Help clients understand and break the toxic [wounds + unawareness] cycle

Four Requisites for Effective Clinical Service

Special Clinical Skills Needed,
by Client-type - p. 2 of 4

By Peter K. Gerlach, MSW
Member NSRC Experts Council

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Continued from p. 2...

  The Web address of this four-page article is http://sfhelp.org/etx/req/skills.htm

        This page continues an outline of four requisites for effective professional service to typical childhood-trauma survivors and divorcing-family and stepfamily clients:

        The prior pages outlines the special knowledge requirements, requisite self-awareness and process awareness, and general clinical skills required for all six types of clients covered by this model. This page summarizes special clinical skills required for each phase of the work with these clients:

  • adjusting to divorce or mate-death,

  • pre-stepfamily courtship,

  • committed stepfamily couples denying primary-relationship problems,

  • committed stepfamily couples admitting such problems,

  • re/divorcing stepfamilies; and...

  • families in any of these phases where at least one adult survivor of childhood trauma is motivated to reduce their false-self wounds and harmonized their personality subselves. This may be individual or family work.

1) Clinical Skills Needed for Divorcing-biofamily Clients

        For perspective on working with these needy, multi-problem client families, study this perspective on the current US divorce epidemic, this slide presentation on divorce, and this worksheet on divorce-recovery status before continuing here. The general skills on the prior page should be adequate for most families adjusting to the death of an adult or child.

        Effective clinical work with these families requires unique clinical knowledge and these special skills in clinicians, supervisors, consultants, and program and/or clinical directors:

  • help divorcing partners and their families to...

    • stabilize any personal and family crises, and...

    • if appropriate, help couples evaluate whether legal divorce is their best long-term choice, including...

      • assessing each partner's marital needs, how well each need has been filled, and what prevents filling unmet needs; and

      • whether or not to use a qualified marriage counseling (you?) and/or a professional mediator.

 If the decision to divorce is firm, then...

  • devise and implement an effective family-reorganization plan, and (b) manage their changes cooperatively. This includes helping divorcing parents...

  • assist in (a) evolving viable, stable co-parenting and child-custody agreements, and possibly (b) stabilizing and (c) reducing the need for legal orders of protection. The latter is strong evidence of major false-self wounds in one or both partners. And...

  • educate parents on the normal developmental and special divorce-adjustment needs of their minor kids, and assess each child's current status with them;

  • if presenting problems include one or more children "acting out," assess how best to help each child while working with the whole family system. This may justify expanding the clinical metasystem to include an appropriate co-therapist, school counselor, tutor, and/or clinical program; and coordinating the family work with them; And effective clinicians also need to be skilled at...

  • maintaining their personal and the client-family's balances through the stressful divorce-adjustment  process. This may involve working with adversarial attorneys and a Guardian ad Litem (children's attorney), family-court judges, and/or court-appointed mediators and child-custody evaluators for many months. If your client has been ordered by the court to "get counseling," see this. And...

  • evaluate and achieve effective divorce recovery over time. Some clients may need special help to resolve problems from marital affairs, family violence, sexual traumas, compound legal and financial problems; and someone's addiction, including co-dependence. Each of these surface stressors is strong evidence of significant adult (GWC) wounds, which is the primary problem.

  • helping divorcing parents (a) acknowledge and (b) permanently reduce significant barriers to cooperative child-nurturance over time. This long-term work often requires focused education and some version of skilled parts work.

  • Many divorcing Catholic families need empathic, knowledgeable assistance to navigate the difficult church annulment process, which may overlap with legal divorce and extend beyond it.

  • help adults and kids to (a) acknowledge (vs. deny, repress, intellectualize, or ignore) and grieve and adjust to biofamily reorganization (splitting into two co-parenting homes) following parental divorce, and (b) understanding and patiently achieving genuine divorce recovery before making stepfamily commitments;

  • help the client's extended-family system (a) understand, (b) accept (vs. deny), and (c) grieve and adjust to their divorce-related losses and changes.

        Think of several divorcing-family clients, and comparing the work with them to this clinical-goal and skill summary. Clinicians will usually not be able to cover all these goals adequately, and will need to triage their time and efforts to achieve the best long-term systemic changes that limits allow.

        Typical stressed divorcing-family clients will probably focus short-term relief (surface-problem reduction), and will not be able to focus on a long-term systemic goals. In such cases, a special clinical skill is weaving long-term suggestions into short-term work. ("For your kids' sakes, you'll probably want to improve your adult communication and problem-solving skills over time, won't you?")  

        In my experience, almost all divorcing families are headed by survivors of childhood trauma - Grown Wounded Children (GWCs). Few (no?) such adults are aware of the [wounds + unawareness] cycle that promoted their and their kids' psychological wounds. Unless divorcing adults are middle-aged and have clearly hit true bottom, it's usually premature to suggest they commit to personal wound recovery while they grieve and adapt to divorce-related losses and changes. It is appropriate to plant seeds (comments, handouts, etc.) about the cycle's toxic effects and eventual personal wound-recovery. If one or both divorcing adults are ready to commit to wound recovery, see this.

        The more knowledgable and skilled a clinician is at facilitating client progress on this complex mosaic of systemic goals, the more likely they are to minimize future stepfamily stresses.

2) Extra Skills Needed During Pre-stepfamily Courtship

        My clinical experience since 1981 steadily suggests that one of five interrelated reasons for the US re/divorce epidemic is one or both needy, psychologically-wounded partners committing to the wrong people (partner + kids + ex mate/s and kin), at the wrong time, for the wrong reasons. With such clients, the definition of effective clinical work becomes (a) compassionately facilitating couples to make three wise commitment choices, and (b) preparing couples to (eventually) accept of the [wounds + unawareness] cycle that may threaten them and any living and future descendents.

        Projects 1-7 here - and this entire nonprofit site - exist to protect courting co-parents and their descendents and society from probable re/divorce trauma, and help them co-create stable, satisfying high-nurturance stepfamilies.

        To gain perspective on special skills needed effective clinical work with this type of client family, first study...

        Now reflect on how much of this information typical courting co-parents and their supporters  have acquired and accepted as pertinent to their situation. My experience is - well under 5%. Implication: typical courting and committed stepfamily couples and their supporters don't know what they need to know, and often resist admitting this - specially if they're unrecovering Grown Wounded Children in denial.

        Special clinical knowledge and skills are required for effective clinical service to divorcing family systems which include one or two parents who are seriously dating a new partner - with or without biochildren. The legal and any Catholic divorce and annulment processes may or may not be completed. Such families are already multi-home psychological stepfamilies, though adults (including ex mates and relatives) often minimize or deny this.

        The more common of two scenarios is one or both adult partners seeking professional help to learn what they need to evolve a successful remarriage and stepfamily  - i.e. to guard themselves and their kids against another divorce trauma. They may term this "education," or "pre-(re)marital counseling." Often, presenting needs focus on preventing future (step)family and re/marital problems, rather than solving current (surface) problems. The second scenario is the dating co-parents do want to resolve pre-stepfamily surface problems - e.g. relations with a "difficult" ex spouse, or kids' initial adverse reaction to their bioparent dating a new partner.

        In both scenarios, one or both partners are usually...

  • unaware of being dominated by a false self, (significantly wounded and needy),

  • minimizing or denying current relationship stresses and warning signs,

  • unaware of - and often resistant to genuinely admitting (a) their stepfamily identity and (b) related realities and (c) hazards, and (d) their ex mates' full membership in their pre-legal stepfamily, and...

  • deny, minimize, and/or rationalize these.

  

Extra Clinical Skills Needed for Stepfamily Mates in Denial

       In addition to the general and courting-couple skills, clinicians working with stepfamilies who's couples deny any significant partnership problems need skills like these:

 

Recap

        This page summarizes the second requisite for effective clinical outcomes with these complex clients: (a) general special skills, and (b) 19 special skills for each phase of the work. Clinicians who haven't fully accepted how different average divorcing-family and stepfamily clients are from intact biofamilies are apt to discount the need for these special skills. Restated: it will take average licensed clinicians several years and several dozen client families of all six types to really appreciate the need for and impact of these many special skills.

        Clinicians, supervisors, and colleagues who need to deny (a) significant false-self wounds and (b) how different these client families are, are apt to c/overtly trivialize or discount the need for these special skills. That risks providing ineffective long-term help to client families and leaving their descendents vulnerable to inheriting significant psychological wounds and ignorance and passing them on.

Reality check: on a scale of one (I believe these skills are not needed or useful) to ten (I believe that clinicians must proactively develop all these special skills for effective outcomes with these clients), I am now a __.

Continue with the third of five requisites for effective service to trauma-survivors and divorcing-family and stepfamily clients: special personal traits.

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Updated  June 28, 2009