Treatment+Plan

Process of Treatment

1. Team approach much like the one-way mirror set-up of the clinic.

2. Brief

3. Systemic. Attempt to incorporate all individuals in therapy that are relevant to the presenting problem.

4. Focus on the presenting problem only.

5. Observe the interaction and communication that the family demonstrates. Look at the meaning behind the words.

6. Initial Interview. Used to elicit clear, specific and sufficient information on the nature of the presenting problem, how it is being handled, and the goal of treatment.

7. Case planning. a. Assess cleint's complaint. b. Assess client's attempted solutions. c. Deciding what to avoid. d. Formulate a strategic approach. e. Formulate specific tactics. f. Framing the suggestions and selling the tasks. g. Formulating goals and evaluating outcomes.

8. Termination. (Postpone further treatment if another problem arises.)

**Initial Interview**

-constitutes base for further meetings since steps are intertwined; sets the tone for the relationship -AVOID long historical accounts...interested in the present

A. Find out the nature of the presenting problem: "What is the problem that brings you here?" -need **observable** descriptions of the problem - What you would see or hear

Client's answers should provide detailed statements of: *problem that has led them to treatment *in what way this involves difficulties in daily life *how it is that they are in therapy __now__ *how the person was referred to you

B. Find out how the problem is being handled now: "How have you attempted to resolve the problem?" *Focus on behavior in relation to the problem-what they DO and SAY when problem occurs, or when attempting to stop it   *What have others attempted in hopes of helping with the problem

C. Find out the client's goal of treatment: "At a minimum, what would you hope to see happen as a result of therapy?" *Single goal is usually selected *Want observable, behavioral answers-concretely defined


 * Techniques/Interventions**

A. Use client language 1. Grasp the client's view of the problem through their language 2. Acknowledge and accept it    3. Reframe the view-turn it in a new direction 4. Utilize the new direction in suggesting new actions for expediting change

B. Reframing the behavior

*define the problem in a way that opportunity to suggest different, or opposite, behavior from what she or he has been attempting

C. One down position

*therapist takes a modest position, does not come across as perfect

D. Go SLOW

*suggesting that things don't move to quickly paradoxically speeds up the treatment

E. Pessimism

*Therapist expresses pessimism and the feeling of hopelessness is explicit and can then be examined and challenged by client *Express the possibility that things sometimes get worse before they get better

F. "Dangers" of improvement (uses:)

1. Increases motivation 2. Redefine family roles

G. Prescribing the symptoms

*ask client to perform the unwanted symptom at a particular time and place

H. Credibility Gap

*Client takes on the unwanted behavior voluntarily and other times acts it out, as he/she is doing so the other person involved (spouse) attempts to keep a baseline of the behavior, which will be inaccurate, creating a credibility gap and stopping the game of accuser/defender

I. Collusion (parents/children)

*Implement a task that will change the interaction in which the problem exists.


 * Termination**

*A small, but significant, change has been made in the problem *The change appears to be durable *The client implies or states ability to handle things without the therapist *Give client credit for change, but warn against believing that the problem is solved forever.