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1 Bruno Hillewaere & Iris Deuss Psychologist & Family Therapist ; Social worker & Family therapist PTC De Viersprong - Congress solution-focused, Amsterdam.

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Presentation on theme: "1 Bruno Hillewaere & Iris Deuss Psychologist & Family Therapist ; Social worker & Family therapist PTC De Viersprong - Congress solution-focused, Amsterdam."— Presentation transcript:

1 1 Bruno Hillewaere & Iris Deuss Psychologist & Family Therapist ; Social worker & Family therapist PTC De Viersprong - Congress solution-focused, Amsterdam - 22 /05/ ‘07 More Families, more possibilities, more solutions? ‘ By nature we have no weakness that could not become a strength’ J.W.Goethe A day care treatment program for Families with adolescents at the Viersprong Institute, Halsteren

2 Note for the reader: all material from the clients, case-examples, videofragments,… have been removed out of this handouts, out of respect for the clients. Articles from the author can be sended by request

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4 The strengths and possibilities of families… And their willingness to help!

5

6

7 The day care treatment program for families with adolescents

8 1. Introduction: on the origin of the idea of a day care program for families in ‘De Viersprong’ + some concrete information about the actual program 2. Theoretical View and methodology: 1. The changing paradigm in systemic therapy 2. Solution – focused therapy 3. Multiple Family Therapy 4. Reflecting team 3. The program from intake to finish 4. Summary and discussionContent:

9 1: On the origin of the idea of a day care treatment program for families with adolescents in ‘DeViersprong’: The context

10 From the Viersprong institute as an oasis …

11 To bridges towards the families… And other therapists …

12 1. Multidisciplinary: 1 psychiatrist, 1 ‘coördinator’ 2 systemic therapists, 3 family workers/trainers 2. Day care treatment: 9 days/ total Intake & home visit 4 * 2 days (Friday & Saturday) + 1 day In total approx. 3 months 3. 3 to 4 Families with adolescents Variety of problems –Focused problem –Multi – problem: only in a larger therapeuic context The team and the program (some concrete information):

13 2. Theoretical view & methodology 1. The changing paradigm in systemic therapy (the larger context)

14 From modern to postmodern: From the individual at the center From modern to postmodern: From the individual at the center ‘The (w)hole of Lacan’ (Steve de Shazer, words were originally magic)

15 Attention to individual units leads to blindness of relationship (Gergen,1999, p.18) With some blindness:

16 … and the therapist as: ‘master catalyst of change’

17 Symptoms as parts of dissipative patterns, that supported family systems to survive at moments of change (Prigogine & Stengres, 1984) … and systems, with problematic patterns:

18 To ‘postmodern theories’: the not – knowing position

19 Anderson & Goolishian (1988) Collaborative (language) approach We learned to use the not-knowing position as a new stance to become involved in conversations that generate - through a crisscrossing of ideas - new meanings toward the dissolving of problems

20 The art of conversation

21 Wittgenstein (1978) Words are not a represention or reflection of reality, but they do things. Words create reality; they create the stories we live.

22 Postmodernism in family therapy: a refreshement… Postmodernism in family therapy: a refreshement… Filmfragment: What the bleep do we know?

23 All contributed to replacing the belief in absolute and objective knowledge acquired through individual thinking by emphasizing the existence of multiple local truths that are constructed within language Constructivism, social constructionism, postmodern thinking

24 ‘Postmodern’theories: Respectfull, equal – ‘Collaborative’ ‘Not- knowing’(Anderson & Goolishian): relative: – ‘Informed not knowing’ (Epston) – Curiosity ( Cecchin, Epston) Shared expertise – dialogue More then one perspective or truth Narrative : the man and his stories Solution-focused:the cliënt and his resources

25 Theoretical View and methodology: Theoretical View and methodology: 2. Solution focused therapy

26 Solution focused therapy: Steve de Shazer en Insoo Kim Berg Brief Family Therapy Center, Milwaukee (Solution focused brief therapy)

27 Solution- focused therapy: The essence (for us): Film-Fragment

28 Solution-focused therapy: more then miracles! Respectful, equal Client-centered ‘leading from one step behind’ Strengths Resources Possibilities Small, concrete steps Future-oriented

29 1. Introduction 2. Vision and methodology: 1. The changing paradigm in systemic therapy 2. Solution – focused therapy 3. Multiple Family Therapy: cfr. infra 4. Reflecting team: cfr. infra 3. Concrete: from intake to finish 1. Intake 2. The program 3. MFT 4. Reflecting team 5. Program from start to finish 4. Summary and discussion

30 1. Intake: Genograms : same story: 1. Intake: Genograms : same story: From a diagnostic instrument of the therapist

31 From problematic stories: Genograms in Family Assessment (Mc.Goldrick & Gerson,1985)

32 Genograms: more than squares and circles…

33 … towards a collaborative therapeutic instrument … towards a collaborative therapeutic instrument Genograms: Assesment ànd Interventions (Mc.Goldrick & Gerson, 1999)

34 Narrative and solution-focused applications using genograms: ‘From what position does a therapist speak or listen in a storry-telling universe where all tell stories and all stories are valid though not necessarily true?’ (Parry, 1991)

35 A universe of meanings…

36 Were we create meanings…

37 From ‘Causal ’ thinking in a genogram:

38 From ‘thin descriptions’ and a problemsaturated story…

39 Towards ‘rich descriptions’ and stories of possibilities

40 Narrative and solution- focused applications: An exercise…

41 Genograms: The challenge Shift from: The therapist focusing on structure and patterns of pathology Towards the creativity of the client and the family to create stories of hope and possible solutions Creating a safe environment and therapeutic relation

42 You can start with pictures…

43 Genograms: ‘Qualities’, positive aspects or characteristics Hobbies…. Stories of hope or strength

44 ‘Postmodern’ genograms: Don’t allways lead to more clearness, but do lead to more collaboration … (and fun) (Note that we let the family draw the genograms)

45 Genograms: A collaborative approach Looking for the positive aspects, but without ignoring the problems (re-authoring lives; creating hopefull stories) Involving all time aspects: Past (timeline), present and future (hope, goals) Life can only be understood backwards, but it must be lived forwards. (Soren Kierkegaard)

46 Genograms: Genogram Timeline (Coping; exceptions!) Goalsetting: – at first, stay close to the words of the clients: words are originally magic

47 1. A) Intake: Stay close to the words from the families! ( Systemic therapists) ‘Words are originally magic’ B) Home – Visit: social workers 2. The day care program: Contract: systemic therapists & social workers Goalsetting as the leading principle and main framework Holding and Containment: non-verbal material, Drawings, collage… 3. Multiple Family Therapy 4. Reflecting team 5. Program from start to finish: End: Evaluation & ‘separation’ 3. The program:

48 Goalsetting: Some examples

49 Techniques: verbal and non verbal material Drawings Collages Games Post-its Corequalities

50 Core qualities model Another tool:

51 Core Qualities Model Opposite Positive --> Too much

52 Core Qualities Model Opposite Positive --> Too much

53 3. Multi Family Therapy: Together and yet …. Sometimes separate

54 Multi Family Therapy: A video fragment: ….

55 Families with adolescents: allways looking for the right distance

56 Sometimes together and sometimes separate …

57 3. Multiple Family Therapy Same principles and processes as in groups: Support, hope, insights… But also same pitfalls: anxiety, problem-talk,… Teenagers and kids: other language, healthy balance between shared and seperated experiences Leading from ‘one step behind’: Family workers Systemic therapists: one & one step behind MFT: Laquer; Asen; Lemmens, Migerode e.a. (Leuven)

58 4. Reflecting team Tom Andersen

59 Looking for humble, helpful reflections

60 4. Reflecting team Bateson: a small difference that can make a difference Steve De Shazer: – Polyocular view: shift in attention – Message from the team: change the pattern (action) Tom Andersen : – Reflections in action How to mobilize the families into this process?

61 5. Program & process: From start to finish Each weekend another theme, –E.g. strengths and competences, communication, education Growing process, smal & concrete steps (subgoals) towards the goals Towards ‘letting go’ – better connecting to better separation (team and families) Last weekend: survival kit Evaluation: middle and end

62 4. Summary & discussion: Different forms offering different possibilities Different families offering different possibilities The program seems to be most effective when integrated in a larger process Most struggling point is still the space the families need for their ‘individual’problems Research has just been started – results will be for a next congress (we hope)

63 Summary: From a problem saturated story

64 Towards a story of possibilities (reflections, actions and systems)

65 Solution-focused MFT: more then miracles (Story of Bateson)

66 Reference: Andersen, T. (1987). The Reflecting Team: Dialogue and metadialogue in clinical work. Family Process, 26, Asen, E. (2002). Multiple Family Therapy: an overview. Journal of Family Therapy, 24:3-16. Berg, I.K., & De Jong, P. (1998). Interviewing for solutions. New York: Brooks/ Cole. De Shazer, S. (1991). Putting difference to work. New York: Norton. De Shazer, S. (1994). Word were originally magic. New York: Norton. Hillewaere, B. (2006). Werken met de mogelijkheden van cliënten en families door middel van kernkwadranten en genogrammen.Tijdschrift voor Psychotherapie, 32, 3, pp. 161 –177. (English: Strengthening families using genograms and core qualities, subm.) Hillewaere, B., & Lefevere de Ten Hove, M. (2006). Narratieve en oplossingsgerichte toepassingen bij genogrammes: samen hoopvolle perspectieven creëren. Tijdschrift voor systeemtherapie, 18, 2, pp (English: Narrative and solution-focused applications of genograms: creating hopeful perspectives, subm.) Laquer, H.P. (1976). Multiple Family Therapy(pp ). In: P.J. Guerin (ed.), Family Therapy: Theory and practice. New York: Gardner Press.

67 More information / articles:

68 Thank you for your attention… And good luck with the families!


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