sg_chpt4

Families are not screened in advance of treatment 2

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Unformatted text preview: bservers meet briefly after each session to discuss their observations and interventions. Cases are also discussed weekly in a longer meeting. Treatment has six stages: 1. Obtain basic demographic data and introduce families to the treatment arrangement. Families are not screened in advance of treatment. 2. Formulate a clear statement of the presenting problem. If a number of problems are presented, the family is asked which is most troubling. 3. Estimate which behaviors maintain the problem by determining how family members are attempting to solve the problem. Observation and inquiry continue until the therapist has a concrete picture of the reinforcing behaviors. The therapist must decide which behaviors are most salient. 4. Delineate treatment goals. Small, definable, observable goals are selected. The therapist may ask the family to indicate the smallest change acceptable. The goals are refined through discussion, clarification, and further inquiry. The therapist should have a defined goal by the end of the second session. 5. Formulate behavioral interventions. Brief therapy emphasizes behavioral intervention. The therapist uses the family’s special characteristics to determine interventions. Homework tasks are assigned to utilize the time between sessions and broaden the within-session gains to the real world. Behavioral suggestions are usually indirect, implicit, suggestive, seemingly insignificant, or contradictory. When change is recommended directly, the family may be told to enact the changed behavior only once or twice until the next session. An important paradoxical intervention is to prescribe the symptom. The family is asked to engage in the symptomatic behaviors. The goal is for the family to rebel and in the process, lessen symptomatic behaviors or bring seemingly automatic behaviors under voluntary control as the family engages in the behaviors by choice. This therapeutic double bind promotes progress no matter how the family responds. Paradoxical instructions are also used in mor...
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