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

Effective Clinical Work with
Court-referred Families

Assess and Adapt to Extra Factors

By Peter K. Gerlach, MSW
Member NSRC Experts Council

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

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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:

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

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        This clinical model focuses on providing effective professional service to six types of family client. Litigating co-parents in any of these types may be ordered to seek clinical help by a family-law judge. In such cases, the definitions of "the client" and "effective clinical service" differ significantly from non-court-referred clients. From 36 years' professional experience with these systems, this article hilights these differences and their implications for effective clinical assessment and interventions with court-ordered client families.

        To get the most from this article, first (a) view this slide presentation on the [wounds + ignorance] cycle, and read (b) this general introduction, and these introductions to effective (c) assessments and (d) interventions with these complex clients.

 Perspective

        Some divorcing-family and stepfamily adults seek legal help to resolve co-parenting impasses over (a) personal-boundary violations (e.g. harassment), and/or (b) disputes over child custody, visitation, financial support, names, adoption, education, and/or parenting-agreement design and compliance. Hiring attorneys to force resolution of such family impasses indicates...

  • (a) one or more family adults are significantly wounded and unaware, and (b) family adults are unskilled in effective problem-solving;

  • one or more adults or kids may be blocked in grieving major losses (broken bonds), and family adults and professionals are unaware of this or what to do about it;

  • the family's nurturance level is low, and some or most family-members' primary needs are not filled well enough;

  • the antagonistic win-lose court process will add significant current and long-term stressors to the family's situation, rather than reducing them; and...

  • the family adults and supporters, and their attorneys and associated judges and ancillary professionals lack awareness of how these six topics are promoting the current intra-family impasse. This usually means that legal proceedings and rulings will (a) not reduce the adults' wounds + ignorance that cause the impasse, and (b) will probably increase intra-family disrespect, distrust, hurts, resentments, frustrations, hostility, anger, anxiety, guilt, shame, and polarization.

       Typical self-referred clients are motivated to work with clinicians to reduce some presenting "problems" (unfilled needs). Clinicians can use that motivation for constructive systemic change. Often, court-referred adults come to therapy to avoid noncompliance and contempt-of-court charges, rather than because they believe it can really help them. They typically...

  • are cynical and skeptical that therapy will resolve their impasse/s - specially if they've tried counseling and/or professional mediation before with no major benefit,

  • resent being forced to interrupt their schedules to work with - and pay for - a professional they (usually) didn't choose; and client-adults...

  • are so distracted by a web of old and new (legal and financial) "problems" that short-term therapy is unlikely identify and reduce the primary problems causing the current impasse/s.

Restated - typical court-referred client adults want the clinician to side with them against their other family member/s, the hostile "other attorney," and perhaps an "unfair or biased" Guardian ad Litem (court-appointed child's attorney) and/or family-court judge. If the clinician says "you both are co-creating your impasse, and you each must want to make some fundamental changes to get what you need, clients are apt to sabotage, ignore, or abort the clinical process. They're not ready to accept responsibility for half of their distress.

Clinical Options

        Compared to work with self-referred clients, key clinician choices here include...

  1. redefining "my client" to include the attorneys, judge, and other professionals (e.g. mediators, doctors, tutors, and psychologists) involved;

  2. assessing all metasystem-members for significant wounds and ignorance;

  3. redefining "effective clinical work" to fit the results of the assessment;

  4. educating all metasystem members on the probable primary causes of the client-family's impasse;

  5. (a) assessing the client-family's unmet primary needs, and (b) refocusing all metasystem members on acknowledging and filling these needs (i.e. on problem-solving), rather than on winning the legal case;

  6. making specific written and verbal recommendations to all parties on (a) ending the current (harmful) legal process, and (b) reducing the family's primary problems long term; and...

  7. if clients get no benefits from initial therapeutic contacts (by their own definition), respecting this and not urging them to continue - even if the judge orders them to. If client adults become more self-motivated to continue clinical work, treat them like self-referred clients with one exception - make acknowledging and resolving the stresses from the legal battle/s an early clinical priority.

        If this looks like a lot of work and potential conflict - it is! Links above will take you to more detail on each option.

1) Redefine the Client

        With typical court-referred families, the client metasystem includes...

  • all family members involved in - or affected by - the presenting impasse, and all influential supporters of these members - e.g. biased siblings and senior adults (grandparents); and

  • all legal professionals, including all attorneys, and the family-court judge/s;

  • all other involved professionals like mediators, clergy, social caseworkers, law-enforcement professionals (including any probation officers), doctors (prescribing medication), and child-welfare evaluators.

        Premises: (a) all of these people are probably significantly wounded and unaware of major ignorances that will stress the client family, and (b) typical over-busy, self-confident professionals aren't seeking self-growth, and will deny, ignore, or discount their wounds and unawareness in order to fill higher-priority needs.

2) Assess All Metasystem Members

        Starting with initial phone and personal contacts, clinicians need to estimate each involved lay and professional adult's level of (a) woundedness; and (b) awareness of...

  • the [wounds + ignorance] cycle and its common effects on people and family systems;

  • who rules their personality - in general, and in this legal/therapeutic case;

  • effective communication, problem-solving, and grieving basics;

  • family nurturance levels (low to high), and the factors that usually determine this level;

  • the difference between surface (secondary) problems, and the unfilled primary needs that cause them (e.g. cause the client-family's current impasse); and...

  • the inherent limitations of short-term family therapy.

        And if the client-family is a stepfamily, also assess metasystem-professionals' awareness of...

        To make effective assessments, the clinician needs to first assess himself/herself for these same things - honestly. Typical clinicians ruled by a false self will resist, postpone, or discount doing this. Others will self-assess and do nothing meaningful toward reducing their wounds and ignorances.

        Reality check: do you know how to tell if your true Self is guiding your personality now? If so - who currently leads your team of subselves? If it's not your Self (capital "S"), lower your expectations about getting anything of value from this article.

       

 

 


Wound
Assessment

        psychological wounds range from minor to significant to extreme. With practice, you can quickly guesstimate another person's degree of woundedness (false-self dominance) by watching for the frequency, scope, and context of behaviors like these. With client adults, you can also assess their family trees and their related homes for wound-symptoms. The more contacts you have, the sharper your assessment can become.

        Use your wound-assessment results to (a) guide how and when to educate metasystem members on subselves, wounds, wound-recovery, and the [wounds + ignorance] cycle; and to (b) adjust your goals and expectations of working with this metasystem. The more "significantly-wounded" members the metasystem has, the lower the odds that clinical interventions will cause long-term positive systemic change - unless such interventions trigger someone "hitting bottom," breaking their protective denials, and committing to real (vs. pseudo) wound-recovery.

Realty check:

  • from 1 to 10, rank how useful you feel wound-assessment is in working with typical client families - 1 = "unimportant " and 10 = "extremely important."

  • Have you honestly assessed yourself for psychological wounds? (Yes  /  No  /  Other)


Unawareness
Assessment

        Because contacts with metasystem professionals are usually limited, clinicians need to develop some strategic "all-purpose" questions to ask in order to sense the professional's (a) self-awareness, and (b) accurate knowledge of the topics above. Each contact can deepen these assessments.

        Useful broad assessment questions to ask professionals include things like...

  • "Who's needs are you working to serve in this case?" The answer will often be a subset of all members of the metasystem, which inherently promotes systemic conflicts.

  • "In cases like this, what do you see as the main real problems?" Typical answers will (a) focus on the client-family's surface problems, and (b) minimize or ignore the primary needs, conflicts, and goals of all members of the metasystem.

  • "On a scale of 1 (unimportant) to 10 (very important), how significant do you believe family-adults' childhood environments are in cases like this one?" If the answer is low, the professional probably has little or no awareness of the [wounds + ignorance] cycle and its effects - in general, and in this case.

  • How do you usually assess whether a client family like this one (a) communicates and (b) problem-solves effectively?

  • "What role, if any, do you believe healthy grieving plays in problems like this family is struggling with?"

  • "How do you define "effective therapy (or counseling)?"

  • "How do you define the main responsibilities of the attorneys in cases like these?" Typical answers focus on winning the case (a short-term, non-therapeutic goal), rather than long-term healing and client education (improving the client-family's nurturance level so they don't need legal interventions).

  • "How do you define "an effective court intervention" in cases like this? An unaware answer sounds like "settling this case." An aware answer sounds like "the family adults become more (a) aware of what they all need to do to resolve family conflicts without litigation, and (b) more committed to doing this as teammates."

Client Assessment

       In addition to the above, clinicians need to assess client adults for several things:

  • prior experience with professional mediation and/or counseling, if any; and...

  • adults current attitude and expectations about court-ordered counseling. Typical assessment questions for this might sound like:

    • "Who's idea was it that you should get counseling?"

    • "Why do you feel s/he did?"

    • From one (not at all) to ten (totally), how accurately do you feel the judge assigned to your litigation understands your family situation so far?"

    • "How do you feel about being ordered to attend counseling together now?"

    • "In your opinion, what is 'effective counseling (or therapy)'?"

    • In your situation, what would have to happen to have you judge counseling as 'worthwhile' or 'successful'?"

    • "How likely is it that counseling can help you (a) resolve your current dispute, and (b) prevent similar conflicts in the future?"

        Each response to questions like these will probably suggest additional questions to sharpen the clinician's assessment. Again the assessment results will guide the clinician's decisions of how and when to educate metasystem members on (a) the key topics above, and (b) how the topics relate to the client-family's impasse.

3) Redefine "Effective Clinical Work"

        A definition of "effective clinical work" with self-referred family members can be something like "the family adults become (a) more aware of their respective primary needs + any significant psychological wounds + their systemic process (how they try to fill their needs, and (b) more motivated and skilled at problem-solving, so (c) their family's nurturance-level increases, over time."

        With a court-referral metasystem, additional clinical goals include...

  • all legal and other professionals involved in the family's impasse become notably more aware of these topics (above), and...

  • they all become motivated to use their knowledge to...

    • assess themselves honestly for wounds and ignorance, and take appropriate actions;

    • motivate client adults to adopt a long-range view, end the lose-lose litigation quickly, and to...

    • assess for psychological wounds - with clinical help as appropriate; and motivate client adults to...

    • learn, tailor, and apply the topics above to (a) resolve their current impasse/s and (b) intentionally raise their nurturance level, over time.

Note your reaction to this proposal. If you were one of the client-family adults, how would you feel about this definition of "effective clinical work," once you understood it?

4) Educate All Metasystem Members

        An economical way to do this is to give each metasystem member your version of a one-page summary like this early in the process. Then discuss it with each person (or ideally in a group), and follow up to see what each person does. Expect significantly-wounded people to balk, evade, postpone, dispute, scoff, or ignore ("resist") your request. Use these ageless guidelines as needed, and adjust your clinical goals and plans to match metasystem limitations (wounds and ignorances).

        Options:

  • Compose a brief written digest on each topic above and give it to selected metasystem members. ....If useful, print and distribute copies of selected articles in this nonprofit Web site - ignoring stepfamily references if inappropriate;

  • Patiently and repeatedly refocus each metasystem member on the client-family's primary problems (wounds + ignorance) when they focus on the family's impasse and/or the legal process (the surface stressors);

  • Refer to selected topics above in phone, personal, and written contacts, and educate people "real time." Do this even if the person has followed the suggestions in your initial digest, to reinforce their learning and understanding;

  • steadily encourage all members to adopt and keep a long-term view in making their decisions (e.g. the next 25 years), vs. a short-term focus on ending the legal battle..

5) Refocus Metasystem Members on Effective Problem-solving

        Typical metasystem members will not be aware of the difference between surface and primary problems (unmet needs) - in general, and in the current case. They also will usually not know how to (a) be objectively aware of their communication process, and to (b) clearly distinguish between true win-win problem-solving and common lose-lose alternatives. Clinicians who accept the vital difference between surface and primary needs have an opportunity (and ethical obligation?) to (a) explain it and (b) persistently remind other metasystem members of it as the clinical/legal process proceeds.

        Clinicians' second-highest overall priority with any client should be to facilitate the client adults learning to...

  • discern their respective primary needs,

  • become aware of how the [wounds + ignorance] cycle promotes their current impasse and other significant conflicts, and then help them...

  • learn to use these attitudes and skills to fill their primary needs as co-equal partners, vs. adversaries. Achieving this requires all adults' true Selves to consistently guide their personalities, which needs to be their first priority. Typical wounded client adults and other metasystem members will not know this, and will often resist the concept's relevance and/or acting on it.

6) Make Specific Written Recommendations

       

7) Respect Clients' Wishes About Further Clinical Work

        Again - typical court-ordered clients are ambivalent at best about being forced to participate in and pay for professional clinical work. Many will resist and may sabotage "counseling" and/or go through the motions but aren't genuinely committed to the process. Even veteran clinicians usually can't offset this ambivalence, resentment, or disinterest.  

       If client adults attend one or more sessions, the clinician can begin to assess (a) their attitude and expectation about clinical work, and (b) what their primary systemic problems are. The latter will usually be some combination of false-self wounds and unawareness. A practical clinical goal can be to "plant seeds" (new knowledge, attitudes, and communication options) with unmotivated, resentful, and skeptical adults, rather than to trying to motivate them to make significant systemic changes. A related goal can be to describe the probable long-term personal and family benefits of investing in further self-motivated clinical work regardless of the legal process. Then empathically accept the client's local response, despite any court order.

        With limited time and client motivation, I suggest focusing on how (a) mutually-disrespectful attitudes and (b) unawareness of communication sequences and skills guarantee ineffective problem-solving - which promotes using the legal system to solve family problems - which aggravates the surface problems, rather than solving them. If clients are receptive, a second core point to seed is that false-self wounds promote disrespectful attitudes, and once acknowledged, such wounds can be intentionally reduced, for everyone's benefits. At the least, recommend clients review and discuss these articles on the [wounds + ignorance] cycle, normal personality subselves, and effective communication and problem-solving basics. 

       If client adults become more self-motivated for further clinical work during or after the legal process, then clinicians can shift toward their normal assessment and intervention goals and plans. If clients don't become more self-motivated at this time, (a) they're probably controlled by well-meaning false selves, and (b) that probably won't change unless each adult hits their personal bottom. Therapy and the legal process cannot force this, and the Serenity Prayer applies to everyone.


 Implications for Clinicians

        The above ideas suggest that counselors and therapists who accept court-referred divorced-family and stepfamily clients have some "extra" challenges to providing effective service :

the conflicting needs and opinions of involved attorneys, judges, and other professionals _ adds more discussions, paperwork, conflicts, and decisions to each case, and _ amplifies the ongoing task of assessing and prioritizing these;

clinicians and related colleagues have an ethical responsibility to _ qualify to serve these clients, and _ patiently strive to motivate clients and related legal professionals to learn, accept, and act on the realities above, over time.

the legal-process family stressors above are real, and secondary without exception. With limited time and energy to invest, clinicians are challenged to help clients and others understand and stay focused on (1) keeping a long-range view, (2) focusing on strengthening the client family's nurturance level over time, and (3) identifying, prioritizing, and improving the primary problems:

  • co-parents' false-self wounding ,

  • ineffective communication,

  • blocked grief , and...

  • related unawarenesses

Co-parents who choose legal force to fill their needs are probably more apt to make malpractice charges than other clients. Clinicians need to be clear on their ethical and strategic stance in case a participating co-parent or child asks or demands "Don't tell ___ about ___, OK?" They also need to know prevailing ethical and legal constraints on what client information to reveal to whom, when - e.g. if a clinician is subpoenaed to depose or testify about the case, what are her or his obligations and options?

        Professional associations like NASW, APA, and AMA publish guidelines and/or offer consultation on conforming to "best practice" confidentiality guidelines. A supervisor or clinical director who has clear answers to questions like these is a major asset during the work.

there is rarely (never?) one informed person monitoring and guiding the complex interactions between client, legal, clinical, insurance, and related human-service systems over time. This is like a construction crew trying to build a complex structure without a coherent plan or qualified leader. The clinician must accept and adapt to the resulting confusions, conflicts, and frustrations as s/he works to serve the client family over time.

Whatever their litigation stressors (above), the attitudes and motivations of client co-parents toward court-ordered clinical intervention usually include ...

_ un/focused resentments 

_ anger, blame, hostilities, and antagonisms

_ weariness and/or "depression"

_  anxieties or fears (plural) and "defensiveness"

_ c/overt shame and righteous justifications

_ significant guilts

_ skepticism, cynicism, and distrusts

_ intense frustrations (unmet needs)

_ "numbness and apathy" (overwhelm) 

_ confusions and ambivalences

        Co-parents' mix of emotions like these are often thoughtlessly dubbed client resistance to forced clinical intervention. A judge's "suggestion" or order to "get professional help" implies "I see you as an incompetent co-parent and/or adult now, and I don't trust you to get appropriate help on your own." 

        To typical shame-based  co-parents already (long?) embroiled in grieving and complex, frustrating (old/new) conflicts, this public verdict of incompetence usually (a) amplifies personal psychological wounding , and (b) intensifies co-parents' existing hostilities, blamings, defensiveness, and denials. These all raise the co-parents' respective E(motion)-levels , which inhibits empathic listening and problem-solving effectively without professional help. Their vulnerable kids lose in many ways.

        A common early target with legally-referred clients is invite any "resistive" co-parents to make a second-order attitude shift about clinical or professional service. At times, there is too much inner-family, client family, and metasystem chaos and conflict for one professional to master. In such cases, these timeless wisdoms are practical helps.
 

        Early in working with legally-referred clients, clinicians need to assess some special systemic factors like these:

1) _ Who comprises the service-provider metasystem affecting this client family? _ Who's making the key decisions in this system? _ What does each decision-maker really need now? _ How knowledgeable is each influential professional about stepfamily basics, including my supervisor or case manager? Low to high, what's the apparent nurturance level ("functionality") of this provider metasystem, and _ what interventions seem  warranted, if any, and _ who should make them?

2) What biases does the clinician, supervisor, and/or case manager have, if any, about _ parents who sue each other, _ the family-law system and/or specific legal professionals, _ working with legally-embroiled clients, and _ being caught up in a complex lose-lose web of conflicts among antagonistic co-parents, attorneys, opinionated, unaware colleagues, and ancillary people like client relatives, and law-enforcement, welfare, and/or media professionals.

3) What, specifically, does the referring judge want _ this service to provide, _ for whom, _ by when, _ based on what?

4) Relative to this client family, what are the real (vs. surface) priorities and biases of each active lawyer, including Guardians ad Litem (GAL)? How is each attorney currently affecting the nurturance level of the client family? How accessible is each lawyer?  

5) What current legal actions are in process, and what's the (active / inactive / hearing or review scheduled / ...) status of each? Who initiated each action, when, and why? According to whom? 

6) What realistic options exist for making initial contact with each client co-parent, including those not ordered to participate? Does the order or type of contact matter here? (phone / letter / e-mail / fax /  messenger...)

7How willing or able am I to testify in court about my work with, and perceptions of, the client family? What organizational policies and laws affect my answer? Do I need a consultant to help guide me, if I'm called to testify? If "Yes"- who?

8Do I feel qualified to work effectively with this client-provider situation? If "No," or "I'm not sure", who can/should I consult with about possibly referring this client out? To whom? If I do take this case, what consultation help will I probably need? What are my options? 

9) Including the above, what factors should I assess first with this client, after normal  introductions and initial trust-building?

10) How receptive are all client co-parents to identifying and owning their primary needs, and learning alternatives to using legal force to fill them - e.g. (a) working to put their true Selves in charge (co-parent Lesson 1), and then (b) learning to use the communication basics and skills in Lesson 2)? 

        Every case will require "extra" initial assessments like these. These illustrative questions imply the necessity of including concurrent assessment of (a) each provider, (b) the impact of the whole provider system on the client system, and (c) the court-ordered client.

 Recap

        Each of the six client-types in this clinical model may initiate clinical service because of, or during, legal conflict between divorced co-parents or other relatives. Serving such clients effectively requires clinicians, supervisors, and consultants to be aware of extra complexities and special needs. These include (a) being alert for special ethical and malpractice concerns, (b) assessing how the legal system is affecting the client-family's nurturance level, and (c) helping all involved identify and stay focused on the primary client stressors.

        This article summarizes common secondary legal stressors, proposes key realities about working with litigious co-parents and unaware legal professionals, and outlines common clinical implications of these realities. An overarching premise is that co-parents resorting to legal force...

  • are significantly wounded ,

  • cannot problem-solve effectively,

  • are unaware of these and other key things, and...

  • are unintentionally wounding their minor children.

A related premise is that most legal (and other human-service) professionals are unaware of stepfamily basics, implications, and hazards; and may hinder effective clinical work by using "traditional" intact-biofamily norms.

        Where this is true, a proactive option for clinicians is to suggest or urge appropriate education for legal (and other) professionals. Options include selected handouts, referral to Web information like these articles, and/or seminars or an in-service program for non-clinical professionals.

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Updated  10.05.2015