Brian Murimi Kaaria

For each peer response, please : Ask a probing or clarifying question. Share an insight from having read your colleague’s posting. Offer, support, or challenge a position Validate an idea with your own experience. Expand on your colleague’s posting. PEER 1 F Post COLLAPSE Top of Form Solution-Focused Treatment Plan Plan    Presenting Problem (What issue(s) bring the clients to therapy?)   Overall better and healthier family functioning and to help Danny to feel better when he is alone at the house and to decrease his anxiety and feelings of abandonment. Another presenting problem is to combat the worry Gwen and Felisha feel when leaving Danny.   Assessments (What tools would I use to evaluate the system and further explore the problem? Is there risk present? How would I assess for it?   In the assessment phase it would be important for each family member to define what the problem means to them. Collaborative dialogue and conversations are an important part of the assessment process. Scaling questions surrounding the problem, for example using a 1-10 scale on how challenging the problem is can be a good starting point before setting goals and starting solution-focused based interventions. It is also important to ask what has been tried in the past, what has worked and what has not. Asking questions are an important part of the assessment process.   I would be sure to do a suicide risk assessment as standard procedure with Danny.    Initial Phase Client Goals (What do the clients want to achieve as a short-term goal?)   Reframe the problem to include more positive talk about how they wish to see their lives as a happy and functioning family. It is important that Danny sees his challenges not as problems, but as part of the normal life cycle. To set goals for Danny to decrease anxiety and feelings of abandonment and for the children to feel less worried. To shift the focus and basis from problem centered to solution oriented.    Initial Phase Therapeutic Interventions and Tasks (What interventions and tasks would I use to guide the clients to their initial phase goals?)   Constructive questions to learn about the definition of the problem to reframe problem talk to more solution talk.    Goal setting with the family. Goals are important to the client and should be small, realistic, and achievable. They are the start of new beginnings and should be concrete, specific, and behavioral. (for example, a goal for Danny may be to feel less anxious when he is home alone).    Scaling questions surrounding the goal (for example how bad the anxiety is currently at when Danny is home alone). Scaling questions will be used as a basis for constructing the goals and then used in each stage to judge improvement/change/solution achievement from session to session.    Working Phase Client Goals (What do the clients want to achieve as a mid-term goal?)   Clients implement changes towards the positive. Progress is made towards goals that were set and solutions are being implemented.    Working Phase Therapeutic Interventions and Tasks (What interventions and tasks would I use to guide the clients to their working phase goals?)   Exception questions for both Danny and Gwen and Felicia. For Danny this may look like “What was going on when you did not feel abandoned or anxious about your family leaving you. When have you felt moments of peace when you were alone, What was going on at that time?” For Gwen and Felicia this may look like, “What was going on when you were not worried about your father, Danny?” Exception questions will look for times the problem did not exist, and for the clients to be able to recreate those moments more often.     Miracle Question: Asking Danny if he were to wake up the next morning and his feelings of abandonment and anxiety were gone, what would the day look like?    Coping Questions: Danny would be benefited from coping questions because his anxiety is so severe. To point out time he has been able to cope and to use those as examples that he is capable of having solutions within himself will show that he has strengths already within himself.    Closing Phase Client Goals (What do the clients want to achieve as a long-term goal?)   The goal in the closing phase and later in therapy is devoted to finding, amplifying, and measuring progress and to continue to move towards the goals set. A goal here is for clients to call attention to their successes and rediscover their own coping strategies. The goal here is to continue to do what is working and leave behind what is not.    Closing Phase Therapeutic Interventions and Tasks (What interventions and tasks would I use to guide the clients to their closing phase goals?)   Compliments. It is important to complement each family member to validate what they are doing well. It is important to acknowledge how difficult the problems are and that any step towards feeling better is a huge accomplishment. If Gwen and Felicia have felt moments of less worry is important to validate these. It is important to encourage Danny on any strides he has made towards handling his time alone at the house more productively and to have less feelings of anxiety and abandonment.    Scaling Questions: These can be used throughout therapy to judge improvement and understand what is working and what has not. Once solutions are found, it is important to use scales to see if the clients have moved any further towards their goals and if their problems have decreased on the scale from the initial data.   Evaluation of what is working and what has not. Treatment plans and interventions may change based on what is working and what isn’t. It is important to harp on what is working for the clients and the strengths they are showing to do more of what is working for them and bringing them closer to their goals and to leave behind what is not.   Ethical/Legal Issues (What ethical and legal issues do I see in this vignette that would merit further exploration or supervision? Consider abuse, competence, boundaries, etc.)   It is important to have informed consent and to go over confidentiality especially if Felipe is not present for sessions. It needs to be mutually understood what will be shared and not shared. Going over mandated reporting guidelines surrounding confidentiality is a must. Scope of competence to work with same-sex couples and to make sure not to make medical advice to anyone.   Referrals (Based on the issues presented in the vignette, what other professionals need to be involved with the client(s)? What other resources do I need to provide to the client(s)?   Psychiatrist for Danny, couples counseling, individual therapy for anyone if necessary.   Other After careful exploration of the vignette, what potential biases might a therapist struggle with?   While I do not struggle with the concept of a same-sex couple raising children, this may be a bias a therapist may struggle with. Also, it would be important to explore the bias that there may be marriage issues since Felipe is not able to make therapy sessions. I may be biased that this means he does not care, when he very well may be busy and has a lot on his plate as he may be the main provider for the family.    What steps would a therapist need to take to manage their biases?   Steps to manage biases would be to use tools surrounding cultural competency and to stay open-minded and objective to all clients. It is important to have self-awareness and to identify areas they may be biased and where they may be inexperienced and look for educational tools to gain more experience (in this case, counseling couples/parents from the LGBTQIA+ community). They can also work through their biases through supervision.    What is the role of the therapist through the lens of this therapeutic approach?   The role of the therapist is to be a coach and consultant for the client as the client stays the expert of their own lives. They assist the client in solution-finding, which the client inherently already has within themselves. They work collaboratively with the client throughout the therapy process to set goals and uses questions to facilitate a conversation around solutions. The therapist role is to stay connected with the client’s reality throughout the course of therapy. They are to listen and understand the client and not rush into or work towards their own agenda. They are to have empathy and compassion.   Reference Nichols, M. P., & Davis, S. D. (2021). Family therapy: Concepts and methods. Pearson. PEER 2 S Post COLLAPSE Top of Form Presenting Problem Danny is a stay-at-home parent who often feels abandoned when Felipe, his partner, and Gwen and Felisha, his children, are not at home with him. Danny reports feeling anxious and he appears emotional. Felipe initially contacted us, but he is the only member of the family not present; reporting that he will be happy to attend when he is needed. The most serious presenting problem is Gwen and Felisha's grades are suffering at school because Danny often keeps them home to feel less anxious. Assessments I would want to ask Danny, Felipe, Gwen, and Felisha questions. With questions I can better help Danny, Felipe, Gwen, and Felisha find solutions to their presenting problem and better develop goals for my treatment plan.  Initial Phase Client Goals Gwen and Felisha will miss less school. Initial Phase Therapeutic Interventions and Tasks An initial phase intervention I would like to use is the miracle question (Miller, 2019). Danny's answer to the miracle question will help provide a road map for future goals and solutions for Danny, Felipe, Gwen, and Felisha. Working Phase Client Goals  Danny, Felipe, Gwen, and Felisha will work on solutions to enable the entire family to come to therapy. Working Phase Therapeutic Interventions and Tasks A working phase intervention I would like to use is scaling questions (Miller, 2019). There are a lot of variables in Danny, Felipe, Gwen, and Felisha's case, and scaling questions will help the family find solutions and goals to each specific variable (Miller, 2019).  Closing Phase Client Goals Danny, Felipe, Gwen, and Felisha will work on solutions to making Danny feel better by reducing his anxiety about feeling abandoned. Closing Phase Therapeutic Interventions and Tasks A closing phase intervention I would like to use is experiment journals (Miller, 2019). Experiment journals will encourage Danny, Felipe, Gwen, and Felisha to perform experiments in their lives that concern future presenting problems (Miller, 2019). This will help the family solve future problems (Miller, 2019).  Ethical/Legal Issues I cannot think of an immediate ethical or legal issue in this case. If I do eventually feel countertransference, it would be my ethical duty to refer Danny, Felipe, Gwen, and Felisha to another Solution-Focused Family Therapy clinician. Referrals Individual therapy would be especially helpful for Danny. I can help Danny, Felipe, Gwen, and Felisha find solutions to making Danny feel better, but he may need additional help.  Bias I have some similarities with the story of Danny, Felipe, Gwen, and Felisha. I do not think I would feel countertransference, but it is important to be aware of this. I am also a little suspicious of Felipe, but I do not think that is so much bias as it is Felipe missing the intake session of a family struggling with abandonment issues because he feels he is not needed is a red flag. He may have had a very good reason, though. Managing Bias One must be aware of countertransference and judgments. The countertransference will unfold depending on what is revealed in future sessions, but judgements should be avoided in Solution-Focused Family Therapy. I could be here to help Felipe determine a solution to missing sessions. Role of Therapist The role of a therapist in a Solution-Focused Family Therapy approach is to help clients find solutions and make goals. References Miller, K. (2019). 7 Solution-Focused Therapy Techniques and Worksheets. Positive Psychology. https://positivepsychology.com/solution-focused-therapy-techniques-worksheets/ Bottom of Form Bottom of Form