Considering the Health Insurance Portability and Accountability Act (HIPPA), the idea of discussing confidential information with a patient in front of an audience is probably quite foreign to you. However, in group and family therapy, this is precisely what the psychiatric mental health nurse practitioner does. In your role, learning how to provide this type of therapy within the limits of confidentiality is essential. For this Discussion, consider how limited confidentiality and other legal and ethical considerations might impact therapeutic approaches for clients in group and family therapy.<\/p>\n
To prepare:
\nReview this week\u2019s Learning Resources and consider the insights they provide on group and family therapy.
\nView the media, Legal and Ethical Issues for Mental Health Professions, Volume I, and reflect on legal and ethical considerations for group and family therapy and individual therapy.<\/p>\n
Post an explanation of how legal and ethical considerations for group and family therapy differ from those for individual therapy. Then, explain how these differences might impact your therapeutic approaches for clients in group and family therapy. Support your rationale with evidence-based literature.<\/p>\n
Learning Resources
\nRequired Readings
\nAmerican Nurses Association. (2014). Psychiatric-mental health nursing: Scope and standards of practice (2nd ed.). Washington, DC: Author.<\/p>\n
Standard 5A \u201cCoordination of Care\u201d (page 54)
\nNote: Throughout the program you will be reading excerpts from the ANA\u2019s Scope & Standards of Practice for Psychiatric-Mental Health Nursing. It is essential to your success on the ANCC board certification exam for Psychiatric\/Mental Health Nurse Practitioners that you know the scope of practice of the advanced practice psychiatric\/mental health nurse. You should also be able to differentiate between the generalist RN role in psychiatric\/mental health nursing and the advanced practice nurse role.<\/p>\n
Wheeler, K. (Ed.). (2014). Psychotherapy for the advanced practice psychiatric nurse: A how-to guide for evidence-based practice. New York, NY: Springer.<\/p>\n
Chapter 11, \u201cGroup Therapy\u201d (pp. 407\u2013428)
\nNichols, M., & Davis, S. D. (2020). The essentials of family therapy (7th ed.). Boston, MA: Pearson.<\/p>\n
Chapter 1, \u201cIntroduction Becoming a Family Therapist\u201d (pp. 1\u20135)
\nChapter 1, \u201cThe Evolution of Family Therapy\u201d (pp. 6-22)
\nBreeskin, J. (2011). Procedures and guidelines for group therapy. The Group Psychologist, 21(1). Retrieved from http:\/\/www.apadivisions.org\/division-49\/publications\/newsletter\/group-psychologist\/2011\/04\/group-procedures.aspx<\/p>\n
Khawaja, I. S., Pollock, K., & Westermeyer, J. J. (2011). The diminishing role of psychiatry in group psychotherapy: A commentary and recommendations for change. Innovations in Clinical Neuroscience, 8(11), 20-23.<\/p>\n
Koukourikos, K., & Pasmatzi, E. (2014). Group therapy in psychotic inpatients. Health Science Journal, 8(3), 400-408.<\/p>\n
Lego, S. (1998). The application of Peplau’s theory to group psychotherapy. Journal of Psychiatric and Mental Health Nursing, 5(3), 193-196. doi:10.1046\/j.1365-2850.1998.00129.x<\/p>\n
McClanahan, K. K. (2014). Can confidentiality be maintained in group therapy? Retrieved from http:\/\/nationalpsychologist.com\/2014\/07\/can-confidentiality-be-maintained-in-group-therapy\/102566.html<\/p>\n
U.S. Department of Health & Human Services. (2014). HIPAA privacy rule and sharing information related to mental health. Retrieved from http:\/\/www.hhs.gov\/sites\/default\/files\/ocr\/privacy\/hipaa\/understanding\/special\/mhguidancepdf.pdf<\/p>\n
Microskills: Family Counseling Techniques 1
\nProgram Transcript
\nNARRATOR: Aaron and Robyn are seeing a counselor as they are concerned
\nabout the alcohol drinking behavior of their adolescent daughter, Michelle. As
\nyou watch this segment, observe the techniques used by the counselor.
\nCOUNSELOR: So really one of the defaults for you, one of the positions that you
\ntake is, honey, because you don’t know what’s going on in our lives. I don’t hear
\nthat just about you and Michelle. I hear it’s about, or Michelle’s life, it’s about your
\nlives. We’re living our lives and you’re out working. I mean that’s kind of the
\nsense that I’m getting from you.
\nAnd it’s interesting to see the way in which, when you came in today, the way
\nthat you sat. You’re very close together. Michelle, it’s almost like you’re between
\nyour mom and dad. So I’m wondering if that feels like that way sometimes for you
\nif you feel like you’re kind of in the middle of a, I don’t know, a conflict between
\nmom and dad.
\nMICHELLE: Well, sometimes, I mean, when he’s gone, everything’s perfectly
\nfine. But then when it comes to the weekends, everything has to change. And
\nthat’s when all the conflicts happen. Otherwise, everything’s fine.
\nCOUNSELOR: Yeah, I noticed earlier that one of the things that you said, Aaron,
\nis that you said the rules in my house. And I’m wondering if that’s how it feels like
\nto be a member of this family is that it’s your house and these girls have to follow
\nyour rules. I mean, does that feel– you look like that’s really something that
\nhappens for you.
\nROBYN: I notice with myself, I start getting very stressed on Thursday night,
\nbecause I know that he’s coming home, and he’s going to be critical of how I
\nparent Michelle, and critical of the decisions I’ve made in the week. It didn’t used
\nto be like that. We used to be a family. And now it’s just him wanting to have
\nthings perfect. He’s so worried that someone’s going to see that we’re not
\nperfect, and that we have to work really hard on Thursday night, Friday morning,
\nto make sure everything is the way that’s going to make him happy when he gets
\nhome.
\nCOUNSELOR: So one of the ways in which you manifest that things aren’t
\nperfect, is you land here, you’re in my office. I’m wondering if this feels hopeful to
\nyou, like finally, we’re at a place where we can start addressing something that
\nhasn’t felt perfect, that we’ve been trying to put up this front about perfection.
\nDoes that fit for you? Or does this feel like you are here, because you’re in
\ntrouble just like you were taking care of your daughter who was throwing up in
\nthe toilet?
\n\u00a9 2017 Laureate Education, Inc. 1<\/p>\n
Microskills: Family Counseling Techniques 1
\nROBYN: I think right now, more than anything, I’m just kind of scared, because I
\ndon’t know what’s going to happen when we leave here.
\nCOUNSELOR: Yeah. What’s your sense about that? What’s your fear about what
\nmight happen?
\nROBYN: That maybe we’ve been holding it together in this way for so long, we
\nhave a system that works. And what happens, what happens if that system no
\nlonger works for us? I mean, I don’t want our family to fall apart.
\nCOUNSELOR: As in, you don’t want to get divorced?
\nROBYN: Right.
\nCOUNSELOR: Or you don’t want Michelle to run away and leave? Are those part
\nof that kind of fantasy that you have that may happen?
\nROBYN: And also, we’re just really good friends. We’re not just mother and
\ndaughter. We’re good friends. We have a lot of fun together. And what also
\nhappens if we lose our time that we have together, and we’re not as close after
\nall this is over.
\nCOUNSELOR: How might this affect you’re relationship together? What are your
\nfears, Aaron?
\nAARON: I’ve just kind of got so many right now. My fear is, that this is the first
\ntime I’ve heard my wife and daughter use the language like, we’re friends. And
\nsomewhere in there, there’s got to be a parent, or in this case, we have to parent.
\nAnd I’m just a little unsettled with the coziness that I’m seeing here. No, I don’t
\nwant a divorce from my wife. I really don’t. I don’t want anything bad to happen to
\nmy daughter, but the drinking’s got to stop. It’s really, just really, frustrating and
\nconcern. I’m a very concerned dad.
\nCOUNSELOR: Michelle, I’m wondering what kind of fears you might have around
\nthis? Because, again, you’ve kind of landed in this counselor’s office, and you’re
\ntalking about some very personal things related to your family. I mean, what fears
\ndo you have around all this?
\nMICHELLE: Well, for me, I just don’t want everything to start changing all of a
\nsudden, because I like the way things are, I mean, during the week. Because I
\nget to go out with my friends. I get to do a lot of things that I want to do,
\neverybody comes over and they like my mom, everything’s cool. And I like that,
\nand that’s the part I don’t like to change.
\n\u00a9 2017 Laureate Education, Inc. 2<\/p>\n
Microskills: Family Counseling Techniques 1
\nBecause on the weekends, everything has to change. I can’t go out anymore. I
\nhave a curfew, and I have all these rules come down on me. And I don’t want that
\nto be the every day thing.
\nCOUNSELOR: That, as in pointing to dad.
\nMICHELLE: Because he sets all the rules, and then mom changes.
\nCOUNSELOR: He’s kind of the heavy that comes in and says, this is the way that
\nit’s going to be. And mom allows you a lot of freedom to do what you want?
\nMICHELLE: Well, we did it together. Yeah.
\nCOUNSELOR: Yeah. Because one of the things that I’m curious about, and I just
\nwant to have you consider is, I’m wondering if this was your first drinking with
\nyour mom? Or when you are with your friends on the weekends, that happens
\nthat, with them, too?
\nMICHELLE: It happens sometimes.
\nCOUNSELOR: Sure. And I appreciate you being open. I understand that that
\nquestion, in and of itself, probably put you in kind of an uncomfortable position.
\nBut again, I think it’s really important that if we’re going to be working towards
\ndeveloping some healthier ways for your family to function, that you have to be
\nhonest about this.
\nSo dad’s sense about you coming in, and him seeing you drink for the first time,
\nthis hasn’t been the first time for you?
\nMICHELLE: No, and like, we can have a drink or two at home. It’s me and mom,
\nwe’re just relaxing and watching the hills or something. And it’s not a big deal. It’s
\nreally not.
\nCOUNSELOR: So this is new for you, and this feels like a big deal for you?
\nAARON: This is brand new to me. I had no idea that my wife and my daughter
\nwere at home drinking while I was away at work making money to bring home, so
\nthat we could have a great looking family. This is– I don’t–
\nROBYN: So why do you think you had no idea?
\nAARON: I don’t know. I thought that we set the rules, and those were the rules
\nthat we were living by.
\nROBYN: I can answer that, because you’re not there. That’s why you had no
\nidea.
\n\u00a9 2017 Laureate Education, Inc. 3<\/p>\n
Microskills: Family Counseling Techniques 1
\nMICHELLE: You haven’t been there in like a while.
\nAARON: It has been different since my new job. I’ll give you that, but I thought we
\nwere really good. I thought we really had the rules set.
\nCOUNSELOR: Well, you know, and it’s interesting, Aaron, the way that you had
\ntalked about, just a moment ago, when you said, I work so hard to bring the
\nmoney home so we can have a good looking family. It wasn’t so we can live a
\ngood life. So I’m wondering if the sense that Robyn mentioned earlier about
\nneeding to have appearances really is a big thing for you. About making sure that
\nthe face that this family puts on in the world is a respectable one, one that
\ndoesn’t have problems like this.
\nAARON: We live in a very small community. Everybody knows everybody. We all
\nshop at the same grocery store, church, and faith, and working, it’s just like one
\ngreat big family. And I really don’t want the message to get out that Aaron let’s
\nhis wife and daughter party while he’s out of town.
\nCOUNSELOR: So one of the things that happens, is that this means something
\nabout you?
\nAARON: Yeah.
\nCOUNSELOR: Like, if this is happening, people are going to make some
\njudgments about me that I’m not a capable father, that I’m not a good
\nbreadwinner, that I can’t keep my own family together.
\nAARON: Yeah, I never thought about it on that level, but you’re right. A lot of this
\ncomes back to me. A lot of this comes back to me.
\nCOUNSELOR: Reputation in the community. I’m wondering what that feels like
\nfor you two. It’s interesting when I kind of come back to you, it’s like you two.
\nLike, you are very, very close. I mean, does come up for you, too, do in terms of
\nlike, wow, we could really blow this thing wide open?
\nROBYN: When he was talking, I was just sitting there thinking he has no idea the
\npressure he puts on us, and that it’s always–
\nCOUNSELOR: Could I stop you for one second, because I think this is really
\nimportant. What I’d like to do is begin to kind of separate the us that I see into
\nyou each, as individuals. And so when you’re talking about your experience, refer
\nto your experience. And Michelle, I’m going to have you do the same thing, for
\nyou to talk about what your experience is like, too. They might be very similar.
\nBut I think it’s important for you to talk about what it’s like for you as an individual.
\nSo what pressure is on you, mom?
\n\u00a9 2017 Laureate Education, Inc. 4<\/p>\n
Microskills: Family Counseling Techniques 1
\nROBYN: Well, to be perfect. To always just have everything look like it’s so well
\nput together, and that we don’t have any problems. How much freedom would I
\nfeel if we could just live and not worry about what the neighbors think, or what the
\npreacher thinks, or what your parents think? I would just like to not always feel
\nlike I’m performing for somebody else, or for you.
\nCOUNSELOR: Yeah. So for you the pressure is, I don’t want to keep playing this
\ngame. I don’t want to keep putting this front up.
\nROBYN: Exactly.
\nCOUNSELOR: How about for you, Michelle?
\nMICHELLE: Well, yeah, I get the same thing. It’s like, whoever I want to hang out
\nwith might not be good enough, or whatever guy that wants to take me out, he
\nnever likes. And like what my grades are, and college I want to get in to. And all I
\nhear about really are my SAT scores, and it’s just a constant pressure. It’s like
\nhe’s gone, but then he comes back, and he’s like all these demanding answers,
\nand I’m not ever living up to it and all these things that he wants. Never stop to
\nask what I want and what I want to do.
\nCOUNSELOR: Yeah. Like, what’s coming up for you is that you see your dad as
\ncoming in and talking about all these things, and you never feel like you measure
\nup?
\nMICHELLE: Oh, right.
\nCOUNSELOR: You never feel like you quite make it. Like, you’re OK with who
\nyou are to him. And I think that that’s an important thing, because one of the
\nthings that I see dad saying is that I’m making money so that we can have a
\ncertain life. And my hunch is, that that’s a way that you show your love for your
\nfamily.
\nAARON: That’s the way that my dad did. My dad worked a lot, was away from
\nhome an awful lot. His rules, he brought home the money, so we could have a
\ngood life. And I don’t want anything bad to happen to my daughter, and I love
\nher, but that’s why I do these things. I work this hard to bring home this kind of
\nmoney, So that she can go to a good school. And that’s why I want her to do
\ngood on her SATs. I don’t want her to hang around with the wrong crowd. I want
\nher to date good kids.
\nROBYN: Have you ever asked her what she wants from you?
\nAARON: I’ve got to be honest with you, honey, I have a hard time asking my child
\nwhat she wants. I’m in the position to dictate what she wants.
\n\u00a9 2017 Laureate Education, Inc. 5<\/p>\n
Microskills: Family Counseling Techniques 1
\nCOUNSELOR: Yeah. Yeah, that’s kind of an interesting thing. I’m in the position
\nto dictate what she wants, so it’s like you have a pretty good idea of what she
\nwants, or in other words, what you want her to want?
\nAARON: Yeah.
\nCOUNSELOR: And you look like you have a reaction to that, Michelle.
\nMICHELLE: Yeah, it’s been very clear. I know who he wants me to be, but he has
\nno idea who I am. And I know what school you want me to go to. I understand
\nthat you want me to be a lawyer. I understand all this. But you never ask me what
\nI want to do. And like the last thing I want to do, is what you do. Or whatever you
\nwant me to do.
\nNARRATOR: Shawn and Weston are seeing a counselor as they are dealing
\nwith feelings of growing apart in their relationship. As you watch this segment,
\nobserve the techniques used by the counselor.
\nCOUNSELOR 2: Let’s try something if we might. Weston, just a few moments
\nago, I asked each of you to name three things that would be different qualities of
\nthe relationship if things were going well. What were the three things that you
\nheard Shawn name? Or here, how about this, I’m sorry. Let me re-structure that.
\nWhat I’d like you to do, is actually tell him what you heard him say.
\nWESTON: I heard emotional intimacy, that you wanted me to be emotionally
\nintimate with you. I heard being present, so when there’s something going on in
\nyour life, being available, and being able to talk about it, and being around you.
\nAnd I heard spending time together. For example, going out to the bar again, to
\nthe dance club. Going out maybe for a date night and having dinner and having
\nthat connection on that level as well.
\nCOUNSELOR 2: Was that a representation of what you presented of what you
\nwant for the relationship?
\nSHAWN: Yes.
\nCOUNSELOR 2: So well, what’s clear to me, and I don’t know if it’s clear to you
\nor not, Shawn, that there was something that he heard that you said. And there
\nwere the things that were important to you were heard in that. I wonder what’s
\nthat like for you?
\nSHAWN: Well, I mean, like I said before, it is something that I’ve heard that’s
\nimportant. I just don’t see anything being done. I mean, like for instance, those 30
\nminutes that he needed after work, all of a sudden, it turned into two hours. And I
\nsaid, I’m going to bed and now he’s ready to talk. I mean, that’s probably why he
\nused the term, zinger, because I’m pretty good at that, actually. When I don’t feel
\n\u00a9 2017 Laureate Education, Inc. 6<\/p>\n
Microskills: Family Counseling Techniques 1
\nlike a person is, Weston is, putting forth the effort or giving me the energies I
\nneed. I’m pretty good at kind of attacking him verbally a little bit, just a little bit.
\nWESTON: A little bit?
\nSHAWN: Yeah, just a little bit, not much. I mean, that was probably mild.
\nProbably, I don’t know, but I just get so frustrated with I care about you, and I
\nwant us to be together. And I’m tired now, and I can’t talk to you so it’s kind of
\nconflict. On the one hand, he says he cares and he loves me, then on the other
\nhand, he doesn’t want to take the time to hear about my days. It doesn’t seem
\nlike it’s important to him.
\nCOUNSELOR 2: So where does the zinger fit into that?
\nSHAWN: Well, I try to give back to him how I’m feeling. And I don’t do it in a very
\nnice way. I know I do that. When I get frustrated, and I don’t feel like he’s trying to
\nhear me, or pay attention to me, or get my needs met, I tend to go on the attack,
\nkind of, sort of. Not physically, but with words. And I feel bad after I do it, but I do
\nit. I would say often, but I do it. Well, maybe I do do it often.
\nWESTON: It feels like it’s more lately.
\nCOUNSELOR 2: Talk a little bit more, Weston, about being on the receiving end
\nof those zingers.
\nWESTON: I’m of two minds.
\nCOUNSELOR 2: OK.
\nWESTON: The first is, it does hurt. And I just had to say, ouch, like I just did, just
\nto say, that hurts. And I appreciate Shawn saying he’s aware that he does it. So
\none mind, I want it to stop. I don’t like it. It hurts. It’s almost two sides of the same
\ncoin, because the other side is, part of what I love about Shawn is his energy.
\nHe’s got this energy that just fills up a room.
\nIt was not by accident that I saw him across the room when we first met six years
\nago, was because he just lit up the room. And I get, he’s lonely, he’s hurt, he
\ndoesn’t feel heard, and it’s still that passion coming out in a way that we just don’t
\nseem to be connecting very well. So I get it on one hand. I understand why the
\nzingers are there, but on the other hand, it still hurts.
\nCOUNSELOR 2: Tell me what you’re noticing as this as this is being said,
\nShawn?
\n\u00a9 2017 Laureate Education, Inc. 7<\/p>\n
Microskills: Family Counseling Techniques 1
\nSHAWN: I didn’t think about the energy, the passion part. I was just trying to get
\nback at him, but I guess that makes less sense. And I know it hurts, and I do
\napologize for that.
\nWESTON: Thank you.
\nSHAWN: I just, I don’t know.
\nCOUNSELOR 2: We’ve talked a lot about the zingers, and the impact of them.
\nAnd your awareness, Shawn, of yeah, that’s something I do and I know that it’s
\nreally not the best thing. I think that’s of value, and I think we do want to go
\nahead and probably continue with that discussion at some point.
\nAt this point though, I’d like to go ahead and table that if I could, because I do
\nwant to go back to an exercise that I introduced earlier. And I’d asked Weston to
\nname three things that he observed that you said about what you’d like to see
\ndifferent in the relationship. What, in fact, would be the qualities of the
\nrelationship if, in fact, it was meeting your needs and was growth fostering? And
\nso now, I’ll ask you to share with Weston what you’ve heard him say, as the three
\nthings that he identified would be growth fostering elements of the relationship.
\nSHAWN: Well, I heard you say that you wanted more intimacy, specifically,
\nsexual intimacy. And I heard you say that you want more balance in the
\nrelationship. Balance among us. And the third thing I heard you say, is that you
\nwant to have more fun, go out more, and go out on dates and things like that.
\nThat’s what I heard.
\nCOUNSELOR 2: Does that represent what you said, Weston?
\nWESTON: I think it’s a good representation. Even just an example, right now, in
\nour session today. I haven’t heard Shawn say, I love you, Weston. and I’ve said it
\ntwo or three times. And he says those are nice words, but he doesn’t say them
\nback to me. I’d like to hear that sometimes, too.
\nSHAWN: OK. I love you.
\nWESTON: Thank you.
\nCOUNSELOR 2: What’s that like for you?
\nWESTON: I know it’s hard for him to do it, and I get it. And I appreciate it. I really
\ndo. What’s it like– hear, let me ask when I say what’s it like– what’s it like first of
\nall to have said it, but then also to here Weston, again, be very genuine and say,
\nI liked it. I know it’s hard, and I heard him say it and I really like it.
\n\u00a9 2017 Laureate Education, Inc. 8<\/p>\n
Microskills: Family Counseling Techniques 1
\nSHAWN: I appreciate that part because it is hard. That’s hard. I appreciate him
\nrecognizing that it is hard for me to say. It is nice to hear to know that he’s aware
\nthat it is hard for me to verbalize that. I’m such a doing person, that sometimes I
\nforget about the verbal stuff is just as important as doing.
\nNARRATOR: Billie is coping with the loss of a significant relationship. For six
\nmonths she has been working with the counselor, which is now concluding today.
\nAs you watch this segment, observe the techniques used by the counselor.
\nCOUNSELOR 3: I’m thinking back. I guess it was probably about three months
\nago, and you gave me a call. And it was during the week, and we weren’t even
\nscheduled for that week. I think we had a week off or something. And you said, I
\nsaw him again. Remember that day?
\nBILLIE: Yeah.
\nCOUNSELOR 3: What was that like?
\nBILLIE: It was funny. You think you make this progress. I guess I was a little
\ncocky at first. You think you’re making this progress. I can do it, everything’s OK.
\nAnd then I saw him, and I felt it was like a punch in the stomach. Like I felt all the
\nair just leave. I had to collect myself, and kind of sit with myself a little bit to say,
\nwow, I’m really need to slow this down. I have to work on this a little bit more.
\nSo that was really rough at that time when I called you about that.
\nCOUNSELOR 3: Yeah, I was listening to my voicemail that day, and I was
\nthought, oh, she’s really struggling right now. And I imagine that she’s feeling like
\nthat all of the strides that she’s made have probably fallen away.
\nBILLIE: Right.<\/p>\n
COUNSELOR 3: And also feeling like, oh, wow, we’ve got a week and a half
\nbefore I see you again, wondering what was going to happen. And you came
\nback in and you were still together.
\nBILLIE: Right.
\nCOUNSELOR 3: So you were able to take what you had learned already, and it
\ndidn’t all fall away? It stayed with you. Even though, when you left me the
\nmessage, you didn’t believe that that was the case.
\nBILLIE: No, you’re absolutely right. I had to sit back and remember some of the
\nthings that we had talked about during our previous sessions. And I was able to,
\nyes, I saw him, yes, he did. He really broke my heart and hurt my feelings. And I
\nwas all wrapped up in this person, but I’m a good person. I’m a significant
\n\u00a9 2017 Laureate Education, Inc. 9<\/p>\n
Laureate Education (Producer). (2015). Microskills: Family counseling techniques 1 [Video file]. Baltimore, MD: Author.
\nMicroskills: Family Counseling Techniques 1
\nperson. I need to be significant to myself. And I need to be authentic to who I am.
\nAnd I have to value myself. And in order to do that, they’re going to be times
\nwhen seeing him, or seeing his pictures, or maybe run into his family members,
\nthat I still might go a little twinge in my stomach.
\nCOUNSELOR 3: Tell me what you mean by twinge.
\nBILLIE: Twinge. Like butterflies, like nervous, nervousness, like oh my God, here
\nhe is. Here’s his mother. I don’t know what to say. I don’t know what to think, but
\nit will pass. And I’ll be OK. I’ll be able to work through that.
\nCOUNSELOR 3: It sounds like you’ve really been practicing that self-talk that we
\ntalked about. You said the word, authenticity, a couple of times. I know we’ve
\ntalked about it many, many times. But it seems like your understanding of that
\nword has really evolved over time. And so I would like to know on this last day,
\nas you’re leaving, what does authenticity mean for you right now?
\nBILLIE: For me, it means just really being true and genuine to who Billie is and
\nowning who I am. And appreciating and really, I guess, falling in love with myself
\nfirst.
\nCOUNSELOR 3: But you’ve acknowledged that there are flaws, right?
\nBILLIE: Yes, absolutely, absolutely. And I have to embrace those, work on those
\nthat I can.
\nCOUNSELOR 3: But we all have flaws, and that’s part of the human condition, I
\nguess. I would like to believe that I don’t have any. I would prefer to believe that
\nevery day I’m as good as I would choose to be or want to be. But not always. And
\nI guess, part of being authentic, like you said, is acknowledging those times when
\nthat’s not true and then just taking it as information for the future.
\nBILLIE: And I think I’ve learned, too, that I don’t– even when I fall back, that I’m
\nnot falling as hard as I did the first time. I’m not pulling my hair like you said, or
\ncrying uncontrollably or anything like that. It’s just that over time, that will lessen.
\nCOUNSELOR 3: Speaking of pulling of your hair. I guess it was what, about a
\nmonth ago? You said, how will I know when I’m done? And I said, I think you’re
\ngoing to be feeling it. And it sounds to me like you’ve made a lot of movement
\nalready. And then you said I’m scared. And you said I’m going to be right back
\nthere in that tornado again. So are you pulling out your hair right now?
\nBILLIE: No, I’m not pulling out my hair now. I do feel a little nervous about us
\nseparating, because you’ve been just wonderful in helping me put this back
\ntogether and picking up to the debris. And severing this or pulling away from this,
\nis almost like losing another relationship.
\n\u00a9 2017 Laureate Education, Inc. 10<\/p>\n
Microskills: Family Counseling Techniques 1
\nCOUNSELOR 3: And just as I’ve always wanted you to know, that really
\nexperienced a relationship on a deep and personal level as well. This has been
\nvery powerful for me. I’ve learned a lot about you. But I’ve also learned about
\nmyself in this process.
\nWe have these boundaries that we have set up as a counseling relationship, and
\nit’s always been about you. But I’m going to also feel good about having learned
\nabout myself in this process as well. And it is, I guess, separating is the word that
\nI heard you use just now. But really, for me, it’s about, you’re moving on to
\nsomething greater. You’re taking what you’ve learned and you are incorporating it
\nin all of those relationships.
\nAnd if you need to come back, then come back. Or if you need to see someone
\nelse, then we’ll give you names for someone else. But just as you said, you were
\nready.
\nBILLIE: Right. And I want to be committed to trying to talk– practicing myself to
\ntalk, when I’m having those moments where am I feel like, I’m falling apart. I’m
\nnot going to make it. I want to be committed to doing that so that’s something I
\nwanted to tell you, that I will commit to the different changes that I’ve made
\nduring this process.
\nCOUNSELOR 3: I’m glad that you said that. I often wrap up these sessions,
\nthese counseling relationships, with a personal commitment as well. And that day
\nthat you told me that you experienced that as pushy. That time, that
\ndisconnection that you discussed. I thought, when she’s made it, I want to go
\nback to that.
\nAnd I want to say that I’ve learned from you to even further consider how my
\nfeeling compelled to get into the deep end and to really connect can be
\nexperienced as pushy. My personal commitment then, is to be very considerate
\nof that. And to check in if I experience that pulling away of someone that I felt that
\nafternoon when you left. To ask about it, and so both, thank you for that. And
\nthen I will make the commitment just as you did to check in.
\n\u00a9 2017 Laureate Educat<\/p>\n
Laureate Education (Producer). (2015). Microskills: Family counseling techniques 2 [Video file]. Baltimore, MD: Author.
\nMicroskills: Family Counseling Techniques 2
\nProgram Transcript
\nNARRATOR: Aaron in Robyn are seeing a counselor as they are concerned
\nabout the alcohol drinking behavior of their adolescent daughter, Michelle. As
\nyou watch this segment, observe the techniques used by the counselor.
\nCOUNSELOR: So I’m wondering if you would do something for a minute. I’m
\nwondering if you could share with your dad what he doesn’t get about you. If you
\nwere to think about your dad really being in a place of really not knowing what it
\nis that you are or who you are. To be able to say to him, this is what you’re not
\ngetting about me. And Dad, I’m wondering if you could just hear what she has to
\nsay. And then I want to talk with you a little bit about that.
\nAARON: I have to be quiet?
\nCOUNSELOR: Yeah.
\nAARON: That’s going to be hard.
\nCOUNSELOR: Yeah. I’m sure it will, yeah.
\nAARON: I’ll give it a shot. I’ll give it a shot.
\nMICHELLE: Well, I’m not a robot. And I’m not your little Barbie doll toy. And I’m
\nnot your dancing monkey when we go out places. I don’t like performing for
\npeople. And get things that I get– who I am. I am a person. And I want to make
\nmy own decisions. And maybe I don’t know what I want to do. And I think that
\nshould be OK.
\nCOUNSELOR: Anything else? Now I want to stop for a second. It looked to me,
\nas you were talking to dad, that there were a couple times where you were
\nlooking to mom, almost for some reassurance. I wonder if you noticed that, Mom.
\nYeah. And Dad, what were you hearing? What were you hearing Michelle say?
\nAARON: I’ve got to be honest with you. My internal language was just telling me
\nto just be quiet and listen to her. So I was hearing my own internal voice at the
\nsame time I was trying to listen to her. But I kept hearing words like “Barbie doll”
\nand “dancing monkey.” And that’s not what I want my daughter to think that I
\nwant of her.
\nMICHELLE: You get the message that she feels like you want her to perform.
\nAARON: Yeah, that’s what I heard. I just\u2026 That’s not what I want at all.
\n\u00a9 2017 Laureate Education, Inc. 1<\/p>\n
Microskills: Family Counseling Techniques 2
\nCOUNSELOR: So one of the things that may be happening in your family is that
\nyou may be making some assumptions about your dad, about what he wants you
\nto do, that may not be his intention. Do you think that he wants to have you
\ndance around like a dancing monkey or to perform and be the perfect person?
\nHow does he want you to do that?
\nMICHELLE: Well, if we’re out somewhere and if I’m not happy, I shouldn’t be
\nforced to smile. Or if we’re out at a church function or something like that, and if I
\ndon’t really want to mix and mingle and meet whoever you want, I just don’t feel
\nlike I should have to be really happy and go and entertain them or share stories
\nabout something that happened at school or share about something that I did. I
\njust don’t feel like I should have to be doing that.
\nAARON: I’m just very proud of you. You’ve had good grades up until recently.
\nAnd I’m proud of you. That’s why want you tell folks these things. I’m just so
\nproud of you and the good grades that you make. But I’m worried about the– the
\ndrinking’s going to– I get that next report card and it’s going to be all B’s and C’s
\ninstead of A’s. And it’s been all A’s ever since. And that’s what I want for you.
\nROBYN: You know, she and I have talked about this before. She feels like she’s
\nyour trophy. And I know I feel that way sometimes, too. You can’t have a
\nrelationship with a trophy.
\nCOUNSELOR: So one of the things that you experience, Robyn, that you
\nexperience yourself as a trophy, and not just Michelle– because again, it’s almost
\nlike you were talking for Michelle. She feels like you view her as a trophy. But you
\nfeel that way, too. And so what does feel to be like a trophy?
\nROBYN: That I am in his life just to show off, some other acquisition or evidence
\nof success that he has. And that he doesn’t really care about who I am as a
\nperson, or care about our family. You know, he’s gone all during the week and
\nwhen he comes home, you know what he does? He does and plays golf all day
\nSaturday. So there’s this idea of, you have to be perfect. And you have to be this
\nway. You have to look that way. And you have to do all these things so the rest of
\nthe world can see how successful he is or I am. But there’s no connection.
\nCOUNSELOR: It’s interesting. During the week, you don’t have to be a trophy.
\nIt’s almost like y’all can get together and just do what you need to do. So in some
\nways, his working during the week serves you. It helps you to do– to put off the
\ntrophy and to live how you want to live.
\nMICHELLE: Yeah, we can just relax and chill together.
\nCOUNSELOR: And so my hunch is that if that arrangement were to change, that
\nwould be pretty interesting to see what would happen in this family. Meaning if
\n\u00a9 2017 Laureate Education, Inc. 2<\/p>\n
Microskills: Family Counseling Techniques 2
\nyou weren’t on travel so much, if you were home, that would certainly be different
\nfor you and this family.
\nAARON: Yeah. I wouldn’t have drinking buddies to come home to.
\nNARRATOR: Well and the other thing, too, Aaron is that I get the sense that
\nyou’ve depended upon this partner that you have– who is your equal, who is your
\nwife– to keep the homefront a certain way. And so when you were talking earlier
\nabout them being buddies, you don’t like the coziness. And what you’re saying is
\nyou don’t like the fact that Robyn has abandoned her parenting role to be a
\nfriend.
\nAARON: Yeah. When I hear “buddies,” I’m just worried about where the parent
\nside of you comes from. That’s my concern. I love that you two get along so well,
\nbut I just have a hard time with mom and daughter drinking. I really struggled with
\nthat.
\nCOUNSELOR: So what’s your what’s your feeling about that?
\nROBYN: Sometimes I do feel like we’re at opposite ends of the spectrum. Here’s
\nthis cold, hard, distant dad. And so my job is to make up for it and give her all the
\nrelationship for both of us together.
\nCOUNSELOR: So almost like you have to offset that harshness that dad brings
\nin.
\nROBYN: Right. Because if I were more parental– by his definition– what would
\nshe have? She’d have parents who she felt like didn’t care about her as a
\nperson.
\nCOUNSELOR: So drinking with Michelle is a way that you show that you love
\nher.
\nROBYN: It’s not really drinking. We just– every once in a while we’ll make some
\ndaiquiris together and we just relax. And I guess this last time, we probably put
\ntoo much rum in the daiquiris she just got drunk. But it’s not like we’re going out
\ndriving or going to bars. We’re just hanging out together. We’re just connecting
\nand relaxing before he comes home.
\nCOUNSELOR: Right. And you have this special time together. And it’s just you
\ntwo. And it doesn’t involve him. And it doesn’t even involve your friends, too.
\nMICHELLE: I mean, they’ll come over. They know she’s a cool mom. But not all
\nthe time.
\nCOUNSELOR: So do your friends know that you drink with your mom?
\n\u00a9 2017 Laureate Education, Inc. 3<\/p>\n
Microskills: Family Counseling Techniques 2
\nMICHELLE: Yeah they know how cool she is. And she understands. And we can
\ntalk to her about anything.
\nCOUNSELOR: So being a cool mom is a pretty important thing to you.
\nROBYN: Oh, it’s great. I can go out around town, see one of them, they call me
\n“mom,” and come over and hug me. It’s wonderful to have her friends like me. So
\nI get to really stay connected with them and know what’s going on.
\nCOUNSELOR: So you’re a couple of years away from going to college. And I’m
\nwondering what it’s like for you, Robyn, to think about her leaving and–
\nROBYN: Oh, I don’t think about it.
\nCOUNSELOR: Because she goes off to college and then you’re home by
\nyourself with a cold-hearted husband who is home on the weekends.
\nAARON: Never thought of it that way. It’s hard to hear.
\nCOUNSELOR: And that’s where I’m curious. It looks like that it’s really difficult for
\nyou hear yourself being perceived that way, like “is this all I am? Just this coldhearted–”
\nAARON: In my own head, I provide for my family. And that’s how I show my love.
\nAnd it’s just hard to hear the talk about cold and hard and not there and all that
\nstuff. Just hard to hear.
\nROBYN: But you weren’t always that way. There was a time, when Michelle was
\nreally young, we used to go on picnics together and do stuff together. And as she
\ngot older and the years when by, work became more important to him than us.
\nCOUNSELOR: And one of the things that you’re saying, Robyn, is that what’s
\nhappened over the years is that you’ve grown apart. That you and Aaron have
\ngrown apart. Because I hear the family piece. I hear that’s not only has he grown
\napart from both of you. But you have felt some distance in your relationship. So I
\nwonder if in some ways Michelle has replaced that connection that you seek.
\nLike she’s somebody– I envision when you have these moments together during
\nthe week where you’re together and– yeah it may involve alcohol, but you share
\nthings with each other about each other’s lives. And you feel like you’re close
\nfriends. And I’m hearing that you don’t– it doesn’t seem obvious that you have
\nthat with Aaron.
\nROBYN: No. I mean, we still had a good relationship, but she was younger. And
\nwe couldn’t really have conversations. And I did feel really, really lonely. And now
\nI don’t feel lonely anymore.
\n\u00a9 2017 Laureate Education, Inc. 4<\/p>\n
Microskills: Family Counseling Techniques 2
\nNARRATOR: Shawn and Weston are seeing a counselor as they are dealing
\nwith feelings of “growing apart” in their relationship. As you watch this segment,
\nobserve the techniques used by the counselor.
\nCOUNSELOR 2: We’ve got just a few minutes left. And so I think that one of the
\nimportant things that we do next is to take what we’ve spoken about today and
\nreally translate that into action steps. So what I’d like– and I’ll start with you,
\nWeston. I’d like you to summarize the things that you heard Shawn say to you.
\nAnd the way that I want you to do that is to say, “What I heard you say was–”
\nand again, provide a summary of that. And then close that with, “And in response
\nto that, I will–” Blank Whatever you’re going to do in response to that.
\nWESTON: OK. What you just said there kind of clicked for me. You’re a man of
\naction versus words. And I tend to be of more words than action. And it’s like two
\nships that need a better job talking to each other. Because we’re both powerful
\npersonalities. I’d like to commit or propose let’s come up with a date night.
\nWhether we just go out for a coffee date, dinner date, dancing date, let’s pick a
\nnight where it’s just the two of us. I be home. You be home. We all be home by
\n4:00 or 5:00. That night’s ours. And it’s sacred. And my guess is that might be an
\naction step where you know that time is yours so we can have fun together.
\nI think the other thing I’d offer is I will try to keep my downtime when I get home
\nto 45 minutes. Maybe even set an egg timer– mm-ding– and then I check in with
\nyou about where I’m at and check in with you about where you’re at for the day.
\nAnd we see where it goes for the evening.
\nCOUNSELOR 2: I know you’re probably thinking about your response. And
\nbefore you do formulate that, I think what I’d like to do, Weston is to challenge
\nyou a little bit further. You said, “I will try to set an egg timer for the 45 minutes.”
\nI’d really like to hear you commit to that 45-minute downtime period each day.
\nWESTON: I will commit to the 45-minute period each day.
\nCOUNSELOR 2: OK. And we can certainly test it out for the next week and see
\nwhat happens. And so there were two things that I heard that you were offering
\nas new possibilities. First of all, there’s this very concrete action that’s the “I will
\nuse an egg timer and I will keep my time to 45 minutes, recognizing that you
\nneed time, too.” And also, “I want us to have a date night.” And so, really
\nresponding to, “here’s what I want, and this is my yearning. And in order to do
\nthat, in order to facilitate that, and move us forward to creating this possibility,
\nhere’s what I’m willing to do.” What’s it like to have named those things?
\nWESTON: I think it’s easy to name them. I think where the difficulty will be is the
\nfollow-through in the next week or so. I’m excited by them. But I’m also like, now I
\ngot to do it. I’m just kind of hesitant, or anxious, or nervous, about making that
\ncommitment.
\n\u00a9 2017 Laureate Education, Inc. 5<\/p>\n
Microskills: Family Counseling Techniques 2
\nCOUNSELOR 2: OK. So feeling some anxiety over making a commitment that’s
\ngoing to really be changing. Does it feel at all vulnerable?
\nWESTON: Vulnerable as in “scary,” no. Vulnerable as in “will it work?” I’m
\ncautious. I want to have hope. But I don’t know if it’s there completely yet.
\nCOUNSELOR 2: OK. Great. So really wanting to move back into connection, yet
\nalso wondering if the possibility really exists, and really knowing that you’re
\nsticking your neck in a way by making some changes– or proposing some
\nchanges– and really making a concerted effort toward doing that. OK. Now let
\nme ask you. Before you respond to that, what was it like to hear that summary
\nand then the proposal for his commitment and then also his hoped-for outcome
\nof that?
\nSHAWN: Well, it was nice to hear. And yeah, it was nice. It lets me know that
\nhe’s heard what my concerns are and he’s willing to try address them. So that
\nwas good. So I’m encouraged. And I agree. I think he’s right. It is nervous in
\nterms of whether or not it is actually going to happen. And I think my
\nnervousness centers around, well, if he doesn’t do it one day, how I going to
\nrespond to that? Am I going to be like, well, he is trying. Is trying enough? And I
\nknow that in my mind, trying is enough, but like I said earlier, with the zingers,
\nsometimes they just come out before I think about the fact he is trying. So that’s
\nwhere my nervousness stems from. But I am encouraged, though. Definitely
\nencouraged.
\nCOUNSELOR 2: And the thing I’d like to caution you against is creating a bad
\nscenario before it happens. I think an important thing to do is to give this is an
\nopportunity before saying, but I also know that it may not happen. And here’s
\nwhat I’m thinking and how I’m going to respond to that. And I’d rather you
\napproach this from a different perspective rather than trying to anticipate how
\nyou’ll respond if things don’t happen. I’d like to consider the possibility that these
\nthings will happen, and what that might mean for you. And while you’re holding
\nthat in your mind, I’d like you to also provide that same summary to Weston that
\nyou’ heard him say, Shawn, which is the, “What I heard you say was–” Provide
\nthe summary. And then end that with, “And in response to that, I will–” And you
\nfill in the blank.
\nSHAWN: OK. OK. Well, what I heard you say was that you would like to have a
\nnight that’s ours, a date night that we would have between us. We both would get
\noff at around 5:00 and then just make that date our night. And that you’d also be
\nwilling to have 45 minutes when you got home for your downtime. And then the
\nother time would be spent processing and talking with me.
\nAnd in response to that, I’m willing to allow you to have those 45 minutes by not
\nbeing in your face as soon as you walk through the door, and allowing you to
\nhave that time. And also I’m willing to organize my thoughts, the things that I
\n\u00a9 2017 Laureate Education, Inc. 6<\/p>\n
Microskills: Family Counseling Techniques 2
\nwant talk about, and just take away the things that maybe aren’t that important.
\nBecause I do recognize that a lot of stuff that happens at the job you don’t want
\nto hear. So I do understand that. And so I will do that so that when we do have
\nthat time it’ll be more focused. And so I’m willing to do that.
\nNARRATOR: Billie is coping with the loss of a significant relationship. For six
\nmonths, she has been working with a counselor, which is now concluding today.
\nAs you watch this segment, observe the techniques used by the counselor.
\nCOUNSELOR 3: Do you have words of wisdom? Things that, if this had been
\ndifferent, if this had been even better, what could we have done differently over
\nthis course of these counseling sessions?
\nBILLIE: What could have been done differently? I think that– I don’t know, it’s
\nreally hard to say. I think because of where I was when I came in– I was a
\nwhirlwind of mess– and I’m hoping– really on my end, I guess on what could
\nhave been differently, if I could have been a bit more receiving at first. It took me
\na little while to get to the point with working with you that I can be an independent
\nperson. That I can coexist with a person as opposed to existing within a person.
\nCOUNSELOR 3: But how could you have? That first day, you were really hurt.
\nBILLIE: I was. I was. It was really a lack of words. I keep using stormy-type of
\nwords, and “tornado,” because I felt totally wiped out. But just being able to do
\ndifferently for me, I think, is to– as far as in relationships, is to coexist with the
\nperson. And in working with individuals, even if I come to see you again, if
\nsomething happens and I’m really upset about what’s going on, it’s that I’ll know
\nthat I’m going to be OK. And that it’s not the end of the world, like I thought it was
\nthen. So that’s the only thing I can think of for me doing differently.
\nCOUNSELOR 3: Any thoughts about– if we reestablish therapy, if we start back
\ncounseling again, what will you want to acknowledge with me or with whomever
\nyou’re seeing that this particular relationship, the way that we do it, although what
\nyou said that you’re going to do differently for yourself, are there ways that you
\nwant to interact differently with your counselor?
\nBILLIE: I think how we interacted was appropriate. Nothing seemed out-of-place.
\nWe were laughing and we make hit one another. You might hit me or something
\nlike that which is perfectly fine.
\nCOUNSELOR 3: We get into it, sometimes.
\nBILLIE: Right. You know, no. I can’t really think of anything that would need to be
\ndifferent. I think it was fine. It was tumultuous at first, it was kind of stormy. But I
\nthink over time it worked its way out. Where do you think, as far as with me
\n\u00a9 2017 Laureate Education, Inc. 7<\/p>\n
<\/p>\n
Microskills: Family Counseling Techniques 2
\nmoving on, anything in particular you think I should take– any bullet points you
\nthink I would take away from this experience?
\nCOUNSELOR 3: Well, what I’ve heard from you is that it takes two people that
\nwant to be in relationship to be in one. I’ve heard you say in the past that, I’m
\nworthy of a relationship, even if someone doesn’t believe that that’s true. And I
\nwant you to stay true to those things you told me. I think if you do that then we’ve
\nbeen successful.
\nBILLIE: You know what’s great about that is that you used the words that I used
\nand really facilitating me growing as opposed to just telling me what to do. But
\nfacilitate me to grow and to enhance my life and to be centered and authentic
\nwith myself. So I appreciate that.
\nCOUNSELOR 3: Well, you are, of course, welcome. But those are all things that
\nyou’ve always known but that you somehow didn’t trust because of that break-up,
\nright? I think that all of the things that you’ve told me have come from within you.
\nI wonder what happened along the way, just as we’ve always said, how is it that
\nwe come to not trust those things? Or how do we get wrapped up in someone
\nand then we lose it because they’ve left us?
\nBILLIE: That’s a really good point. That those answers are always there. And you
\nkind of help uncover them and bring them out. And that makes a lot of sense.
\nAnd I can take that away with me, that even if I can’t connect with you right away,
\nor whatever the case may be, that I can work through them and find those
\nanswers within me, that’ll help get me through.
\nCOUNSELOR 3: I appreciate that you’re so willing to take that and believe it.
\nEven though, in the beginning I think you said that you didn’t have that within
\nyou.
\nBILLIE: No, absolutely not. Not in the beginning. Absolutely not. I was not
\nprepared to– I almost needed convincing that I can exist outside of that
\nrelationship. And it sounds so crazy now to say that. That I needed to be
\nconvinced. And I didn’t even come naturally, on my own, to counseling. My
\nfriends were just like, you can’t keep being this way, where you’re just locked in
\nthe house by yourself. And you’re not really doing anything.
\nAnd they really prompted me to come here, as you know. And it’s just interesting
\nto hear me even say that now, that I needed some level of convincing that I can
\neven exist independent of a person. That I could sit here and actually be sitting
\nup as opposed to all slouched in a chair, my face in my hands, and– I have some
\nhair left.
\nCOUNSELOR 3: Yeah, you didn’t pull it all out.
\n\u00a9 2017 Laureate Education, Inc. 8<\/p>\n
Microskills: Family Counseling Techniques 2
\nBILLIE: I didn’t pull it all out. But it’s amazing to see that kind of growth over time.
\nEven though I’m nervous moving own.
\nCOUNSELOR 3: Well, you did trust your friends enough to come in, right? And
\nyou did listen to them when they said, hey something’s up. And I think there’s
\nsome relational confidence in knowing that “I can rely on some people that really
\nknow me.”
\nBILLIE: Yeah, that’s right.
\nCOUNSELOR 3: I think there’s some knowledge to say, these people really have
\nsomething to offer me. And I owe it to them to listen.
\nBILLIE: Yeah, that’s a good point. You’re right.
\nCOUNSELOR 3: So what do you think they think now?
\nBILLIE: Oh, wow. Now that I’ve emerged out of my house, I think they think that
\nI’ve made tremendous strides. I’m taking a lot better care of myself. That I’m
\nenjoying life again. I do feel a lot of anxiety around dating again. We talked about
\nthat. And trying to move on there. It’s one thing to be able to find strength in self,
\nand be able to find out who you are. But there’s some apprehension around
\nmeeting someone else in the future. What is that going to look like?
\nI’ve heard a couple of them say, that hey, you might want to start dating again,
\nand things of that nature. And that I don’t know. That I’m still a little nervous
\nabout. This is new for me, this owning myself, emerging as a person and feeling
\nworthwhile. But moving into a new relationship, I’m still kind of working on that a
\nlittle bit.
\nCOUNSELOR 3: We acknowledged a number of qualities that you’re going to be
\nlooking for if you choose to move into a new relationship with someone. What
\nwere some of those things that you identified?
\nBILLIE: I’m trying to remember. Someone who would value me as a person. That
\nwould be first and foremost.
\nCOUNSELOR 3: That’s first.
\nBILLIE: Right, right. That is respectful of my needs and desires and allows me to
\nbe independent of him. And I don’t have to fully immerse myself in a person. And
\nof course, all those things that people want in relationships. Someone that’s kind
\nand nice, and can communicate with me. But really, valuing me as a person, I
\nthink, is the key thing you and I talked about.
\n\u00a9 2017 Laureate Education, Inc. 9<\/p>\n
<\/p>\n
Microskills: Family Counseling Techniques 2
\nCOUNSELOR 3: So on a day-to-day basis, what will you be doing differently
\nnow?
\nBILLIE: Differently. OK. I would say that– and some of the things that I had been
\ndoing and of course as we’ve been talking, over the course of all this time, is of
\ncourse not spending my entire day wondering about “what is he doing? What is
\nhe doing now? Who is he talking to now? Who is he calling now?” And I’m not
\ndoing that. And when I have these moments of feeling really bad for myself, if I
\nallow myself to feel that way, to be able to talk to myself, like, no, I don’t have to
\nbe here. I don’t have to be in this place. You know?
\nThat I am worthy and I can move forward. So I think that’s one of the biggest
\nthings I’ll do it differently is really doing a lot of self-talk and engaging in my
\nhealthy relationships with my friends and coworkers. So really providing a lot
\nmore support around me before I jump in the dating pool again. So I think those
\nare some other things I’ll be doing differently this time.
\n\u00a9 2017 Laureate Education, Inc. 10<\/p>\n
Microskills: Family Counseling Techniques 3
\nProgram Transcript
\nNARRATOR: Aaron and Robyn are seeing a counselor, as they are concerned
\nabout the alcohol drinking behavior of their adolescent daughter, Michelle. As
\nyou watch this segment, observe the techniques used by the counselor.
\nCOUNSELOR: I’m wondering, Aaron, what it would feel like if in our work
\ntogether that we could work towards having you move towards being more
\nconnected with your family and expressing love in a little bit different way than
\nyou’re used to? Because one of the things that I heard loud and clear is that
\nwhen you come home on the weekends– And I don’t know how accurate this is. I
\ndidn’t check this out with you. But when you come home on the weekends, you
\ngo out and play golf, because it’s probably a time where you get to wind down.
\nThere’s probably still very little time that you spend with the family.
\nAARON: I’m willing to try anything. Whatever keeps my daughter from going
\ndown the road she’s on now. I’ve heard some things today that are really new to
\nme. And I’m just trying to make sense of it now. And I’m just trying to make it
\nsettle. But I’m OK with trying things.
\nCOUNSELOR: My hunch is that when we begin to do counseling work together
\nlike this, that sometimes people have this sense about counseling, that it’s this
\ntranquil, wonderful, feel-good type of situation. But it’s really a disruptive thing
\nthat occurs. When you’re coming here and you’re sitting here as a family and
\nyou’re saying, we have a problem, in some ways I communicate to you. I’m here
\nto help you disrupt your family right now. And that can be a very unsettling thing.
\nI was just thinking, Michelle, if I were you, one of the things I might feel like is
\nlike, oh wait a second. I’m not ready to have this situation. Go away. Like I’m not
\nready to have my mom and my relationship disrupted in any way.
\nMICHELLE: No. And at this point, I want to be out with my friends. I don’t need a
\nbunch of new rules. I don’t need all this right now. I’m at the end of high school.
\nI’m about to leave. I just– No.
\nCOUNSELOR: So when you think about trying new things to make it work in your
\nfamily differently, your investment is up in the are with that right now. Like you’re
\nsaying, I’m not interested in making any changes in my life.
\nMICHELLE: Because I’m hearing just rules.
\nCOUNSELOR: So when you heard me to talk to your dad about him learning
\nhow to express his love differently than he does, you hear that as rules?
\n\u00a9 2017 Laureate Education, Inc. 1<\/p>\n
Microskills: Family Counseling Techniques 3
\nMICHELLE: Well whenever you’re around, yeah that’s what it is. So I don’t know
\nwhat else it’s going to be.
\nCOUNSELOR: How would you want him to communicate his love to you?
\nMICHELLE: Well, if you show up to something that I do. Start there. There’s
\nalways a game that I cheer at you can show up to if you’re interested.
\nCOUNSELOR: Do you play softball or volleyball?
\nMICHELLE: No. I’m a cheerleader.
\nCOUNSELOR: Cheerleader. OK. So one of the things that would be different for
\nyou, but that might feel good to you, is if your dad came and saw you cheer.
\nMICHELLE: [INAUDIBLE] like my mom.
\nCOUNSELOR: Yeah. So that would be different. And that might be a start.
\nMICHELLE: Yeah.
\nCOUNSELOR: Robyn, I’m wondering what it would be like for you to– wondering
\nif you would be willing to learn some different ways of relating to Aaron that
\nmaybe you had done before when Michelle was younger, but that maybe have
\ngotten pushed to the side a little bit as you’ve grown up.
\nROBYN: This might sound corny, but we used to– My favorite board game is
\nYahtzee. And we used to play Yahtzee all the time. And it was just a lot of fun. It
\nwas a way to connect. And maybe that’s something we could start doing again.
\nAARON: We had fun doing that. I won’t deny that.
\nCOUNSELOR: And one of the things that I would encourage us to do in terms of
\nfollow up work is not so much me making sure that you’re playing Yahtzee every
\nweek. But me checking in with you and just seeing how things are going and just
\nwhat changes. Because this is a place where when we meet, we check in. And I
\ntalk with you about how things are going. But the real work that occurs really
\noccurs on the outside of this office.
\nYou all have participated in sharing some very tender things about your family in
\nterms of this being your first time in counseling. This is really a hard thing
\nsometimes to sit in front of a stranger and talk about such personal things. And
\nyou’ve all done great today. But one of things I’d like to encourage you to do is to,
\nas we go along, not necessarily figure out some strategies and give you a list of
\nthings that you can do. And all of a sudden you’re going to have a happy family
\n\u00a9 2017 Laureate Education, Inc. 2<\/p>\n
Microskills: Family Counseling Techniques 3
\nagain. But just to begin to consider relating to each other in a different way.
\nThat’s sometimes hard.
\nAgain, Michelle, from your end, it would be a little bit of a challenge to give up
\nyour mom if your mom and dad started connecting with each other in a more
\nloving way and the distance shortened between the two, there might be feelings
\nin you that say, well where am I in this picture? And does my mom loves my dad
\nmore than me, that kind of thing? Whereas right now, you feel like you have a
\npretty close relationship with her.
\nROBYN: Well can’t it be that he could be part of this and that we don’t really have
\nto change?
\nCOUNSELOR: Probably. That’s not for me to say. It’s for you all to work out to
\neach other. I’m not sure that you would want to come in and join your family
\ndrinking. Because I’m hearing that that’s a really big concern for you.
\nAARON: Yeah. The drinking thing, I’m very uncomfortable with that. I don’t want
\nto be part of encouraging my daughter to drink.
\nCOUNSELOR: Again, that’s not something that just is a casual thing for you. It
\nreally causes, not only some big concerns, but some anger comes up and
\naround. I want Robyn and I to be parents to Michelle and show her the right way
\nand–
\nAARON: Yes. Yes.
\nCOUNSELOR: And not participate in destructive behavior for her.
\nAARON: You’re absolutely correct. You hit it dead on.
\nCOUNSELOR: And that’s an area for you that I would think would be tough to
\nwork through. Because you have a very different view of that. You’re feeling like,
\nI’ve got to balance out this roughness that my husband has. And I want to show
\nher what the world is really like. I also get a sense that there’s a, if I don’t drink
\nwith her, she might go out and drink with others and really get in trouble.
\nROBYN: And I didn’t know that she was doing that. So that’s definitely something
\nwe need to revisit and talk about. Because that’s not safe, if she’s out riding in
\ncars or driving while drinking.
\nCOUNSELOR: You had this arrangement. You thought, well if I drink with her,
\nthat’ll keep her from drinking with her friends. But That’s not how it’s turned out.
\nROBYN: But we’ll talk about that.
\n\u00a9 2017 Laureate Education, Inc. 3<\/p>\n
Microskills: Family Counseling Techniques 3
\nCOUNSELOR: Well I appreciate you coming in, as I said. I’m wondering if you
\nhave any questions for me about today. Maybe even if you could just talk about
\nwhat you’re taking away from our meeting today. Robyn you can start. What are
\nyou taking away today?
\nROBYN: Well I was able to hear Aaron a little bit differently. Instead of him just
\ncoming down and laying down the law of the land, I hear a little bit more that
\nmaybe he thinks he’s showing us love that way. He thinks he’s showing me love
\nthis way. And he thinks he’s showing Michelle love this way. And maybe that’s
\nsomething else that I’ll take away too, is that I have feelings and Michelle has
\nfeelings. But they’re not necessarily our combined feelings.
\nCOUNSELOR: Yeah. Thank you.
\nROBYN: Thank you.
\nCOUNSELOR: Michelle what are you taking away? Maybe a discovery that you
\nhad or something that you’re taking away today.
\nMICHELLE: Well, I guess it’d be something like that. You do care. And it’s not
\nthat you’re just trying to care just by giving us money. So that’s nice to know,
\nbecause I didn’t know that.
\nCOUNSELOR: It’d be nice to hear it every once in a while.
\nMICHELLE: Yeah. That would be nice. Or maybe not to hear it, but to do
\nsomething else. Get to know me before I have to leave. So that would be nice.
\nCOUNSELOR: That would be a really good thing to talk about next time we do
\nmeet too, what that’s like for you. And maybe some longings that you have to get
\ncloser to your dad before you do leave. Thank you. Aaron, what are you taking
\naway?
\nAARON: I’m taking away, a, a lot of just stuff I didn’t know. And I’m still trying to
\nlet that settle. As hard as it was for me, I’ve heard some real concerns from both
\nmy wife and my daughter that I’m concerned, I should have been hearing for
\nquite awhile now. And I’m leaving here with all that, but also a little
\ndisappointment about myself.
\nCOUNSELOR: Yeah. And I appreciate that this is for you today, it’s been a real
\neye opener in terms of some things that you didn’t know was going on. One of
\nthe things that is really important that I typically tell my families in these types of
\nsituations is, it’s really important for you, as we work together, to cut each other
\nsome slack. This is hard stuff, when you make changes in your lives. And these
\nchanges affect each other in ways that we really can’t anticipate.
\n\u00a9 2017 Laureate Education, Inc. 4<\/p>\n
Microskills: Family Counseling Techniques 3
\nAnd so what may seem like resistance or something that feels like adversarial or
\nharsh, may be somebody’s attempt to change something that they’re doing. And
\nit’s really important to not rush to judgment and get condemning of one another,
\nbecause this is hard stuff. All right. Well I look forward to meeting with you next
\nweek. And again, nice to meet you.
\nMICHELLE: Thank you.
\nAARON: Thanks Doc. Thanks.
\nNARRATOR: Shawn and Weston are seeing a counselor as they are dealing
\nwith feelings of growing apart in their relationship. As you watch this segment,
\nobserve the techniques used by the counselor.
\nCOUNSELOR: I want to make sure that I’m clear with this commitment. So part
\nof what you said was that you’re willing to not talk about your job so much. Now
\nwith what Weston committed to, we have a pretty easy way of measuring
\nwhether or not this happened. Either it does or doesn’t. There’s a very concrete
\nthing. How will we know that the things that you committed to today, Shawn,
\nwould be delivered on?
\nSHAWN: Well for the date night, that takes some work to restructure my
\nschedule. Because I just made partner at the law firm. So I would definitely, even
\nthough I’m partner, we still working 12 and 15 hour days. So that would definitely
\nfor me to say, hey, I’m leaving at five on this day because this day is important.
\nThat would definitely show that I’m committed to that.
\nAnd the other thing is that I am willing to write down what it is I want to talk about
\nand try and ex out the things that aren’t relevant. And I don’t mind showing that to
\nyou, to show that I do hear what he’s saying and I am willing to do that, to make<\/p>\n
Considering the Health Insurance Portability and Accountability Act (HIPPA), the idea of discussing confidential information with a patient in front of an audience is probably quite foreign to you. However, in group and family therapy, this is precisely what the psychiatric mental health nurse practitioner does. In your role, learning how to provide this type […]<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[1],"tags":[],"class_list":["post-403","post","type-post","status-publish","format-standard","hentry","category-research-paper-writing"],"_links":{"self":[{"href":"https:\/\/papersspot.com\/blog\/wp-json\/wp\/v2\/posts\/403","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/papersspot.com\/blog\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/papersspot.com\/blog\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/papersspot.com\/blog\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/papersspot.com\/blog\/wp-json\/wp\/v2\/comments?post=403"}],"version-history":[{"count":1,"href":"https:\/\/papersspot.com\/blog\/wp-json\/wp\/v2\/posts\/403\/revisions"}],"predecessor-version":[{"id":404,"href":"https:\/\/papersspot.com\/blog\/wp-json\/wp\/v2\/posts\/403\/revisions\/404"}],"wp:attachment":[{"href":"https:\/\/papersspot.com\/blog\/wp-json\/wp\/v2\/media?parent=403"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/papersspot.com\/blog\/wp-json\/wp\/v2\/categories?post=403"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/papersspot.com\/blog\/wp-json\/wp\/v2\/tags?post=403"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}