The Therapist's Notebook
eBook - ePub

The Therapist's Notebook

Homework, Handouts, and Activities for Use in Psychotherapy

  1. 460 pages
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eBook - ePub

The Therapist's Notebook

Homework, Handouts, and Activities for Use in Psychotherapy

About this book

When did you last have enough free time to carefully create, develop, and test a therapeutic concept or teaching method to improve the help you provide to your patients? With The Therapist's Notebook, a compilation of original ideas by practicing clinicians, you can tap into the knowledge and experience of seasoned professionals to give your clients tangible, field-tested assignments that will represent their work and progress in therapy. Appropriate for practicing marriage and family therapists, psychologists, social workers, and other therapists of any professional affiliation who deal with children, adolescents, adults, couples, or families, this dynamic handbook provides you with handouts and homework activities that are quick and easy and require little effort or experience to use. The Therapist's Notebook is a valuable resource for both experienced and novice clinicians. Established clinicians will know how to fit each chapter to a particular clientele, while uninitiated clinicians or trainees will appreciate how the ready-made materials help their clients and spur their own creativity in intervening. You'll find therapeutic work becomes less stressful and more enjoyable as you learn about helping these populations deal with important issues:

  • Adults--goal setting, boundary issues, life transitions, communication, problemsolving, compulsivity, feelings
  • Couples--trust, infidelity, leisure time, communication, conflict resolution, sexuality, enrichment
  • Families--rules/punishment, decisionmaking, gender roles, chores and responsibilities, communication
  • Children--self-esteem, school problems, social skills, abuse, discipline problems
  • Adolescents--peer pressure, school issues, communication, involvement in therapy, behavior
  • Other--resistant clients, crisis counseling, linking clients with social resources

The Therapist's Notebook gives you a tangible, useful product you can utilize with clients. The book's compilation of homework, handouts, and activities that have been successfully applied to client populations is valuable not only for therapists'daily use, but also to illustrate creative, clinically tested interventions to future counselors, therapists, social workers, teachers, school psychologists, and special educators. Particularly useful as an ancillary text in university courses in psychotherapy-related fields, the book's user-friendly format will enliven practicum courses and ensure heightened student participation.

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Information

Publisher
Routledge
Year
2013
eBook ISBN
9781135884154
SECTION II: HOMEWORK, HANDOUTS, AND ACTIVITIES FOR COUPLES

19
Assertiveness Homework for Couples

A. Peter MacLean
Type of Contribution: Homework/Handout

Objective

In order to help couples master the assertiveness skills they have been learning in session, they are instructed to apply the following A-B-C Model of Assertiveness as homework in role-plays and in vivo situations. These role-plays involve both actual and ideal behaviors. Through the practice of genuinely expressing one’s feelings and needs—while recognizing the rights of one’s partner—couples learn to resolve disputes in a positive way that facilitates greater intimacy.

Rationale for Use

Greenberg and Johnson (1988) describe the marital relationship as providing ā€œthe opportunity for interdependence, the chance to have one’s feelings and needs respected, and the opportunity to be the most important person to a significant other. This type of relationship between adults promotes trust, intimacy, disclosure, and the expression of intense feelingsā€ (p. 3). Marital relationships are often complementary in nature (Hendrix, 1988), and this is frequently evident in couples’ communication patterns. For example, a nonassertive person in a marriage will often only express frustration to major annoyances whereas an aggressive partner may lack patience and tend to become upset and angry too often. This type of relationship will clearly develop communication problems with respect to having each partner’s needs met. One approach to resolving this type of problematic relationship is to adhere to the wise maxim, Aristotle’s Golden Mean. That is, find and follow a middle road between the interpersonal extremes of nonassertive and aggressive behavior. That middle road is assertiveness, the expression of one’s feelings and needs in an empathic way.
The focus of the present intervention is on helping couples become more assertive with each other. This intervention has effectively been employed in individual as well as group couples therapy.

Instructions

Prior to having clients actually do homework assignments, it is important in assertiveness training that they learn certain fundamental principles of human interactions and, in particular, the language of assertiveness. For example, a basic component of assertiveness training involves teaching clients to differentiate between the three basic types of behavior on the assertiveness continuum: (1) nonassertion (an individual allows others to violate one’s rights); (2) assertion (standing up for one’s own rights without denying the rights of others); and (3) aggression (lacking empathy and patience, and often infringing on the rights and dignity of others) (Jakubowski and Lange, 1978; Alberti and Emmons, 1982). In addition, clients learn about the eleven ā€œBasic Assertive Rightsā€ that all humans have (see Appendix A; it is given as a handout to each partner as a component of the psychoeducational learning process in couples assertiveness training). They include, for example, the right to be treated with respect, the right to experience and express your feelings, and the right to ask for what you want (Jakubowski and Lange, 1978).
After the basics are learned, it is time for couples to apply these important principles in their interactions. An insightful yet simple model of assertiveness was proposed by Heisler and Shipley (1976), the A-B-C Model of Assertive Behavior. This strategy consists of the following three steps. After being the recipient of an offending behavior by another person, Step A involves briefly telling this individual how you feel using ā€œI … ā€ statements (e.g., ā€œI feel embarassed and a bit upset because you were impatient with me just now in front of our friends.ā€). Step B is an empathic statement (and, with friends, is also supportive—see Appendix B) that considers the feelings of the offending individual and enhances the chances that the message being sent will be received (e.g., ā€œI still think you meant well and were probably just in a hurry.ā€). Step C is a request for behavior change in which the individual expresses his/her need that the offending behavior not occur again (e.g., ā€œI need you not to criticize me in front of our friends again in the future. Can you try not to do that?ā€). (Please refer to Appendix B, a second handout given to clients which provides examples of appropriate [i.e., assertive] and inappropriate [i.e., nonassertive and aggressive] behavior.)
Clinical experience has shown that nonassertive partners need to practice more on the A and C parts of the model (i.e., readily expressing their feelings and needs), whereas aggressive individuals must concentrate more on part B, consciously focusing on seeing their partner’s perspective. In addition, a very important concept in all assertiveness work is that of ā€œappropriate assertiveness.ā€ This idea is nicely embodied within the A-B-C Model in that respect for others is evident with the inclusion of a focus on empathy.
Before couples apply the ABC model for homework, it is first important that they fully understand and can properly apply it in session with the therapist present to act as a guide. The therapist has the couple role-play a recent frustrating interaction or fight (the ā€œactualā€ situation, i.e., their usual nonassertive and/or aggressive behavior). After this is completed, they share their reactions to this role-play with each other. Next, the therapist has the couple each identify their respective assertive rights (see Appendix A), and explicitly describe how they should ā€œideallyā€ act (i.e., assertively) according to the A-B-C Model of Assertive Behavior. This is followed by the couple role-playing their former interaction, but this time in an assertive way following the Heisler and Shipley (1976) model. In addition, videotaping ā€œactualā€ and ā€œidealā€ behavior has proven effective as a learning tool in giving clients immediate feedback on their interactions.
Finally, it is important to discuss with the couple their feelings about how this assertive interaction compares with their earlier nonassertive and/or aggressive role-play. Typically couples will express mixed emotions. That is, although they typically feel pleased with their new style of interacting and report more positive (and fewer negative) emotions toward their partner, they nonetheless express anxiety about the novelty of this new mode of behavior. It is therefore important to state clearly that learning to act assertively is like learning any new skill in that a person must go through two general phases: (1) an initial anxious stage when he/she is trying to integrate unfamiliar ways of behaving assertively, and (2) an automatic phase in which assertive behavior has become a natural way of interacting with others and which only comes with consistent practice. This information is usually helpful in motivating clients to practice the assertiveness skills they have been learning.
Assertiveness homework with couples initially involves having them do more of the role-plays that they have been introduced to in session. For at least one to two weeks, they should include both ā€œactualā€ and ā€œidealā€ role-plays of any negative interactions they experience. This practice will help to reinforce the distinction between the three types of assertive behavior and, as assertiveness becomes more natural, they can decrease the rehearsal of their dysfunctional ā€œactualā€ behavior. In addition, keeping an ongoing diary of these interactions is strongly encouraged.
For homework, the couple should be encouraged to bring in ā€œsuccess storiesā€ of in vivo situations where they have acted assertively despite initial feelings of anxiety. When assertive behavior is becoming more automatic, the therapist will typically observe greater independence and interdependence in the couple as well as higher levels of trust, intimacy, and expression of intense feelings. Preparations for termination can then begin.

Suggestions for Follow-Up

Perhaps the most important factor necessary for maintaining a couple’s gains in acting assertively and avoiding backsliding into old problematic behaviors is for them to adopt a disciplined attitude of tolerating some ā€œshort-term pain for long-term gain.ā€ That is, this perspective will allow the couple to recognize that, with time and practice, their initial anxiety and awkwardness associated with acting assertively will be replaced with interpersonal confidence and enhanced relationship satisfaction. Clients need to embrace every chance they have to practice being assertive using the A-B-C Model as a guide not only with their partners, but in all of their interpersonal situations. Furthermore, continuing to keep a brief log of assertive interactions is important, especially before these new adaptive behaviors have progressed to the stage of being automatic. This record keeping will help prevent backsliding and will aid the client in identifying ways in which s/he did not act as assertively as a particular situation called for, which should facilitate more assertive behavior in a similar future situation.
In more difficult assertive situations, it is often a good idea beforehand to visualize oneself in the particular interaction acting in an assertive way. In addition, by practicing hypothetical role-plays of upcoming stressful interactions, clients have reported success and greater confidence in their interpersonal ability to act assertively.

Contraindications

Like all types of couples therapy, a commitment to the process of change must be evident in both partners. Thus, the active practice of the A-B-C Model of Assertiveness as a homework tool for enhancing dyadic satisfaction is not likely to be effective unless both partners are committed first to the relationship, and also to personal growth as well as the process of therapeutic change. (This commitment is of particular importance in maintaining the gains made in therapy after the sessions have finished.) A history of partner abuse in the relationship would therefore be a contraindication for this homework activity. In addition, if one partner is ...

Table of contents

  1. Cover
  2. Halftitle
  3. Title
  4. Copyright
  5. Contents
  6. Foreword
  7. Preface
  8. Acknowledgments
  9. SECTION I. Homework, Handouts, and Activities for Individ Uals
  10. SECTION II. Homework, Handouts, and Activities for Couples
  11. SECTION III. Homework, Handouts, and Activities for Families
  12. SECTION IV. Homework, Handouts, and Activities for Children
  13. SECTION V. Homework, Handouts, and Activities for Adolescents
  14. SECTION VI. Therapist Helpers
  15. Index

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