Collaborative Therapy Approach with “Good Mother, Bad Mother”

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timer Asked: Nov 12th, 2016

Question description

Postmodern Therapy Models: Collaborative Therapy Model

Instructor: Aurelia Bickler , PhD , abickler@ncu.edu


Introduction:

Postmodern Therapy Models: Collaborative Therapy Model

Collaborative language systems was founded by the late Harry Goolishian and Harlene Anderson. According to Anderson, conversation is the key to everything. “Through conversation we form and reform our life experiences; we create and recreate our meanings and understandings; and we construct and reconstruct our realities and ourselves” (Anderson, 1997). It is imperative that we are able to distinguish the difference between the conversations of our daily lives and the conversations that can be therapeutic. Although, one may wonder how our most important relationships might change if we applied more of the listening skills of the collaborative therapist to our interactions with friends and family.

This week you will see a demonstration of the collaborative therapy approach by Harlene Anderson. You will have the opportunity to respond to the demonstrated session as you analyze the approach taken.

Instructions regarding AATBS materials, the readings listed below will be found in the following volumes:

  • California Volume- Treatment Planning and Treatment Table 4, p. 17
  • National Volume – MFT Designing, Conducting, Evaluating, and Terminating Therapy Table 4, p. 18 (see the chart, there is no specific section on Collaborative Therapy).

Be sure to carefully review this week’s resources. You will be expected to apply the information from these resources when you prepare your assignment.



Books and Resources for this Week:
Books
ReferenceInstruction
Association for Advanced Training in the Behavioral Sciences (AATBS) materials

Instruction:Read materials related to the Collaborative Therapy model

Gehart, D. R. (2014) Mastering competencies in family therapy

Read Chapter 10 (the part that covers Collaborative Therapy)

Websites
ReferenceInstruction
Create Speaker Notes. Microsoft.
https://support.office.com/en-us/article/Create-speaker-notes-fc59586b-888f-4ebf-ab07-8a3cc8297867

Review Website

Document/Other
ReferenceInstruction
Anderson, H. Good Mother, Bad Mother: A Dissolving Dilemma [Video File].
http://www.viddler.com/v/f67bef08?secret=82067950

View Video

PowerPoint - Chapter 10 Pomo MCFT
Chapter 10 Pomo MCFT.pptx

View PowerPoint

Tips for success from Dr. Shatavia Thomas.
http://www.viddler.com/v/bed944f0?secret=105578716


Week 6 Assignment: Collaborative Therapy Approach with “Good Mother, Bad Mother”


Activity Description

For this assignment, you will be preparing to provide a presentation regarding the collaborative therapy approach. Your audience is a group of colleagues in a county mental health agency. Your presentation will be part of an in-service training designed to enhance the therapeutic skills of the staff and to reiterate the utility of the recovery model.

You will start by reading the required learning materials and then watching the video “Good Mother, Bad Mother: A Dissolving Dilemma” (Harlene Anderson, run time 56 minutes).

Note: The link for the video is available in the Week 6 resources area. Depending on your Internet speed you may have to wait up to 60 seconds for the video to buffer and start playing after clicking the play button.

This video is a consultation with a woman who questions her own mothering since her 15 year-old daughter wishes to go live with her biological father. There is also an excerpt from a follow-up session several months later.

Based on the video, and what you have read about this approach, prepare a PowerPoint or Prezi presentation in which you address for your colleagues each of the following (it is recommended that you use the bolded phrases as titles for your slides or transitions):

  1. Explain the concepts of shifting the meanings and beliefs of clients. Feel free to cite examples from the video you watched. You can use the actual words and dialogue of the client and therapist to illustrate your examples if that will be helpful to your presentation.
  2. How do the concepts of seeking to restructure client interactions or direct the client to change their behavior work? The questions focus on general types of change that any therapy model might address. A model can target cognitive changes (changes in thinking or beliefs), behavioral changes (changes in behaviors or interactions), or emotional changes (changes in how people feel) or a combination of these things. The questions in this assignment are referring to these more general types of changes. They are essentially saying, "How does collaborative therapy make cognitive changes (changes in meaning/beliefs)?" and "How does collaborative therapy make behavioral changes (changes in interaction/behavior)?" For example, if a therapist is more of a partner, rather than being directive, what does this mean for how they might help a family change their way of interacting with each other? Cite examples from the video you watched. You can use the actual words and dialogue of the client and therapist to illustrate your examples if that will be helpful to your presentation.
  3. Based on what you have read and what you saw Harlene Anderson do, explain to your colleagues how she is using Collaborative approach ideas to change client's meanings and behaviors. Once again, use examples from the video you watched or other sources.
  4. Social constructionist therapists work to stabilize, normalize, and create acceptance in clients as methods of solving the concerns of clients. Help your colleagues to understand what these mean and how to use them in therapy.
  5. Another method of intervention in the collaborative therapy approach is to focus on strengths and resiliency. How could this strategy be applied to clients with whom your colleagues in this agency work?
  6. From your knowledge about this model, name and describe additional techniques used by Harlene Anderson that you believe would be helpful in treating the agency’s clientele.
  7. Describe to your colleagues how this therapy model and techniques could be used with the recovery model.
  8. Finally, describe to the participants in the training, how you believe this model will enhance their ability to intervene in the lives of clients served by the agency. Use some concepts from the case conceptualization section in Chapter 10 of the Gehart (2014) text.

Length: 10-15 slides or transitions (excluding the title slide/transition and references slide/transition)

Good presentations do not contain too much information in the slides/transitions. They contain enough information to “whet the appetite” of the participants and then the presenter completes the presentation with his or her narration. So, to complete the presentation, add narration with the presentation. You may do this by adding audio or writing out exactly what you would say to the audience either in the presenter notes or in a word document.

Your presentation should demonstrate thoughtful consideration of the ideas and concepts that are presented in the course and provide new thoughts and insights (yours) relating directly to this topic. Your presentation should reflect scholarly writing and current APA standards (slides should have citations where information is used from an outside source and there should be a references slide at the end with full APA citations of all material used in the presentation).

Learning Outcomes
6.0 Assess the professional value, applicability, and personal fit of Collaborative Language Systems as a model of family therapy.

9.0 Develop the foundation of your own personal model of therapy.

10.0 Apply treatment planning concepts specific to postmodern MFT models.

I also sent the last paper I sent in. She said "

Amanda,

Thank you for your submission. You have identified many important elements of this model and that’s excellent.

Though you have presented a good understanding of the purpose of these concepts, I encourage you to make a stronger connection between the concepts, their definition and the practical piece. This will help you connect the dots between theory and practice.

For the reason mentioned above, I have deducted 1.5% from your grade. Please let me know if you have any questions about my feedback.

~Dr. Bickler

11.11.16

98.5%

********************Therefore you can see she is tough!********************

I just do not have time as my daughter is getting Married today and my brother in law is now on hospice care. He is not doing well. Please let me know if you are too busy.

Review video




Running head: POST MODERN MFT MODELS Post Modern Marriage and Family Therapy Models Amanda June Lewis Post Modern MFT Models November 6, 2016 Dr. Aurelia Bickler 2 POST MODERN MFT MODELS Post Modern MFT Models There are a number of different therapy approaches that can be implemented when professionals are seeking to help an individual overcome psychological, physical, and other types of limiting barriers. One of the more prevalent types of therapy approaches is referred to as Solution Focused Brief Therapy (SFBT). Solution Focused Therapy is explained to be a professional form of therapy wherein “a goal-directed and collaborative approach to psychotherapeutic change that is conducted through direct observation of clients' responses to a series of precisely constructed questions” (Nunnally, 1993). As the name might suggest, this form of therapy is primarily achieved by way of being brief and focusing more on solutions to stated, or observed problems, compared to spending a great deal of time allowing the patient to discuss the impact(s) of their struggles on their life. This approach seeks to eliminate wasted time that was once spent on thinking, analyzing, and talking about problems while the patient continued to suffer. Instead, this approach offers an expedited approach to resolutions which, in many instances, such as the client Insoo Kim Berg is working with, that has been diagnosed with terminal AIDS, proves to be substantially more beneficial than discussing problems. The purpose of this paper is to review a video of an interview conducted by Insoo Kim Berg and a patient that has just recently been diagnosed with terminal aids. Insoo Kim Berg was a Korean-born American “psychotherapist who was a pioneer of solution focused brief therapy; she influenced the fields of psychotherapy, consulting, supervisions and coaching with concepts such as resource-orientation and brief therapy” (Berg, De Jong, 1996). In this evaluation will be an POST MODERN MFT MODELS 3 illumination on the pattern of questioning that Berg used in a video titled, “Dying Well” while also annotating how repetitious Berg was with the client throughout the interview. One of the pivotal realizations, as it relates to Solution Focused Therapy, brought to light by Berg is the understanding that even chronic problems have periods of time wherein their effects are less intense and by taking the time to study these periods, people are able to see the many positive things that they have done that might have otherwise been overshadowed by the negative effects of the problems they are used to. This is one of the key components that was presented in Berg’s interview with the terminally ill patient in the “Dying Well” video. The pattern of questioning that Berg chose to use in “Dying Well” was to continuously bring about positive points and ensured that she restated keywords that would allow for the client to address, and re-visit cognitive and psychologically challenging ideas in a conscious manner. During the interview, Berg was able to understand that the terminally ill client was hoping to “die well”, meaning she wanted to die in a dignified way, and in such a way that her mother would know, even after she was gone, that she was a good person, regardless of the tumultuous past she had up to the point of her diagnosis. In her questioning approach, Berg ensured that she pointed out what the client might feel were minor or insignificant details that would later prove to have been key components to the client’s ability to manage not only her illness but also the ways in which she revealed her diagnosis to her family, more specifically, her mother. Berg seemingly achieved this by asking the client, what Berg referred to as clarifying questions, which are inherently “meant to reiterate concepts that may initially sound tenuous but upon re-visitation, creates the ability to form more concrete perceptions of reality” (Issa, 2010). Clarifying questions are one of the four techniques used in active listening. POST MODERN MFT MODELS 4 As was mentioned in the foregoing information, the pattern of questioning, submitted by Berg, manifested itself into a regimen of questions that would aid the client in recognition of positive topics, as they related to her ultimate goal, rather than allowing for her to focus solely on the negative components of her diagnosis. What’s more, Berg ensured that she initiated, and maintained the ability for the client to participate in thought processes that would allow for her to come up with her own solutions to various concerns she vocalized prior to her death. The language utilized by Berg was thoughtful and formulated which resulted in the client understanding that Berg did, in fact, feel empathy for her situation and this allowed for the client to feel validated in her feelings without letting her spend too much time on the negative components of those feelings. Through her expression of empathy for the client’s situation, the client was able to feel the necessary degree of encouragement to make determinations of her own goals and ultimately generate her own solutions (Berg, 2012). Further, it was very clear that Berg asked constructive questions that were indicative of forward-moving questions which would help the client to avoid getting stuck, mentally, on one thought over another. “It’s an invaluable human ability to think about what we do, but reviewing our mistakes over and over, re-experiencing the same negative emotions we felt the first time around, tends to keep us stuck in negativity” (Kross, 2008). One of the most effective approaches that Berg claimed to have been a part of the Solution Focused Therapy approach was that of repetition. Repetition was commonly used throughout the entire interview with the client and would result in Berg asking, either the same questions that had been asked earlier in the interview, or clarifying questions, later in the interview to allow for the client to create thoughtful and concrete answers that may have been absent when it was asked the first time around. For example, when initially asking, how does this diagnosis make you feel? The response was significantly more depressing and not lined with hope. However, after some time POST MODERN MFT MODELS 5 was spent allowing the client to generate her own solutions to inevitable issues that would arise, asking this same question would result in a much more positive answer. It was noticed that Berg, during the interview, would let some statements and/or concerns, expressed by the client, pass without question or requesting clarification, but would bring it up later in the interview. This is explained to be an effort of which allows the client to focus on smaller details of her emotions that might have otherwise been overlooked entirely. This therapy approach is explained by many researchers, to be highly effective because it allows for the therapist, Berg in this interview, to act as a kind of sounding board for the client. This would allow for the client to become aware of all statements made and emotions expressed so the propensity for success, when dealing with independent issues is increased. In this particular interview, Berg acted as a resource and professional ‘tool’ designed to assist the client in her ability to achieve a selfdetermined resolution to the presented issues they client was initially concerned about. Regarding whether or not the client in this interview was able to get, both what she wanted, and what she needed, the simplified answer is, yes. In the beginning of the interview, the client was, for good reason, seemingly very depressed and while she had a generalized goal in mind, did not exhibit a strong approach on how to achieve it. However, as the interview progressed, the client was able to achieve the validation she needed for the emotions she was feeling, by way of Berg showing empathy for the client’s situation and goals. The client was open about her desire and willingness to learn about her health condition, what to expect, and ways in which she could go through the process in such a way that she remained in control; in control of her future, and in control of her emotions. It is significantly easier to deal with the negative effects of anything if the individual is aware of what to expect, when to expect it, and how to best deal with it. In this sense, the client got exactly what she needed. POST MODERN MFT MODELS 6 The outcome of the interview, overall was very positive as Berg was successfully able to direct the client in a positive manner without discounting the fears and emotions that the client had regarding her diagnosis. Berg utilized a focused and direct approach to conversation with the client which eliminated any ideations of pity and allowances of disintegrating self-worth. Berg was effective in her ability to isolate integral concepts that would allow for the client to achieve her goal of ‘dying well’ and being remembered, not for who she was in the past, but who she was in the end. Berg ensured that the conversation stayed on task, with the task being the ability to see the problem, create solutions, and determine what steps were needing to be made to achieve the goals of the client. Other concepts used in the recording certainly included positive feedback, variations in the pattern of questioning that was utilized, hypothetical solutions that were ultimately adopted by the client, and concepts found within the Ericksonian approach to therapy. Berg utilized repetition techniques throughout the interview which allowed for the client to repeat concepts, concerns, and ideas that she had, in different ways. After repeating the same concepts, concerns, and ideas she had, a few times, the client was able to come to a definitive decision as to how she was going to feel, cope, and achieve her stated goals. Berg utilized pattern questioning methods to aid the client in achieving her stated goals and allowing the client to feel more at ease with her dire situation. One of the more pivotal ways in which the pattern questioning method was successful in this particular interview was allowing the client to cycle through topics and ideas in different ways so she might be more apt to attain the awareness that she would need to ‘die well’. While Ericksonian ideations were not directly mentioned, as far as could be told, in the interview itself, there were overtones of some components of Ericksonian therapy approaches. Research supports that “brief therapy, solution-focused therapy, strategic therapy, systemic family POST MODERN MFT MODELS 7 therapy, child psychology, and even sports performance training have all been influenced by Milton Erickson’s work and ideas” (Carlson, 2001). Further, it was one of Milton Erickson’s beliefs, that the role of the subconscious did not allow for individual insight to make its way into the cause of problems; thereby eliminating the allowance of self-pity and forcing the individual to initiate forward thinking, even in the most despair of times. Berg utilized this component of Milton Erickson’s therapy approach by ensuring that she utilized forward-thinking questions and disallowing for the client to focus, for too long, on the negative components of what her future had to hold. All of the aforementioned patterns of questioning, the utilization of repetition, and additionally mentioned concepts that were implemented in the “Dying Well” interview, conducted by Berg, all led up to a specific aspect of the Recovery Model that would later prove to have been effective for the client. In the Recovery Model implemented, the client's collective strengths, weaknesses, and resources of which were made available to her were highlighted, and working in conjunction with Berg, would allow for the client to effectively achieve her initially vocalized wants and needs. In this case, it is imperative that the Recovery Model allow for redirection as the emotional state of the client, over time, is likely to be unstable. The client must understand that failures in her Recovery Model are only brief, and instead of focusing on those failures, let them pass, and celebrate individual successes that have presented themselves up to that point. One of the most pivotal lessons that were learned in this particular interview is the importance of empathy, not pity, but empathy. Showing empathy for a person’s situation allows for validation of feelings instead of shame. In today’s society, especially, people are consistently shamed for feeling certain ways and as a result, a psychological cycle, typically veiled by depression, begins. Berg showed the client empathy for her situation but did not let her stay stuck 8 POST MODERN MFT MODELS in these ‘validations’ and instead, initiated forward-thinking questions that allowed for the client to move forward as well. Being stuck in an emotional rut is potentially one of the most damaging parts of therapy and failure to initiate forward thinking can be the difference between dying well and just dying. CLIENT TREATMENT PLAN 1. Conduct a Mental Health Assessment a. Gather client information regarding past social problems, family history, and relationships. b. Explain the limitations of confidentiality. c. Share with the client the procedures that are required, by law, in the event of a mental health emergency or crisis. 2. Complete Evaluation Form a. Reason for referral b. Current symptoms and/or behaviors c. History of the problem/ date of diagnosis d. Current and future impairments the diagnosis will generate e. Current risk and safety concerns shared by the client (i.e. thoughts of suicide?) f. Determine and agree upon treatment goals and commitment level of the client 3. Regular Counseling Sessions: Noting Behavioral Observations a. Determine ultimate relationship goals, direct focused discussions on the pursuit of those goals and validate personal ideas and realized solutions. b. Focus on client’s strengths, hopes, and available resources. POST MODERN MFT MODELS 9 c. Develop an understanding of initial assumptions of possible issues that will arise due to diagnosis and discuss viable solutions to dealing with these assumptions. 2. Measure Client Goals and Progress a. Client commits to a pre-determined amount of time for therapy that is reasonable for achieving the client’s stated goals and desires as they relate to treatment. b. Identify what works and what does not work for the client when it comes to approaching solutions and goals submitted by the client. 3. Monitoring a. Goals have been established and now need to be monitored to ensure that progress is being made at the rate agreed upon between therapist and client. b. Has the client been able to, at this point, reconnect with her mother and/or share her diagnosis with her family? i. If not, what needs to be done so the client can move forward with this major goal? ii. If so, how did it go and what types of new goals are needed as a result of the reactions received? c. Submit and official evaluation of the alliance between client and therapist to ensure that trust and commitment are still present (if not, steps will need to be made to re-establish this trust and commitment or the Recovery Model will fail) 4. Develop end-stage life goals in preparation for the ultimate goal. a. Intervention: Determine possible conflict or roadblocks for desired outcomes on all goals. 5. Review finalized treatment plan with the client. POST MODERN MFT MODELS a. Conclusion valuation of goal accomplishment or complications. b. Concluding plan for self-achievement. 10 11 POST MODERN MFT MODELS References Berg, I. K., & De Jong, P. (1996). Solution-building conversations: Co-constructing a sense of competence with clients. Families in Society: The Journal of Contemporary Social Services, 77(6), 376-391. Berg, I. K. (2012). Dying Well. Retrieved from http://www.viddler.com/v/c5249886?secret=64169979 Carlson, T. D., & Erickson, M. J. (2001). Honoring and privileging personal experience and knowledge: Ideas for a narrative therapy approach to the training and supervision of new therapists. Contemporary Family Therapy, 23(2), 199-220. Issa, J. (2010). Four Techniques for Active Listening. Retrieved from http://www.onlinepsychologydegrees.com/articles/active-listening-techniques/ Kross, E. (2008). Facilitating Adaptive Emotional Analysis: Distinguishing Distanced-Analysis of Depressive Experiences from Immersed-Analysis and Distraction. Personality and Social Psychology Bulletin Jul 2008 vol. 34 no.7 924-938. Retrieved from http://psp.sagepub.com/content/34/7/924.abstract Nunnally, E. (1993). Solution focused therapy. In Casebook of the brief psychotherapies (pp. 271-286). Springer US. Retrieved from http://link.springer.com/chapter/10.1007/978-14615-2880-7_18
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