Reluctance and resistance are hot topics in therapy with individuals, families, and groups. Some clients may be resistant to just about every suggestion and option you present to them in therapy, while others are much more open to new ideas, suggestions, and perspectives. Collaborative therapy examines reluctance and resistance from a different viewpoint than many other approaches. It suggests that, perhaps, labeling a client or family as resistant causes you to engage with them in unhelpful or problematic ways. Clients pick up your nonverbal cues; if you are working with a family who seems to be resistant, they will likely notice this in your nonverbal, as well as verbal, reactions to them and become even more resistant. Carefully consider and reflect upon your own assumptions about reluctance and resistance, and practice taking a different, collaborative, approach to it to see if, perhaps, you gain different outcomes.
Background Information
After reading the two chapters assigned for this workshop, you will see how to challenge your beliefs and ideas about the concept of resistance in working with families. In this discussion assignment, you will have the opportunity to reflect upon and discuss how taking a collaborative, relational stance to resistance or reluctance may change how families respond to therapy. Perhaps in your practicum you are working with a family (or individual client or a group) who you find to be particularly resistant; you could try some of the options noted in the chapter on reluctant and resistant families to see if any of them provide you and/or the family/client with new possibilities. If you are able to experiment with these collaborative approaches to resistance before this discussion assignment is due, your experience may also inform your discussion question answers.
In this assignment, you will watch the final video in the case study.
Characters in the Case Study Video
Social Worker
Carl: Social worker at Child and Family Services counseling center
Family
Kalia: 17-year-old Chinese female, adopted
Kalia’s parents:
• Sharece: African American female, 48 years old, nurse
• Alira: Middle Eastern descent female, 47 years old, underemployed saleswoman
Case Study Synopsis
Sharece and Alira, a lesbian bi-racial couple in their late 40s, have an adopted Chinese daughter, Kalia, a 17-year-old teenager experiencing psychiatric symptoms.
A few months ago, the couple, who monitor Kalia’s social media posts and texts, saw that she had expressed suicidal thoughts. They looked in Kalia’s history of web searches and found suicide-associated terms (for example, “suicide methods” and “how to kill yourself”) and, at the suggestion of a psychiatrist, hospitalized the teen for about three weeks, based on her depression and crying episodes and lack of communication.
Kalia used to do well in school, but in the past six months, her grades have been declining. The family has had meetings with the school counselor and teachers. The parents worry that the teen is taking illegal drugs, as well. It is unclear if the teen has made much improvement due to lack of communication.
The couple are multi-stressed due not only to being gay and in a bi-racial relationship, with a daughter with psychiatric symptoms, but also because they have income issues. Alira, a saleswoman, has been underemployed for over a year and has been looking for steady employment for over a year and a half. The couple tends to get along well most of the time, but the income issues and the stressors of a depressed and possibly suicidal teen have been hard on their relationship; fights and arguments have been increasing. Sharece is a nurse, and the time she spends away from the family due to taking additional shifts at the hospital is putting stress on the family, as well, leaving Alira to deal with difficult parenting issues on her own.
Carl, a social worker and therapist at a Child and Family Services counseling center assigned to the family, uses collaborative therapy and a relational stance to work with this multi-stressed family.
The video depicts the third therapy session.
Instructions
- In your textbook, Collaborative Therapy with Multi-Stressed Families, read:
a. Chapter 3, “Collaboration is a Two-Way Street: Engaging Reluctant Families”
b. Chapter 4, “Developing a Proactive Vision to Guide Clinical Work: Collaborative Therapy Contracts” - View the case study video “Planned Changed Process: Intervention.” You can also download the Planned Change Process: Intervention Video Transcript.pdf. ALL LOCATED IN THE FILES
- Based on the video, answer the following questions in order
a. How will one use collaboration and a proactive vision to create an effective intervention and treatment plan that would be different from “regular” or “common” practices in developing a treatment plan with the family shown in the video?
b. How might one use a collaborative approach to address the concerns the parents have for their daughter, who may be considering suicide?
c. What types of resistance or reluctance did you observe in the case study video, and how might one attempt to address these using the suggestions from Chapter 3?
d. How did the social worker integrate the importance of diversity and difference into his practice of designing an intervention with this multi-stressed family?
e. How can the social worker continue to advance the human rights (gay families, foreign adoptees) of the family in the intervention stage?
Sample Solution