The Therapist's Notebook for Families

Solution-Oriented Exercises for Working With Parents, Children, and Adolescents

Bob Bertolino

• Publisher: Routledge
• Year: 2015
• eBook ISBN: 9781317860112
• Topic: Psychology
• Subtopic: Mental Health in Psychology
• Index: Psychology

The Therapist's Notebook for Families, Second Edition, provides 72 solution-oriented activities for an array of challenging problems faced by mental health professionals when working with clients. The Therapist's Notebook offers clear, practical, easy-to-use exercises to help therapists work effectively and creatively with parents, adolescents, children, and families. Its solution-focused perspective provides a foundation based on collaboration, the utilization of client strengths, and the creation of possibilities to facilitate present and future change. The book is arranged in five parts, with 15 fully revised and 23 brand-new exercises.

Part I:
The Family as a Resource

1
The Therapist's Notebook

Preparing for Working With Families

Overview

Purpose of Exercise

Culture background, experience, education, and training are but a few of the influences that shape how we think about and work with families. A starting point for therapists is to explore beliefs and assumptions, which represent our "personal philosophies." From there we can consider how our personal philosophies affect all aspects of therapy, from assessment through transition from services.

Whereas some personal philosophies open up possibilities for change, others close them down. The purpose of this exercise is to identify underlying personal philosophies and to gain a better understanding of how they inform therapy. Doing so can help therapists to remain better attuned to any preconceived feelings and thoughts and those that may arise during therapy and influence the therapeutic relationship and course of services.

Considerations for Use

1. This exercise can be completed prior to the start of services or after a phone contact or face-to-face interaction.
2. It should be noted that the more information the therapist has about an adolescent and/or family, the more likely there are to be preconceived ideas. This is because information influences us.
3. This exercise can be repeated and/or updated in between interactions or sessions as a way to monitor biases and changing perspectives.
4. It can be helpful to share information from this exercise with a supervisor or peers as a vehicle for discussion and learning. In doing so it is important to remain open to the feedback of others.

Exercise

For Therapists: To complete this exercise, reflect on the following questions. Then write your responses in the space provided.

What are my core beliefs, ideas, or assumptions about adolescents and families?
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How have I come to believe what I believe about adolescents and families?
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What has most significantly influenced my beliefs, ideas, and assumptions as they relate to adolescents and families?

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How have my beliefs, ideas, and assumptions affected my work with adolescents and families? With colleagues/peers? With the community at-large?

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How do I believe that change occurs? What does change involve?
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Do I believe that some degree of change is possible with every youth? Every adolescent? Every family? (If you answered yes, then proceed to Question 8. If you answered no, proceed to the next question.)

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How do I work with adolescents and families whom I believe cannot (or do not want to or are resistant to) change? What do I do? (Proceed to Question 7.)

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In 50 words or less, write out your personal philosophy about working with adolescents and families. Be as concise as possible.

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After responding to these questions, take a moment to reflect on your answers. Consider how your thoughts, beliefs, and ideas might influence your initial contacts with youth and families. Continue to monitor how your "personal philosophy" evolves over time and in what ways those changes affect your approach to single interactions, ongoing encounters, and your overall approach.

Share your personal philosophy with peers or supervisors and ask them to do the same. Maintain a posture of awareness, remaining open to feedback. When offering feedback to others about their personal philosophies, keep in mind that our philosophies are not truths; they instead represent points of view.

2
The Pyramid

Identifying Levels of Need

Overview

Purpose of Exercise

Families and the individuals within families are better able to adapt to change and developmental transitions, manage crisis, and grow when they have their basic needs met. Maslow (1943) suggested that basic needs include but are not limited to food, water, sleep, and safety. In therapy, when basic needs are met, clients are better able to focus on higher level concerns and problems.

The purpose of this exercise is twofold. The first is to identify fundamental needs and plans to meet those needs, should they require attention. A second purpose is to determine "second order" needs, which may or may not be considered basic but nonetheless contribute to distress and can potentially derail families in their attempts to focus on the concerns that led to therapy. As with basic needs, therapists can help families to develop plans to meet second order needs. A pyramid is used as a way to visualize and order identified needs and corresponding plans.

Considerations for Use

1. This exercise can be used with families or individuals (for example, adolescents who are preparing to leave home and could benefit from a scan of their needs and to what degree they are being met).
2. Second order needs are subjective. It is recommended that practitioners work with families to determine what needs will increase the likelihood of present and future success and to sustain any positive change.
3. This exercise can be used as a training tool to help current and future practitioners to think at multiple levels.

Exercise

For Therapists: It is understood that when families seek therapy they are under some form of distress. Practitioners can help clients to get the most out of services by helping families to get both basic and second order needs met. Basic, or first order, needs are those that are considered essential to everyday functioning. Second order needs are those that can assist individuals and/or families to more fully address the concerns that led to the start of services. Needs can be met through direct or indirect assistance. An example of direct assistance would be taking a client to a food pantry. An example of indirect assistance would be referring a client to another resource in which he or she could get a need met. With needs met, clients will be better able to focus on higher level concerns or goals and engage in tasks to help achieve those goals. A pyramid is used as a visual way to help clarify and keep track of needs. To complete this exercise, first consider the following questions. Then for each, write your response in the space provided.

Think about a specific client with whom you are currently working. Give a brief synopsis of the reason(s) you became involved.

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Next, consider the basic needs of both the individuals and the family as a unit. There are three listed and space is provided for a fourth. In the spaces provided, on a scale from 1 to 10 with 1 standing for "not at all" and 10 representing "completely," rate the degree to which those basic needs are being met. If a rating is below 5, write down the plan for that need to be met. You may also choose to write each of the basic needs into the first level of the pyramid provided earlier in this exercise.

Level 1 (Basic Needs)

1. Food and Water (Acceptable sources of nutrition, fresh water)
   Rating:____________
   Plan: _________________________________________________________
2. Safety (Housing, low degree of threat of harm)
   Rating:____________
   Plan:__________________________________________________________
3. Health and Well-Being (Medical, dental, special nutritional needs, clothing)
   Rating:____________
   Plan:__________________________________________________________
4. Other (Please describe):—
   Rating:___________
   Plan:___________________________________________________________

For the second part of this exercise, collaborate with the individual(s) or family with whom you are working to determine second order needs. Second order needs are things that will provide stability, connections to others, greater life satisfaction, and so on. Examples are being part of a community, opportunity for continuing education or vocational training, job advancement, and so on. List up to three Level 2, second order needs in the spaces provided. Also consider adding the second order needs to the pyramid located at the end of this exercise.

Level 2 (Second Order Needs)

1. ____________________________________________________________________
   Rating:______________________
   Plan:_________________________________________________________________
2. ____________________________________________________________________
   Rating:______________________
   Plan:_________________________________________________________________
3. ____________________________________________________________________
   Rating:______________________
   Plan:_________________________________________________________________

What difference do you think it might have for the client(s) to have his or her or their basic and second order needs better met?

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In your ...

Table of contents

• Cover Page
• Half Title Page
• Title Page
• Copyright Page
• Dedication
• Contents
• Acknowledgments
• Introduction
• Part I The Family as a Resource
• Part II Getting Clear on Change
• Part III Changing Views and Perspectives
• Part IV Changing Actions and Interactions
• Part V Keeping the Ball Rolling
• Index