Enhancingand( invigorang ( therapy’s(conversaonal...
Transcript of Enhancingand( invigorang ( therapy’s(conversaonal...
Enhancing and invigora-ng therapy’s conversa-onal work: collabora-ve inquiries with
clients and colleagues O<ar Ness
o<ar@o<arness.com Buskerud University College,
Trondheim Family Therapy Centre, Norway &
Tom Strong [email protected] University of Calgary, Canada
Workshop at TCX May 11 2012
overview • WHY learn Johnella Bird’s relaHonal language-‐
making pracHces TOGETHER?
• HOW we learned Johnella Bird’s relaHonal language-‐making pracHces TOGETHER?
• Involving clients in therapist’s learning processes
• How to start learning groups TOGETHER – learning new ideas and pracHces as a shared inquiry
Trondheim Family therapy centre (TFTC)
-‐ TFTC is one of Norway’s largest public family therapy centres, with client services paid for by the Norwegian government
-‐ 20 therapists that represent a mixture of professions (e.g., social workers, psychologists, pedagogues) and theoreHcal orientaHons to pracHce (e.g., systemic, narraHve, EFT, EMDR, SoluHon-‐focused, collaboraHve therapy etc.)
Why learn Johnella Bird’s rela-onal language-‐making approach together?
• Inspira-on and new ideas for enhancing our work as couple therapists
• Helping couples become more mindful of their language use and its effects on their relaHonship, AND our own parallel challenge of in becoming mindful in using language with couples in therapy
• Curious about what would happen as we learned together, using video for self-‐supervision, group-‐supervision and in discussions about our clinical conversaHons (learning from our learning).
Johnella Bird’s rela-onal language-‐making prac-ces
• RelaHonal externalizing conversaHons
• NegoHaHng language use to move from individual meanings to relaHonal meanings
• NegoHaHng power-‐relaHons Johnella Bird: h]p://www.cybersoul.co.nz/hearts/
Bird’s Rela-onal language-‐making
• How well are couples served by the language they use in describing their relaHonship, and each other?
• ReflecHng on the taken-‐for-‐granted in language use
• TherapeuHc dialogue as opportuniHes to reconnect with intenHons and re-‐negoHate more mutual language use.
• From ‘I’ language to ‘we’ language?
Rela-onal language-‐making: Co-‐construc-ng we-‐ness
• Shared meaning? (therapist & client, client/client)
• NegoHaHng meaning & relaHonships?
• NegoHaHng meaning/affirming words and gestures blames
• Tomm’s PIPs & HIPs -‐ defends
Nego-a-ng Discursive tensions
Accomplishing the acceptably familiar? • “Dissonance” as feeling torn between discourses • Discourses as immune systems • RelaHonally inviHng and welcoming
Tensions – discursive communi-es
!
Research ques-on
• How do therapists interpret their learning experiences in using Johnella Bird’s relaHonal
language-‐making approach – from training
exercises, reviews of videotaped pracHce, self-‐
and group-‐supervision, and client comments?
Chronology of the learning process a) We (five therapist colleagues) met every other week for two hours from
Aug 2008-‐April 2009. Reading, discussing Bird’s books, CDs, DVDs
b) We recruited 5 couples to parHcipate Oct 2008-‐Febr 2009
c) Video-‐recorded the therapeuHc conversaHons where Bird’s approach was being used.
d) Selected passages (e.g., CPA) from the video-‐recorded sessions for self-‐supervision, group-‐supervision, and client feedback
e) This was a back-‐and-‐forth-‐process between reflecHons and pracHce up to a point where Bird’s pracHces became a part of our normal work with couples in therapy
f) We wrote ‘Learning journals’ through the whole learning process.
Inquiry as Change
• Learning together without pre-‐determined processes and criteria
• Vygotsky’s tool and result learning processes
• ImprovisaHon and growing a head taller /versus learning scripts
• Socially construcHng what counts as valid learning/meaning? Tensions
Cri-cal Intersubjec-vity?
Good on people / exacHng on ideas & pracHces • Social construcHon of validity?
• EffecHve not correct ideas/language/pracHces
• Is negoHaHng meaning negoHaHng relaHonships?
Co-‐opera-ve Inquiry
• AcHon Research methodology
• Co-‐operaHve Inquiry (Heron, 1996) – a form of CollaboraHve Inquiry used to facilitate our shared learning process: • Co-‐operaHve Inquiry is a form of collaboraHve,
parHcipaHve, person-‐centred inquiry, which does research with people not on or about them
• Involving two or more people researching a topic through their own experience of it
• Using a series of cycles in which parHcipants move between this experience and reflecHng together on it
Situa-onal analysis (SA)
• Developed by Adele E. Clarke (2005)
• Derived from Grounded Theory, Clarke supplemented basic GT methods with a situaHon-‐centered approach influenced by postmodernism.
• She did this by offering an innovaHve method that uses situa.onal maps to analyze a wide range of narraHve, discourse, and visual data
• Three mapping strategies: • Abstract situaHonal maps (Messy version, ordered version and relaHonal
analysis) • Social Worlds/Arenas map • PosiHonal map
Therapists’ comments on the learning process • The experience of using video for self-‐supervision, group
supervision and showing back to clients has been the most important learning process. (Mia, therapist, Nov 11 2008)
• This way of learning has worked be>er for me instead of going to lots of seminars and workshops. Now we are in a process and you feel involved and always learning something new – that I can ul.mately use conversing with clients. (John, therapist, Dec 9 2008)
• The most important for me has been the group discussions where we have been learning together in a structured process (Mary, therapist, Oct 28 2008)
Therapists’ comments on the learning process
• ”Using video for looking at my development in learning Bird’s approach has been very exci.ng and useful for me (…) when looking at the video-‐recordings I saw that I had learned more than I thought. … I should include video-‐recorded sessions more oIen as part of my daily work as a therapist, for my own development, but also as sort of an interven.on.” (Lisa at group meeHng October 10, 2008)
• ”We need to be careful about how to recruit clients to par.cipate, so that
they understand what they are going to take part in, so that we find a balance of both learning Bird’s approach, and doing this in a helpful way for the clients. So that we don’t become more interested in ourselves as the learners, but that we are actually trying to help the clients with their difficult issues as well.” (Lisa at group meeHng, September 2, 2008)
Therapists’ comments on the learning process
• ”I looked at the therapy session, and then I got aware that I interrupted the clients a lot, this was helpful to see. I then asked the clients about this when showing the passages back to them, and they weren’t concerned at all about that.” – ”isn’t that your job?” (John, group meeHng, Dec 9, 2008)
• ”Perhaps we underes.mate how long it takes to learn new ideas and prac.ces, but it is very useful to do this in such a structured manner. So even though it takes .me, we need to learn slowly.” (Mary, group meeHng, Dec 9. 2008)
• ”It is much more useful to structure our learning together instead of just par.cipa.ng in too many workshops – this structure helps to integrate the learning together in our group.” (Mary, group meeHng, Sept 18, 2008)
Clients’ comments on the learning process • Looking at video with my (each couple’s) therapist where Bird’s pracHces were being used: – Useful to see my own world from a different posiHon (Gregory, client, Feb. 13 2009)
– When the therapist asked quesHons about “effects on the relaHonship”, this brought forward sensiHvity instead of anger (Ann, client, Dec 12 2008)
– I can see how I stop listening to her (Jack, client, Nov 3 2008)
Clients’ comments on the learning process
• I am working as a pilot and found in my training using video to prepare myself for flying very useful, as a kind of a ‘simulator’ (…) I had very useful experiences from this. I also think it was very useful for our rela.onship with you as a therapist that you opened up for feedback from us on how you work… this helps us to get to know you more. It was also very interes.ng to see how your ques.ons challenged us to really think and feel around our rela.onship instead of figh.ng about who was right or wrong on certain topics. (Daniel, client comment Nov 1, 2008)
Key highlights of our learning experiences • CollaboraHve learning projects are useful for making professional development as a daily pracHce at a therapy centre.
• Learning together from colleagues is helpful to staying fresh as therapists involved in ongoing pracHce.
• Using video (in self-‐supervision, group supervision, eliciHng client feedback) was the most useful element in our learning.
Research and training implica-ons
• InvesHgaHng principles for collaboraHve counselling pracHce enhancement.
• InvesHgaHng collaboraHve professional ethics when elicHng client feedback -‐ when therapists are learning new ideas and pracHces.
• InvesHgaHng how collaboraHve learning projects contribute to pracHce-‐based evidence for counselling outcomes.
• Using collaboraHve inquiry processes in training therapist developments – when learning new ideas and pracHces
• Using CPA as part of training in process of self-‐supervision, group supervision and client feedback
• How to learn from what we do, not as just a simple evaluaHon
• IncorporaHng client feedback into training context
Ques-ons we s-ll have
• How do therapists know (pracHcally-‐speaking and ethically) when they are ready to use a new skill or pracHce with clients?
• How can evidence-‐based pracHce and pracHce-‐based evidence be integrated?
• Is relaHonal language-‐making about changes to processes by which couples make meaning or about specific meanings derived in therapy?
How to start up a learning group? • Get together
• Make a shared decision of what kind of pracHces you want to learn
• NegoHate a shared learning process (e.g., co-‐operaHve inquiry)
• NegoHate also a Hme frame for the learning, when to meet – for how long etc.
• Involve other colleagues, and clients in your learning
• Involve the leader
Heuris-cs
• What can be gained and lost when colleagues learn in group-‐directed ways together? Learning how to do therapy from clients? How about peer supervision? How do we deal with issues of power in purportedly collaboraHve relaHonships (e.g., clients, colleagues)?
References
• Bird, J. (2006). Construc.ng the narra.ve in super-‐vision. Auckland, NZ: Edge Press.
• Bird, J. (2004). Talk that sings: Therapy in a new linguis.c key. Auckland, NZ: Edge Press.
• Bird, J. (2000). The heart’s narra.ve: Therapy and naviga.ng life’s contradic.ons. Auckland, NZ: Edge Press.
• Clarke, A. E. (2005). Situa.onal analysis: Grounded theory aIer the postmodern turn. London: Sage.
• Ellio], R. (1989). Comprehensive process analysis: Understanding the change process in significant therapy events. In M. J. Packer & R. B. Addison (Eds.), Entering the circle: Hermeneu.c inves.ga.on in psychology (pp. 165-‐184). New York: State University New York Press.
• Ferrara, K. (1994). Therapeu.c ways with words. New York: Oxford University Press.
• Gass, S. M., & Mackey, A. (2000). S.mulated Recall methodology in second language research. Mahwah, NJ: Lawrence Erlbaum Associates
• Gergen, K. J. (2009). Rela.onal being: Beyond self and community. Oxford: Oxford University Press
• Gergen, K. J. (2006). Therapeu.c reali.es: Collabora.on, oppression and rela.onal flow. Chagrin Falls: Taos InsHtute PublicaHons.
References • Hawes, L. C. (2006). Becoming Other-‐wise: ConversaHonal performance and
the poliHcs of experience. In J. Hamera (Ed.). Opening acts: Performance in/as communica.on and cultural studies (pp. 23-‐48). London: Sage.
• Heritage, J. (1984). Garfinkel and ethnomethodology. Oxford: Polity. • Heron, J. (1996). Co-‐opera.ve Inquiry. London: Sage. • Holzman, L. (Ed.). (1999). Performing psychology: A postmodern culture of the mind.
New York: Routledge. • Levi], H., Butler, M., & Hill, T. (2006). What clients find helpful in psychotherapy:
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• Linell, P. (2009). Rethinking language, mind, and world dialogically. Charlo]e, N.C: InformaHon Age Publishing.
• Lock, A., & Strong, T. (2010). Social Construc.onism: Sources and s.rrings in theory and prac.ce. New York: Cambridge University Press.
• Ness, O., & Strong, T. (2012). RelaHonal consciousness and the conversaHonal pracHces of Johnella Bird. Journal of Family Therapy, DOI: 10.1111/j.1467-‐6427.2011.00567.x
• O’Brian, J. (1993). AcHon research through sHmulated recall. Research in Science Educa.on, 23, 214-‐221.
• Strong, T., Sutherland, O., & Ness, O. (2011). ConsideraHons for a discourse of collaboraHon in counseling. Asia Pacific Journal of Counselling and Psychotherapy, 2(1), 25-‐40.
• Strong, T., Busch, R. S., & Couture, S. (2008) ConversaHonal evidence in therapeuHc dialogue. Journal of Marital and Family Therapy, 34, 388-‐405.
References
• Sheets-‐Johnstone, M. (2009). The corporeal turn: An interdisciplinary reader. Charlo]esville, VA: Imprint –Academic.Com
• Sho]er, J. (1993). Conversa.onal reali.es. Thousand Oaks, CA: Sage. • Strong, T. (2007). Accomplishments in social construcHonist counseling: Micro-‐
analyHc and retrospecHve analyses. Qualita.ve Research in Psychology, 4(1-‐2), 85-‐105.
• Strong, T., & Sutherland, O. A. (2007) ConversaHonal ethics in psychological dialogues: Discursive and collaboraHve consideraHons. Canadian Psychology, 48, 94-‐105.
• Strong, T., Zeman, D., & Foske], A. (2006). Introducing new topics and discourses into counselling interacHons: A micro-‐analyHc examinaHon. Journal of Construc.vist Psychology19(1), 67-‐89.
• Strong, T. (2006). Wordsmithing in counselling? European Journal of Psychotherapy and Counselling, 8, 251-‐268.
• Strong, T., & Paré, D. (Eds.) (2004) Furthering talk: Advances in the discursive therapies. New York: Kluwer Academic/Plenum.
• Wertsch, J. (1998). Mind as ac.on. Oxford: Oxford University Press. • Wooffi], R. (2005). Conversa.on analysis and discourse analysis. London: Sage. • Morson, G., & Emerson, C. (1991) Mikhail Bakh.n: Crea.on of a prosaics. Stanford,
CA: Stanford University Press.
Contact informa-on
O<ar Ness o]ar@o]arness.com h]p://www.o]arness.com
Tom Strong [email protected] h>p://www.ucalgary.ca/strongt