Premise - a requisite for effective clinical work with
trauma-recoverers and divorcing-family and
stepfamily clients is to be aware of your
key attitudes.
As you know, attitudes are un/conscious opinions of something's or
someone's...
-
priority (trivial > vital)
-
value (nourishing >
toxic)
-
likelihood (impossible >
certain)
|
|
To
simplify this variety, we often use the shorthand
attitude "good > bad," and "right > wrong" to
judge many things, as in "that was good communication."
Try out the ideas that (a) each of your attitudes comes from one or more of
your active subselves; (b) subselves may conflict in their attitudes,
producing "confusion," "ambivalence," and "seeing two sides" to some
subjects ("Divorce is always wrong!" / "No it's not!").
Implication - to shift any of your attitudes about clients or
clinical work, you may need to (a) be clear on what
comprise your
(b) which subselves cause the attitude you want to change, and (c) have your
explore what - if anything - blocks each such subself from adopting a more
helpful attitude, and (d) negotiating for that change.
Not doing some form of this "parts
work" will usually produce
(temporary, superficial) attitude changes.
Two groups of attitudes in
clinicians, supervisors, consultants, and clinical and program directors are key
in promoting effective outcomes with these clients;
Let's look at some key
attitudes in each domain. Option - use this as a checklist to profile
your key attitudes, and star or hilight any you wish to explore further
or change.
Requisite Attitudes about
Therapy and Counseling
Rank your stance on each of these attitudes: do you Agree, Disagree, or feel something else
(?)...
1) long-term problem prevention vs. short-term
problem reduction.
I want to maximize my ongoing and long-term professional satisfaction by investing
most of my time, skills, and energy in
preventing family stress and divorce, rather than in
helping to reduce existing client-family stressors. (A D
?)
2) mixed clinical modalities
- effective clinical service to divorcing-family
and stepfamily
clients requires a progressive balance of family-system + dyadic
+ intrapsychic (inner-family
systems therapy) modalities. Ignoring, discounting, or
favoring any of these modalities will significantly reduce my odds of
successful outcomes. I also need my supervisor, consultants, case manager/s, clinical or program
director, and any co-therapists to fully share this attitude.
(A D ?)
3) grief therapy
- Blocked or incomplete grief is a significant stressor
in typical
persons and
families. Typical
clients don't (want to) know this, and usually won't include it in their
presenting problems. So I need to include assessing each client for...
I also need to
grow
my competence at (a) modeling and teaching "good grief" to my clients, and (b) motivating
and empowering them to free any blocked grief among their adults and kids. I
also need the professionals I work with to share this attitude. (A D
?) See
4)
insight ("talk") therapy
vs. experiential therapy - My odds for effective clinical outcomes rise
if I balance didactic teaching equally with offering clients experiential learning
. This balance is most likely if my
usually
my
(A D ?)
Evidence of this
pro-experiential attitude include a clinician's wanting to weave things like role-plays;
guided imagery; sentence completions, client
homework exercises; and group, art, Gestalt, massage, poetry, psychosynthesis, EMDR,
and voice-dialog interventions and modalities into the work.
5) time-limited therapy
- low-nurturance and wounded clients usually have multiple concurrent stressors that
need to be identified, sorted, ranked, and reduced one or a few at a time over
many sessions. If circumstances limit the number of clinical sessions
or hours, my goals are to help adult clients ...
-
learn how to
and separate
multiple problems
and to...
-
effectively, while...
-
teaching
them what I can on relevant
and...
-
alerting them to useful
resources for filling
their needs together. (A D ?)
6)
I accept that
brief,
problem-centered, Rogerian, non-systemic, and cognitive therapies are less
apt to produce desired clinical outcomes than long-term,
multi-phase
systemic attitudes and treatment strategies. (A D ?)
More requisite clinician attitudes about the therapeutic process...
7) including
spirituality
- using my own spirituality strategically and empathically encouraging clients to develop
and use their spiritual faith (if it's not
or
are helpful clinical choices - as long as I don't preach or evangelize.
This attitude opens up a range of spirituality-based interventions (for clients
believing in a Higher Power ) not otherwise available.
Stable client faith in a
benign Higher Power is
usually required for true (vs. pseudo)
from false-self
(A D ?)
8) communication
assessment and skill-building - I believe that...
-
assessing client
and
communication effectiveness,
-
teaching effective
communication and
problem-solving basics and
and...
-
proactively modeling these steadily in every clinical contact and session...
are
essential for effective service to all clients. This means that I and
any colleagues need to know these basics and skills thoroughly, and how to
teach them strategically to every client. (A D ?)
9) supportive-only vs.
strategic confrontational and frustrating interventions - respectfully
confronting clients (e.g. "My sense is that you're in protective denial
about your partner's addiction and your own codependence;" or "I notice you
steadily avoid doing the homework I suggest.") and strategically frustrating
them (e.g. "I'm stumped about what to do about your problem.") can be just
as productive in growing client competence as supportive interventions. (A D ?)
10) responsibility
for desired changes - each participating client adult
is responsible for achieving desired personal and
changes. I am responsible for respectfully encouraging client adults to take
this responsibility, and to find necessary resources to fill their own
needs. (A D ?) The alternative is "I am
responsible for filling the client's needs," which is an inherited view from non-systemic medical-model service. Unless clients are disabled,
this attitude is inherently
and promotes client's self-distrust and dependence, and choosing a victim
role in some or all situations
11) surface and primary needs
- I expect that (a) typical clients will be unaware of the
difference between surface needs ("presenting
problems") and underlying
and that (b) any client or co-worker will benefit from my teaching
this difference, and modeling how to
to discern current primary needs. (A D
?)
In addition to these requisite attitudes about the clinical process,
effective clinicians also need...
Helpful Attitudes about Client Traits and Behaviors
Premises: we all "leak" our true beliefs
and priorities to other people via tiny voice, face, and body cues, despite
wishes to disguise them. Our ever-alert subselves perceive these cues
subconsciously, decode them, and trigger hormones, thoughts, "senses,"
and autonomic body responses. Therefore
some semi-conscious attitudes
can promote or hinder successful intervention outcomes, and may increase client distress (unmet needs).
For
example, judgmental attitudes that can hinder effective work with these
clients are...
"Divorce is a personal failure and a moral
wrong."
"Stepfamilies are abnormal and second best.
"Most stepkids don't turn out as well as
biokids." and...
"Parents who neglect or abuse their children
are morally weak, irresponsible, and despicable."
Choose the open, curious "mind of a student" now. Take some undistracted
time to respond to this attitude inventory, and return. As you
respond,
imagine a typical client adult taking the inventory. Consider how you might use the
inventory strategically (e.g. as an intake or "homework" handout) to help
clients and co-workers raise their attitude awareness, and make better choices.
You or a client shifting attitudes to mostly 4's
and 5's on these inventory topics is a second-order
Clients' Attitudes
Strategically assessing clients' attitudes about key topics like those on
the inventory above promotes effective clinical outcomes. A set of attitudes
that can be helpful or harmful relates to what divorced parents feel about
themselves, each other, and "divorce." Think of a divorced mom and dad
you've worked with, and keep them in mind as you review
this article. Then
imagine how they and/or other family adults would each react to the article,
and how you might use it to help them reduce post-divorce
to effective co-parenting and personal-wound recovery.
Try this status check, and see what
you learn:
-
I can define "attitude" clearly, and I'm
clear on where most attitudes come from. (True False
?)
-
I know how to identify a client's attitudes
about key subjects now. (T F ?)
-
I know when and how to talk productively
with clients about their attitudes now. (T F ?)
-
I know how to help typical minor kids
understand what "attitudes" are, and how to interest them in judging
whether attitudes are helpful or toxic.
(T
F ?)
-
I know how to facilitate clients changing
toxic attitudes to healthier ones. (T F ?)
-
I can describe (a) the difference between
first-order and second-order changes, and (b) how this difference
relates to clients' presenting problems and clinical effectiveness.
(T F ?)
-
I'm usually clear on which subselves are
guiding my
personality.
(T F ?client needs and
+ + +
Pause for a moment and reflect: what are your subselves
now?
Recall why you used this worksheet - did you get what you needed? if so,
what do you need to do now? If not - what do you need?
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Web address of this article is https://sfhelp.org/pro/req/attitude-wks.htm