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Resource

How the body keeps the score on trauma | Bessel van der Kolk for Big Think+

August 21, 2024 by Jennifer Benjamin Leave a Comment

Filed Under: Resource

Why does Burnout and compassion fatigue happen for systemic family therapist?

August 5, 2024 by Jennifer Benjamin Leave a Comment

Burnout and compassion fatigue are significant concerns for systemic family therapists due to the emotionally intense and often challenging nature of their work. These phenomena can occur for several reasons, deeply impacting therapists’ professional and personal lives.

Emotional Intensity and Complexity

Systemic family therapists deal with complex family dynamics and deep-rooted issues, which can be emotionally draining. They often hear distressing stories and witness intense conflicts, leading to emotional exhaustion. The constant exposure to clients’ traumas, conflicts, and suffering can overwhelm therapists, particularly when they empathize deeply with their clients.

When you are working with highly dysregulated systems you need supervision and/or weekly consultation!

High Emotional Investment

Therapists are typically highly invested in their clients’ well-being, striving to help families achieve positive outcomes. This high level of emotional investment can lead to compassion fatigue, where therapists become emotionally depleted due to the continuous demand for empathy and support. The effort to maintain this level of emotional involvement, session after session, without sufficient recovery time, can be overwhelming.

When you are working with a family system fostering a small change in structure is the most caring thing the family therapist can do. Then when you discharge they can maintain the changes!

Lack of Clear Boundaries

In systemic family therapy, the interconnectedness of family members’ issues can blur professional boundaries. Therapists may find it difficult to detach from their clients’ problems, leading to a spillover of work-related stress into their personal lives. This lack of clear boundaries can contribute to burnout as therapists struggle to find a balance between their professional responsibilities and personal well-being.

When you are working with a family system and your boundaries are bumped up against, ask yourself, “could I tell my colleague about this choice I am about to make?” If the answer is no, say no.

High Workload and Administrative Burdens

The demands of maintaining a high caseload, along with administrative tasks such as documentation, insurance claims, and continuous professional development, can be taxing. This workload can lead to physical and mental exhaustion, reducing the therapist’s capacity to provide effective care.

When you are working with larger case loads develop a plan for how you will utilize your clinical model to inform your documentation. Working from a clinical coherent, theoretically sound model, will foster alignment between your intervention and your note writing.

Insufficient Support and Supervision

Therapists who lack adequate support and supervision are more prone to burnout and compassion fatigue. Without a robust support system, therapists may feel isolated and overwhelmed by the emotional burden of their work. Regular supervision and peer support can provide a space to process these emotions and gain perspective, but when these are lacking, therapists are at greater risk.

What would make supervision valuable to you, or is it that you also need your own clinical support? Learn to invest in yourself the same way you invest in others.

Personal Vulnerabilities

Therapists’ own personal histories and unresolved issues can also contribute to burnout and compassion fatigue. If therapists have experienced similar traumas or conflicts as their clients, they may find it particularly challenging to maintain emotional distance, leading to increased vulnerability to burnout.

Be prepared to work on your person of the therapist and know your signature themes. If they are still disrupting your growth and development in service of the families you need to seek your own clinical support.

Conclusion

Burnout and compassion fatigue among systemic family therapists arise from the emotionally demanding nature of their work, high levels of emotional investment, blurred boundaries, heavy workloads, insufficient support, and personal vulnerabilities. Addressing these issues through regular supervision, self-care practices, manageable caseloads, and professional support networks is essential to sustain therapists’ well-being and effectiveness in their practice.

Filed Under: Resource

Essential Resources for Assessing Aggression, Anxiety, ADHD, Global Functioning, Medication Side Effects, and Suicide Risk. Check out the link.

August 1, 2024 by Jennifer Benjamin Leave a Comment

Rating Scales

In the field of mental health, accurate assessment is crucial for effective treatment planning and intervention. Below are some essential resources for evaluating aggression, anxiety, ADHD, global functioning, medication side effects, and suicide risk. These tools can help clinicians gather comprehensive data and make informed decisions about their clients’ care.

Aggression Assessment

1. Aggression Questionnaire (AQ) The AQ measures physical aggression, verbal aggression, anger, and hostility. It is a widely used self-report tool that helps identify different dimensions of aggressive behavior in individuals.

2. Overt Aggression Scale (OAS) The OAS is designed to assess the frequency and severity of aggressive episodes. It includes subscales for verbal aggression, physical aggression against objects, physical aggression against self, and physical aggression against others.

Anxiety Assessment

1. Generalized Anxiety Disorder 7 (GAD-7) The GAD-7 is a brief self-report questionnaire that screens for generalized anxiety disorder. It is commonly used in clinical practice to identify symptoms and monitor treatment progress.

2. Hamilton Anxiety Rating Scale (HAM-A) The HAM-A is a clinician-administered assessment that evaluates the severity of anxiety symptoms. It covers both psychological and physical symptoms of anxiety.

ADHD Assessment

1. Conners’ Rating Scales Conners’ Rating Scales are used to assess ADHD symptoms in children and adults. These scales include parent, teacher, and self-report versions, providing a comprehensive view of the individual’s behavior across different settings.

2. ADHD Rating Scale-IV The ADHD Rating Scale-IV is a commonly used tool for diagnosing ADHD and monitoring symptom severity. It includes both inattentive and hyperactive-impulsive symptom scales.

Global Functioning Assessment

1. Global Assessment of Functioning (GAF) Scale The GAF Scale is used to rate the overall psychological, social, and occupational functioning of individuals. It helps clinicians assess how well individuals are managing daily life activities.

2. World Health Organization Disability Assessment Schedule (WHODAS) The WHODAS measures health and disability across multiple domains, including cognition, mobility, self-care, and social interaction. It provides a comprehensive picture of an individual’s functioning.

Medication Side Effects Assessment

1. Abnormal Involuntary Movement Scale (AIMS) The AIMS is used to detect and monitor involuntary movements that may result from antipsychotic medications. It is crucial for identifying tardive dyskinesia and other movement disorders.

2. Glasgow Antipsychotic Side-effect Scale (GASS) The GASS helps clinicians evaluate the side effects of antipsychotic medications. It covers a wide range of potential side effects, including physical, cognitive, and emotional symptoms.

Suicide Risk Assessment

1. Columbia-Suicide Severity Rating Scale (C-SSRS) The C-SSRS is a widely used tool for assessing suicide risk. It evaluates suicidal ideation, plans, and attempts, providing a clear picture of an individual’s risk level.

2. Beck Scale for Suicide Ideation (BSS) The BSS is a self-report questionnaire that assesses the intensity of an individual’s suicidal thoughts and behaviors. It helps identify those at risk and guides intervention strategies.

Conclusion

Accurate and comprehensive assessment is the cornerstone of effective mental health treatment. By utilizing these resources, clinicians can better understand their clients’ needs and provide tailored interventions that promote healing and well-being. Regular use of these tools ensures that clinicians can track progress, adjust treatment plans, and address any emerging concerns promptly.

Filed Under: Resource

The six F’s of Trauma Responses.

July 25, 2024 by Jennifer Benjamin Leave a Comment

The 6Fs of Trauma Responses
6F’sDownload

Filed Under: Resource

Resistance from clients can be frustrating. But what does it really mean is happening?

July 22, 2024 by Jennifer Benjamin 4 Comments

Resistance from clients in systemic family therapy can be particularly frustrating for therapists, but it often signals deeper underlying issues that need to be addressed. Resistance is not simply a refusal to participate or engage; it represents a complex interaction of emotions, beliefs, and dynamics within the family system.

When clients resist, it typically means that there is a significant level of discomfort or fear regarding the changes therapy might bring. For some family members, the established patterns, even if dysfunctional, offer a sense of predictability and security. Change can threaten this stability, leading to resistance. Additionally, resistance can indicate a lack of trust in the therapist or the therapeutic process. Clients may have had negative past experiences with therapy or may not yet feel safe enough to open up and be vulnerable.

Resistance also highlights the presence of conflicting motivations within the family. Each member may have different levels of willingness to change, varying degrees of insight into the issues, and diverse perceptions of the problem. This can result in some members pushing back against the process, either overtly or subtly, to protect their own viewpoints or roles within the family.

For therapists, understanding and working through resistance involves creating a safe and supportive environment where clients feel heard and understood. It requires patience, empathy, and the ability to navigate the complex web of relationships and emotions that contribute to resistance. By addressing the root causes of resistance, therapists can help clients move past their fears and engage more fully in the therapeutic process, ultimately leading to more effective and lasting change.

Joining therapeutically is a crucial technique in systemic family therapy that can significantly help with resistance to change. The process involves the therapist actively engaging with the family system in a manner that fosters trust, rapport, and a sense of alliance. Here’s how it aids in overcoming resistance: SEE NEXT BLOG INSTALLMENT FOR JOINING!

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Enmeshed Family Systems

July 19, 2024 by Jennifer Benjamin Leave a Comment

Enmeshment refers to family dynamics where boundaries are unclear, leading to confusion in roles and expectations. In such situations, parents may excessively depend on their children for support, hindering the children from achieving emotional independence and separation from their parents.

Children raised in enmeshed families often struggle with low self-esteem and a lack of personal identity. They may find it difficult to establish and maintain healthy relationships outside the family, as they have never learned how to set appropriate boundaries or advocate for their own needs.

As adults, they might continue to feel responsible for their parents’ happiness, leading to feelings of guilt and anxiety whenever they prioritize their own needs. This can manifest in various ways, including difficulty making decisions independently, a tendency to seek constant validation from others, and an overwhelming fear of rejection or abandonment.

Healing from enmeshment involves learning to set and maintain healthy boundaries. This can be a challenging process, but it’s essential for developing a strong sense of self and building healthier relationships. Here are some steps that can help:

  1. Recognize the problem: The first step towards healing is acknowledging that enmeshment exists and understanding its impact on your life.
  2. Seek professional help: A therapist can provide valuable guidance and support as you work through the complexities of your family dynamics and develop healthier patterns.
  3. Establish boundaries: Start by identifying areas where boundaries are needed and practice setting them. This might involve limiting the amount of personal information you share with your parents or asserting your need for independence.
  4. Focus on self-care: Prioritize activities and relationships that support your well-being and personal growth. This could include pursuing hobbies, spending time with supportive friends, or engaging in self-reflection.
  5. Develop a sense of identity: Explore your interests, values, and goals separate from your family’s expectations. This can help you build a stronger sense of who you are and what you want out of life.
  6. Practice saying no: Learning to say no without feeling guilty is crucial for maintaining healthy boundaries. Remember that it’s okay to prioritize your own needs and well-being.
  7. Build a support network: Surround yourself with people who respect your boundaries and support your journey towards independence.

Remember, healing from enmeshment is a gradual process that requires patience and persistence. By taking these steps, you can begin to reclaim your sense of self and create a more balanced and fulfilling life.

Resource: https://psychcentral.com/blog/imperfect/2019/05/the-enmeshed-family-system-what-it-is-and-how-to-break-free#Common-signs-and-symptoms-of-enmeshment

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    Creating Competence From Chaos: A Comprehensive Guide To Home-Based Services (1998) by Marion Lindblad-Goldberg, Martha Dore and Lenora Stern, W.W. Norton, New York.

    Creating Competence from Chaos

    Buy On Amazon

    Children with emotional and behavioral disorders are often adrift in our society, lacking adequate mental health care or caught between several child-serving systems, such as child welfare, juvenile justice, and the schools.

    In Pennsylvania, a commitment has been made, on a statewide basis, to serve these children and strengthen their vulnerable families through a home-based approach grounded in ecosystemic thinking and practice. This book tells the story of Pennsylvania’s evolving treatment program, providing a model for other professionals who believe that a family’s needs are best met through individually tailored, family-centered, community-based, culturally competent, and outcome-oriented services.

    This is a complete, comprehensive guide, covering everything from planning and development of home-based services through supervision and training of home-based practitioners and evaluation of treatment outcomes. Particular attention is given to the clinical challenges faced by home-based therapists working with families where children are depressed and perhaps suicidal, oppositional and defiant, out-of-control and aggressive, or hyperactive/impulsive. These families commonly have multiple problems, complex histories, and a negative view of outside “helpers.”

    Delivered in the family’s home and involving parents as partners, the services described here work to improve child and family functioning through family therapy, creation of collaborative links between appropriate community and family resources, and provision of family support funds for concrete services such as transportation, respite care, and emergencies. Home-based treatment serves both children at risk for out-of-home placement due to a diagnosis of severe mental illness or behavioral disorders and children being discharged from inpatient hospitals and psychiatric residential placements.

    The authors, active at every level of program conceptualization and implementation, share their wealth of experience with readers. Their advice and case studies move from the big picture to the small details of where to sit in a family’s home, what to say, and how to think about a problematic situation. Several appendices of forms used for assessment, evaluation, and training add to the book’s practical value. Theoretically sound and fully practical, this guide to home-based services will encourage all professionals serving children to involve their families and communities-and to meet them where they live.


    Quotations from Professional Reviews

    “This book provides the blueprint for this groundbreaking care system, with practical guidelines for starting a home-based system on the right foot; maximizing collaboration…with agencies; and, most important, delivering hands-on help to at-risk children and vulnerable families. Therapy chapters run the gamut of skills needed for providing home-based care…Case examples…illustrate systemic intervention used in a variety of family situations.”
    Behavioral Science

    “This book lives up to its…promise of being a ‘comprehensive guide to home-based services.’ Clearly written with many case examples, it fills a hole in the family therapy literature.”
    Eric McCollum, The Family Therapy Networker

    “This wonderful volume takes a huge step towards specifying competence in a field that has tremendous potential. I highly recommend this pragmatic and insightful text to practitioners and administrators alike.”
    Scott W. Henggeler, Ph.D.

    “This book about home-based services is written from the perspective of three disciplines-policy making, clinical services, and research. Reading this book is like opening one of those fertile Russian nesting dolls… Even when we get to the smallest details about the training of home-based staff and the supervision and organization of treatment, we understand how they are interconnected and fit within the big picture.”
    Salvador Minuchin, MD.

    “This richly illustrated book is an excellent resource. It should be a reference for all professionals who work with children and an essential text for those who provide home-based care.”
    Lee Combrinck-Graham, MD.