The Couple and Family Therapist's Notebook

Homework, Handouts, and Activities for Use in Marital and Family Therapy

Katherine M. Hertlein, Dawn Viers

• Publisher: Routledge
• Year: 2014
• eBook ISBN: 9781317760603
• Topic: Psychology
• Subtopic: History & Theory in Psychology
• Index: Psychology

Get a sneak peek at clinical vignettes that demonstrate the power of creative interventions!

Couples and families present unique challenges in therapy, and other books rarely illustrate the effectiveness of particular types of interventions on actual cases. The Couple and Family Therapist's Notebook provides clinicians with a wide range of practical field-tested therapy activities and homework that are solidly grounded to each intervention's theoretical underpinning, then explores their effectiveness by briefly relating real-life cases. Continuing The Haworth Press Therapist's Notebook series, respected experts detail how to perform several creative interventions and then follow with insightful clinical vignettes to illustrate under what specific circumstances each particular approach is effective.

Each chapter of The Couple and Family Therapist's Notebook: Homework, Handouts, and Activities for Use in Marital and Family Therapy has an objective statement to orient the reader to the homework, handout, or activity, followed by a rationale. Instructions explain how to perform the activity, followed by clinical case vignette, a section of contraindications, and a list of useful resources for both the practitioner and the client. Illustrations and appendixes also provide helpful guides for the therapist.

The Couple and Family Therapist's Notebook: Homework, Handouts, and Activities for Use in Marital and Family Therapy gives you the tools for approaches such as:

• emotionally focused therapy
  
• symbolic-experiential therapy
  
• transgenerational theory
  
• solution-focused therapy
  
• experiential therapy
  
• and many others

And some of the intervention techniques that are illustrated:

• the Metaphor of Gardens
  
• the Coming Clean Ritual
  
• creating rituals for couples coping with early pregnancy loss
  
• the Four C's of Parenting
  
• identifying family rules
  
• the Systemic Kvebaek Technique
  
• physical acting techniques
  
• the Feelings Game
  
• writing to combat adolescent silence in family therapy
  
• Family Stress Balls
  
• the Goodbye Book
  
• the Puppet Reflecting Team Technique
  
• family-based school interventions
  
• and many more

The Couple and Family Therapist's Notebook: Homework, Handouts, and Activities for Use in Marital and Family Therapy provides invaluable insight and vital clinical tools for creative couple and family intervention, perfect for adaptation by counselors, psychotherapists, practitioners in private practice, school systems, hospitals, government settings, homeless shelters, and not-for-profit agencies and counseling centers.

SECTION II:
INTERVENTIONS FOR FAMILIES

–9–

The Four Cs of Parenting

Lee Williams

Erin Cushing

Type of Contribution: Handout

Objective

The objective of the handout is to provide parents with an introduction to four important parenting principles.

Rationale for Use

The Four Cs of Parenting provide a basic framework for conceptualizing important parenting principles. The Four Cs are Consequences, Consistency, Calm, and Charged Batteries. The first two Cs, administering consequences and doing so in a consistent manner, are integral parts of most parent management programs. These concepts are rooted in the behavioral therapy tradition, where positive reinforcement and punishment are used to shape behavior. The third C, remaining calm while administering consequences, encourages parents to be nonreactive, which helps reduce the level of negativity in the parent-child relationship. Finally, the fourth C, maintaining charged batteries, recognizes that effective parenting is difficult if one’s personal resources are depleted. The Four Cs provide a simple and easily recalled model of parenting, making it ideally suited for parent psychoeducation. Therapists can also easily use the Four Cs as a checklist for assessing a client’s potential strengths or growth areas with regard to parenting.

Instructions

When the therapist perceives a parent would benefit from some basic education about parenting, the Four Cs can be introduced as a way of organizing the key elements of successful parenting. The therapist can introduce the Four Cs either verbally or by using the handout. The advantage of the handout is that it can be used as a reference or reminder for the parent at home, particularly if it is posted in a visible place within the home (e.g., refrigerator). Use of the handout assumes that the parent or parents can read, which may not always be the case. The advantage of the Four Cs, however, is that principles can be easily remembered even if they are not recorded in written form.

In most cases, the therapist should provide a description of all Four Cs in one session. Doing so is helpful because each concept is related to the other, and the Four Cs are most effective when used together. Depending upon the needs of the clients, however, some of the Four Cs might need to be explored in more detail in subsequent sessions to help build their knowledge and skill within that area.

Usually the first C to be introduced is Consequences. The therapist explains that in real life our actions carry consequences. As a result, parents need to teach their children that their actions will have consequences. If a child misbehaves by breaking a rule, for example, then the parent is expected to attach a consequence to the behavior. Ideally, the consequence or punishment will fit the crime.

It is important that the therapist explain that attaching consequences to behavior not only happens when a child misbehaves but should also occur when a child does something positive. Parents are encouraged to “catch your child doing well.” A parent, for example, might praise a child for an act of honesty or compassion toward others.

One common difficulty that parents encounter is administering consequences that require the cooperation of the child. Asking the child to clean his or her room, for example, may not work as a consequence since it requires the child’s cooperation to succeed. In these cases, the parent can become frustrated or believe that consequences are ineffective. Therefore, the therapist can explain that it is best to choose consequences that do not require the cooperation of the child, particularly if the child can be oppositional. Withholding an allowance or restricting privileges (e.g., putting a video game in timeout) might be a more effective alternative. Therapists may need to help parents brainstorm possible consequences that can be enforced without the child’s cooperation.

The next C to be introduced is Consistency. The therapist explains that the power of attaching consequences to behavior is most effective when done consistently. The therapist can further explain that if a child receives a consequence for breaking a rule only occasionally, then the child may continue to misbehave out of the belief that he or she can get away with it most of the time. Being consistent also reassures the child that the parent can be depended upon, not only for setting limits but also for protecting or ensuring the child’s welfare. It is also helpful to remind parents not to threaten consequences that they are not prepared to actually carry out. Otherwise, this can make the parents appear inconsistent and undermine their authority. To the extent possible, both parents (or other caretakers who are in a parenting role in relation to the child) should try to follow the same rules and be consistent in giving consequences. This avoids giving children mixed messages and reduces the likelihood that they will take advantage of the parents not having a united front.

The third C usually introduced is Calm. The parent is encouraged as much as possible to deliver the consequence in a calm and nonreactive manner. The therapist explains that this is important for two reasons. First, remaining calm helps the child avoid assuming that he or she is being punished simply because the parent is upset rather than for breaking a rule. In other words, children may focus more on the fact that the parent is upset or angry rather than the lesson to be learned from the consequence. Second, children who sense that they can make their parents upset may enjoy having this kind of power or influence over their parents. As result, the child may continue to act out as a way of maintaining power over the parent. The therapist can also point out that parental power comes from giving consequences, not by becoming upset. Hecker (1998) encourages parents to be like “good cops” to illustrate this concept. Rather than berate a driver for speeding, a good cop will be pleasant and polite while giving the individual a ticket. The officer’s power comes from his or her ability to give the individual a ticket or consequence rather than being upset with the driver.

The final C to be introduced is Charged batteries. The therapist explains that coming up with consequences, administering them in a consistent manner, and remaining calm are all very difficult if your personal batteries are run down. Therefore, an important aspect of parenting is keeping one’s batteries charged. Depending upon the specifics of the case, the therapist can point out possible factors that may contribute to the client having poorly charged batteries, such as struggling with depression, health problems, stress, or limited resources. In addition to treating the problems that are draining the parents’ batteries, the therapist should encourage parents to do self-care activities that will help recharge their batteries. Attending a support group, exercising, taking personal time for a recreational activity, starting a hobby, or spending time with friends are some examples of things that individuals might do to charge their batteries.

Brief Vignette

Charlie was a fourteen-year-old Caucasian teenager, and his mother, Linda, was a single mother in her early forties. Linda complained that Charlie was disrespectful, ungrateful, and constantly pushing her limits. Charlie felt his mom was always in a “bad mood” and nagging, yelling, and criticizing him. The dyad was introduced to the Four Cs of parenting. Charlie expressed reluctance to the notion of more rules, while Linda was excited to lay ground rules. During the therapeutic conversation about positive and negative consequences Linda revealed that she felt powerless to enforce her rules. She emotionally retold an incident in which Charlie had threatened to “turn her into CPS if she punished him.” She explained that she felt Charlie would turn on her again if she set limits. Once this deep-seated fear was revealed, Linda was able to begin setting consequences. The two worked together at home to author clear and concise consequences for both positive and negative behaviors and brought their ideas back to therapy.

Previously Linda had difficulty being consistent and following through on her consequences because she would threaten extreme penalties she could not follow through with. Part of her and Charlie’s work was finding the proper “consequence to fit the crime” that Linda could enforce without Charlie’s cooperation. Linda also began working on delivering consequences in a calm manner. Charlie had been acting out to receive negative attention from Linda. By remaining calm, Linda was able to become the parental figure once again. Charlie appreciated the neutral voice and began feeling less blamed and criticized. In return, he was able to show his mom more respect by refraining from name-calling and profanity.

As Linda practiced her new parenting skills she also worked on self-care activities so she would have charged batteries. In the past she had found running in the morning to be a helpful stress release and she began practicing it on a regular basis. She also began turning off her cell phone during meals and set aside one hour a night to spend structured quality time with Charlie. This simple change gave Charlie positive attention and gave Linda a much-needed break from work-related stress.

Suggestions for Follow-Up

The presentation of the Four Cs gives an excellent introduction to important principles in parenting. This type of model will be particularly helpful for clients who need some psycho-education about parenting skills or practices. The therapist, however, should be prepared to explore common difficulties that parents often experience with instituting one or more of the Four Cs.

One difficulty faced by many parents is feeling guilty about some aspect of their child’s life, thereby making it difficult for them to set limits with their children. A mother of a seven-year-old admitted that she hated to give her son consequences because she felt guilty about divorcing his father. In these circumstances, the therapist may need to frame setting limits as a means of providing security for the child rather than as a punitive measure. The mother of the seven-year-old was told that her setting limits with her son communicated that she was in charge of the situation and could take care of him. This in turn would make him feel more secure about the family transition.

Another common difficulty is that some parents ignore misbehavior until they can no longer tolerate it. As a result, anger or frustration has built up to the point where it is difficult for the parent to remain calm. In addition, when they finally do step in to correct the behavior, they may give out a more severe consequence because they are angry. Later, after they have calmed down, they may regret the severity of the consequence and not enforce it. This process ultimately undermines the parents’ efforts to be both calm and consistent. Parents can be instructed that a more effective approach is to intervene sooner using smaller consequences that are consistently given, rather than waiting until the misbehavior can no longer be tolerated.

Parents often need additional guidance on how to get their batteries charged by recognizing possible stressors or underlying factors. Some parents, for example, may be significantly depressed and have limited energy for parenting. In these cases, a referral for a medical evaluation and possible medication may be appropriate, and/or individual therapy. Some parents may focus too much on taking care of others at the expense of their own needs and may need coaching on how to integrate more self-care. Life stressors such as job stress, marital/couple conflict, or health problems may also drain a parent’s batteries. In some of these cases, individual or couples therapy may need to be considered in addition to family therapy.

At times, it is also helpful for the therapist to warn parents that some children may act out more initially as a way of testing a parent’s new resolve in setting limits. This may be particularly true for children who have experienced little in the way of limit setting and value the freedom they have had in the past. If parents are forewarned about this possibility, they are less likely to give up at the first bit of resistance. In addition, the therapist might work with the parents to p...

Table of contents

• Cover Page
• Half Title page
• Title Page
• Copyright Page
• Dedication
• Table of Contents
• List of Contributors
• List of Contributors
• Foreword
• Preface
• Acknowledgments
• Interventions for Couples
• Interventions for Families
• nterventions Including Larger Systems
• Index