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Author(s): Diane R. Gehart

Publisher: Brooks Cole, Year: 2013

ISBN: 1285075420,9781285075426

detailed Table of Contents xi Part II Family Therapy Theories 59 4 Systemic and Strategic Therapies 61 Lay of the Land 61 MRI Systemic Therapy 62 In a Nutshell: The Least You Need to Know 62 The Juice: Significant Contributions to the Field 62 Rumor Has It: The People and Their Stories 63 The Big Picture: Overview of Treatment 64 Making Connections: The Therapeutic Relationship 65 The Viewing: Case Conceptualization and Assessment 66 Targeting Change: Goal Setting 69 The Doing: Interventions 71 Putting It All Together: Case Conceptualization and Treatment Plan Templates 72 Strategic Therapy 75 In a Nutshell: The Least You Need to Know 75 The Juice: Significant Contributions to the Field 75 Rumor Has It: The People and Their Stories 76 The Big Picture: Overview of Treatment 76 Making Connections: The Therapeutic Relationship 79 The Viewing: Case Conceptualization and Assessment 79 Targeting Change: Goal Setting 81 The Doing: Interventions 81 Putting It All Together: Case Conceptualization and Treatment Plan Templates 85 Milan Systemic Therapy 88 In a Nutshell: The Least You Need to Know 88 The Juice: Significant Contributions to the Field 89 Rumor Has It: The People and Their Stories 89 The Big Picture: Overview of Treatment 90 Making Connections: The Therapeutic Relationship 91 The Viewing: Case Conceptualization and Assessment 93 Targeting Change: Goal Setting 94 The Doing: Interventions 94 Putting It All Together: Case Conceptualization and Treatment Plan Templates 96 Tapestry Weaving: Diversity Considerations 99 Ethnic, Racial, and Cultural Diversity 99 Sexual Identity Diversity 100 Research and the Evidence Base 102 Clinical Spotlight: Multisystemic Therapy 102 Goals 103 Case Conceptualization 103 Principles of Intervention 103 online Resources 104 References 104 Systemic Case Study: Adolescent Substance Use and Divorce 107 Case Conceptualization Using Systemic Theories 108 Clinical Assessment 116 Treatment Plan 121 Progress Notes 123Copyright 2013 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. xii detailed Table of Contents 5 Structural Family Therapy 125 Lay of the Land 125 In a Nutshell: The Least You Need to Know 125 The Juice: Significant Contributions to the Field 125 Rumor Has It: The People and Their Stories 128 The Big Picture: Overview of Treatment 129 Making Connections: The Therapeutic Relationship 129 The Viewing: Case Conceptualization and Assessment 131 Targeting Change: Goal Setting 133 The Doing: Interventions 133 Putting It All Together: Case Conceptualization and Treatment Plan Templates 136 Tapestry Weaving: Working with Diverse Populations 140 Cultural, Ethnic, and Socioeconomic Diversity 140 Sexual Identity Diversity 141 Research and the Evidence Base 141 Clinical Spotlight: Brief Strategic Family Therapy 142 Goals 142 Case Conceptualization 142 Principles of Intervention 142 Clinical Spotlight: Ecosystemic Structural Family Therapy 143 Case Conceptualization 143 Goals 144 Interventions 144 online Resources 144 References 144 Structural Case Study: Teen Conduct Issues 146 Case Conceptualization Using Systemic Theories 147 Clinical Assessment 155 Treatment Plan 160 Progress Notes 163 6 Experiential Family Therapies 165 Lay of the Land 165 Common Assumptions and Practices 165 Targeting Emotional Transactions 165 Warmth, Empathy, and the Therapist’s Use of Self 166 Individual and Family Focus 166 The Satir Growth Model 166 In a Nutshell: The Least You Need to Know 166 The Juice: Significant Contributions to the Field 166 Rumor Has It: The People and Their Stories 169 The Big Picture: Overview of Treatment 169 Making Connections: The Therapeutic Relationship 170 The Viewing: Case Conceptualization and Assessment 172 Targeting Change: Goal Setting 175 The Doing: Interventions 176 Interventions for Special Populations 179 Putting It All Together: Case Conceptualization and Treatment Plan Templates 179 Symbolic-Experiential Therapy 183 In a Nutshell: The Least You Need to Know 183Copyright 2013 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. detailed Table of Contents xiii The Juice: Significant Contributions to the Field 184 Rumor Has It: The People and Their Stories 185 The Big Picture: Overview of Treatment 185 Making Connections: The Therapeutic Relationship 185 The Viewing: Case Conceptualization and Assessment 186 Targeting Change: Goal Setting 188 The Doing: Interventions 189 Putting It All Together: Case Conceptualization and Treatment Plan Templates 192 Internal Family Systems Therapy 196 In a Nutshell: The Least You Need to Know 196 The Juice: Significant Contributions to the Field 196 Rumor Has It: The People and Their Stories 197 Making Connections: The Therapeutic Relationship 197 The Viewing: Case Conceptualization and Assessment 198 Targeting Change: Goal Setting 200 The Doing: Interventions 201 Putting It All Together: Case Conceptualization and Treatment Plan Templates 203 Tapestry Weaving: Working with Diverse Populations 207 Cultural, Ethnic, and Gender Diversity 207 Sexual Identity Diversity 207 Research and the Evidence Base 208 online Resources 208 References 209 Experiential Case Study: Child Sexual Abuse 211 Case Conceptualization Using Systemic Theories 212 Clinical Assessment 220 Treatment Plan 225 Progress Notes 227 7 Intergenerational and Psychoanalytic Family Therapies 229 Lay of the Land 229 Bowen Intergenerational Therapy 229 In a Nutshell: The Least You Need to Know 229 The Juice: Significant Contributions to the Field 230 Rumor Has It: The People and Their Stories 231 The Big Picture: Overview of Treatment 232 Making Connections: The Therapeutic Relationship 232 The Viewing: Case Conceptualization and Assessment 233 Targeting Change: Goal Setting 236 The Doing: Interventions 237 Interventions for Special Populations 238 Putting It All Together: Case Conceptualization and Treatment Plan Templates 239 Psychoanalytic Family Therapies 243 In a Nutshell: The Least You Need to Know 243 The Juice: Significant Contributions to the Field 243 Rumor Has It: The People and Their Stories 243 The Big Picture: Overview of Treatment 244 Making a Connection: The Therapeutic Relationship 244 The Viewing: Case Conceptualization and Assessment 245 Targeting Change: Goal Setting 247Copyright 2013 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. xiv detailed Table of Contents The Doing: Interventions 247 Putting It All Together: Case Conceptualization and Treatment Plan Templates 248 Tapestry Weaving: Working with Diverse Populations 252 Gender Diversity: The Women’s Project 252 Ethnicity and Culture Diversity 253 Sexual Identity Diversity 253 Research and the Evidence Base 254 online Resources 254 References 255 Intergenerational Case Study: Panic, Launching Children, and an Adult Survivor of sexual Abuse 256 Case Conceptualization Using Systemic Theories 257 Clinical Assessment 265 Treatment Plan 270 Progress Notes 272 8 Cognitive-Behavioral and Mindfulness-Based Couple and Family Therapies 275 Lay of the Land 275 Behavioral and Cognitive-Behavioral Family Therapies 276 In a Nutshell: The Least You Need to Know 276 The Juice: Significant Contributions to the Field 276 Rumor Has It: The People and Their Stories 277 The Big Picture: Overview of Treatment 278 Making a Connection: The Therapeutic Relationship 278 The Viewing: Case Conceptualization and Assessment 279 Targeting Change: Goal Setting 283 The Doing: Interventions 284 Putting it All Together: Case Conceptualization and Treatment Plan Templates 290 Mindfulness-Based Therapies 294 In a Nutshell: The Least You Need to Know 294 A Brief History of Mindfulness in Mental Health 295 Mindfulness Basics 295 Specific Mindfulness Approaches 297 Gottman Method Couples Therapy Approach 300 In a Nutshell: The Least You Need to Know 300 Debunking Marital Myths 300 The Big Picture: Overview of Treatment 301 Making a Connections: The Therapeutic Relationship 301 The Viewing: Case Conceptualization and Assessment 301 The Doing: Interventions 304 Tapestry Weaving: Working with Diverse Populations 305 Ethnic, Racial, and Cultural Diversity 305 Sexual Identity Diversity 308 Research and the Evidence Base 309 online Resources 310 References 310 Cognitive-Behavioral Case Study: ADHD and Blended Family 313 Case Conceptualization Using Systemic Theories 314 Clinical Assessment 322 Treatment Plan 327 Progress Notes 329Copyright 2013 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. detailed Table of Contents xv 9 Solution-Based Therapies 331 Lay of the Land 331 Solution-Based Therapies 332 In a Nutshell: The Least You Need to Know 332 Common Solution-Based Therapy Myths 332 The Juice: Significant Contributions to the Field 333 Rumor Has It: The People and Their Stories 333 The Big Picture: Overview of Treatment 335 Making a Connection: The Therapeutic Relationship 336 The Viewing: Case Conceptualization and Assessment 337 Targeting Change: Goal Setting 339 The Doing: Interventions 344 Interventions for Specific Problems 347 Putting It All Together: Case Conceptualization and Treatment Plan Templates 349 Solution-oriented Ericksonian Hypnosis 353 Difference from Traditional Hypnosis 353 The Big Picture: Overview of Treatment 353 The Doing: Interventions 353 Tapestry Weaving: Working with Diverse Populations 354 Ethnic, Racial, and Cultural Diversity 354 Sexual Identity Diversity 355 Research and the Evidence Base 356 online Resources 357 References 357 Solution-Based Therapy Case Study: Divorce 360 Case Conceptualization Using Systemic Theories 361 Clinical Assessment 368 Treatment Plan 374 Progress Notes 376 10 Collaborative and Narrative Therapies 379 Lay of the Land 379 Collaborative Therapy and Reflecting Teams 380 In a Nutshell: The Least You Need to Know 380 The Juice: Significant Contributions to the Field 381 Rumor Has It: The People and Their Stories 381 The Big Picture: Overview of Treatment 383 Making a Connection: The Therapeutic Relationship 384 The Viewing: Case Conceptualization and Assessment 386 Targeting Change: Goal Setting 388 The Doing: Interventions and Ways of Promoting Change 389 Reflecting Teams and the Reflecting Process 392 Putting It All Together: Case Conceptualization and Treatment Plan Templates 394 Clinical Spotlight: Open Dialogue, an Evidence-Based Approach to Psychosis 398 Outside the Therapy Room 398 Narrative Therapy 399 In a Nutshell: The Least You Need to Know 399 The Juice: Significant Contributions to the Field 399 Rumor Has It: The People and Their Stories 400 The Big Picture: Overview of Treatment 401Copyright 2013 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. xvi detailed Table of Contents Making a Connection: The Therapeutic Relationship 401 The Viewing: Case Conceptualization and Assessment 403 Targeting Change: Goal Setting 404 The Doing: Interventions 405 Interventions for Specific Problems 413 Putting It All Together: Case Conceptualization and Treatment Plan Templates 414 Tapestry Weaving: Working with Diverse Populations 418 Ethnic, Racial, and Cultural Diversity 418 Sexual Identity Diversity 422 Research and the Evidence Base 424 online Resources 425 References 426 Postmodern Case Study: Self-Harm, Depression, Lesbian Blended Family 430 Case Conceptualization Using Systemic Theories 431 Clinical Assessment 438 Treatment Plan 443 Progress Notes 445 11 Evidence-Based Treatments in Couple and Family Therapy 447 Lay of the Land 447 Myths About Evidence-Based Treatments 447 Emotionally Focused Therapy 449 In a Nutshell: The Least You Need to Know 449 The Juice: Significant Contributions to the Field 449 Rumor Has It: The People and Their Stories 451 The Big Picture: Overview of Treatment 451 Making Connection: The Therapeutic Relationship 453 The Viewing: Case Conceptualization and Assessment 454 Targeting Change: Goal Setting 457 The Doing: Interventions 457 Putting It All Together: Case Conceptualization and Treatment Plan Templates 460 Tapestry Weaving: Diversity Considerations 464 Evidence Base 465 Functional Family Therapy 466 In a Nutshell: The Least You Need to Know 466 The Juice: Significant Contributions to the Field 466 Rumor Has It: People and Places 467 The Big Picture: Overview of Treatment 467 Making a Connection: The Therapeutic Relationship 468 The Viewing: Case Conceptualization and Assessment 469 Targeting Change: Goal Setting 472 The Doing: Interventions 472 Putting It All Together: Case Conceptualization and Treatment Plan Templates 476 Tapestry Weaving: Diversity Considerations 479 Evidence Base 480 online Resources 481 References 481 EFT Case Study: Building Trust Between Gay Couple 483Copyright 2013 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. detailed Table of Contents xvii Case Conceptualization Using Systemic Theories 484 Clinical Assessment 492 Treatment Plan 498 Progress Notes 500 12 Evidence-Based Group Treatments for Couples and Families 503 Lay of the Land 503 Brief overview of Types of Groups 503 Psychoeducational Groups or “Classes” 504 Process Groups 504 Combined Groups 505 General Group Guidelines 505 Number of People 505 Open Versus Closed Groups 505 Group Selection: Who’s in Your Group? 505 Group Rules 506 Evidence-Based Couple and Family Groups 506 Psychoeducational Multifamily Groups for Severe Mental Illness 506 Groups for Partner Abuse 508 Relationship Enhancement Programs 511 Parent Training 512 Summary 513 online Resources 513 References 513 Part III Clinical Case documentation 515 13 Case Conceptualization 517 Step 1: Mapping the Territory 517 Case Conceptualization and the Art of Viewing 518 overview of Case Conceptualization 518 Introduction to Client and Significant others 519 Presenting Concern 519 Background Information 520 Strengths and Diversity Resources 521 Personal or Individual Strengths 522 Spiritual Resources 524 Diversity Resources and Limitations 525 Family Structure 525 Family Life Cycle Stage 527 Boundaries: Regulating Closeness and Distance 528 Triangles and Coalitions 529 Hierarchy Between Child and Parents 530 Complementary Patterns 530 Satir’s Communication Stances 530 Gottman’s Divorce Indicators 532 Problem Interaction Patterns 533 Systemic Hypothesis 535 Intergenerational Patterns 535 Attachment Patterns 536 Solution-Based Assessment 538Copyright 2013 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. xviii detailed Table of Contents Previous Solutions That Did Not Work 538 Exceptions and Unique Outcomes: Previous Solutions That Did Work 539 Answer to the Miracle Question 539 Dominant Discourses 540 Identity Narratives 541 Local and Preferred Discourses 541 Narratives and Social Discourses 540 Client Perspectives 541 Case Conceptualization, Diversity, and Sameness 542 online Resources 543 References 543 Case Conceptualization Form 545 14 Clinical Assessment 551 Step 2: Identifying oases and obstacles 551 Clinical Assessment overview 551 Benefits of Clinical Assessment and Diagnosis 552 Potential Dangers of Clinical Assessment and Diagnosis 552 Understanding Diagnostic Labels 553 Systemic Perspectives on Diagnosis 553 Postmodern Perspectives on Diagnosis 553 A General Family Therapy Approach to Diagnosis 554 Parity and Nonparity Diagnoses 554 The Recovery Model and Diagnosis 555 Family Therapy Approach to Clinical Assessment 556 Diagnostic Interview and Mental Status Exam 556 Family Therapy Approaches to Clinical Assessment 556 Written Assessment Options 559 Example of a Clinical Assessment Form 561 Completing a Clinical Assessment 565 Communicating with other Professionals 571 DSM-ese 571 Mental Status Terms 572 online Resources 574 References 574 Sample Client Information Form 576 15 Treatment Planning 581 Treatment + Plan = ? 581 Step 3: Selecting a Path 581 A Brief History of Mental Health Treatment Planning 582 Symptom-Based Treatment Plans 582 Theory-Based Treatment Plans 582 Clinical Treatment Plans 583 Writing Useful Therapeutic Tasks 585 Initial Phase 585 Working Phase 586 Closing Phase 586 Diversity and Treatment Tasks 586 Writing Useful Client Goals 587 The Basic Steps 587 The Goal-Writing Process 590 Writing Measurable Goals 590Copyright 2013 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. detailed Table of Contents xix Writing Useful Interventions 592 Client Perspectives 592 Do Plans Make a Difference? 593 online Resources 593 References 593 16 Evaluating Progress in Therapy 595 Step 4: Evaluating Progress 595 Nonstandardized Evaluations 595 Pros and Cons 596 Strategies 596 Standardized Evaluations 597 Pros and Cons 597 Effects on the Therapeutic Relationship 597 Real-World options for Standardized Evaluations of Progress 598 Guidelines for Standardized Measures in Everyday Practice 598 Ultra-Brief Measures 598 Brief Measures 600 Final Thoughts on outcome 603 online Resources 603 References 603 17 Document It: Progress Notes 605 Step 5: Documenting It: A Profession Behind Closed Doors 605 Two Different Animals: Progress Notes Versus Psychotherapy Notes 606 Progress Notes 606 Progress Note Ingredients 607 Progress Note Options 607 The All-Purpose HIPAA Form for Progress Notes 608 Completing a Progress Notes Form 609 A Time and Place for Progress Notes 611 Final Note on Notes 612 online Resources 612 References 612 APPenDIx A The Family Therapy Core Competencies 613 APPenDIx B CACREP Family Counseling Competency-Based Standards 623 AFteRwORD Closing Thoughts: Where to Go from Here? 627 Getting Started: Working with a Supervisor 627 Realistic Expectations 627 Asking for What You Need 628 Seeking Advanced Training 628 Belonging: Professional organizations 628 Self-Supervision 629 Last Words 629 index 631

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