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

Education Options on Seven Vital
Topics for Clinical Professionals

By Peter K. Gerlach, MSW
Member NSRC Experts Council

The Web address of this two-page article is

        Clicking links below will open a full window or an informational popup, so please turn off your browser's popup blocker or allow popups from this nonprofit, ad-free Web site. If all these links feel distracting, read the whole article before following any of them.

        Based on my clinical training and private-practice experience since 1979, this Web series for clinicians proposes a five-part model (framework) of effective service to six types of client-family systems. Part of the model proposes knowledge-requisites for effective service outcomes.

        This article suggests seven modular in-service topics for clinicians, program directors, admin-istrators, coaches, and consultants who serve families. Raising professional awareness of  these topics can significantly improve clinical outcomes with typical client families and individuals. The topics build on each other, so the order matters. They are...

  • self-improvement Lessons 1 thru 7 in this Web site

       This article includes...

  • premises underlying this proposed educational scheme,

  • (a) perspective and (b) links to tutorial information on each topic, and...

  • summary comments on how the topics relate to effective clinical assessments and interventions with typical family clients.

        If you're not yet familiar with all these topics, I suggest you follow all the links above before designing an educational program from the links below.


        Counselors, therapists, life-coaches, and family-life educators aim to help clients "function" better - i.e. to learn how to consistently identify and fill their personal and family needs more effectively. Clinical professions and programs exist because our wounded, ignorant society doesn't (a) screen for unqualified parents or (b) teach parents how to nurture their family members effectively and prepare their kids to do the same.

        These seven topics are interactive, rather than stand-alone concepts. For example, healthy three-level grieving is strongly affected by family-members' respective personality subselves + their ability to communicate effectively + their awareness of primary human needs and family nurturance-levels. Implication: for best long-term results, focus on each topic in the context of how all seven affect intra-personal and interpersonal family systems together. 

        Premise - Clinical outcomes can be significantly improved if clinicians are able to strategically...

assess clients' (a) self-awareness and (b) knowledge of the topics above,

illustrate how appropriate topics relate to the clients' presenting (surface) problems, and...

motivate clients to (a) learn and apply the topics in their situation, and (b) note the results.

        To do this, clinicians need to be (a) conceptually knowledgeable of the topics, (b) experienced at using them in their own lives, and (c) aware of the results. These are part of the requisites for effective professional service. To gauge your current knowledge of these topics, try these quizzes when you're not distracted. As you do, imagine typical client-adult reactions to doing the quizzes.

        This nonprofit divorce-prevention site offers many practical articles on these seven topics, which can be used to help design an effective self-education and/or in-service program.

        Realities - the design and delivery of effective professional training will acknowledge that individual clinicians (including supervisors and case managers) will differ on (a) personalities and gender-priorities, (b)  preferred modalities and models of client assessment and intervention; and (c) different levels of clinical experience. In group service-delivery settings (agencies, departments, program staffs), in-service training will be shaped by existing organizational policies that were probably not designed to include some or all these seven topics in serving client families.

        Where true, the person/s responsible for designing and implementing an in-service program must (a) ignore existing policies or (b) persuade policy-makers to revise organizational guidelines to include the topics. Implication: often, the second step in facilitating effective in-service programs is (a) informing policy-makers that the topics are well-grounded, relevant, essential, and compatible with "standards of effective clinical service." The first step is becoming personally convinced of these things.

        Reality check: if you work in a group setting, (a) who makes your service-delivery standards and policies, and (b) how would they react to educating professional staff on each of these seven topics? If individual policy-makers and administrators have clinical training and experience, it's likely they were never trained in these topics - specially the concept of non-pathological multi-subself personalities.

In-service Modalities

        Increasing clinicians' knowledge and awareness of these seven topics can be achieved by...

  • individual self-improvement, plus semi-structured discussion groups;

  • informal or formal (structured) classes and discussions (seminars); and/or...

  • peer case-reviews including focus on these topics.

        In-service sessions may be led by qualified co-workers and/or qualified outside consultants. "Qualified" means the leader clearly has (a) these requisites and (b) significant professional experience using the topics above in direct client contacts.    

        The usefulness of this in-service training can be amplified if supervisors and case and program managers intentionally plan and monitor individual cases for effective use of these topics in client assessments and interventions.

        Resources - each modality may include: (a) topical handouts (e.g. reprints of articles here or equivalent); (b) selected reading lists, and (c) reality-checks to help clinicians demonstrate their conceptual knowledge.

        In-service sessions can be required or voluntary, and may stand alone or be blended into a larger professional educational program. Content resources on these topics can include printed and on-line articles, e-booklets, and/or slide-presentations. Also note this free 8-Part self-improvement course for lay people which you may tailor to suit your situation.

        Educational programs on these topics can target...

  • client-family adults and groups of such adults,

  • non-clinical human-service providers like mediators, family law professionals, family-life educators, and social case workers; and/or to...

  • the general public in the community. Doing this is a high-return way of preventing family stress and divorce!

        Before we focus on in-service options on each of the seven topics, pause and reflect - why are you reading this article? What do you need?


In-service Parts for Each Topic

        The following acknowledges that there are always other relevant topics to include in any comprehensive in-service program, and tries to make these seven topics modular, so they can "fit in" with an overall in-service program design.


        The goals of in-service training are the same for each topic and all of them together: to...

  • enable clinicians to clearly understand these topics as a mosaic of interactive concepts;

  • motivate clinicians to validate and apply these concepts in their own lives and families;

  • evaluate the practical benefits of melding these concepts into existing and future client-treatment plans and practices;

  • motivate clinicians to tailor and apply these concepts in their work with client families, and perhaps the local community; and...

  • invite clinicians to evaluate the pros and cons of alerting professional colleagues and organizations to the validity and utility of these topics.

Can you think of other goals of in-service programs on these topics? 

In-service Parts by Topic

Part 1) Human needs and family nurturance-levels

        This clinical model proposes that all human behavior is motivated by the ceaseless urge to reduce current physical, mental, emotional, and spiritual discomforts - i.e. "needs." A corollary is that all individual and relationship "problems" are unfilled needs in one or more people, who often can't identify their needs, and/or don't know how to fill them effectively.

        The model further proposes that normal adults and children are unaware of the primary needs that cause their surface or secondary problems. Where true, this means they will try to reduce the local surface stressors, and the primary needs go unfilled. - so the symptoms often return in some form.

       Another premise here is that the priority (vs. the nature) of adults' and kids' primary needs vary with time and circumstances, as the family evolves through it's natural developmental path. Other primary needs like respect, security, freedom, and belonging are constant.

       Finally, the model proposes that family systems  "work" when the adult leaders are consistently able to...

  • identify their members' current primary needs,

  • devise and implement effective strategies to fill key needs (i.e. to nurture), and to...

  • teach minor children how to do this on their own.

        Family leaders' ability to do this determines where their family ranks on the continuum between "very low nurturance" and "very high nurturance." This model calls this ranking a family's "nurturance level." It is a primary client-assessment factor. Final premise here are: (a) that high-nurturance family systems display observable traits like these, and (b) low-nurturance family trees have many of these characteristics.

        These premises suggest that effective clinical work with any clients will...

  • learn to assess client-family's (a) nurturance levels and (b) family-tree characteristics;

  • identify the primary needs causing clients' presenting problems;

  • educate clients on (a) primary and secondary needs and (b) how to discern the former; and...

  • facilitate effective client strategies to fill their primary needs - i.e. help client adults to (a) be aware of and (b) permanently raise their family's nurturance level.

        Corollary - for effective outcomes with client-families including minor and grown kids and grandkids, clinicians need to know and understand kids' (a) normal developmental needs, and (b) any special adjust-ment needs from family changes, like parental death, desertion, separation, divorce, and/or parental re/marriage. (The "/" notes that it may be a stepparent's first union.). Then they need to assess family adults' (a) awareness of these needs, and (b) their ability to fill them - and their own needs - well in calm and stressful situations.

        Pause and reflect: what percentage of your co-workers would agree with these premises? Do you agree with them?


2) Human personality development, structure, and functioning - internal family systems


3) The silent [wounds + ignorance] cycle that is steadily degrading our families and culture;


4) Effective communication and problem-solving basics and skills


5) Attachment, loss, and healthy three-level grief


6) Human relationships and solving relationship "problems"


7) Effective clinical work with typical stepfamilies


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Updated September 30, 2015