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10 Reasons You're Stuck
Transcript of 10 Reasons You're Stuck
They Don't Feel Heard
Change is Uncomfortable
Equal and Opposite Reaction
Narrative Therapy "externalizes" the problem and makes that the bad guy
Bad Guy Principles
Any Problem can be pinned on a "bad guy"
The bad guy is almost always out of the room
Bring the bad guy into the room and
pretty soon he's just a guy
Guiding Principle of Bad Guy Theory:
There are no bad people, only people.
Hurt people, hurt other people.
ex: depression, angry tiger, "what if"
Like a Black Hole, you can't see the secret but the way objects around it behave tells you that there is something there
Culture is the Rules of
It's critical that we understand the family culture in order to identify what strategies are likely to work
example: if dad is the decision maker in the family, you won't make much progress if he's not in your meetings
People need to feel like you understand where they are coming from.
This is different than whether or not you actually understand them
This needs to happen before they are willing to hear you.
Active listening is the most useful therapeutic skill by a wide margin.
Eye contact, no distractions,
Repeat back your understanding of what they are saying periodically
Reference what they have said when you speak about their situation
Therapist empathy, genuineness, and warmth and patient therapeutic outcome.
Truax, Charles B.; Wargo, Donald G.; Frank, Jerome D.; Imber, Stanley D.; Battle, Carolyn C.; Hoehn-Saric, Rudolf; Nash, Earl H.; Stone, Anthony R.
Journal of Consulting Psychology, Vol 30(5), Oct 1966, 395-401.
"therapists providing high therapeutic conditions had 90% patient improvement while those providing lower conditions had 50% improvement"
Study measured therapist empathy, warmth and genuineness
"High-empathy counselors appear to have higher success rates regardless of theoretical orientation. Low-empathy and confrontational counseling, in contrast, has been associated with higher drop-out and relapse rates, weaker therapeutic alliance, and less client change"
Is low therapist empathy toxic?
Moyers, Theresa B.; Miller, William R.
Psychology of Addictive Behaviors, Vol 27(3), Sep 2013, 878-884.
When everything you've tried fails, try doing the opposite
Stop trying (chasing, begging, rescuing)
if the answer is always no, ask them to do the thing you're trying to prevent
Have Some Fun!
Get out of talking and meeting and do an activity
C16 Team Building for Every Team
If you are laughing with each other you are team building
On a societal level we are terrible at talking about sex and there are big costs to that
D9 Sex Talk: Guiding Healthy Discussions About Sexuality - Thurs 10:30am
Clinicians are often hesitant about assessing and making use of a families spiritual beliefs and supports
F12 Using Spirituality in Family Treatment - Fri 10:30
E9 Advocating for Social Justice as a Care Provider
If staff are not aware of their own privilege it's easy to miss critical pieces or be part of the problem ourselves
Historical trauma can make it extremely difficult for families to believe in positive outcomes
Working the "System"
"Bad Guying" principles can be used to realign the system when families are being treated unfairly
If everything feels nice and happy then:
Some of the best sessions involve:
1. You are not needed
2. You are working on the wrong thing
If a family pushing back hard but still showing up you are probably on the right track
Cussing (at each other and you)
Asking for your supervisor
(also the worst sessions so good luck)
Human Behavior Almost Always Makes Sense
If someone seems to be behaving in a way that does not make sense it's most likely that you are missing the information that justifies the behavior
We tend to assume we know everything about each other and this is literally never true
Listen and build trust! They have not trusted you enough yet to share the secret
With behavior you don't understand, hypothesize what circumstances would justify that behavior
Normalize that everyone has secrets and sharing them may be both scary and relieving
You can talk about the experience of holding a secret without needing to know what it is
We Can Not Change
Things to Respect in
Relationships work much better when we focus on our own part in them and minimize time wasted on how the other person should act
Some relationships involve some control over the behavior of others (parent/child, boss/employee) but they go much better when we ask and reward instead of demand and punish
Don't tell other people what to think
It doesn't work and it's not appreciated
Ask what people believe.
If it contradicts other beliefs or evidence, ask about that.
Never tell someone how to feel!
Can you think of a single time someone said "don't be angry" and you stopped being angry?
Try not to take up someone's time without their consent
Usually combined with demanding behavior "Come pick me up!"
Can be more passive like letting someone wait for past when you said you'd be ready
Try not to tell others what to do
Don't invade people's personal space uninvited
Examples - Going in someone's room, sitting at their desk, going through their phone or purse
Never do anything to someone's body that they do not want done to them
This is basic consent and we relate it most to sex but it doesn't need to be
What if you are not sure if they want it? Either ask and find out or don't do it
Unhealthy, unhappy people spend a lot of time trying to control others or complaining about the actions of others. Healthy, happy people focus on what they can do to impact their own circumstances.
It is important to recognize how often the families we work with point the finger at each other and avoid responsibility for their own actions.
It is perhaps more important for us to realize that we can’t change others behavior and the most therapeutic thing we can do is allow people to be themselves.
If you want to be a force for positive change you must be willing to sit in an