Alert others to inherited wounds + unawareness
 


Environmental Requisites for Effective
Clinical Service to these Clients

By Peter K. Gerlach, MSW
Member NSRC Experts Council
 

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  The Web address of this article is http://sfhelp.org/pro/req/environment.htm

        Clicking links here will open a new window or an informational popup, so turn off your browser's popup blocker or accept popups from this nonprofit, ad-free site . If the windows distract you, read the article before following any links.

        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 is one of several articles summarizing four requisites for human-service professionals serving divorcing families, stepfamilies, and survivors of childhood trauma:

        To get the most from this article, first review (a) this slide presentation on the [wounds + unawareness] cycle; (b) these several pages on preventing family stress, psychological wounding, and divorce; and (c) this introduction to effective clinical service with these complex multi-problem clients.

Summary - Environmental Requisites

        Premise - In any setting, the metasystem in which a clinician works will significantly affect the outcomes of their work. To maximize the effectiveness of the model proposed here, these factors need to be steadily available to the clinician:

  • Policy makers, executives, and/or co-workers and colleagues who...

    • place high value on preventing family stress, psychological wounding; and divorce;

    • are fully open to (a) considering these premises and this model (b) are usually guided by their true Selves, and/or (c) are open to assessing themselves for significant psychological wounds;

    • endorse a systemic approach to assessing and intervening with individual, marital and family clients - including an inner-family systems approach for individual work;

    • fully accept the value of including spirituality in clinical work and wholistic health;

    • create and use an effective training program  for new and veteran clinicians;

    • fully understand the unique systemic norms, realities, dynamics, developmental phases and tasks, and phase-specific needs of typical divorcing families and stepfamilies;

    • hiring and performance-evaluation policies that consistently promote all of these traits;

    • provide effective support for clinicians working with these complex, needy clients, including case-load balancing, case management, clinical supervision, and case-consultation groups;

    • proactively seek to inform other human-service professionals and organizations of (a) the [wounds + unawareness] cycle and its common effects, and of (b) this model;

    • refer clients when appropriate to human-service professionals and organizations with these same attributes.

        And to be consistently effective with this multi-modal model, clinicians also need...

  • A comfortable distraction-free physical setting conducive to working with whole families;

  • An intake process that effectively assesses for key variables in this model; 

  • Financial conditions which allow offering clinical service (a) on a sliding scale (b) without limiting hours or sessions;

  • A comprehensive array of brief handouts (didactic texts and self-assessment worksheets) for clients and community members on these (and other) topics;

  • A comprehensive library of current professional materials on systemic work with personal wound-recovery (reducing "dissociative disorders"), divorcing families, and stepfamilies;

  • Access to effective client support groups for (a) grievers, (b) wound recoverers, (c) addiction recoverers (including codependence), (d) divorce recoverers and single parents, and (e) stepfamily co-parents and stepkids;

        Few clinicians will have all of these environmental requisites. What are their (your)...

Options

        Start by objectively assessing which of these requisites you have now, perhaps using a scale of one (definitely yes) to five (not at all). Then consider ranking the missing requisites in order of importance to your professional goals and clients. The composite effect of missing some of these requisites will range from minor to significant to critical.

        You have limited time and energy, and must choose how to apportion these between growing the special skills and knowledge you need for serving these clients, and improving your professional environment. You can improve some of the requisites above, and not others.

         My consistent clinical experience since 1981 is that a high percentage of typical human-service professionals are significantly wounded survivors of childhood trauma. We choose to work in a solo or group private practice, or unconsciously choose low-nurturance organizational settings that psychologically replicate our early family. Typical professionals who are not in true wound-recovery will rationalize, minimize, or deny this.

        If you are such a survivor, an inexorable question you face every day is whether you have chosen a low-nurturance organization and metasystem to work in, and if so, how that is affecting your life, wholistic health, and professional effectiveness.

        A key trait of low-nurturance service organizations is that their policy makers, sponsors, and executives are significantly wounded and unaware, and deny this. Often, such well-intentioned, dedicated people will c/overtly minimize or oppose many of the premises in this model, which will significantly lower your clinical effectiveness. If this is true for you now, four choices you face are...

  • patiently try and raise the nurturance level of your organization (e.g. inform and interest your co-workers in wound-assessment and recovery), or...

  • take no action at this time (the default choice), or...

  • accept the limitations you work in and use your low-nurturance environment to help you progress at personal wound-recovery and developing your knowledge and skills, or...

  • find a healthier professional environment that fills your life-purpose, financial, geographic, and other primary needs.

        If (a) you're progressing well enough on the other requisites here, and (b) your local work setting has "enough" of the requisites above, then consider ranking the individual and composite nurturance levels of the other human-service organizations you work with regularly. If you do, consider these three options for upgrading any parts of your professional metasystem that are limited by the toxic effects of the  [wounds + unawareness] cycle. If you don't do this - who will?          

Recap

        This is one of a series of articles summarizing four requisites for providing effective clinical service to psychologically-wounded persons (Grown Wounded Children, or GWCs) and low-nurturance (e.g. divorcing and step) client families. This article proposes an array of specific requisites to help you assess the nurturance level and wholistic adequacy of your professional environment, in the context of this clinical model of professional service to these complex, needy, multi-problem clients.

        If you're a non-clinical human-service professional, see these options for breaking the [wounds + unawareness] cycle with these clients and larger groups.

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        Pause and reflect - did you get what you needed from this article? If so, what do you wish to do next? If not - what do you need now?

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Updated September 30, 2015