Module 5: Lesson 3

Practicing Your Skills in Selecting Your Pathway and Goals for Treatment

Worksheet

FST Digital Advanced Training Course12 FST Techniques to Become a Family Trauma Expert

1

Lesson 3Practicing Your Skills in Selecting Your

Pathway and Goals for TreatmentThis worksheet will help you practice your skills in selecting your pathway (stabilization, active trauma, or hybrid) and setting your goals for treatment. You are encouraged to re-watch my consultation with Sandra in your Lesson #3 video and practice using your Three Rules of Thumb + 1 Hybrid Handout. And then practice setting your goals for treatment.

This worksheet is designed to help you:

• Examine an intensive case study to practice using your Three Rules of Thumb + 1 Hybrid Handout to sharpen your skills in your pathway choice of stabilization, active trauma, or a hybrid recommendation.

• Practice setting the goals of treatment.

• Thought-provoking questions are used to elicit critical thinking and as an on-ramp to the discussion at your next Facebook Group.

Two Action Steps#1 – �Practice�Your�Three�Rules�of�Thumb�+�1Re-Watch the Intensive Case Study with Sandra (13:17 –19:03)Re-watch the intense discussion between myself and Sandra over the rationale to choose stabilization first.

Table 1 illustrates the two rules of thumb that were debated between Sandra and me.

Questions to Ask YourselfAs you re-watch the debate, ask yourself and answer these questions:

1. Would you have recommended a stabilization only path based on the assessment data and the child and mother’s seed and symptom picks?

________________________________________________________________ ________________________________________________________________ ________________________________________________________________ ________________________________________________________________

2

Or

2. Would you have chosen a different path? And if “yes” or “no,” why or why not?

________________________________________________________________ ________________________________________________________________ ________________________________________________________________ ________________________________________________________________

And

3. Do you think based on the discussion between Sandra and me that the trauma of dad’s constant deployments were “small paper cuts” that simply exacerbated problem behaviors in the child that was already there?

Or do you think that the problem symptoms with the daughter were primarily based on the dad’s emotional distance and the marital stress that the girl is caught in the middle of?

________________________________________________________________ ________________________________________________________________ ________________________________________________________________ ________________________________________________________________

Please write down your answers and then join the next scheduled Facebook Live Group as we debate these questions and answers together.

You can then compare your answers with this discussion.

3

#2 – �Practice�Your�Goal�SettingRe-Watch the Intensive Case Study with Sandra (19:47 –24:56)In this part of the consultation, I provide Sandra with the following recommendation for the goals of treatment:

✔ Meet with just the parents for the next session around safety first

✔ To clarify their roles as parents who must put aside their differences for the sake of their daughter.

Questions to Ask YourselfAs you re-watch this part of the video lesson, ask yourself, and answer these questions:

1. Based on the entire case discussion, is this a goal of treatment you would have also pursued? Why or Why not?

________________________________________________________________ ________________________________________________________________ ________________________________________________________________ ________________________________________________________________

Table 1: Two Rules of Thumb Discussed in Case Study

Rule of Thumb #1: Chronicity, Bitterness, and Burn Out Levels

1. Are the behaviors extreme and happen almost every day or at least once a week? (i.e., aggression, extreme disrespect, running away, alcohol or drug use, self-harm, suicidal ideation, refusal to attend school, etc.)

2. Are the parents or caregivers extremely burnt out and overwhelmed?

3. Are the parents or caregivers extremely angry, bitter, or resentful toward their child?

Recommendation: If “YES” to all 3 Questions: Stabilization First

Rule of Thumb #2: Timing or Onset of the Child’s Problem Symptoms

1. Were the problem behaviors with the child or adolescent present before the wounds occurred and simply got worse after the traumatic event?

2. OR did they only emerge after the trauma took place?

Recommendation: Stabilization First if “YES” to Question #1 and Active Trauma Work First if “YES” to Question #2

4

2. And if “no?” what would your recommendations be, and what would it look like?

________________________________________________________________ ________________________________________________________________ ________________________________________________________________ ________________________________________________________________

This is a difficult case because of the extreme marital problems and that the parents have not asked for marital therapy. However, the stress of the marriage is clearly spilling over to the daughter, who is stuck in the middle. But if you push the marriage issue at all or too far, the risk is that these parents may not show up for another session. If this happens, the daughter will suffer and get worse. So, the question is:

3. What would you do? How would you indirectly or directly connect the dots between marital problems and the daughter’s symptoms vs. bypassing the martial issues altogether?

Marital problems are a “hot potato” when the child symptoms and unresolved trauma is a direct result of a dysfunctional marriage, yet the parents are not there for marital therapy but kid therapy only.

________________________________________________________________ ________________________________________________________________ ________________________________________________________________ ________________________________________________________________

As with the first action step, please write down your answers and then join the next scheduled Facebook Live Group as we debate these questions and answers together.

You can then compare your answers with this discussion.

5

Success MilestonesAfter you complete this Lesson #3 worksheet look for this success milestones to see immediate positive outcomes in your practice:

✔ Practicing Skills with Community Helps – Often, we do not apply new tools using a thought-provoking case analysis. New tools are learned on our own without the benefit of debate or interactive critical thinking and discussions.

To address these challenges, this worksheet was created with specific video clips to re-watch and very strategic questions to answer and debate within your next Facebook Group.

Iron sharpens iron. This means that the questions in this worksheet, coupled with the interaction and debate of the FST Community in your Facebook Group, will enhance your practice.

Big Ideas: Lesson 3 VideoStress Chart and Case History

✔ You receive a bird’s eye view of what FST Certification can look like.

✔ Sandra graduated from the Advanced Training Course. After graduation, Sandra enrolled in FST Certification.

✔ This means that Sandra is now getting direct consultation to onboard a case using the entire FST Model.

✔ Sandra initially presents her stress chart and case history.

✔ After we get the family’s top seed and problem selections, the overall goal of this consult is for Sandra to get my recommendation on stabilization, active wound work, or a hybrid approach.

Child�and�Parent�Seed�and�Problem�Picks ✔ I highlighted the adolescent’s pick and the parent’s selection with an emphasis

on mom

✔ Mom decides to turn the definition of the Misuse of Power seed from the child to describe her emotionally absent husband, who misuses his power.

6

✔ Sandra describes the tight rope she must walk on to keep the session from going into marital therapy and imploding. The key ingredient she describes is her use of “compassion.”

The�Moment�of�Truth:�Stabilization,�Active�Trauma,� or�a�Hybrid

✔ Here you see Sandra’s rationale for Stabilization first because of the tremendous burn out she sees in both parents.

✔ In the FST Consultation process, Sandra is part of a small group. She gets excellent support and suggestions from other colleagues. You will hear what this kind of support looks like.

✔ In this worksheet, you are asked to answer questions on whether you agree with the stabilization only pathway? And if you do not agree, what would your choice be and why?

Next Steps ✔ Here you see the next steps. Within this direct consultation format, Sandra asks

me what the next steps around this FST Technique are?

✔ I give a specific suggestion of meeting with just the parents for the next session around safety first that is indirect to the marriage but clarifies their roles as parents who must put aside their differences for the sake of their daughter.

✔ You are asked in this worksheet to comment directly on these recommendations and think about “what would you do?” if you were in my shoes.

Please Note: Materials that are included in this course may include interventions and modalities that are beyond your authorized practice as a mental health professional, case manager or parent support liaison. As a professional, you are responsible for reviewing your scope of practice, including activities that are defined in law as beyond the boundaries of practice in accordance with and in compliance with your professions standards.