This article
begins a series based on this clinical
framework for assessing low-nurturance client
families for a group of common
A "low nurturance family" is one in which members seldom get their
met in wholistically-healthy ways. An
effective intervention is an instinctive or intentional behavior of the clinician which significantly
raises the family's nurturance level, in the opinion of all involved. This article ...
-
offers an
introductory perspective,
-
defines "effective intervention" in this context,
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summarizes
what's different about intervening with these complex, multi-problem clients
Perspective
Needs are caused by current emotional, physical and/or spiritual
discomforts. A problem occurs when one or more people have unmet
current personal and/or social needs.
Typical problems have surface symptoms (e.g. "I need to get gas for the car."),
and underlying primary discomforts that cause them ("I need to end my
anxieties about being stranded far from home, being harmed, and worrying
everyone.") People hire mental-health professionals because they can't fill one or more of
their current
themselves.
To intervene means to "come between." Here, this means
to strategically "come between" clients and their current ineffective ways of thinking,
perceiving, and behaving, to empower them to consistently fill their primary needs themselves.
Two Levels of Systemic Change
One
implication is that there are two levels
of systemic change, which
Dr, Paul Watzlawick and colleagues have labeled
first order and second order.
First-order change shifts surface needs (symptoms), and second-order
change permanently alters a person's (subselves') primary beliefs, priorities,
values, attitudes, and perceptions. The former promotes trying fruitlessly to
change unwanted and harmful behaviors like smoking, over-eating,
impulse-spending, lying, rageful outbursts,
and
("bad habits").
Even
if a clinician is (a) aware of both levels of change and (b) is adept at
helping the client
his/her/their current
primary needs, it's unlikely
the client family will be able to fully satisfy them if one or more of their adults is
governed by a false self. Implication: Clinicians need to assess for
false-self domination in various sessions and client situations, and watch for
strategic chances to use Lesson-1 interventions as appropriate.
Why People Hire Clinicians
This
clinical model proposes that typical clients can't fill their current needs well
enough often enough because.they're unaware of...
-
often or always being governed a well-meaning "false self" - i.e.
by one or more
who distrust and
the wise resident
which is usually capable of filling current primary needs; and
they're unaware of...
-
the difference between surface needs and
primary needs; and...
-
how to accurately
and fill
their and others' primary needs (think, communicate, and problem-solve)
effectively and cooperatively. ...
Also, their
well-meaning false selves
steadily seek relief from discomforts now (immediate
gratification), and therefore persistently focus on
surface problems.
Hazards and Projects
One of the unique features of this clinical model is that it proposes
five widespread systemic
(hazards) that promote most personal and family "problems":
-
undetected psychological
in one or more adults and kids, caused by inadequate early-childhood
nurturance and cultural unawareness;
-
adult
of a group of inner and social dynamic and key topics;
-
incomplete or
in one or more client family members;
-
wounds + unawareness +
+ societal ignorance and permissions cause many couples
to commit to the wrong
for the wrong
at the wrong
-
specially in stepfamilu unions; and...
-
stepfamily adults can find little effective help in their communities and
the media when they need it.
| Premise: These stressors are symptoms
of the lethal [wounds + unawareness]
that is silently weakening our families and spreading down our
generations.
So the core intervention here is societal: (a)
alerting people to this cycle
and its toxic effects, and (b) motivating and empowering them to mute or
stop it in their relationships, homes, and communities.
This non-profit Web site exists to do just that.
|
This clinical
model also proposes a sequence of
8
that aware clients can learn, adapt, and use to avoid or reduce these four or
five stressors and enjoy high-nurturance relationships, homes, and families.
These articles for professionals necessarily distort reality in several ways.
First, they focus separate-ly on assessment and intervention, when in real life
these occur interactively as the work evolves. Second, focusing on specific
interventions ignores the reality that each client family and session is unique,
so the intervention examples here must be illustrative, not absolute.
Use the following index for information on each Project's key interventions.
Interventions with
All Clients
Lesson 1a) - present the basic concept of
and relate it to the clients' presenting problems. See
* Lesson 1b) below
Project 2) - improve thinking, communicating,
and problem-solving
Lesson 3) - facilitate a healthy family
and facilitate freeing any family members' blocked grief
Project 6)
- encourage client adults to evolve and use a
meaningful family
Project 8) - help committed couples strengthen
their relationship
Lesson 10) - help families with one or more
minor or adult children build co-parenting teamwork, co-parent effectively,
and increase their nurturance level
Lesson 11) - encourage family adults to build
and use a support network to fit their needs
Lesson 12) - grow adult awareness of their
personal and family balances over time, and facilitate their improving these
balances effectively
Interventions with
Courting Co-parents
Project 3) - (a) facilitate client adults accepting
their stepfamily
and what it
and (b) identify and resolve
any major family
(inclusion / exclusion) conflicts
Lesson 7) - (a) facilitate client adults
learning stepfamily basics, (b) identify
any major stepfamily misconceptions,
and (c) propose and discuss probable realities for each of them.
Project 7)
- use the prior six Projects to
motivate and empower courting co-parents to choose the right
to commit to, for the
right
at the right
Interventions with
Committed Stepfamily Co-parents and
Kids
Lesson 7) - facilitate family
adults evolving and following an effective biofamily-merger plan
Projects 10, 11, and 12 - per
the above
* Lesson 1b) - facilitate
effective inner-family therapy if one or more adults has hit personal
bottom and is motivated to
admit and reduce psychological wounds, free their true Self, and and harmonize their subselves.
Interventions with
Re/divorcing Families
Help the couple review (a) the
wisdom of their courtship-commitment decisions, and (b) options
for saving the relationship. If it is beyond salvage, (c) facilitate a
successful re/divorce for the client family, including appropriate grieving
in kids and adults.
What is an Effective Clinical Intervention?
The
premises above suggests that to intervene effectively, clinicians,
supervisors, case managers, and consultants need to...
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understand and fully accept the factors above,
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use
them to assess clients accurately with a two-level, long-range systemic paradigm, and...
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(a)
teach and (b) empower clients to make
second-order (core attitude) changes to their inner-personal, family, and social systems.
Empowering typical clients requires
clinicians to (a) assess their knowledge and beliefs, and educate them on these
basic ideas as needed; (b) answer related questions, and (c) facilitate wounded client adults to enable their true Selves to
guide their other subselves (personality).
This is often not possible, because
wounded adults have not hit
yet,
and are not motivated to make second-order changes in their lives.
Pause and reflect: how does this proposal compare with your current beliefs and
practices? Who's
answering
- your
or a
protective
How do you
What's Unique About These Interventions?
From
extensive post-graduate education + personal wound-recovery +
36 years' research
and practice, the assessment and intervention paradigms described in these
articles are significantly different than traditional
therapeutic frameworks. These combined differences may inhibit clinicians who
are uncomfortable with changing their beliefs and behaviors from experimenting
with these techniques.
The
differences result from adopting the old idea
that normal people have an inner-family system of semi-independent
personality "parts" or subselves that is often dominated by a
well-meaning "false self." This unseen dynamic promotes most presenting problems. Few
clinicians and fewer lay people accept this, so far. If you're skeptical, read
my letter to you, and try
this safe, interesting exercise. Then see what you think.
Another uniqueness is that these interventions
are systemic, hierarchical, and multi-modal.
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A systemic view
requires clinicians to believe that clients' personal and dyadic "problems"
(unmet needs) are caused by the combined, interactive dysfunction of
individuals' inner and relationship subsystems, rather than by discrete
individual problems like "alcoholism," "affairs," or "depression." A
systemic view also will determine if and how clinicians assess and intervene
with a client-family's structure.
Problem-focused and client-centered practitioners may find this systemic
framing alien and perhaps unacceptable;
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A hierarchical view invites
clinicians to assess and intervene considering...
-
interactive
"layers" of individual needs (surface, intermediate, and
primary), and...
-
subsystem interactions (inner-families of subselves + dyads +
subsystems - e.g. marital + parental + sibling + multi-home subsystems -
e.g. custodial, non-custodial, and relatives' related homes.
-
A multi-modal view posits
that effective interventions with these clients are proportional to the
clinician's motivation and ability to shift dynamically between individual,
dyadic, and family modalities as session dynamics and treatment goals
evolve. This also applies to co-therapists, supervisors, case managers, and
consultants.
Clinicians who are
uncomfortable and/or inexperienced with these views are likely to get
limited results at best with this or their own clinical model - unless their
governing subselves will try these views with an open mind.
This 12-part scheme of interventions here is also unique in that it uses integrated
concepts of family-system nurturance levels + effective systemic communication +
bonding and healthy three-level grieving of broken bonds. Individually, these
concepts are not new. What may be new to
some clinicians is the interactive combination of these elements and the
other factors summarized above in assessing clients and making case goals
and strategic interventions over time..
-
they view
client families in a variable time-frame - i.e. these interventions
work backwards from long-term family welfare to avoiding and reducing
primary problems in the present. And for stepfamily clients, they...
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use an
experience-based framework of unique norms, realities, developmental stages,
and interactive problems based on 27 years' research and experience.
Finally, some professionals may not have
evaluated the pros and cons of using the
in this model. It is is based on the developmental phases of
typical low-nurturance families, and provides a practical framework for deciding
which interventions are appropriate for which client. Within that, it is a guide
to how
relatively important each intervention is. For example, most Lesson 7, 4, and 7
interventions are best used with type-2 clients - courting stepfamilies.
Reading the outlines of these interventions will provide a wide-angle context
for understanding the overall strategy behind them. It will not provide
enough information to decide whether to adopt individual interventions or
not. Tailoring them to fit your style and circumstances and trying
them with a variety of clients following appropriate differential systemic
assessments is the best way to judge their effects and worth.
Recap
This
article is the first of a series for clinicians on effective interventions with
low-nurturance families and psychologically-recovering persons -
(GWCs). It (a) offers
basic perspective on two levels of systemic change, and the
that promote most presenting problems.
Ther article also proposes two reasons typical clients can't fill key current primary
needs well enough, often enough - so (some) seek professional help.
The
article suggests that the 12 sets of interventions outlined in this series are
significantly different from general clinical traditional for several reasons.
An implication is that many veteran "traditional" clinicians will discount or
reject this paradigm because it differs too much from what they're used to.
Clinicians guided by true Selves will be most apt to try these ieas with an open
mind, and judge them by results with a range of clients over time.
The Web address of this article is
https://sfhelp.org/pro/rx/intro.htm