During AAMFT's monthly Twitter chats, Tracy Todd discusses a topic of interest with other tweeters, offering his insight as an MFT and Executive Director of AAMFT. In the past, he's talked about stuck cases, developing a clinical specialty, social responsibility, and more. Explore the past twitter chats here!
This month, Tracy talked about a topic he's passionate about- the diminishment of MFT as a profession. Scroll through the tweets to learn how you can help advance your profession. Have thoughts to share? You can reply, retweet, or favorite right from here. We hope you will join us on twitter next month, November 2 at 3 PM ET.
When you’re working with clients, how do you know when you are stuck? What is your first reaction when you realize you are stuck? What do you do?
The answer to these three questions should NOT be attributed to your client. When stuck, there are four areas about you and your therapy process to examine: theory, attitude, process, and outcome.
Theory. First, examine if your theory about therapy is creating a positive change barrier. If you are more focused on your theory than your client, you are probably not listening well and looking to prove your theory.
Attitude. Is your attitude pathologically or strength based? A pathological attitude can understandably create resistance from clients. An outcome of pathological attitude can be historical intimidation, which can overwhelm you as a therapist. In these situations, ask yourself what is triggering this negative attitude towards your client(s). Then, try to engage in a session devoted to assessing strengths, resilience, and includes future-oriented talk. If you are challenged by historical intimidation and cannot engage in future talk, consider at least peer consultation. Often, therapists claim clients will not engage in strength-based talk. Simply, that’s blaming the client for your stuckness.
Process. Are you spending too much or too little time in process talk? It is also possible that your process talk is not what the client wants processed. The outcome of this dynamic is clients not feeling heard, or feeling hopeless because of little change. If process is a stuck point, then monitor and evaluate your in-session talking points. Process talk is oriented towards feelings, history, and thoughts about the presented problem.
Outcome. Outcome talk is oriented toward actions, change, and tasks. Too much or too little outcome talk can lead to clients not feeling heard or not gaining positive therapy momentum. It is possible that outcome talk is missing the target and clients will be understandably confused or resistant.
As you can see, before labeling clients as resistant or unmotivated, there are many steps to take.
Asses if your theory or attitudes towards your client(s) are barriers
Assess if you are too focused on process or outcome in therapy
Continuously monitor your internal processes and external actions to evaluate what heightens client receptivity
Use this matrix/flow chart as a reminder (click to enlarge)
A healthy therapist should possess excellent insight about their own contributions to a stuck therapy situation. As you learn what increases receptivity, do more of it and you will experience fewer stuck cases.
AAMFT has clearly outlined the major reasons behind the proposed restructuring: market competitiveness, engaged members, anticipating needs of the next generation of therapists. What I would like to address is the necessity for AAMFT to become a leader of relevance in the behavioral healthcare profession.
Another way to view leadership of relevance is "being at the table." We have done well the last few years with such events as being invited to the White House conference on Mental Health, having Rep. Kennedy as a keynote speaker, and being invited to comment on such matters as integrated health care and high risk practice guidelines by the American Psychological and Psychiatric Associations.
These invitations represent AAMFT moving toward a position of respect and credibility by high level policy makers and our sister associations. While these opportunities represent marriage and family therapists making good progress as respected professionals, it simply isn't enough. Not a week goes by that I see an article, policy statement, or conference with non MFT presenters commenting about family and family therapy. We have many members with excellent credentials to speak and advance the systemic/relational paradigm. Yet, we lack means to capitalize on the intellectual capital of our esteemed members.
One advantage of restructuring is the ability for members with specific clinical/topical interests to network and share their knowledge, skills and experience. Since all interest groups will need to create deliverables (white papers, briefs, core competencies), these groups will provide AAMFT the necessary information to begin taking more of an active leadership role in the behavioral health community. Rather than AAMFT being invited to a table, AAMFT might soon recognize the ability to set the table and invite others to dinner.