Trust & Engagement with Challenging Clients. John DeCostanza, MSW Staff Therapist Community Counseling Centers of Chicago (C4). Why Engagement? . Objective Focused Obtaining Facts Thorough history Presenting Problem Risk and Resilience Factors Establishing Relationship Trust
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John DeCostanza, MSW
Community Counseling Centers of Chicago (C4)
(Cooper Altman, 2008)
Your Ct Population
Many families come…because a crisis has forced the issue, or an agency or court has mandated it. Motivation is uneven… They show up irregularly, mostly when new crises erupt. In sessions, they have trouble presenting their stories coherently. They seem in disarray as they talk over one another or talk hardly at all. Some have described these families as disorganized; I prefer the term underorganized.
Underorganization suggests not so much an improper or randomly chaotic organization as a lack of organization, a structure that has not fully developed. These structures have not achieved the constancy, differentiations, and flexibility they need to meet the demands of life.
Harry Aponte, Bread and Spirit: Therapy with the New Poor: Diversity of Race,Culture, & Values, 1994 p. 17
Definition: A collaborative, person-centered form of guiding to elicit and strengthen motivation for change.
Highlights: interpersonal; client is the locus of change & motivation; purpose is CHANGE
RESISTANCE: A battle of counter-intuition
STOP: Don’t push back or move further
DROP (back…tone it down): Monitor your own behavior (this is about you not the client).
ROLL: Come alongside the client
Responding to RESISTANCE:
STOPTeen: “Why aren’t you letting me go home with Diamond?”
DROP & ROLL
GAL: “I’m not. This is a result of your decision to live with her in the first place.” Emphasizes personal control.
GAL: “Well, what makes you think that I don’t want you to go home with Diamond?” Redoubling
GAL: “You want me to place with you with Diamond.” Reflection
Teen: Everything about school is boring. I don’t learn anything, and I don’t know why I go.
Me: It sounds like you get bored in school every day. I wonder if there’s some way that we can make classes more interesting for you.