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


Common Blocks to Effective Clinical Service
with Low-nurturance Families

By Peter K. Gerlach, MSW
Member NSRC Experts Council


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        This article is one of a series on effective professional counseling, coaching, and therapy with (a) low-nurturance (dysfunctional) families and with (b) typical survivors of childhood neglect and trauma. These articles for professionals are under construction.

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Typical Issues Hindering Effective Therapy (Tx)

1) The clinician is psychologically wounded, and/or is ignorant of wound-symptoms, or ignores client's wound-symptoms (e.g. shame-based  and fear-based  communication patterns; denied addictions);

2) The clinician is (a) unaware of stepfamily differences and norms, and/or (b) lacks clinical experience with stepfamilies. The clinician treats the clients as an intact biofamily;

3) The clinician defines the client too narrowly - e.g. ignoring or minimizing co-parenting ex mate/s and their households, et. al.;

4) The clinician is unclear on (a) primary (vs. presenting) problems, (b) specific Tx phases and objectives, and/or (c) effective strategies;

5) The clinician bounces among multiple client-family problems, and is unable to prioritize and stay focused;

6) The clinician is untrained in - or inexperienced at - assessing and effectively treating clients' _  blocked grief, and/or _ ineffective communication sequences and patterns;

7) The clinician _ proposes inner-family (recovery) work too soon, or _ omits it from the Dx - Tx plan;

8) The clinician has unrealistic Tx goals: trying to do too much, too fast;

9) The clinician is uncomfortable with fluidly switching between group, couple, and individual work  in the client stepfamily, and/or is constrained by agency policy or a supervisor/case manager from doing so;

10)  Supervisors and/or involved consultant/s are unrecovering GWCs, and/or are stepfamily-untrained and unaware;

11)  Some client-stepfamily co-parents are uncooperative or unavailable; The clinician is ambivalent about or resistant to engaging hostile or disinterested co-parents in Tx;

12)  The clinician is blocked by client co-parents' denial of their stepfamily identity - and hence of step realities and viable solutions;

13)  The clients' overwhelm or triangle the clinician in their multi-home systemic conflicts;

14)  The clinician is negatively biased on divorce, re/marriage, stepfamilies, stepparents, stepkids, ..., and denies this or sending covert messages about these attitudes;

15)  The clinician is frustrated / paralyzed / burned out from too many multi-problem stepfamily client/s in crisis.

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Updated April 30, 2013