Therapeutic Engagement of Therapeutic Engagement of Women Who Have Been Women Who Have Been

Mandated to Participate in Mandated to Participate in TherapyTherapy

Ann Marie Dewhurst, Ph.D.Ann Marie Dewhurst, Ph.D.

Karen M. Nielsen, Ph.DKaren M. Nielsen, Ph.D

Athabasca University Athabasca University

November 7, 2008November 7, 2008

Common Mandating AgentsCommon Mandating Agents

Criminal Justice SystemCriminal Justice System Parole or Probation systemsParole or Probation systems Drug CourtDrug Court

Child Protection ServicesChild Protection Services Return of children from protective careReturn of children from protective care Prevention of children being taken into carePrevention of children being taken into care

Family Court ServicesFamily Court Services Participation in high conflict parenting Participation in high conflict parenting

situationssituations Family violence situationsFamily violence situations

Motivation to helpMotivation to help

Mandatory response to criminal Mandatory response to criminal activityactivity

Concern for well-being and health of Concern for well-being and health of the woman.the woman.

Protection of children and vulnerable Protection of children and vulnerable peoplepeople

Protection of communityProtection of community

Women and Acting Out Women and Acting Out

Mad or badMad or bad More deviant or flawed for same actsMore deviant or flawed for same acts

Motivations for therapyMotivations for therapy

Sincere interest in changeSincere interest in change

A means to an endA means to an end

Avoid negative consequencesAvoid negative consequences

Woman Centred WorkWoman Centred Work

Professional helpersProfessional helpers

Strategies used to engage resistant Strategies used to engage resistant women women

Bringing People TogetherBringing People Together

Engage people in a shared viewEngage people in a shared view Ensure that mandates are made Ensure that mandates are made

explicitexplicit Demonstrate respect for mandatesDemonstrate respect for mandates Build common goals to meet client Build common goals to meet client

and system needs.and system needs.

Risk and Need AssessmentRisk and Need Assessment

Describes problem behaviourDescribes problem behaviour

Determines potential barriers to changeDetermines potential barriers to change

Determines strengths and supportsDetermines strengths and supports

Identifies treatment goalsIdentifies treatment goals

A few ethical issues before we A few ethical issues before we begin any intervention begin any intervention (O’hare, 1996)(O’hare, 1996)

Gain specifics of the mandate the woman is facing. Gain specifics of the mandate the woman is facing. Explore the woman’s understanding of the mandate & Explore the woman’s understanding of the mandate &

consequences of participating or not participating in consequences of participating or not participating in therapy.therapy.

Ensure goals of the intervention process are understood Ensure goals of the intervention process are understood & agreed to by the woman & mandating agency.& agreed to by the woman & mandating agency.

Ensure that reporting requirements are clear & Ensure that reporting requirements are clear & acceptable to both the woman & the mandating agency. acceptable to both the woman & the mandating agency.

Acknowledge existing dual rolesAcknowledge existing dual roles..

Feminist Counselling Feminist Counselling PrinciplesPrinciples

Egalitarian relationshipEgalitarian relationship The person is politicalThe person is political Valuing the female perspectiveValuing the female perspective

Good Lives ModelGood Lives Model

There are nine basic human goalsThere are nine basic human goals1.1. Life Life (Healthy living, optimal physical functioning, sexual satisfaction)(Healthy living, optimal physical functioning, sexual satisfaction)

2.2. KnowledgeKnowledge3.3. Excellence in work and play Excellence in work and play (including mastery (including mastery

experiences)experiences)

4.4. Excellence in agency Excellence in agency (autonomy and self-directedness)(autonomy and self-directedness)

5.5. Inner peace Inner peace (freedom from emotional turmoil and stress)(freedom from emotional turmoil and stress)

6.6. Relatedness Relatedness (including intimate, romantic and family (including intimate, romantic and family relationships)relationships)

7.7. Spirituality Spirituality (broad sense of finding meaning and purpose in life)(broad sense of finding meaning and purpose in life)

8.8. HappinessHappiness9.9. CreativityCreativity

Basic Problems Leading to Basic Problems Leading to OffendingOffending

Problems of means used to attain goals Problems of means used to attain goals

Lack of scope within a good life planLack of scope within a good life plan

Presence of conflict among goals or confusion between Presence of conflict among goals or confusion between goalsgoals

A lack of the necessary capacities to form & adjust a A lack of the necessary capacities to form & adjust a Good Life plan in response to changing circumstances.Good Life plan in response to changing circumstances.

Understanding the woman’s Understanding the woman’s contextcontext

Resiliencies

Cultural Context

Social Supports

PowerDynamics In family

Family structure

Past trauma experiences

Overall level of functioning

Financial situation

Woman whox has offended

Stages of ChangeStages of Change

I don’t have a problem – you doI don’t have a problem – you do There is a problem – I am not sure There is a problem – I am not sure

what it is or what to do about it.what it is or what to do about it. Learning about what I need so I can Learning about what I need so I can

fix what is wrongfix what is wrong Putting my plan into actionPutting my plan into action Figuring out if my plan works and Figuring out if my plan works and

tweaking it until it doestweaking it until it does

Therapeutic EngagementTherapeutic Engagement

Working WithNurturingExpressiveSeekingEngagingCollaborative

AmbivalentQuestioningLostUnsureFrustratedHelplessStressedConfusedDistancing/ avoidant

Working AgainstAngryOverwhelmedDefiant“antisocial”DefensiveHopelessRejecting / avoidant

Fear and ResistanceFear and Resistance

Resistance is not futileResistance is not futile

Women mandated to therapyWomen mandated to therapy Have experience resisting. Have experience resisting.

Resistance is how they have survived. Resistance is how they have survived. We do what we know. Coping strategies previously We do what we know. Coping strategies previously

called upon return and are sometimes amplified.called upon return and are sometimes amplified. It may not be efficient but it is better than no response.It may not be efficient but it is better than no response.

May be survivors of abuse themselves and may be coping May be survivors of abuse themselves and may be coping with PTSDwith PTSD

Are often socially isolated with few positive supportsAre often socially isolated with few positive supports ..

Push & PullPush & Pull

PushingPushing = forcing someone to act where they have no = forcing someone to act where they have no option but to obey.option but to obey. Based on another having authority that impacts the needs Based on another having authority that impacts the needs

of the person.of the person. The level of threat is perceived as high and real.The level of threat is perceived as high and real.

PullingPulling = creating conditions the person choses = creating conditions the person choses themselves. themselves. showing them how something else will be beneficial to showing them how something else will be beneficial to

them. them. They decide rather than just you deciding. They decide rather than just you deciding.

PushPush

Short term option.Short term option. Creates fearCreates fear

Create the crisis in some casesCreate the crisis in some cases Requires the least effort from Requires the least effort from

external sources.external sources. Works in situations where you just Works in situations where you just

need to get people moving.need to get people moving.

Starting to PullStarting to Pull

Where and how you’ve lived Where and how you’ve lived influences how you understand influences how you understand reality – experience matters.reality – experience matters.

The words you use can be liberating The words you use can be liberating or limiting – our reality is reflected in or limiting – our reality is reflected in our language.our language.

Starting to PullStarting to Pull

We have to have a vision to move to We have to have a vision to move to before change can happen.before change can happen. stories of change help to model change. stories of change help to model change. The stories we experienced influence The stories we experienced influence

our ability to see possibilities and have our ability to see possibilities and have hope.hope.

When we shift our viewpoint within When we shift our viewpoint within our own stories we see new options our own stories we see new options for alternative truths.for alternative truths.

Understanding TroubleUnderstanding Trouble

Trouble Hibernates

Trouble Enters and settles in

Trouble shows its

face

Coping with

trouble’s wake

InterventionIntervention

Therapeutic StoriesTherapeutic Stories

Listen to major themes in the Listen to major themes in the presented story.presented story.

The Backpack StoryThe Backpack Story

Transforming ResistanceTransforming Resistance

Clarify the dominant stories Clarify the dominant stories Look for alternative stories where themes of action, Look for alternative stories where themes of action,

cooperation and collaboration exist.cooperation and collaboration exist. Negotiate what aspects of the story needs to be changed and in Negotiate what aspects of the story needs to be changed and in

what order. what order. Find agreement.Find agreement. Create change strategies highlighted in alternative stories part Create change strategies highlighted in alternative stories part

of a more dominant story – one of hope rather than resistance of a more dominant story – one of hope rather than resistance & despair.& despair.

Clarify what might need to happen for more change to occur Clarify what might need to happen for more change to occur on the shared goals.on the shared goals.

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