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Caregiver Depression and Solution Focused Therapy
Transcript of Caregiver Depression and Solution Focused Therapy
Values & Experiences Methods of Engagement
Forming a Therapeutic Alliance
Evaluation and Follow-up Due to:
lack of support Caregiver Depression and Brief Solution Focused Therapy By Veronica Lira (Diez)
Dr. Levine Balancing Work and Life for "Sandwhich Generation"
Wait list in Community-Based Mental Health
Transportation and Accessibility
Cognitive abilities Cultural Concerns Telephone Based Consultation
Casemanagement style of connecting to resources
Reinforcement of services provided Engagement Difficulties with accessing services and
Compounding encounter of societal problems
Client's ability to access solution within them or societal methods
Short term encounter
Works well in a medical model Setting Why is Solution Focused Therapy Best Method 1st step Finished 2nd step Spark Last step Start (cc) image by nuonsolarteam on Flickr 1st step Finished 2nd step Spark Last step Start (cc) image by nuonsolarteam on Flickr Spark (cc) image by nuonsolarteam on Flickr "Taking Care of my husband is draining me"
Therapist: "It makes sense you would feel this way, you've been through a lot this past year. The heart attach, constant monitoring, and financial strain, and operation has taken a tool on you."
Client: " Yes, it all hit me at once." Normalizing Behaviors May Include
That sounds familiar Restructuring Statement
"it's understandable where you are now, you're at a time when decision making doesn't come easy. You have been talking about ways to make your caregiver role easier. Affirmations May introduce: Scaling the Difficulty
of perceived thought or miracle questions Therapist: Affirmation of Competencies You have come a long way. You were able to find support in your church group, found alternatives for a caregiver when you went on vacation, and found a way to educate yourself about your husband's condition. Maybe you can use those same methods to find a solution today's problem. Connecting the Client's Thought to a Working Idea Bridging Statements Client: " I want to be more in control of my husband's medical Condition."
Therapist: "you haven't gotten this far without taking control of some aspects of your husband's condition. Notice some of the things you are in control of. Spark Independence
Strengthen Caregiver Role
Lowering Hospitalization Treatment Plan Socializing and Joining
Building alliance with client
assessing current needs Normalize Behaviors
Affirmation of Competencies
suggesting Solutions Keep Client focused
Gather brief description of problem/ hoping to achieve Assess for Safety
What is the client's Language
Interest and motivations
Frames of Reference
Beliefs Assessment Time is limited
goals oriented Client's ability to access solution within themselves or society
role of positive expectations
indirect communication by therapist
change is constant
therapist job is to identify and amplify change
client defines goals
no right or wrong way
focus on what is possible
unnecessary to know a great deal about the complaint in order to solve it Major Concepts of SFT Stage 1 stage 2 Stage 3 Offer Solution that is achievable for Client Treatment Plan Continued Intervention Methods: Assessment
Creating Fit of Reality
Offering Resources Stage 5
Formulating Action Plan may use scaling Method to assess difficulty level of proposed solution
Goal setting ALWAYS ENDS WITH COMPLIMENTS May use scaling the level of difficulty
Transition Case Management Team
Ensure Continuity of Care
Reiterate Client's Strenghts and Goals
Follow-up (Mail, Email,)
CBT Support Group Termination Return Sessions:
Reinforce What Worked Step 1 Treatment Plan Step 2 establishing rapport Identifying major Problems Dealing with Feelings Strength Based Language Stage 4
Exploring Possible Alternatives Precipitating Factor
give extra support to caller Step 3 Transportation Issues For eldery
Know local resources
OCTA/ Access Enrollment process
AT&T Telephone services Delivery of Service to Complex, Urban Enviornments VA Health-Care History
Encouraging Team involvement for Continuity of Care
Managing Effective Team Work
Interpersonal Relationships Social Worker Obstacles and Domain Difficulties Campbell, J., Elder, J., Gallagher, D., Simon, J., & Taylor, A. (1999). Crafting the “Tap on the Shoulder:” A compliment template for solution-focused therapy. The American Journal of Family Therapy, 27, 35-47. Retrieved from Proquest Research Libray
Eisdorfer, PhD, MD, C., Czaja, PhD, S. J., Loewenstein, Phd, D. A., Rubert, PhD, M. P., Arguelles, PhD, S., Mitrani, PhD, V. B., & Szapocznik, PhD, J. (2003). The Effect of a Family Therapy and Technology-Based Intervention on Caregiver Depression. The Gerontologist, 43 (4), 521-531. Retrieved from http://gerntologist.oxfordjournals.org
Iveson, C. (2002). Solution-focused brief therapy. Advances in psychiatric treatment, 8, 149-156. http://dx.doi.org/10.1192/apt.8.2.149
Lewis, T. F., & Osborn, C. J. (2004). Solution-Focused counseling and motivational interviewing: A consideration of confluence. Journal of Counseling and Development. Retrieved from Proquest Research Library
Mireau, R., & Inch, R. (2009). Brief Solution-Focused counseling: A practical effective strategy for dealing with wait lists in community-based mental health services. National Association of Social Work, 54 (1), 63. Retrieved from Proquest Research Library
Rachor, M. M. (1998). When worlds collide: Elder caregiving poses new challenges for balancing work and life. Employee Benefits Journal, 23 (3), 20. Retrieved from Proquest Research Library
Ricker, J. (2002). Study shows telephone counseling can be effective. American Psychological Association, 33 (4), 14. Retrieved from http://www.apa.org/monitor/apr02/studyshows.aspx QUESTIONS??? Resources Normalizing Behavior
"Taking care of my husband is draining me."
Therapist: "it makes sense you would feel this way, you've been through a lot this past year. The heart attach, constant monitoring, and financial strain, and operation has taken a toll on you.
Client: "yes, it all hit me at once." Therpist: "it's understandable wehre you are now. You're at a time when decision making doesn't come easy. You have been talking about ways to make your caregiver role easier. Let's look at what has worked in the past."
Restructuring Statement Therapist: "You have come a long way. Joining a Church support group was helpful and you found an alternative for placement when you needed time for yourself. You also informed yourself about your husband's condition through resources. You have been very resourceful." Affirmations of Competencies Connecting the client's thought to a working idea
Client: "I want to be in control of the situation."
Therapist: "you have gotten this far. Let's notice some of the things you have been in control of." Bridging Statements