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

Introduction to Effective Assessment of Low-nurturance Family Clients
 - p. 2 of 5

Assessment Factors, Projects 1 thru 4

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.

        This series assumes you're familiar with:

        Before continuing, pause and reflect - why are you reading this article? What do you need?

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        This continuing an outline of key assessments of a client metasystem  - their extended family-system plus any impactful social subsystems.
 

  Lesson 1 Assessments (all clients)

Premise: the degree and nature of client-adults' unawarenesses and false-self wounds will affect (a) every other systemic problem, and (b) the client-system's receptivity to clinical interventions. Do you agree with this?

        Based on this and related premises, assess some or all of these factors over time...

  • How wounded is each key adult and child? (low > moderate > high)

  • How informed, self-aware, and process-aware is each key adult, including key supporters? (little > moderately > very)

  • How are these wounds and unawarenesses affecting the client-family's nurturance level (minor > moderate > major)

  • How do these effects relate to the client's presenting problems? (directly > indirectly);

  • How receptive is each key client adult to learning about the [wounds + unawareness] cycle,  personality subselves and wounds, personal wound-recovery, and what each of these means to current and future family members? (low > moderate > high);

  • Is any wounded client adult or child currently addicted to a substance, activity, relationship, and/or cause? (no > unclear > yes)

  • If so, how knowledgeable are other family members about (a) addictions, typical addiction effects, and addiction (vs. wound) recovery; and (b) how psychological wounds relate to typical toxic compulsions? (unaware > moderately knowledgeable > very knowledgeable);

  • Is each addicted adult genuinely motivated to control (reduce) their toxic compulsions? (strongly > sporadically > not at all);

  • How nourishing are the client-family's spiritual beliefs and practices (a) in general and (b) relative to any addiction and wound recoveries? toxic or ineffective > moderately nourishing > very nourishing)

  • How receptive is each wounded adult to committing to personal recovery now? (not at all > ambivalent > highly receptive or committed);

  • How nurturing is any support network for each genuinely-recovering adult, starting with other family members? (low > moderate > high);

  • How high in priority does each wounded client adult rank (a) their own and (b) each other's wound-recovery in current family affairs? (low > moderate > high); and...

  • Assess any other client-specific systemic factors.

  Selected Lesson-1 Resources

Key interventions related to these assessment variables (for all families);

An introduction to normal personality subselves (Inner family systems), a safe initial dialog with a subself, and an open letter to skeptics

An example of psychological wounds (+ unawareness) stressing a real stepfamily

The Lesson-1 overview and article-index

Q&A about psychological wounds, and this introduction to wound-recovery

<<  main assessment index  /  project assessment index  >>
 

  Lesson 2 Assessments (all clients) -

Premises:

        Ineffective thinking, communicating, and problem-solving are primary causes of most surface problems in typical client families;

        Most client adults don't know how those contribute to their presenting problems, or what they need to learn about these vital topics. Implication - clinicians usually need to be proactive about Lesson-2 assessments and interventions.

        Significant psychological wounds in average (unrecovering) adult clients will degrade their thinking and communication effectiveness regardless of what they know. Implication: effective clinical work with all clients should give priority to concurrent Project1 and Lesson 2 assessments and interventions as circumstances allow.

        Based on these and related premises, this model suggests assessing any client for these Lesson-2 factors...

  • the clarity of reach client adult's thinking and articulation. Watch for patterns of...

    • vague pronouns (him/her, s/he, it, that, them, the issue, this problem, deal with, etc.);

    • hand-grenade (emotionally provocative) words and phrases;

    • unfinished thoughts and sentences;

    • abrupt topic changes and/or interruptions, and...

    • staying focused on key topics until done; (fuzzy / unfocused > clear / focused); and...

  • assess each adult clients' ability to identify and respectfully assert their current primary (vs. surface, or secondary) needs clearly, vs. denying, numbing, passivity, submitting, or aggression (e.g. demanding, threatening, ordering); and...

  • the client's definitions of...

    • effective communication and win-win problem-solving; and...

    • common alternatives to effective problem-solving. Option - assess which of these alternatives client family-members often use, and what usually results;

  • Ask each adult client to rank the effectiveness of their family communication from one (very ineffective) to ten (consistently very effective). Note the criteria they use to answer this;

  • As appropriate, assess clients' knowledge of these communication basics. Option - ask them to fill out this quiz &, and discuss the results. Use the results to select from basic Lesson-2 interventions.

  • Ask if the clients can describe...

    • the five needs all infants, kids, and adults try to fill by communicating; and...

    • which of these needs will mesh or conflict between communication partners at a given time;

    Option - ask clients to describe how they usually react to typical family communication-need conflicts (unaware > deny/ignore > fight > problem-solve);

  • ask if clients are aware of the vital difference between their communication process and content - specially in stressful situations;

  • Ask if the clients can name the seven effective-communication skills, and when to use each of them;

  • Ask (a) if clients are aware of possible communication outcomes, and (b) which outcomes they usually experience in family disputes and crises.

  • Assess whether are usually aware of...

    • their R(espect) messages in session and elsewhere, and...

    • whether their R-messages promote or hinder effective communication.- specially in conflicts.

    If they're not aware, assess how open client-adults are to learning about, and becoming aware of, their relationship attitudes and R-messages (closed > indifferent > ambivalent > clearly interested);

  • Gauge each adult client's ability to listen empathically to other family members, in session and elsewhere - specially in disputes. (not able > occasionally able> always able).

  • Evaluate each adult client's awareness of their communication process in session and elsewhere - specially in conflicts and crises (none > a little > moderate > high);

  • Across several sessions, assess clients for other common communication blocks and how the clients typically react to them. Look for recurring process-patterns;

  • Across several sessions, identify personal adult and family communication and problem-solving strengths;

  Selected Lesson-2 Resources

Interventions related to effective thinking, communication, and problem-solving;

This quiz about basic communication knowledge

The Lesson-2 overview, article-index, and summary slide presentation;

These illustrations of win-win and lose-lose problem-solving;

These skill practices for awareness, empathic listening, and effective assertion;

These summaries of common blocks, and useful communication terms, tips, and phrases;

This summary of communication-process mapping (an assessment technique);

These Solutions articles about effective communication between partners, and ex mates;

These useful questions (and answers) about communicating effectively; and...

The Lesson 2 guidebook, Satisfactions (Xlibris.com, 2nd ed., 2010).
 

<<  main assessment index  /  project assessment index  >>  
 

  Lesson 7 Assessments (with all courting and committed stepfamily clients) - evaluate whether client adults understand and genuinely accept their stepfamily identity and what it means

Premises:

        Many typical stepfamily clients deny, ignore, discount, are unclear on, or resist accepting (a) their identity as a normal multi-home stepfamily, and (b) what that identity means to all their members. This promotes using inappropriate biofamily role and relationship expectations, which breeds significant stress in and between their related homes. And...

        Client adults, kids, and supporters may be unclear on, and/or conflicted about, who belongs to (is included in) their multi-generational stepfamily - i.e. whose needs, opinions, and values should be respected equally with other members.

        Early in the work, assess if client adults and kids...

  • can clearly define what a stepfamily is;

  • currently accept that they each are members of a normal stepfamily (vs. just "a family.");

  • accept that stepfamilies are ancient, normal type of social unit which can nurture (function) just as well as healthy intact biofamilies if their adults are (a) ruled by their true Selves, and (b) are steadily motivated to help each other learn and apply some key topics and realities;

        And assess if client adults...

  • can describe realistically what it means to be in a stepfamily - personally, and as a group; And...

  • can meaningfully describe what it means to belong to a family;

  • earn whether all client adults and kids fully include...

    • both bioparents of each minor or adult stepchild, and...

    • any divorced-bioparent's new partner, stepkids, and step-kin; and...

    • all genetic, legal, and "ex" relatives,

    as legitimate members of their stepfamily. If not, identify which members are ambivalent or opposed to accepting any of these people as co-equal relatives; Option - show clients a multi-generational stepfamily genogram (family map) to illustrate your questions, and suggest clients make their own map as a group exercise.

These Project-3 assessments are needed to make effective Project-4 assessments of the same client stepfamily.

  Selected Project-3 Resources

Interventions related to these stepfamily-assessment variables;

These articles on stepfamily identity, identity meaning, and membership,

This worksheet on stepfamily-identity-acceptance traits; and...

The guidebook for Projects 1-7, Stepfamily Courtship (Xlibris.com, 2002).

<<  main assessment index  /  project assessment index  >>
 

  PROJECT 4 Assessments (for all courting and committed stepfamily clients) - check for significant adult misperceptions about stepfamily roles, relationships, norms, and developmental stages.

Premises:

        Our wounded, unaware culture doesn't teach typical stepfamily adults and supporters or most family-support professionals accurate stepfamily norms, myths, and realities. This causes typical stepfamily adults and dependents to (a) make unhealthy courtship choices (Project 7), and (b) try managing their stepfamily merger (Lesson 7) with inappropriate biofamily role and relationship expectations.

        This fosters chronic or escalating hurt, disappointment, frustration, and confusion in and between related co-parenting homes, which (a) inhibit healthy stepfamily bonding, (b) lower the stepfamily's nurturance level, and (c)  promote eventual psychological and legal re/divorce.

        Typical stepfamily clients don't (want to) know this, and won't ask for help in reality-checking and updating their stepfamily expectations.

        Implication: effective clinicians will accept this, and proactively assess client-adults' stepfamily expectations even though clients don't ask them to. Effective Project-4 assessment requires prior Project-3 evaluation.

        Over several early sessions with a new stepfamily client, assess:

Project-3 variables. If the clients don't solidly accept their stepfamiy identity and what it means, re-do Project-3 interventions as appropriate. And assess...

the adults' attitudes (very biased > mixed > very non-biased) and expectations on a range of up to 60 stepfamily  role, developmental, and relationship variables; (vague > unrealistic > mixed > realistic); and evaluate...

the adults' (a) understanding and (b) acceptance of...

  • the three common developmental outcomes of typical U.S. stepfamilies, and of...

  • how the normal developmental path of typical stepfamilies compares to that of typical intact biofamilies (ref. Lesson 7 interventions on both of these); And also assess...  

the adults' openness to...

  • adopting new perspectives and stepfamily realities (closed > mixed / ambivalent > open); and...

  • teaching them to other family kids and adults (unmotivated > ambivalent > motivated).

  Selected Project-4 Resources

Interventions related to these stepfamily-assessment variables;

These articles on stepfamily facts, myths, and corresponding realities;

These Q&A items on several common stepfamily topics; and...

The guidebook for Projects 1-7, Stepfamily Courtship (Xlibris.com, 2002).

<<  main assessment index  /  project assessment index  >>

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Continue with basic client-family assessments for Projects 8-12, and more.

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Created March 22, 2014