Building Family Practice Skills Methods, Strategies, and Tools

by Ragg, D. Mark

• ISBN13: 9780534556860
• ISBN10: 0534556868
• Edition: 1st
• Format: Paperback
• Copyright: 2005-08-19
• Publisher: Cengage Learning

Summary

This book presents a transtheoretical 'response system framework' for understanding family practice. This framework organizes theoretical information, assessment protocols, skills, and intervention strategies into a learning structure that helps students understand myriad client situations and the intervention strategies that would be most appropriate for those specific situations. Using this over-arching structure, and focusing on two systems of response--action systems (how family members behave and interrelate) and processing systems (how family members interpret/feel)--Ragg guides readers through the five parts of the book with the goal of building holistic family intervention skills. These five parts are comprised of: 'Family thinking', or knowledge of family systems; 'Assessing families'; 'Building the Working Alliance'; 'Change-Focused Intervention'; and 'Working with Multi-Problem and High-Risk Families.'

Table of Contents

Preface	xv
Introduction: Toward Skills-Focused Learning	xvii
SECTION I Thinking Family	1	(88)
Thinking Family: Theories and Frameworks	3	(34)
Theoretical Grounding	3	(1)
Toward Thinking at the Family Level	4	(2)
Using Family Theory	6	(1)
Understanding Families From the Developmental Perspective	7	(3)
Developmental Premises	7	(2)
Developmental Problems and Resolutions	9	(1)
Developmental Applications to Family	10	(10)
Formation of the Adult Relationship	10	(7)
Family System Development	17	(3)
Using Systemic Premises to Understand Families	20	(14)
Systemic Concepts	21	(1)
Energy and Energy Management	21	(2)
Boundaries and Boundary Management	23	(3)
Intermember Exchanges and Control	26	(3)
Family Interaction Patterns	29	(1)
System-Subsystem Functions	30	(3)
Exercise 1.1: Identifying Theoretical Assumptions	33	(1)
Organizing Theoretical Understandings Into Practice Frameworks	34	(2)
Summary	36	(1)
Critical Content	36	(1)
Suggested Readings	36	(1)
The Four Parenting Functions	37	(32)
Theoretical Grounding	37	(2)
Parental Outcomes	39	(2)
Outcome 1: Promoting Positive Mental Health (Loveable)	39	(1)
Outcome 2: Instilling Child Limits (Limitable)	40	(1)
The Four Parental Functions	41	(1)
The Discipline Function	42	(9)
The Foundation for Limits	42	(1)
The Strategies of Discipline	43	(8)
The Guidance Function	51	(7)
Expanding Perspectives	51	(2)
Dealing With Differences, Tension, and Problem Solving	53	(2)
Developing Boundaries	55	(1)
Developing Social Roles	56	(1)
Internalizing Limits	57	(1)
The Nurturing Function	58	(4)
Physical Contact	59	(1)
Caregiving Acts	60	(1)
Verbalizations	61	(1)
The Access Function	62	(5)
Providing Support	63	(1)
Managing Boundaries	64	(1)
Exercise 2.1: Evaluating Parental Functioning	65	(2)
Summary	67	(1)
Critical Content	68	(1)
Suggested Readings	68	(1)
Cultural Influences on Family Functions	69	(20)
Theoretical Grounding	69	(2)
Parenting Functions: The Foundation for Cultural Transmission	71	(1)
The Culture Ring: Dimensions of Culture and Impact on Parenting	72	(1)
Cultural Influences on Discipline Functions	73	(1)
Abstract Mindedness	73	(1)
Systems of Sanctioning	74	(1)
Cultural Influences on Guidance Functions	74	(3)
Experience of Difference	75	(1)
Values and Religion	76	(1)
Cultural Influences on Nurturing Functions	77	(2)
Collectivism Versus Individualism	77	(2)
Roles and Expectations	79	(1)
Cultural Influences on Accessibility Functions	79	(4)
Systems of Support	80	(1)
Social and Economic Resources	81	(1)
Working With Invisible Cultures	81	(2)
Managing Culture With Issues of Family Violence	83	(4)
Exercise 3.1: Cultural Influences	85	(2)
Summary	87	(1)
Critical Content	87	(1)
Suggested Readings	87	(2)
SECTION II ASSESSING FAMILIES: AN INTRODUCTION	89	(114)
Exploration and Data Collection With Families	91	(38)
Theoretical Grounding	92	(1)
Exploring Situations With the Family	93	(13)
Targeting the Question	94	(2)
Setting Up the Question	96	(1)
Posing the Question	97	(5)
Follow-Up	102	(1)
Exercise 4.1: Transitional Tracking	103	(3)
Data Gathering Through Observation	106	(15)
Observing Family Processing	107	(5)
Observing Family Actions and Interactions	112	(6)
Exercise 4.2: Observing Family Processing	118	(3)
Using Projective Techniques to Gather Data	121	(2)
Draw a Family	122	(1)
Family Sculpting	122	(1)
Family Dances	123	(1)
Family Metaphors	123	(1)
Using Standardized or Structured Questionnaires	123	(3)
Reliability	124	(1)
Validity	124	(1)
Test Types	125	(1)
Using Data Collection and Exploration Skills	126	(1)
Summary	127	(1)
Critical Content	128	(1)
Suggested Readings	128	(1)
Structuring the Family Exploration	129	(44)
Theoretical Grounding	129	(1)
Assessment Frameworks	130	(1)
The Family Genogram	130	(7)
Exercise 5.1: Developing a Genogram	134	(3)
The Four-Cell Assessment of Inherited Family Models	137	(10)
Cell 1: Genetic and Biological Influences	138	(1)
Cell 2: Environmental Influences	138	(2)
Cell 3: Beliefs and Cognitive Influences	140	(2)
Cell 4: Behavior and Interactions	142	(1)
Using the Four-Cell Model: Finding ``Rubs'' and ``Gaps''	142	(3)
Exercise 5.2: Assessing a Romantic Relationship	145	(2)
The Parenting Functions Framework	147	(12)
Assessing the Discipline Function	147	(3)
Assessing the Guidance Function	150	(2)
Assessing the Nurturing Function	152	(3)
Assessing the Access Function	155	(3)
Making the Assessment	158	(1)
The Risk Assessment Framework	159	(12)
Actuarial Approaches to Risk Assessment	160	(1)
Psychometric Methods of Risk Assessment	161	(1)
Clinical Approaches to Risk Assessment	162	(2)
Indicators of High Immediacy	164	(2)
Indicators of Potential Dangerousness	166	(2)
Assessing the Emergence of Risk	168	(1)
Exercise 5.3: Risk Assessment	169	(2)
Summary	171	(1)
Critical Content	172	(1)
Suggested Readings	172	(1)
Moving From Assessment to Treatment	173	(30)
Theoretical Grounding	173	(1)
Toward Formalizing the Assessment	174	(1)
Identifying Critical Data Themes	174	(2)
Attributing Meaning to the Array of Themes	176	(2)
Organizing the Information	176	(1)
Generalizing the Meaning	177	(1)
Inferring Potential Solutions	178	(1)
Elements of the Assessment Report	179	(13)
Sample Family Assessment	181	(10)
Exercise 6.1: Formal Assessment Elements	191	(1)
Developing Treatment Goals	192	(9)
Formulating Goal Statements	193	(1)
Establishing Objectives	194	(1)
Additional Contracted Elements	195	(1)
Sample Plan of Care	196	(3)
Exercise 6.2: Goal Setting	199	(2)
Summary	201	(1)
Critical Content	201	(1)
Suggested Readings	201	(2)
SECTION III Building the Working Alliance	203	(92)
Preliminary Engagement With Family Members	205	(28)
Theoretical Grounding	206	(1)
The Challenges of Engagement	206	(2)
Level 1: Tentative Engagement	208	(6)
Getting People to the Session	208	(2)
Facilitating Initial Interest	210	(2)
Exercise 7.1: Tuning in and Pitching Treatment	212	(2)
Level 2: Building Investment in the Working Alliance	214	(9)
Affirming Individuals to Build Family Focus	214	(1)
Establishing an Atmosphere for Work	215	(6)
Exercise 7.2: Toward the Working Relationship: Identifying Areas for Exploration	221	(2)
Developing a Sense of Purpose	223	(8)
Building on Perspective Overlaps	223	(3)
Framing the Situation to Promote Collaboration	226	(3)
Exercise 7.3: Toward Building a Sense of Purpose	229	(2)
Summary	231	(1)
Critical Content	232	(1)
Suggested Readings	232	(1)
Interactive Engagement With Family Members	233	(26)
Working With Family Energy During Interactive Engagement	233	(2)
Blocking Automatic Patterns of Reacting	235	(6)
Interrupting Automatic Responses	236	(1)
Internalizing the Focus	237	(1)
Shifting From Action to Processing Systems	237	(1)
Validating Experiences and Perspectives	238	(3)
Neutralizing Negative Energy	241	(5)
Positive Illumination	241	(1)
Continued Validation	241	(1)
Identifying Overlapping Themes	242	(1)
Cycling Back to Neutral Territory	242	(2)
Exercise 8.1: Blocking Automatic Reactions and Neutralizing Energy	244	(2)
Building Common Ground	246	(3)
Closing Gaps Between Family Members	246	(3)
Developing a Foundation for Change	249	(6)
Highlighting Shared Needs and Desires	249	(1)
Developing a Shared Problem Definition	249	(1)
Identifying Direction for Change	250	(3)
Exercise 8.2: Building Common Ground	253	(2)
Summary	255	(1)
Critical Content	256	(1)
Suggested Readings	257	(2)
Positioning Families for Change	259	(36)
Theoretical Grounding	259	(1)
Toward Positioning for Change	260	(1)
Understanding Homeostasis	261	(1)
Working With Motivating Affect	261	(4)
Feelings That Motivate Change	262	(1)
Recognizing Feelings and Emotions	263	(1)
Exercise 9.1: Positioning Family Members for Change	263	(2)
Developing Two Visions: Change Versus Nonchange	265	(5)
Identifying the Visions	265	(1)
Assessing the Balance	266	(2)
Exercise 9.2: Change and Counterchange Forces	268	(2)
Positioning Family Members for Change	270	(4)
Allying With Motivating Feelings	270	(2)
Communicating the Dual Visions	272	(1)
Juxtaposing Visions	273	(1)
Strategies of Positioning	274	(19)
Punctuated Positioning	274	(11)
Exercise 9.3: Using the Two Visions	285	(2)
Interactive Positioning	287	(4)
Exercise 9.4: Interactive Positioning	291	(2)
Summary	293	(1)
Critical Content	294	(1)
Suggested Readings	294	(1)
SECTION IV Change-Focused Intervention	295	(96)
Direct Change Strategies for Influencing Family Action Systems	297	(30)
Theoretical Grounding	297	(2)
Changing Action Systems	299	(1)
Actor-Model Strategies	299	(3)
Modeling Interventions	300	(1)
Role-Playing Interventions	301	(1)
Exercise 10.1: Actor-Model Strategies	301	(1)
Educator-Coach Strategies	302	(11)
Maintaining Family Empowerment Through ``CARE''	302	(1)
Using Educator-Coach Strategies	303	(8)
Exercise 10.2: Educator-Coach Strategies	311	(2)
Behavior Interruption Strategies	313	(4)
Time-Out Strategies	313	(1)
Cuing Strategies	314	(1)
Scheduling Strategies	315	(1)
Pattern Interruption Strategies	316	(1)
Weight-Shifting Strategies	317	(7)
Contingency Contracting	317	(2)
Establishing Ordeals	319	(1)
Pairing Stimuli	320	(1)
Behavioral Contracting	320	(1)
Reinforcing Behavior	321	(1)
Exercise 10.3: Using Behavior Interruption and Weight-Shifting Strategies	321	(3)
Summary	324	(1)
Critical Content	324	(1)
Suggested Readings	325	(2)
Direct Change Strategies for Influencing Family Processing Systems	327	(38)
Theoretical Grounding	327	(2)
Identifying Processing Themes and Patterns	329	(6)
Shifts in Focus	330	(1)
Repeated Themes	330	(1)
Reaction Intensity	331	(1)
Cognitive Distortion	331	(1)
Exercise 11.1: Identifying Underlying Processing Elements	332	(3)
Highlighting Processing Themes and Patterns	335	(7)
Critical Skills for Highlighting	336	(1)
Critical Description Skills	336	(4)
Critical Reflecting Skills	340	(1)
Exercise 11.2: Highlighting Family Processing	341	(1)
Challenging Current Systems of Processing	342	(6)
Reconstructing Beliefs	343	(1)
Overgeneralizing Beliefs	344	(1)
Amplifying Beliefs	345	(1)
Cognitive Restructuring	346	(1)
Direct Challenges	347	(1)
Altering the Experience of Events	348	(14)
Influencing Internal and External Dimensions	350	(6)
Influencing Positive and Negative Dimensions	356	(4)
Exercise 11.3: Challenging Beliefs	360	(2)
Summary	362	(1)
Critical Content	363	(1)
Suggested Readings	363	(2)
Influencing Family Members Through Indirect Strategies of Change	365	(26)
Theoretical Grounding	365	(1)
Using Indirect Methods of Influence	366	(1)
Indirect Resource Activation	366	(13)
Meaning Attribution Exercises	367	(1)
Visualization and Guided Imagery	368	(2)
Analogies and Metaphors	370	(3)
Storytelling Techniques	373	(2)
Symbolic Expressive Interventions	375	(3)
Exercise 12.1: Internal Resource Activation	378	(1)
Working Through Others in the Family Environment	379	(10)
Changing Responding Systems	380	(2)
Engaging Supports	382	(2)
Negotiating Room for Change	384	(1)
Exercise 12.2: Indirect Intervention Through the Environment	385	(4)
Summary	389	(1)
Critical Content	390	(1)
Suggested Readings	390	(1)
SECTION V Working With Multiproblem and High-Risk Families	391	(76)
Challenges and Promise	393	(22)
Theoretical Grounding	393	(2)
Toward Helping Multiproblem and High-Risk Families	395	(1)
Challenges to Family Resources	395	(2)
Educational Achievement and Marketable Skills	395	(1)
Financial Resources	396	(1)
Available Supports	397	(1)
Challenges of Adaptation	397	(12)
Intergenerational Family Violence	398	(1)
Domestic Violence	399	(3)
Ineffective Parenting and Socialization	402	(1)
Mental Illness and/or Disability	403	(1)
Parental Substance Abuse	404	(3)
Exercise 13.1: Understanding Multiple Stressors	407	(2)
Challenges to Traditional Treatment Approaches	409	(2)
Promising Approaches to Treatment	411	(2)
Group Treatment	411	(1)
In-Home Support	412	(1)
Multisystemic Treatment	412	(1)
Summary	413	(1)
Critical Content	413	(1)
Suggested Readings	414	(1)
Multiagency Work	415	(32)
Theoretical Grounding	415	(1)
Understanding Systemic Family Stresses	416	(3)
Formal Support Services	419	(4)
The Level of Autonomy	420	(1)
The Level of Fit	420	(3)
Collaborative Support Functions With Multiple Helping Systems	423	(11)
Collaborative Support With Other Professionals	423	(2)
Collaborative Support With Family Members	425	(7)
Exercise 14.1: Support Functions	432	(2)
Case Advocacy	434	(4)
Exercise 14.2: Case Advocacy	437	(1)
Class Advocacy	438	(7)
Exercise 14.3: Class Advocacy	443	(2)
Summary	445	(1)
Critical Content	445	(1)
Suggested Readings	446	(1)
Support-Focused Intervention	447	(20)
Theoretical Grounding	447	(1)
Support-Based Interventions	448	(1)
Principles for Intervention	448	(2)
Maintaining a Family Focus	449	(1)
Maximizing Support and Mutual Aid	449	(1)
Avoiding Traditional Responses	450	(1)
Using Group Work Methods	450	(9)
Developing the Group Structure	452	(3)
Establishing Interpersonal Processes	455	(2)
Exercise 15.1: Group Intervention	457	(2)
In-Home Work With Families	459	(3)
Community-Based Family Interventions	462	(3)
Working Through Host Settings	463	(1)
Working Through Community-Based Partners	464	(1)
Summary	465	(1)
Critical Content	465	(1)
Suggested Readings	466	(1)
References	467	(29)
Index	496