Toward effective service to psychologically-wounded individuals
	Useful Clinical Intervention Techniques - p. 1 of x 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:

The premises underlying this nonprofit, ad-free site Normal personality subselves - text Grown Wounded Children (GWCs) and what it means to be a GWC The [wounds + unawareness] cycle - text Three steps you can take to break this cycle These clinical and lay terms

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

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        This x-page article summarizes some clinical inner-family (parts) work techniques I've developed since 1991 in working with survivors of low-nurturance childhoods - Grown Wounded Children (GWCs). These techniques may stand alone (in individual work), or be strategically combined with other interventions in marital and family work.
 

To better understand the context of, and rationale for, these interventions, first scan (a) this overview of the [wounds + unawareness] cycle, (b) these introductions to Lesson 1 (in this site), false-self wounds, and recovery; and (d) this series of lay articles on the phases and aspects of internal family systems ("parts") work.

Selected Intervention Techniques

        Interventions designed to reduce each of the psychological wounds are described in this series of articles. Most of these clinical techniques for low-nurturance couple or family clients can be adapted for use with recovering individuals. Additional parts-work techniques include these:

introducing the subself concept using skepticism first contacts visualizing subselves identifying active subselves dominant-subself check inner dialogs

direct contact indirect contact building Self trust inner council meetings subself sculptures "owning" subselves using a "Blocker" subself "rescuing" a part stuck in the past ("time travel") assigning a new role

pacing change protecting inner kids using spirituality using body signals using the clinician's subselves reduce "blending" role playing leading and following

  Clarify Client Priorities  

        Before hitting true bottom and progressing on wound-recovery, most typical GWCs (survivors of childhood neglect) habitually neglect their own health, needs, and welfare. They may or may not admit this to themselves or other people, and/or they rationalize it or say "I can't help it."

Goals: This clinical technique will not correct the client's self neglect (excessive shame), but can help them break some denial about it and its implications - like admitting the reality of their personality subselves and related psychological wounds, and the value of personal wound recovery.

Best time to do this - before confronting the GWC on his/her psychological wounds, or soon afterwards.

Preparations - agree with the client on definitions of needs, wholistic heath, shame and guilt, and neglect. Option - first review this Bill of Personal Rights with the client, and ask him or her to identify which of them s/he currently lives by.

Technique - at an appropriate point in the work flow, ask the client something like "Help me understand  what your top 4 or 5  life priorities have been in - say - the last x months. There's no right or wrong answer." Use empathic listening to acknowledge the client's answer without judgment or comment.

        If s/he includes "my wholistic health" or equivalent, decide whether this matches your perception of the client's recent behaviors. If so, affirm that and congratulate the client. If not, factually confront him or her on examples of behavior that indicate self abandonment and neglect - e.g. "You've taught me that you often skip breakfast, use cigarettes and anti-depression medication, and work 60 or more hours each week - is that so?"

        If the client doesn't include some version of "my health or welfare" in describing recent priorities, point that out objectively - "I notice you don't include your own welfare and health in your priorities. Are you aware of that?" Options - ask (a) "What do you feel your self-neglect is teaching your kids about valuing and caring for themselves?", and/or (b) "How would you describe each of your childhood caregivers' attitudes about self-love and self-care?" This technique can lead to a range of strategic Lesson-1 interventions about subselves, psychological wounds, and wound-recovery if the client is receptive.

Inner-family Sculpting 

        Having clients do something physical in a session can be more effective than talking to provide strategic experiential learning. "Sculpting" is one way of doing this

Goals -

Participants -

Preparations -

Best time to do this -

Technique -

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+ + +to the techniques index, or continue with sculpting techniques to illustrate (a) relationship triangles, and (b) present and desired external and internal family dynamics.

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Updated September 25, 2014