This
article is written to counselors, life-coaches, and therapists
("clinicians") who work regularly with divorcing families and stepfamilies.
It is based on these premises, and this
related, experience-based clinical
The article offers...
-
perspective on productive first contacts
between clinicians and these clients;
-
options for
increasing mutual first-contact satisfaction;
-
recommended clinician
questions, depending on the
type of client; and...
-
options on
ending the first contact
effectively.
Before continuing, reflect: why are you reading this? What do you need - specifically?
Perspective
A
client co-parent usually makes the first contact over the phone with a staff
person or the clinician. The contact may just be to make a first appointment,
and/or
there may be an exchange of information about services needed and provided. If
the first contact is with a non-clinician, s/he may collect some basic
information about the client family for the clinician or clinical director,
perhaps using a checklist like this.
This
article considers two cases: (a) the client spokesperson has been
interviewed by an intake worker before meeting the clinician or (b) s/he has
not.
Prior Intake Information
A well-designed intake protocol and well-trained intake workers can save the
clinician and clients valuable time in their first meeting by collecting
important information. An intake worker will usually create a structured report for the clinician
after interviewing a new client. S/He may also have the client spokesperson
fill out a questionnaire. The report will contain factual information and
perhaps preliminary assessments, depending on the intake-worker's training.
The questionnaire may provide preliminary assessment information by the way
the client filled it out. Having both sources can help the first
clinician-client face-to-face contact to be more productive.
With
typical divorcing families and stepfamilies,
effective intake information will
summarize factual answers to key questions like those below.
In an organizational setting, the complexity and special needs of these
multi-home clients justifies training intake workers on what extra information
to collect, and why.
-
which
of client is this, and who referred them - themselves, another client, a
family-court judge, or someone else?
-
what are this client's main presenting
(surface) problems?
-
who does the spokesperson include in their
now, and whom does s/he see as being in charge of it recently?
-
is any family member probably or surely
to anything now? If so, who, what, and are they in some form of
meaningful recovery?
-
has any family member been involved in any
legal suit in (say) the last six months? If so, what, why, who initiated
it, what is the status of the case, and how has the suit affected the
family's functioning?
-
does the client spokesperson feel someone is
in a crisis? If so, who and what is the perceived danger they face now?
-
have any family adults had meaningful
education on effective communication and problem-solving and/or on
healthy grieving in the last years or so? If so, who, what, and when?
-
are any client co-parents separated,
divorced or widowed, and or dating or re/married?
-
if this client is a stepfamily, have the
co-parents actively sought education on stepfamily basics? If so, what
and when?
-
Was any client-family adult raised as a
stepchild, or have they had prior experience as a stepfamily co-parent?
-
Is any family member the survivor of
significant childhood abuse, abandonment, or other neglect? If so, who,
when, and what?
-
if the client family belongs to a religious
movement or community, what is it, and how active have they been
recently?
-
who will participate in the clinical work?
-
what do they hope to get from clinical
consultations?
-
if the family is working now with other
human-service providers, who, why, and how long?
-
are there any insurance or other limitations
to the client's participation?
The answers to questions like these, and how
the questions are answered (e.g. directly, vaguely, defensively,
intellectually, etc.), will direct the clinician's further assessment in the
first client contact. Options - (a) see these sample
divorcing-family and
stepfamily client-intake forms; and
(b) educate intake workers on these topics to
improve their initial-assessment reports.
Filling Everyone's Needs
A need is a discomfort that causes human thoughts, feelings, and behaviors.
A first contact between people is effective if each person
(a) fills their
well enough
(b) in a way that feels good enough to
everyone involved. In first contacts between divorcing-family or stepfamily
clients and a counselor or therapist, there are common and unique needs
to satisfy, compared to other first contacts.
Typical
Client Needs
If you've consulted a professional clinician, recall what you needed and how you felt
during and after the first contact. Compare those to the premises below. When
typical self-referred co-parents first contact a counselor or therapist, they need
to...
-
feel
genuinely
(worthy and dignified) and empathically valued and
by the clinician and each other; and to...
-
feel initial
trust in the clinician's
competence, objectivity,
and concern; and co-parents need to...
-
feel
hopeful that the
clinician can help them solve their presenting problems
in a safe-enough, affordable way. The intensity of this need depends on
whether someone feels there is some kind of
or not;
and typical clients need...
-
information about...
-
the clinician's qualifications (training, background, personal and professional experience,
attitudes, etc.) and...
-
the clinical process - e.g. time and availability constraints,
duration, costs and insurance coverage,
service limitations, and who is responsible for what during the work.
-
Co-parents
referred by family court also need to comply with judicial
orders and perhaps their attorney's and/or a mediator's suggestions or
requests; and...
-
Any children present usually need (a) to feel
safe
and respected, and to clearly understand (b) why they're there, (c) who the
new person/s (clinician/s) are, and (d) what's going to happen in this and any future meetings.
And participating clients need...
-
to agree
on who's
going to do what after the first meeting ends - e.g. "homework," negotiate another
appointment, research some information, invite another family member, etc.
Some
wounded co-parents
(i.e. one or more anxious
may
also need to
a session's process and/or focus ("We're not here to talk about
that.") Other co-parents need the clinician to empathically direct the meeting's agenda and
process. Client participants may have a
on this.
Typical
Clinician's Needs
For a
mutually-satisfying first contact, the clinician needs to be aware of,
respectfully assert, and fill her or his needs as well as the client's.
Typical clients and service-providers aren't used to consciously ranking the
provider's needs equally with the client's needs, which risks subliminal or
overt dissatisfaction and semi-conscious resentments.
This clinical model proposes that
over time is most likely if the client family members and clinician/s respect
their own and each other's needs equally. Clinicians are most likely to adopt
an "=/=" (mutual-respect) attitude and assert their own current needs if their
leads their
How do you feel about
this? Have you ever reflected on what you need when meeting a new client
(or any person)?
During the first contact with a new client,
typical therapists, life-coaches, and counselors need to...
-
feel undistracted, competent, respected, and
heard,
-
help participating clients feel welcome and safe,
-
get agreement on ground rules ("I'm going to ask that only one person talk at a time, OK?") and
any limits for the meeting ("Let's shoot for ending by 3:50"),
-
learn the client spokesperson's initial (presenting) needs,
-
begin to assess the client-family's
(a)
(b) problem-solving
style and effectiveness, and (c) unspoken
-
answer the client's questions to their satisfaction,
-
decide whether the client's apparent needs match the clinician's knowledge and
skills well enough, and if not, make an appropriate referral;
And clinicians also need to...
-
comply with (a) ethical standards of professional conduct and (b) any
employer's policies related to the meeting, and to...
-
negotiate the next contact, if any; and
to...
-
respect others'
needs
by ending the meeting on time.
Each case and meeting will have a
unique mix and ranking of these client-clinician needs. The first contact is
most apt to be mutually satisfying if the clinician is steadily aware of
both sets of needs and the ongoing meeting
process.
First-contact Suggestions
In some ways, meeting divorcing-family or stepfamily client adults for the first time is
no different than any new client - and it differs in several important ways. Every clinician develops their own way of conducting the first meeting with
such clients, so compare the following options to your way. Asterisked
items apply to any client session, not just the first one:
1*) Authorize
yourself to lead the meeting, and be clear on who's responsible for what
- e.g. are you responsible for "fixing" this client family, or are
the family adults? This is most
likely if your
is guiding your personality. "Lead" includes welcoming and
introductions, setting and monitoring the agenda and process, interrupting
and refocusing the clients as needed; summarizing key information,
guidelines, and goals; agreeing on a next appointment and/or referral/s,
suggesting any "homework," providing any relevant handouts or other
resources; and ending the meeting on time.
2) Meet
with co-parents first. Premise - any client-family's
nurturance level is strongly shaped by the co-parents' relationship,
personalities, priorities, and communication patterns. Meeting adults first
(before any kids) allows the clinician to focus more clearly on assessing
these vital variables, and avoids information overload. If co-parents are
strongly conflicted, meet with them individually first, to assess the
stressors, hear both sides, and decide if and when to meet jointly. If the
presenting problem is a minor child's welfare, meet with the adults first
anyway, unless it appears that the child is in significant danger now.
3*)
Expect
a mix of concurrent presenting
problems with divorcing-family and
stepfamily clients. Also expect that the co-parents can't identify, rank, and
systematically fill the
causing their problems. Too many concurrent problems (unmet needs) becomes
a problem by itself (overwhelm and confusion) - specially if one or more co-parents are
ruled by false selves. A useful first-meeting intervention is to
use open-ended questions to elicit information, summarize the clients'
presenting problems, negotiate a ranking of them, and agreeing to focus on
one or two at a time.
4) Expect the client
spokespersons to not know the five
proposed by this model. In
the first contact, qualified clinicians can begin to alert client adults to
the hazards and how they may relate to the presenting problems. This may
motivate help to justify Doing so begins to justify the
co-parents' need to learn and work together on their version of the 12
.
5*) If two or more client family
members are present, arrange the seating so all participants can have
comfortable eye contact vs. sitting side by side. This implicitly invites
the clients to consider whether they do that in important communications
outside the session. Option - ask "Is it your habit to seek good eye contact
in important conversations?"
6*)
Early in the meeting,
check the attending clients for distractions - e.g. "As we sit down together,
what are you each aware of?" / "What are you (each) feeling now?" / "Where is your mind
focused now?" / "What is your partner thinking and feeling now?" / "Is anything
physically or mentally distracting you (your partner) from being fully here now?"
Co-parents' verbal and non-verbal responses to questions like these suggest many
things, including their abilities to (a) focus on the
present moment, (b) describe their current thoughts, feelings, and bodily
sensations clearly, and (c) empathize with other family members
accurately.
If a
co-parent says or implies "Yes, I am distracted, by (something)," (a)
ask him or her to rank the intensity of the distraction on a scale of 1 to
10, and (b) decide whether to make reducing the distraction the first agenda
item. Options:
-
ask "What would help you reduce that
distraction now?"; and/or...
-
use this as a teaching opportunity by asking
the co-parent/s something like "Is it your habit to ask each other about
distractions, or tell each other if you're distracted in important
conversations?"
More
suggestions for successful first contacts with typical divorcing-family and
stepfamily clients...
7) After welcoming and seating the client/s,
introduce yourself if you haven't
already or if there are new people present. Assume one of their needs
is to learn "Who are you, and are you qualified to help us (can we
trust your competence)?" Include summary information like this (or pass
out a summary handout and invite any questions)...
-
Your clinical credentials and years of experience;
-
Whether you're a bioparent and/or a stepparent, and if
so, your kids' genders and ages;
-
Whether you've (a) been divorced or widowed, and/or
(b)
lived in a stepfamily as a child or adult. If you're re/divorced, you
can frame that positively by saying something like "I have learned a great deal
about healthy stepfamily relationships since then (if true!);"
-
Whether you've been a therapy client yourself, without going into details
- "...so I know what it feels like to sit where you are."
-
How experienced you are with divorced-family
and/or
stepfamily clients, and whether you've had any special
training in working with
them;
-
Hilight any areas of expertise that you feel will
reassure and/or alert the co-parent/s - e.g...
-
(vs. healing)
the psychological effects of significant childhood
abandonment, and major
in self-motivated adults ("Grown Wounded Children," in this model);
-
helping motivated clients
and
more effectively;
-
healthy
including spotting and freeing blocked mourning;
-
re/marital counseling;
-
assessment and management, including
-
assessing what
individual minor children need, and
empowering co-parents to fill the needs effectively as nurturing teammates;
-
dealing effectively with local family-court,
marriage mediators, law-enforcement, and child welfare systems on behalf of client families;
-
identifying and reducing common
to co-parenting
among separated or
divorcing co-parents; and...
-
helping courting and committed
stepfamily co-parents and supporters learn how to spot
and make
and to proactively evolve
high-nurturance (step)families together.
8*) Disclosing
relevant personal information during a session - specially the first
contact - can have several benefits. It can (a)
make the clinician seem more "human" and approachable, and (b) reassure clients
that the clinician can probably empathize with and validate their complex
situation (if true). Conflicted stepfamily co-parents often feel unsure if they're
"normal" or "crazy" because of the webs of alien family role and relationship
stressors they're experiencing.
A
clinician's anxiety or reluctance about disclosing limited appropriate personal
information to clients may indicate false-self
over-rigid boundaries, a graduate school dictum, a supervisor's value, an
agency policy, or a mix of these. Another trust-building option is to invite
any brief questions about the revealed information.
9) Option -
frame your clinical relationship
by asking a teaching question like "I'm your employee, and you're my boss/es. I'm working for your (nuclear)
family, so I'm eager to hear what my job is.
What do you need from me now?"
This clinical model proposes that relationships exist to fill mutual needs,
and that "problems" are unfilled needs. Many clients are resistant to
"neediness," and seldom think to ask this vital question of each other.
10*) As you know, face and body language and speech
characteristics "leak" personal feelings and attitudes. These and the
language you use in the first contact may
cause clients to assume your attitudes on some sensitive topics like divorce,
affairs, cohabiting, child neglect, addictions, pre-marital sex, court
battles, and remarriage. Their assumptions can affect how fast and how well they accord you initial trust and
respect. For example, if you feel stepfamilies, stepparents, and/or stepkids are innately
inferior, deficit-based, or abnormal, your attitude will leak despite your
conscious attempt to appear neutral and objective.
Implication: invest time in becoming and staying aware of key
attitudes in yourself and your co-workers about these complex clients and
your work with them - e.g. "Generally, stepfamily clients are dysfunctional
and don't make much progress in therapy." For more perspective, see
this and
this.
11) With
court-ordered clients, intake and
the first clinician contact will be shaped by some special needs and
realities. See this for
more detail and perspective.
More guidelines for first clinical contacts with divorced-family and stepfamily
clients...
12) After the clients
introduce themselves and their situation, ask them for
key information they may omit, like...
-
"Who comprises / makes up /
your
(multi-home)
now?"
-
"Do your family members all consider you to
be a stepfamily?" (If they are)
-
"Who referred you here, and why?"
-
"Have any of you experienced with family counseling or
therapy previously? If so, (a) who initiated it, (b) why, and (c) and how
was that experience for you?"
-
"Do your other family members know you're coming
here? How do they feel about your coming?"
-
"Specifically - how will you (adults) tell when our work
here is done?"
-
"How would you mates / co-parents each
describe your main priorities in - say - the last three months?"
-
"What do you think may happen if your
problems don't improve?"
-
"What do you each feel prevents you from
resolving
these (presenting problems) now?"
-
other questions that occur to you with this
client...
13) In a first meeting,
typical divorcing-family and stepfamily co-parents have a high need to
vent, vs. problem-solve. They may feel unheard, misunderstood, and/or
blamed by other co-parents, key relatives, and friends. Often these co-parents
are wounded (shamed, guilty, anxious, distrustful), socially isolated, and
have no one with whom they can vent honestly with.
This is specially likely for divorced
co-parents who feel anxious and ashamed if their new marriage feels
significantly troubled. The need to vent is also likely for divorced parents who haven't grieved their
divorce and re/marriage losses well, and/or healed any major related guilts.
Implication: effective clinicians will stay empathically aware of this need to vent, and
balance it with their need to ask assessment questions and begin to evolve clear
clinical goals and strategies.
14)
Many client co-parents can't coherently articulate what they need at first,
or they describe their problem/s in very general terms. ("I just need to get
along better with my stepdaughter.") Where so, one first-contact goal
is starting to
to clarify and rank each client-member's
- and describe what you're do9ing and why.
Another option is to model
while digging down ("So Amanda, you resent feeling disrespected by your
husband's ex wife and discounted by him, and you need him to empathize and want to
support you on this."). Typical first meetings also offer many
chances to (a) demonstrate
(objectively commenting on your current communication process), and (b) inviting clients to try out "hearing checks" to prepare for
effective problem solving. ("Carlos,
are you willing to summarize to Nina what you think she just said? Doing so does
not mean you agree with her.")
15) Identify
the clients' personal and family strengths
during and after the first meeting. Typical initiating
co-parents are anxious, guilty, angry, and confused. It can feel reassuring to
have the clinician spontaneously affirm individual and shared strengths as the
meeting progresses - e.g. "I'm impressed at how well you two [ share genuine eye
contact / use your sense of humor / stay focused / assert yourselves ] on hot
topics."
Options: (a) ask co-parents "How does it feel to
have me affirm your strengths? How often do you acknowledge your personal and
family strengths together?" "What would happen if you decided to help each other
do that more often?" (b) At the end of the meeting,
suggest the clients fill out and discuss this (long) inventory of
stepfamily strengths or equivalent.
Then follow up at the next session, if any.
+ + +
Pause and reflect - what are you (your active
thinking and feeling now? How do these ideas compare with your present way
of conducting a first contact with divorcing-family and stepfamily clients?
There are a lot of ideas above. If you had to pick several of special
importance to you, what are they?
Breathe, stretch, and recall why you
began to read this. Are you getting what you need, so far?
.The
next page adds (a) sample
first-meeting assessment questions, and (b) suggestions for closing the
first meeting effectively
The Web address of this
two-page article is
http://sfhelp.org/etx/basics/first_contact.htm