Alexander Ch. 6- Motivation phase

Hey Guys, Sorry I feel really dumb. I wrote this before my client yesterday and then I came home and totally forgot to post it until this morning. 

Motivation represents the gateway for lasting change…therefore it = IMPORTANT!

From the first contact, therapist begin working towards specific goals:

• Establishing balanced therapeutic alliances with indivual family members
• Reducing negativity and blame
• Instilling a sense of hope (e.g., “I have something to gain by being a part of this process”); and
• Creating a family focus, rather than an indiviaul focus, for both problems and strengths

-Family members have developed rigid or defensive cognitive schemata through which all information is filtered. This is what fuels and sustains the negative interactions. Over time they become automatic.

•  Think about areas or rituals where you have automatic processing (driving, mundane tasks), you begin to do and respond to things automatically with very little conscious thought.

-Disrupting these automatic responses and interactions is a critical first step in the FFT treatment process.

The goal: intervene in the moment to create a different experience that disrupts the family’s automatic responses

• This can be difficult as the family strives towards being more controlled and deliberate, so its important for the therapist to have a lot of relational capital (therapeutic alliance).
• In the early stages, the intent may not be to change attitudes and attributions, or other cognition, but rather to disrupt rigid, negative patterns and create an opportunity for family members to experience that something new and more hopeful is possible.

THERAPIST CHARACTERISTICS: ADOPTING A STRENGTH-BASED AND RELATIONAL FOCUS

The emphasis early on in FFT is on creating a context in which family members begin to experience one another in new and more positive ways.

• Fundamentally, therapists must believe in and be committed to a relational and strength-based approach, even when positive strengths and goodwill in the family are not at all apparent.
• The intensity of the problems and behaviors can be a challenge for therapists and can push therapist’s personal buttons.

Traps that the therapist can fall into:

• taking sides
• Challenging a manipulative behavior to protect vulnerable family member
• using interventions that validate one family member but blame/distance another
• engage in a disproportional of supportive interventions towards family members whom they see as being the victim

-To stick to the relentless relational focus in a way that is sensitive to the diversity of individuals and issues presented in the context of treatment, Therapists must have courage and resilience.

“Fearless empathy”

The beginnings of empathy:

• send the message that the therapist is totally committed to understanding their inner world. Individuals need to feel acceptance from the therapist.
• therapist needs to be aware of potential biasing influence from his/her background
• Send the message that the therapist is not personally overwhelmed, shocked, or frightened, disgusted, or intimidated by the intensity or nature of the family members’ emotions and attributions. It is important that the therapist has non-avoidant ways of dealing with the conflict

To successfully play your role as a therapist, there must be creativity, a willingness to introduce new perspectives and frames, and the flexibility to approach conflict in the man different ways until the therapist gets something that sticks (e.g. creates hope).

SPECIFIC INTERVENTION STRATEGIES IN THE MOTIVATION PHASE

Change-Focus Techniques- Intended to disrupt unproductive family interactions

                Divert-Interrupt

• divert and interrupt escalating negativing and blaming behavior during session. This helps families de-escalate the family’s toxic negativity.

Pointing Process Technique

• Commenting on interactions or events that occur during therapy sessions.  Therapists can describe interactions from a strength-based approach. This serves to defuse or at least lessen the negativity by shifting the focus from the specific content being discussed to relational aspects that underlie it but are hidden from the family members at the current moment.

Systematically Attending to Positive Elements

• It is easy for the therapist to become trapped in focusing on problems and blame. Keep an intent to look for positive elements that exist midst the rapid processing of information. These interventions have 

There are more techniques but I, without thinking, went home after my session, spaced posting this blog entry, and also spaced that I had been using Austin's book at the clinic and don't have my own copy to add onto it. They were all pretty simple techniques, however, and should be easy to scan over in your book.