 |
| Help clients understand and break the [wounds + unawareness] cycle
|
 |
A Model of Effective Clinical Work
with Low-nurturance Families and
Childhood-trauma Survivors
p. 1 of 2
By Peter K.
Gerlach,
MSW
Member NSRC Experts
Council |
this is under construction
 The Web address of this
two-page article is
http://sfhelp.org/etx/model.htm
Clicking links here will open a new window or an informational popup,
so turn off your browser's popup
blocker or accept popups from this nonprofit site. If the windows distract you, read the article before following any links.
This two-page article is one of a series on
professional counseling, coaching, and therapy with (a) low-nurturance
(multi-problem, dysfunctional) families and with (b) typical
of childhood
and trauma. These articles for
professionals are under construction.
This article offers...
-
perspective on why effective clinical work
with low-nurturance family systems is challenging, and...
-
a summary of a 5-part clinical model of effective clinical work with these families.
This series is written to
student and practicing
counselors, life-coaches, and therapists and
their instructors, consultants, employers, program managers, and evaluators. Most of the principles
in this model apply to any human group, not just families.
 Note
- this model and series were originally designed to focus on effective
clinical work with typical U.S. divorcing families and stepfamilies. It is
being reorganized in 2009 to pertain to (a) all low-nurturance families, and
(b) persons wounded by
early-childhood trauma ("Grown Wounded Children" - GWCs). Sec-tions
of these articles still
hilight keys to serving divorcing and stepfamily members well.
This series assumes you're familiar with these ideas:
Before continuing, pause and reflect - why are you reading this article?
What do you
Perspective
Families have existed in every age and culture because they are best able to
fill a range of primal
of their adults, kids, and societies.
Families' ability to fill their
members' daily and developmental needs (i.e. to nurture)
varies from low ("dysfunctional") to high ("functional").
Demographers estimate that almost half of recent American marriages have ended in
legal
Uncounted millions of
other mates and their families endure psychological divorce. More
millions never risk forming a family. This
suggests that well
over half of typical current U.S. families have a
significantly low nurturance level. This
has serious effects on
family members, future generations, and society.
Premise - a high percentage of typical American clinical clients and
patients come from low-nurtur-ance childhoods and current families. So do
many human-service providers. Addicted, divorcing, and step families are overrepresented among them.
My experience as a family-systems therapist since 1979 suggests
that most institutions who train and license counselors, therapists, and
psychiatrists don't adequately prepare them to improve family nur-turance levels. If true, this suggests that most
American (and other?) human-service providers
don't know what they need to know
to provide fully effective service to low-nurturance families and
(GWCs).
Test
this premise by taking these
and see what you learn. Then reflect and say your defini-tion of "a
healthy, functional family" out loud, as though to a first-year grad
student. Then compare your
definition to this.
The Challenge
Premise - all social role and relationship
"problems" stem from two interactive factors: adults' (a) psychological
from low-nurturance childhoods,
and (b) their
ignorance of basic information about
personalities and relationships + effective
+
and healthy
+ effective
+ (for some)
stepfamily
and
The more
knowledgeable clinicians (like you) are about (a) these interrelated factors
and (b) causing desired systemic change, the higher
their odds of
satisfying clinical outcomes.
Providing effective counseling and therapy to
typical low-nurturance families is challenging because
their adults and supporters have little or no
awareness of...
-
this toxic cycle of [psychological
+
that spreads down the generations un-less family adults
admit and break it;
-
these
five related
that will significantly stress their family members,
and...
-
up to six vital
about themselves and human relations.
And typical adults are unaware of ...
-
the
protective
required for
typical couples to make three wise, informed marital
and
evolve a stable,
family together.
The clinical
model proposed here is designed to help professionals help clients to (a)
become aware of the [wounds + unawareness] cycle
and (b) break it, to protect their descendents from its toxic effects. The
model includes special application to
An Overview of
the Model
This unique clinical model has five parts:
-
Theoretical foundations,
including a definition of
-
The client-family + professional
metasystem (system of systems);
-
An experience-based set of interrelated
premises about...
-
a practical three-step proposal for
preventing family stress and divorce; and...
-
Relevant resources for clinicians, clinical organizations,
and clients.
Here is brief perspective and
links to more detail on each of these elements.
1) Theoretical
Foundations
My clinical (MSW) training and experience since 1979 has integrated the work of
four groups of respected theoreticians and veteran human-service
professionals into this clinical
model:
-
Human-development and
family-system pioneers, principally Erik Erickson, Virginia Satir,
Murray Bowen, Carl Rogers, Jay Haley, Patricia Papp, Salvador Minuchin, Carl Rogers,
Carl Whitaker, John Gardner, Nathaniel Branden, Celia Falacov, Judith Wallerstein,
Steven Covey, Froma Walsh, and the "Milan Group" - Palazzoli, Boscolo,
Checchin, and Prata;
-
Intrapsychic, communication, and clinical-hypnosis pioneers, including
Abraham Maslow, Gregory Bateson, Milton Erickson, Francis Barber, Paul
Watzlawick, John Weakland, Richard Fish, Eric Berne, Claude Steiner,
Neale Walsch, Anne Moir, Jeffery Zeig, Thomas Harris, Hal and Sidra Stone,
Alexander Lowen, Larry Dossey, John Masterson,
Fritz Perls, Steven Gilligan, Harville Hendrix, Roberto Assagioli, John
Rowan, Deborah Tannen, Robert Bolton, and many others;
-
Childhood-trauma recovery pioneers,
including Bill Wilson et. al., Claudia Black, John Bradshaw, Sharon Wegsheider-Cruse, Janet
Woititz, Charles Whitfield, John and Linda Friel, Rokelle Lerner, Alice
Miller, Jane Middleton-Moz, Robert Ackerman,
Anne Smith, Richard Schwartz, John Rowan,
James Masterson, Mary Jo Barrett, Patricia
O'Gorman, Philip Oliver-Diaz,
Anne Wilson Shaef, Julia Cameron, Robert
Subby, Charles Whitfield, Pia Melody, and many others; and...
-
Pioneer stepfamily
sociologists, researchers and clinicians, including Andrew Cherlin,
A. J. Norton, Larry Bumpass, Jeffrey Larson, Paul Glick, J. A.
Sweet, Esther Wald, John and Emily Visher, Cliff
Sager et. al, Kay Pasley, Marilyn Ihinger-Tallman, and more recently John Bray, Margaret Newman,
Elizabeth Einstein, Patricia Papernow, and many others.
The five-element model proposed here is based on (a) a mosaic of ideas
from these scores of wise practitioners, theoreticians, and researchers; and (b) my experience
at integrating and selectively using my version of their ideas in my clinical practice with over
1,000 self-referred Midwestern-US co-parents since 1981.
Note that except for
Richard Shwartz, none of the experts above
incorporated ideas on normal personality subselves and wounds into their paradigms.
The second element of this clinical model is a group of interrelated premises
about...
2) The
Client-Profession Metasystem
A "system" consists of a boundary containing elements
(subsystems), which interact according to identifiable rules. A
metasystem is a system of systems. Premise -
the clinical outcome
with any client is significantly
shaped by the dynamic metasystem composed of....
-
the multi-generational client
and any support
groups they're using regularly;
-
the social and earthly environmental systems that interact
with the client-family system;
-
the system of clinician/s + coworkers +
administrators + policy makers + funders + support staff;
-
any case-consultants and their organizations,
including clergy, welfare, adoption, and/or foster parenting workers;
-
local and state family laws and legislators + any local law enforcement and
judicial (court) systems
affecting a specific clinical case;
-
local and state professional oversight, licensing, and regulatory
agencies, policies, and laws;
-
any involved healthcare insurers and their policies, representatives,
and assets; and...
-
related human-service organizations - e.g.
AMA, NASW, APA, etc.
The mix of these metasystem elements is unique for every client. It is too complex to
practically evaluate
how these elements are affecting a client's dynamic family system. The challenge to
systemic clinicians is to identify key influences of any of these subsystems on (a) their client-system's nurturance level and
(b) the clinician, and (c) the evolving clinical process.
Premise - to
provide effective service, clinicians need to be aware of how this complex metasystem may affect keeping
their and their client-adults'
in charge of their respective
in and outside the clinical process.
 Clinical Requisites
A vital component of this clinical metasystem is the degree to which each
human-service provider involved with a given client family meets these four
requirements:
-
Special
didactic and experiential
knowledge; and...
-
Key personal traits, including...
-
their
steadily
their "inner
family" of personality subselves, and...
-
clear
self-awareness and
and
-
key
attitudes about the these
complex client family systems and clinical work with them; and...
-
unique
(vs. basic) clinical
skills, and...
-
A high-nurturance, well-informed
work
environment, and...
-
Special
professional
and client
resources.
For more
detail on each factor, follow the links.
The next element in this clinical model has three parts: (a) basic traits of
these client families, (b) a three-level framework of common family
stressors, and (c) a multi-modal framework for effective assessment,
intervention, and case supervision with these family systems.
Model, Part 3)
Premises on a Range of Related Factors
. For links to detail on the
premises (theories) that comprise this model, see
this.
Model, Part 4) Stress and
Divorce Prevention
Read this
overview of the [wounds + unawareness]
cycle. Then read this
series of prevention articles in this Web
site outlines three steps that anyone (like you) can tailor
and commit to to effectively help prevent
inadequate family nurturance and potential divorce trauma in their
community, state, or nation:
-
acquire didactic
knowledge of...
-
the [wounds + unawareness]
cycle and its effects,
-
for and
from psychological
wounds, and...
-
some of or all of these vital
Then...
-
patiently use this knowledge in your own life to
validate these concepts and gain experiential awareness. Then...
-
choose a local, state, or national
target group, and
devise a strategy to alert them to how this knowledge can help them
maintain
relationships and avoid major stress and
illness; Then...
-
patiently implement your plan with or without help,
within your limits, priorities, and other responsibilities, and enjoy
the satisfaction of having made a significant difference in the world.
A keystone
requisite for implementing these steps is that you work toward having your
and
guide
and support you along the way - and then encourage others to do the same.
This
series of prevention articles
includes specific suggestions tailored to different human-service
professions.
More perspective on this model's
elements...
site intro /
course overview
/
site search
/
glossary
/
forums /
contact
/
Updated
July 03, 2009
|