Toward effective clinical service to wounded survivors of low-childhood nurturance

Checklist: Key Interventions with
Typical Psychologically-Wounded Persons

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?

+ + +

       This article is one of a series on effective clinical interventions with six types of divorcing-family and stepfamily clients. It is based on 26 years' study and live clinical experience with hundreds of typical marital and family clients. The article assumes you are familiar with all five elements of this clinical model.

        A basic premise here is that most (all?) clients are unaware that the problems they seek clinical help to resolve are symptoms of these 11 common interactive primary problems. The assessment portion of the clinical model proposes effective ways to (a) diagnose which of these core problems are unbalancing the family system, and (b) how to prioritize them. The other intervention articles suggest effective ways of reducing or resolving each of the common primary problems.

        This article provides a tool for clinicians, supervisors, and consultants to help (a) plan treatment strategies and (b) measure progress in the work with a given client family. Links connect to background on the primary problems and/or to outlines and examples of, each intervention. Depending on the type of client, interventions range from group to couple to individual; and from didactic-education to intrapsychic-change strategies.

Educational (Teaching) Interventions

General Educational Interventions

        Options: "X" each intervention that isn't relevant to this client family, asterisk each one you feel has been attempted well enough, and check each one that has been "successful." Hilights below indicate high-priority interventions with most client families.

__   1) why and __ how to differentiate current surface (secondary) needs from primary needs; and __ explore how this relates to the client's presenting (surface) "problems."

__   2) why and __ how to assess the client-family's nurturance level

__   3) how low childhood nurturance promotes fragmented, disorganized personalities and "false-self" wounds

__  4) the [wounds + ignorance] cycle, and __ its recent effects on the client family.

__  5) why and __ how and to assess for client-adult psychological wounds; and __ overview wound-recovery goals and common benefits

__  6) effective-communication and __ problem-solving basics, and common communication __ blocks and __ tips

__  7) Typical marital needs, __  healthy-marriage requisites, and __ how to identify and reduce typical primary-relationship problems (unfilled needs)

__  8) typical minor kids' developmental and family-adjustment needs, and __ how to assess kids' status with these

__  9) effective child-nurturance (co-parenting) requisites and goals

__  10) identify each client-adult's recent demonstrated (vs. desired) life priorities. Then __ educate the adults on how this relates to their presenting and primary problems - e.g. show that couple's marital "problems" may stem partly from one or both partners not really making their primary relationship a steady high priority. Option: __ illustrate how adults' demonstrated priorities reflect which subselves usually control their personality.

__   11) As appropriate: educate client-adults on attachments (bonding), losses (broken bonds), healthy three-level grieving, and family grieving polices; __ why and how to assess for blocked grief and __ options for freeing it up; and __ how these relate to the client's presenting and primary problems (if they do).

Educate Divorcing-family Adults and Supporters

        Add these educational interventions  to those above as appropriate to where a client family is on this three-phase divorce-adjustment continuum:

__  12) Teach (a) the many meanings of divorce, (b) the three multi-year phases of a typical divorce, and (c) probable impacts of divorce on all client-family adults and kids.

__ 13) Teach how psychological wounds and ignorance (#4 above) can promote making up to three unwise commitment choices which can (a) inhibit filling one or both partner's needs (# 7 above) and (b) promote eventual psychological or legal divorce. Restated - empathically educate divorcing adults on how to assess whether they were never really suited to be long-term committed partners, so odds of reconciling successfully are low to zero.

__  14) Teach (a) the difference between changes and losses (broken emotional bonds), and (b) how to help each their family members manage each of these effectively as they adjust to divorce-reorganization. See # 11 above. Options:

  • teach client adults how to inventory their losses, to help them grieve successfully; and/or...

  • teach and illustrate adults the concept of a family system, and...

  • encourage client adults and supporters to see the divorcing nuclear-family system as living in two inter-related homes, rather than in two independent "new" families.

__  15)  Teach (a) the value of ex-mates maintaining a long-term view as the family's multi-year divorce-adjustment proceeds (e.g. 20 to 30 years), and (b) propose the concept of a "successful" divorce or re/divorce. Then (c) Invite client adults to evolve their own definition/s of this to fit their circumstances..

__  16) Teach divorcing adults to map their usual communication attempts to resolve disputes - as partners - to illuminate blocks that have prevented effective problem solving. Prerequisite: # 6 above.

__  17)  If the client family includes minor or grown children and/or grandchildren, teach client adults kids' typical (a) developmental and (b) divorce-adjustment tasks, and (c) how to assess each child's status on filling these needs. Option - review effective caregiving basics









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Updated 05-22-2013