10CTI: The Empty Chair

see the original article @ Psychology Today

Cool Intervention #9: The Empty Chair

10CTI: Therapy with furniture

Published on January 20, 2010 by Ryan Howes, Ph.D. in In Therapy

The Ten Coolest Therapy Interventions series continues with a technique widely recognized among gestalt therapists, their clients and furniture aficionados everywhere. Gestalt therapy expert Dan Bloom shares his thoughts on this powerful procedure.

The term gestalt refers to a whole that is greater than the sum of its parts. Gestalt therapy, formulated by Fritz Perls (1893-1970) is based on the idea of a whole being as connected with their environment, loved ones and memories. Therapy works toward creating full awareness of the here and now, both within the client and between client and therapist. The empty chair is one of many interactive techniques used to help engage the client's feelings, thoughts and behaviors.

The ol' empty chair has had quite a tongue-lashing over the years. Clients have given a piece of their mind to innumerable spouses, bosses, best friends and dead relatives thanks to this simple tool. But the chair is none the worse for wear, and millions of people have a greater understanding of feelings and communication as a result. This definitely qualifies it as a Top Ten finalist.

I'm honored to host Dan Bloom, JD, LCSW, a New York gestalt psychotherapist and president of the Association for the Advancement of Gestalt Therapy, an international community. He writes, provides supervision and trains therapists in New York and internationally. He kindly shares his thoughts on the empty chair:

1. When would a clinician use the empty chair technique?
The empty chair technique is characteristic of some styles of gestalt therapy. It is often effective at facilitating clients' integration of different aspects or "disowned parts" of their personality in order to further psychotherapeutic insight. It is one of a variety of interventions that help people move from talking about something towards the fullness of immediate, present experience - sensation, affect, cognition, movement. The less people are "in touch," or "verbalizing," or abstractly thinking, the more likely therapists are to use this as an expressive technique. It is not used for clients whose emotionality is already dramatic and who may be already subject to emotional "flooding."

2. What does it look like?
As first popularized by Fritz Perls, one of the founders of gestalt therapy, an empty chair faced the client. The client imagined someone (or himself, herself, or parts of him or herself) in it, and spoke, gestured, or otherwise communicated to the "empty chair," which was now not so empty. The client then sat in the chair, continuing the conversation, this time reversing roles. Variations of the "empty chair" developed over the decades in order to fit the clinical needs of the situation - and as gestalt therapy evolved. The client might participate in this technique without the "prop" of an actual empty chair. Importantly, the technique today always includes attention to the relational dynamic between the client and the psychotherapist.

3. How does it help the client?
This technique often brings clients into present or immediate experiences. Abstractions or verbalizations become enlivened moments. Clients may be able to experience different aspects of their own conflicts in a new manner through empty-chair dialogue. Gestalt therapy is more than a collection of techniques, despite the notoriety of the empty chair. This technique is one of the many interventions within gestalt therapy, all with the common purpose of facilitating discovery and psychotherapeutic insight.

4. In your opinion, what makes the empty chair a cool intervention?
Any intervention that challenges the passivity of the clinician and turns psychotherapy into a creative collaboration is a cool technique. Further, if the empty chair is a new approach to the clients, it offers a new perspective on the therapy process.

10CTI: The Miracle Question

See the original article @ Psychology Today

Cool Intervention #10: The Miracle Question

Published on January 18, 2010 by Ryan Howes, Ph.D. in In Therapy

The Ten Coolest Therapy Interventions series kicks off with supernatural power. Many clients come to therapy looking for a miracle. Here's a technique built on miracles. I'm honored to speak with Dr. Linda Metcalf, expert on the Miracle Question and Solution Focused Therapy.
The therapeutic intervention is a critical element in most forms of psychotherapy. In this series I survey ten diverse techniques that are, in my opinion, cool. For more information on the series take a look at the introduction.

Solution Focused Therapy (aka Brief Therapy) emerged in the 1980's as an branch of the systems therapies. A married therapist couple from Milwaukee, Steve de Shazer and Insoo Kim Berg are credited with the name and basic practice of SFT. The theory focuses not on the past, but on what the client wants to achieve today. By making conscious all the ways the client is creating their ideal future and encouraging forward progress, clinicians point clients toward their goals rather than the problems that drove them to therapy.

The Miracle Question fits perfectly with this model. Imagining an ideal future and connecting it to the present immediately actualizes the work. Clients are challenged to look past their obstacles and hopelessness and focus on the possibilities.

It's cool because it's a relatively simple intervention that can have a powerful impact. Just take a look at the question (response #2). You're probably crafting your response already. It's creative, bold, healing, a bit mysterious and definitely has a cool name. The Top Ten designation is well deserved.

Don't just listen to me, hear it from an expert. Linda Metcalf, Ph.D. is founder of the Solution Focused Institute of Fort Worth, Texas and author of ten books including The Miracle Question: Answer It and Change Your Life. Beyond writing and therapy, she speaks internationally to schools, agencies and universities. She was kind enough to share her wisdom with us today.

1. When would a clinician use the Miracle Question?
The Miracle Question is a goal setting question that is useful when a client simply does not know what a preferred future would look like. It can be used with individuals to set the course for therapy, with couples, to clarify what each person needs from each other and with families, who too often see one person as the culprit. By using the Miracle Question and asking each person what a better life would look like, the system sees perhaps for the first time, what others need from each other.


2. What does it look like?
"Suppose tonight, while you slept, a miracle occurred. When you awake tomorrow, what would be some of the things you would notice that would tell you life had suddenly gotten better?"
The therapist stays with the question even if the client describes an "impossible" solution, such as a deceased person being alive, and acknowledges that wish and then asks "how would that make a difference in your life?"  Then as the client describes that he/she might feel as if they have their companion back, again, the therapist asks "how would that make a difference?"  With that, the client may say, "I would have someone to confide in and support me."  From there, the therapist would ask the client to think of others in the client's life who could begin to be a confidant in a very small manner.


3. How does it help the client?
It catapults the client from a problem saturated context into a visionary context where he/she has a moment of freedom, to step out of the problem story and into a story where they are more problem free. But, more importantly, it helps the therapist to know exactly what the client wants from therapy...and this is what makes Solution Focused Therapy so efficient and brief.

4. In your opinion, what makes the Miracle Question a cool intervention?
It helps the therapist see where the client wants to go. Too often, therapists assume that a client needs to grieve, leave their spouse, quit their job, after the client describes why he/she has come to therapy. The Miracle Question helps the client and therapist to address exactly what the client wants, not what the therapist thinks is best.

10CTI: Intro

This is the first article by Ryan Howes on 10 Therapy Interventions. For the next 10 days I will be posting the 1 of the 10 intervention articles he wrote about.

See the original article @ Psychology Today 

The Ten Coolest Therapy Interventions: Introduction

Published on January 17, 2010 by Ryan Howes, Ph.D. in In Therapy

***This series is for entertainment and basic educational purposes only. My mission for this blog has always been to demystify elements of therapy so it becomes more accessible to the general public. Reading these blurbs is no substitute for the dozens to thousands of hours of training it takes to effectively and ethically apply them. If you're a therapist and find an intervention interesting, please get adequate training before attempting. If you're not a therapist, please seek out a clinician with sufficient training in that specialty. Unless otherwise specified, do not try this at home!

 

Clients talk, therapists listen. That's just the beginning. Most clinicians have a few tricks up their sensitive, rational and insightful sleeves.
I hereby launch another big series, this one honoring a vital component of psychotherapy: the therapeutic intervention. I chose the ten coolest then interviewed the leading experts for each one.
The first thing most psych graduate students learn is how to listen. They study Carl Rogers and others who poured the foundation of the therapeutic relationship with the concept of respectful, empathic and reflective listening. While this is helpful, some clients want more than listening. They want a powerful experience, a deep insight or some tool that provides answers. Many psychological theories address problems on this more tangible and profound level.

Techniques are hailed as vehicles of epiphany by believers and panned as corny gimmicks by cynics. They add dimension and texture to the work, stretching therapy beyond a friendly ear toward a dynamic, transformative process. They're the practical application of psychological theory that creates a turning point for many seeking answers.

For some, techniques are what make therapy meaningful. Others just want to talk and be heard so techniques/interventions get in the way. Which brings me to an important point: this is all incredibly subjective. Some clients work best in a technique-free environment, others thrive in therapy heavy on gizmos. And some gizmos work better for some people than others. Like many elements of therapy, it's a matter of a good fit rather than the One True Best Way to do things.

Rather than give a cursory review of all contemporary psychotherapy techniques, I thought a list of the Ten Coolest would be more interesting. Absurd, given what I just said about subjectivity, but interesting. Now to define cool in this context. In order to qualify as a cool intervention, each must have the following:

• Creativity: innovation beyond convention to find a solution
• Boldness: strong conviction the technique has profound results
• Compassion: directed at healing pain or dysfunction
• Mystery: mechanism for change is not always obvious
• A Cool Name: I'm not sure why, but this tends to be true

Let's also note what I'm not talking about: effectiveness outcomes. I don't want to get into that here. I'll let the bean counters and hall monitors from EBT make their own boring top ten. These interventions have worked powerfully for some people some of the time; I'll leave their validity at that. I'm a therapist and I don't even use most of them, I just think they're cool.

I selected the list then put on my investigative reporter hat to find experts who could tell us more about each one. If you're a therapist, professor, client or a grad student you'll probably be able to guess a few selections, but I doubt you'll guess all ten. My hope is this list will help broaden your idea of psychotherapy. And show how cool it really can be.

***This series is for entertainment and basic educational purposes only. My mission for this blog has always been to demystify elements of therapy so it becomes more accessible to the general public. Reading these blurbs is no substitute for the dozens to thousands of hours of training it takes to effectively and ethically apply them. If you're a therapist and find an intervention interesting, please get adequate training before attempting. If you're not a therapist, please seek out a clinician with sufficient training in that specialty. Unless otherwise specified, do not try this at home!

Here are the Ten Coolest Therapy Inventions (10CTI) (These will link to the article once posted on my blog)
10. The Miracle Question
9. The Empty Chair
8. Paradoxical Interventions
7. Voice Dialogue
6. The Hunger Illusion
5. Head-On Collision
4. Sandplay
3. Primal Therapy
2. Virtual Reality
1. Transference Interpretation

Trauma's Impact on Learning

Trauma's Impact on Learning

School has resumed. Back to school advertisements and school supply lists have consumed parents, teachers and children for the past few weeks. For most this is an exciting time. For others, those who have difficulty in school, it can be quite stressful. After exposure to a traumatic experience many children remain in a heightened state of arousal (stress). This is especially true when a child is exposed to chronic or repeated trauma such as domestic violence, abuse or homelessness. When that arousal does not decrease to normal levels there is a significant impact on a child’s ability to perform in the classroom. Many of the processes required for successful learning become impaired as a result of this increased and persistent stress. Some of these include difficulty focusing, remembering information, and articulating what has been learned, sitting still long enough to complete a worksheet and even having the ability to work on projects with peers.

Knowing this, our first goal has to be to make children feel safe in the classroom. Despite what is going on at home, we have the opportunity to greet them with a smile, ask them if they have had breakfast and offer additional support if needed. When a traumatized child feels safe and has an opportunity to relax, even for a few moments, their ability to learn will improve. After repeated safe experiences in a classroom, even a traumatized child can view that setting as their safe place. Remember that it is in everyday moments and day-to-day interactions that we create a new (safer) experience for children.

From TLC Director Caelan Kuban at ckuban@tlcinst.org.

(See the original article at Trauma's Impact on Learning)

Something New!!!

I have decided to try something new. My original blog (Sarah's Closet) was originally designed to look at beauty and body image and how they are impacted by society and media. I have noticed over time that as a counsellor there are other things I want to talk about. Specifically, I wanted to spend some time providing information on counselling style and pass along resources that people might find useful. There are so many wonderful websites, books and people out there doing amazing work that they need to be shared. Since not all of these resources fit in with my original blog, I have started this one to try and share things I find.
If there is anything you find that you would like me to share, please let me know! I will try and pass on everything that I can.
Thanks!