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Narrative Therapy Article By David Swirnoff

In narrative therapy, the belief is that people are the experts in their own lives and problems are separate from people. As narrative therapists like to say: “The problem is the problem.” The word ‘narrative’ means that the emphasis in narrative therapy is upon the stories of people’s lives and the differences that can be made through particular telling and retellings of those stories.

In many ways, life is the story we tell ourselves. And whether we’re aware of it or not, we all have a story we tell about our lives. A story is like a script. A script tells us what to say and how to act. The script is like a telepromter for our lives. Over time, the script we’ve been living is probably pretty straight-forward: we know the lines, we’ve been through every scene a million times, we know exactly what to expect. By now the script has become second-nature: it’s just who we are.

Because this script tells us who we are, what we’re capable of, and what we can became, for many people, the story we tell to ourselves about ourselves has made it difficult for us to lead the life we would like to lead. 

But where do these scripts come from? How do they get written? And are we to blame for a faulty script?

Absolutely not. In fact, oftentimes, the scripts we live out our not even truly our own, but are a product of the programming and conditioning of the people around us, especially in cases of abuse. For many people, especially those who experience early life or developmental trauma, the script that got written was the script that they needed to survive impossible circumstances or events too painful or treacherous for memory. In this way, the script was adaptive. A creative way to survive the untenable – like an invisible shield made out of the human imagination.    

This is what we mean in narrative therapy when we say the person is not the problem; the problem is the problem. We have many stories and many ways to tell those stories, but sometimes, for very good reasons, we can’t allow ourselves to see all of them.

In studies done by the gerontologist William Randall on the role personal narrative plays in healthy aging, he found that people who are able to “have a certain distance on things”, and were able to consider numerous perspectives and interpretations of the events in their lives, experienced the greatest sense of well-being and happiness in later life. In other words, by seeing their stories within a broader context, people were less inclined to draw a single, definite conclusion from them.

By being less anchored to single interpretations, especially negative ones, we are less burdened by outcomes. We are less inclined to view traumatic events and personal crisis as grand indictments against ourselves, more able to attach levity and humor to what, in the moment, may be extremely difficult and challenging circumstances.  By being less invested in one particular storyline or script, it allows us – or creates the space for us – to be able to remain open to new story lines, new narrative threads, and most importantly, new life experiences.

Gaining the ability to see our lives as a broad spectrum of experiences, instead of feeling limited or restricted, or somehow fated or doomed by our stories, we find ourselves more resilient in times of crisis and hardship, more open and available to whatever comes next.  And that is the goal of narrative therapy.   

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The Therapeutic Assessment Article by Dr. Hill

When a client comes to Parker Collins, they enter a clinic that has been organized as a trauma designed, multicultural, feminist, professional, whole family supportive, and clinically focused treatment program. We practice a respectful and empowering approach and use assessment and treatment methodologies that have been proven to be effective. These guiding principles include engaging clients with a therapeutic assessment, which is an approach to diagnostic assessment and psychological evaluations that is a somewhat unique and often a refreshing and empowering experience.

The practice of therapeutic assessments has been validated by research and clinical experience and differs from traditional top down and intense data gathering “behind the curtain” approach that is somewhat common in the mental health community. A therapeutic assessment starts with being respectful and clinicians believe what clients say. The clinician and client form a collaborative team and work together using the lenses of trauma, multicultural respect, and feminist empowerment. The result is the assessor and the client power differential is minimized to create a collaboration focused on understanding the client’s experiences and challenges, while exploring helpful pathways for change and healing. Clients are involved in the entire assessment process; from developing goals for the assessment, exploring symptoms and possible underlying etiology, validating assessment results, and developing treatment plans that have empirical support to be effective for treating trauma related disorders.

There is a lot of talk and writing in the mental health community about being trauma informed. At Parker Collins, we take that approach a number of steps forward to create assessment and treatment offerings that are trauma designed. A trauma designed approach incorporates a vast amount of current research that guides the use and interpretations of the diagnostic and test result data. All clinicians at Parker Collins are trained in formal programs designed for assessment and treatment of trauma disorders including: therapeutic assessments, Eye Movement Desensitization and Reprocessing (EMDR), Acceleration Resolution Therapy (ART), Adaptive Internal Relational (AIR) Network, and other models. These models are powerful and effective, but different. Not all models work for all clients and our therapeutic assessments are designed to not only help clients better understand themselves, but also to help recommend which of the available treatment models are appropriate in order to provide safe and effective healing.

The therapeutic assessment is spread out over time, which is much different than a traditional marathon, all testing in one day, hard push common to psychological evaluation practices. Spreading the assessment timeframe out allows the clinician and client to have time to assess risk of emotional and trauma triggering disruptions, including possible suicidal ideation symptoms. The respectful and supportive approach also creates time for processing and managing triggered emotions, traumatic memories, or other symptoms that can pop up during assessments. Time and support for managing triggered symptoms helps clients get back to a grounded state that is needed for safe and effective test administration.

When diagnostic interviews and test administration are complete, the therapeutic assessment model continues to be organized as a collaboration between the clinician and client when trying to make sense of the data. Research shows that the vast majority of mental health disorders are associated with trauma experiences, and an empowering approach is used to recognize that trauma symptoms are not something that is wrong (pathological) in a client, but rather reflects that trauma is something wrong that the client experienced.

The goal of this collaborative and empowering approach isn’t a diagnosis. While diagnoses are determined, the goal is to provided helpful explanations and recommendations that help the client and clinicians better understand the client’s symptoms and experiences and to find solutions. Clinicians use a strengths-based approach to guide treatment recommendations and provide empowering feedback to clients. Throughout the process, the attitude of the assessor is to be helpful, create a positive collaborative experience, and remain respectful. The ultimate goal of a therapeutic assessment is to help clients take the first step into effective healing and recovery from the challenges that clients experience because of their trauma and related symptoms.

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INTRODUCING NEW STAFF

Parker Collins is invested in giving back to the Psychological community by training up and coming doctoral level clinicians. Bronwyn and Lindsey joined Parker Collins in June and August for a one year clinical work experience from Saint Mary’s University of Minnesota Counseling PsyD program. They both were excited to accept positions with Parker Collins to broaden their clinical skills working with diverse populations and complex trauma. Bronwyn is in her fourth year and this is her third clinical placement. Lindsey is in her third year of the program and this is her second clinical placement. They are both eager to meet everyone, enjoy copious amounts of coffee, and are excited about the year ahead. You can check out their profiles on our staff page.

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INTRODUCING NEW STAFF

We are very pleased to announce the addition of two new staff members: Jessica Groff, MA LPCC and Bill Koski, MA LICSW.

Jessica Groff is a Licensed Professional Clinical Counselor. She has been active in the mental health field for over ten years. She utilizes art therapy in working with clients and works toward empowering individuals with interventions tailored to their unique needs. Jessica enjoys working with children, teens, and adults. Check out her staff profile and Psychology Today Profile to learn more.

Bill Koski is a Licensed Independent Clinical Social Worker. Bill has offered help and healing through therapy for several years. He is trained in EMDR and utilizes individualized methods to help clients heal. Bill has helped individuals understand themselves so that they can they can take better control of their life. He enjoys working with teens and adults. Check out his staff profile and Psychology Today Profile to learn more.

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INTRODUCING NEW STAFF

We are very pleased to announce the addition of two new staff members. Joining are Paulina Steffer, MA LADC and Erin Dudek.

Paulina Steffer has two masters degrees. One is in Drug and Alcohol Counseling and her second degree is in Marriage and Family Therapy (MFT). She is pre-licensed for MFT and under supervision of Soo Moon, MA LMFT. Paulina is trained in AIR (Adaptive Internal Relational) Network and has passion for working with individuals with complex trauma. She enjoys working with kids ages 9 and older, teenagers, and adults. She has experience working with immigrant population and offers services in Spanish. Check out her staff profile and Psychology Today Profile.

Erin Dudek is in the process of completing her masters degree. She is our newest mental health practitioner at our clinic. Erin is completing her thesis paper on how connecting to nature can have healing properties in improving mental health. She is pre-licensed for LPC track and is under supervision of Jeffrey Hill, PsyD LP and Soo Moon, MA LMFT. Erin enjoys working with kids ages 9 and older, teenagers, and adults. She has experience in providing ARMHS services and has worked with individuals with complex trauma. Check out her staff profile.

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AN INTEGRATED FAMILY APPROACH TO THERAPY ARTICLE BY DR. HILL

Parker Collins Family Mental Health is a small and growing group of diverse therapists. We have men and women from different cultural backgrounds and we come with diverse types of training including psychologist, social worker, and marriage and family trained clinicians. A few of our specialty areas include working with kids and teens, patients with traumatic experiences, and families struggling with harmful relationship patterns. Many of our child and teen patients come to us with very negative descriptions of their behavior. Some appear to take their negative behaviors to quite impressive levels of “badness.” Our behaviors do not normally spring forth in a vacuum. Rather, they are strongly affected by our environment and the relationship interactions with those we are close to. Sometimes individual therapy is not enough.

Children depend on their parents to meet their needs for safety and to gain the love and nurturance we all need, as described by the attachment relationship. When we see a child in therapy, we often (not always) see parents struggling to care for that child. We frequently see other troubled relationships or challenging family situations that appear to interact with the child’s “bad” behavior. It should also be noted that there is strong research evidence showing that a parent (primary attachment figure) who has unresolved trauma and mental health issues is a predictor of child mental health conditions. For these reasons, we often recommend various family groupings for therapy.

We often recommend, for example, co-parenting family therapy for divorced couples who are not yet in agreement on how to raise the children in separate households. Or we may recommend a parent/child combination if there are issues between them. We will recommend a parent for individual sessions if he/she appears to have unresolved issues of their own. These are just examples and we often recommend simultaneous sessions in order to better manage negative interactions between the child patient and other family issues in play.

We have found that there are particular advantages when other family members, or combinations of family members, engage in simultaneous therapy. We see much improved communication between therapists and we can address issues that seem to bounce back and forth. We have described this approach at our clinic as “shuttle diplomacy” therapy. With effective communication between therapists, our recommendations and client’s needs can safely be communicated to other family members. When communicated by a therapist, the needs can be presented in a therapeutic manner that helps clients and families heal and grow. In many cases, when therapists work through family conflicts in consultation with each other and take the results back to their patients, the families start to make progress in ways they did not think possible.

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USE OF CLINICAL HYPNOSIS IN COUNSELING ARTICLE BY SOO MOON

Therapists use a variety of tools in session with clients to help them achieve their goals. One of these tools is Clinical Hypnosis. Research has shown that Clinical Hypnosis can be highly effective in healing from depression, anxiety, physical pain, and an assortment of other ailments. At Parker Collins Family Mental Health we can provide healing for our clients with Clinical Hypnosis.

The American Society of Clinical Hypnosis describes hypnosis as a ‘state of inner absorption, concentration and focused attention.1′ It is the use and manipulation of the mind/body connection to access the subconscious for healing. To do this, therapists provide guided imagery and suggestions to achieve deep relaxation, connect to subconscious parts of a client’s self, and strengthen access to internal resources to aid in healing.

We have all experienced being in a trance-like state. Humans move in and out of trance during much of their day. Human consciousness is continuous, not dualistic (e.g. awake and asleep). In hypnosis, we use formal induction techniques to deepen relaxation and connect to subconscious parts of a client’s self.

 

In order to better understand what hypnosis is, what it is not, and how it can be helpful to clients, we have created the following FAQ.

  1. Who can benefit from hypnosis?
  • Most people who are highly motivated to make a change in their lives can benefit from hypnosis. For example, with smoking cessation, clients who do 9/10th of the work to quit smoking might benefit from hypnosis to aid in quitting for good.
  • Hypnosis can be helpful to alleviate symptoms of depression, anxiety, mood dysregulation, grief, physical pain, auditory hallucination, etc. It can help with performance anxiety, fear of childbirth (many women currently use hypnobirthing techniques), and improvement in confidence/self-esteem.

 

  1. What are some misconceptions about hypnosis?
  • It is not used for humiliation/entertainment. Therapists are under ethical guidelines to not do harm to clients.
  • Hypnosis cannot be used to make clients do something against their will. While in a trance, clients will be able to hear everything the Therapist is saying and can choose which parts to ignore or follow.
  • Some hypnosis therapists specialize in helping clients connect to past lives or engage in past life regression. Therapists at Parker Collins do not provide this type of hypnosis. Rather, we focus on the clinical elements of healing from unwanted symptoms.
  • Clinical Hypnosis is not used to recover memories. While some clients might realize new memories after participating in hypnosis, not all memories can be verified to be true. Memories are always changing and we continuously rewrite our narratives. Therapists will work with a client to identify what new filler memory elements realized feel true.

 

  1. How many sessions does it take to get results?
  • Results vary depending on the level of trauma a client has experienced, their support system, internal resiliency, and motivation.
  • Most adults can gain small increments of change/benefit from each session. Commonly adults take eight to twelve sessions to achieve desired results.
  • Children often are able to benefit from fewer sessions of hypnosis. They might take only three to seven sessions to achieve desired results. One case documented a child who client stopped having auditory hallucinations after one session of clinical hypnosis.

 

1 Retrieved from http://www.asch.net/public/generalinfoonhypnosis/definitionofhypnosis.aspx