#43 – ORIENTATION AND INITIAL CONTACTS

On The Theoretics My first professional role model was one Mary Rygg, MSW, among other roles in her life a volunteer counselor at Karma Clinic. The service arm of Everett, Washington’s non-profit Drug Abuse Council in the early 70’s, Karma was a takeoff on the Haight-Ashbury Free Clinic, providing help aimed primarily at “street youth”. … Continue reading #43 – ORIENTATION AND INITIAL CONTACTS

#41 – WHO’S WATCHING

At some point an increasing insecurity can merge into the realm of terror. James Garbarino’s definition of terrorizing a child includes “making the world seem capricious and hostile”. Prolonged separation and divorce are universally seen as major stressors for youth. This is tension. Add to the child’s experience an unabated dissension or differences between the … Continue reading #41 – WHO’S WATCHING

#40 – LEARNING AND EXPERIENCE Re: #38, 39

Prelude In spite of its novel and progressive origins during the mid-20th century, family therapy tends to be fairly conservative. Understanding that psychotherapy generally has very few absolutes, which themselves are hallmarks of conservatism, the school “tends toward” rather than “ is always”. Conceptually, the basic approach leans more toward the adaptivity model than the … Continue reading #40 – LEARNING AND EXPERIENCE Re: #38, 39

#38 – HARD CASES – INTRO AND TWO VIGNETTES

Loss and escalating tensions in the context of divorce can create potent emotional reactions. The venerable Holmes Scale lists divorce and prolonged separation from a mate # 2 and #3 on the scale’s 43 identified adult stressors, following only the death of a spouse. For children, an exacerbated insecurity at some point can merge into … Continue reading #38 – HARD CASES – INTRO AND TWO VIGNETTES

#37 – Holding At Bay – Analysis and Comments

The therapies for these three cases had a few basic similarities. They were all relatively long, each being more than thirty sessions and lasting more than eighteen months. The anxiety and depression symptoms were largely resolved. The clinical processes all began with conjoint formats that included their siblings, and moved into split-session formats where the … Continue reading #37 – Holding At Bay – Analysis and Comments

#36 – HOLDING AT BAY – THREE VIGNETTES

Continuing the examination of cases involving divorced parents where at least one within the couple appeared to have Axis II issues, in these three situations the contentiousness over child care continued well beyond the divorce itself. The inter-parent struggles involved custody, child support, living arrangements, educational decisions, and/or healthcare authorizations that included those for mental … Continue reading #36 – HOLDING AT BAY – THREE VIGNETTES

#35 – WORKING THRU ADULT AXIS II INVOLVEMENTS

Note:   As a reminder, systematically analyzing the impacts and case management considerations of parental Axis II defense mechanisms occurred recently and not during the practice itself. An awareness of the general problem in each case was certainly there at the time of treatment, and decisions were made during case management in their regard. Nevertheless, … Continue reading #35 – WORKING THRU ADULT AXIS II INVOLVEMENTS

#34 – Working Through Adult Defenses – Introduction

Introduction A major thrust of family therapy processes that treat youth mental health problem(s) is the use of the parents as therapeutic surrogates. In essence, the therapist enables the parents to effect and maintain changes for the child via three basic influencers. They include psycho-educational information, conditioning, and modeling. The educational component includes any information … Continue reading #34 – Working Through Adult Defenses – Introduction