not. Even then I never believed that most of the time one session had the stand-alone power to entirely rearrange the course of family life or of child development (see my article “Revolution/Evolution: Feminism Forces Us to Reconsider Our Expectations about Dramatic Cures,” The Family Therapy Networker, 1986). Actually, I learned during my externship at Philadelphia Child Guidance how much behind-the-scenes help was offered to kids and families—individual sessions, parenting, and psychoeducational input. These important change agents were left on the cutting room floor. Not dramatic enough for audiences, but a critical part of the paradigm that I valued even more as I learned about all the quiet attention families received. So, despite dramatic videos, one family session doesn’t usually do the trick. It is truly powerful, however, if after a dysfunctional dance is challenged during family meetings, the therapist continues to see family members to strengthen different ways of dealing Taffel, Ron. Breaking Through to Teens : Psychotherapy for the New Adolescence, Guilford Publications, 2005. ProQuest Ebook Central, Created from touromain-ebooks on 2020-02-17 19:29:27. 218 BREAKING THROUGH TO TEENS with each other. The power of structured interventions is exponentially increased when transgenerational issues can be dealt with before or after focused family sessions. Even if a specific interaction cannot be dislodged in a focused family meeting, it almost always has a transgenerational etiology that may be addressed later on. Interestingly, my training in systemic family therapy (à la Betty Carter) emphasized how work could be done in sessions in which family members talk just to the therapist in the room. These two vastly different perspectives are wonderful complements to each other—if you are able to conceive of your role as a bridge between the teen and adult worlds. Preparing for Focused Family Sessions Copyright © 2005. Guilford Publications. All rights reserved. In order to protect existing empathic connections, it is necessary to prepare both adolescent and parent for a focused family session. Once a family interaction gets underway, each “side” can feel totally abandoned by you. The family format seems strange to clients used to seeing you alone. The empathic connection of the private session is now fraught with potential for you to be experienced as favoring the other. In addition, clients often land in your office because of out-of-control dynamics. Naturally, both parent and teen are afraid (or secretly hope) that similar escalations will take place in the family meeting: “Now, you’ll really see how crazy my mother is; now you’ll finally understand how impossible my kid is.” They’re often right; family sessions can get wildly out of control, so I prepare in the following ways: First, define ahead of time exactly what the topic will be. To one boy and his parents I said: “We’re going to talk about curfews— nothing more.” To a girl and her mother I said, “The topic is going to be the fights in the morning about what clothes you’re wearing. That’s it.” At the beginning of the family session, I remind both what we’ll be talking about. It’s important to limit the scope in this way. John Gottman, noted researcher on the “science of communi♦ Taffel, Ron. Breaking Through to Teens : Psychotherapy for the New Adolescence, Guilford Publications, 2005. ProQuest Ebook Central, Created from touromain-ebooks on 2020-02-17 19:29:27. 9. Stuck 219 cation,” (Observing Interaction, 1997) is right. Relationship fights are so volatile, they instantaneously move into a physiologically inflamed laundry list of hot-button issues. At the start of the session, remind both parents and kids that they will probably feel unhappy about your role. I say to my teen client, “Listen, at some point during this meeting you’re going to feel I’m taking your parent’s side. Don’t worry. It’s just temporary, to find what works better for you and them.” To parent(s): “At some point, you’re going to feel like I’m taking your child’s side against you. It’s for the purpose of moving the session ahead. Try to remember that I’m not abandoning your perspective.” ♦ Remind everyone that whatever happens during the session, you will have a chance to talk in private meetings. This “to-be-continued” approach takes the heat off everyone, including professionals, and it is the truth. No one should enter a focused family session worrying that it will make or break the relationship. This is the therapeutic equivalent of that mythical “birds and bees” discussion about sex. In real 21st-century life such sex-talks rarely happen just once; rather, minidiscussions on the topic occur many times over. In the same way, real change usually occurs over time. For focused family sessions to work, the hope for instant transformation needs to be lessened, or disappointment is sure to follow. ♦ Copyright © 2005. Guilford Publications. All rights reserved. Enactments and Focused Family Sessions The specific structural technique to use in focused family sessions is “the enactment.” Family members, if prodded to discuss a conflictual issue, invariably act out their most important dynamics. While we all may not have been formally taught this principle, we are certainly familiar with it. Enactments happen in our lives all the time. Borrowed originally from interpersonal psychoanalytic theory, “enactment” is another way to say that family communicational patterns are so ingrained they spontaneously appear no matter how determined we are to avoid them. Taffel, Ron. Breaking Through to Teens : Psychotherapy for the New Adolescence, Guilford Publications, 2005. ProQuest Ebook Central, Created from touromain-ebooks on 2020-02-17 19:29:27. 220 BREAKING THROUGH TO TEENS ♦ Foster an interaction between parents and child over a stuck issue, previously identified in individual sessions. The topic must be one that is currently “alive” to all parties. It may be curfew, friends, verbal abuse, drugs, alcohol, back talk, homework, keeping the room clean, how parents and kids listen to each other, and so on. Your goal is to start parent and child talking to each other (not to you) about one concrete issue. For example, you might say, “Discuss with your son the chores you’d like done. This is an area you’ve all described as a problem.” The authority with which you can lead is the relational traction you’ve gained from previous sessions with parent and teen alone. Prepare family members for a moment or two of self-consciousness. Even if they have known you for years, most people are selfconscious when asked to discuss personal matters in front of a non-family member. Awkwardness needs to be addressed. Say, “This will seem strange at first. But I guarantee in a few minutes, it will feel much more natural.” Normalize by referring to the many other experiences you’ve had with enactments (remember, in your personal as well as professional life these interactions go on all the time). Or, if you can’t think of specific examples, be honest and say, “I’d like to try a technique I’ve just learned.” ♦ To start the interaction, make yourself as invisible as possible. There are several ways to do this. Don’t make eye contact with family members, since this leads to greater self-consciousness. How? Lean back, literally face another direction, or look down at your notes. The boundary expressed through your body language communicates that whatever goes on is the family’s doing, not an artificial exchange created by being in your presence. Copyright © 2005. Guilford Publications. All rights reserved. ♦ After it gets going, artificial as it may feel or as much as a parent or child initially objects—the strength of the “dance” is so powerful you’re quickly into the thick of it. Whenever one has a strong relationship—and what is more intense than a parent–teen showdown—the interaction gets going almost exactly the way it happens around the house. As you listen, your role changes. Taffel, Ron. Breaking Through to Teens : Psychotherapy for the New Adolescence, Guilford Publications, 2005. ProQuest Ebook Central, Created from touromain-ebooks on 2020-02-17 19:29:27. 9. Stuck 221 A Quick Enactment Guide Observe the most concrete behaviors, the basic steps in the family’s dance . Don’t look for hidden motivation. Ask yourself questions that begin with words such as “what,” “who,” and “where.” Do not get yourself stuck on asking “why” or “when.” The following are some examples of what to look for. ♦ Tone of voice—respectful, contemptuous, and so forth. A niceguy dad complains that his boy, James, is an inexplicable wise guy in school. Mom is also concerned about her son’s negative attitude with other adults, with whom he constantly finds fault. During the enactment, this very nice man surprisingly speaks to his son in a derisive tone, especially when the boy disagrees with him. “I’ve never heard anything so ridiculous,” he says. Dad’s attitude infuriates his son and, in turn, the boy shouts, “Yeah? . . . You don’t know anything either!” further aggravating the father. Loudness—Who drowns out whom? In the Marion family, everyone had to yell to be heard. Katie, a fifth grader who had trouble standing up for herself in school, was unable to speak during the enactment. As ev ...
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Family Focused Sessions
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Family-Focused Sessions
Question 1
To conduct a successful family focused session, the first step is to define the topic. The
therapist reminds all family members involved in what they will be talking about to limit the
scope of the session to a particular issue (Taffel, 2010). When the session is about to begin, the
parties must be reminded that they may not like the role of the therapists. Family members must
know that the therapist may seem to be taking sides, and it will be temporary to understand what
works best for them. Another critical step is to remind everyone that in case anything happens
during the session, there is a chance to speak it out during private meetings. The private meetings
ensure no one worrie...

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