The Web address of this
two-page article is
http://sfhelp.org/etx/basics/first_contact.htm
Continued...
This page illustrates useful early-assessment questions, and options for ending
the first meeting. See this for general
perspective on assessing these complex client families over time.
Useful
First-meeting Questions
Typical first face-to-face contacts with new clients move through four phases:
welcoming and introductions, clients' venting and the clinician reacting, client
questions, and closure. During the first (or any) meeting, client reactions to
the clinician's observations and questions help to (a) further assess the client
system, and (b) decide where to focus and how to proceed.
Many clinician
questions can be teaching and awareness-raising interventions - e.g. "On a scale
of one to ten, how would you rank your recent problem-solving effectiveness
as a couple?" The way participating clients respond verbally and
non-verbally also reveals
much about them to a process-aware clinician. Some questions pertain to all
clients, and others to a specific client
In a typical first meeting, there will only be time enough for a select few
of questions like these. Some may have been answered during the intake
process.
All Clients
1)
"Who comprises
/ belongs to your family now?" A related probe is "Do each of the
co-parents / caregiving adults agree on who
comprises/belongs to your family now?" Another option is "Who would
each of your kids say belongs to their family?" These start to test for
values, and
conflicts,
relationship
and
possible incomplete or blocked
2)
"Who
leads your multi-home family now - who asserts their needs and
opinions most forcefully and makes the major family decisions? This is an
initial probe for family-structure
problems,
co-parent
and false-self
3) "What
do you (each) feel is causing this (presenting) problem?" "I don't know" is a common
response. The way clients respond to this usually provides a rich
harvest of assessment information.
4)
"Who's problem is this (for each main presenting problem)
- i.e. who do you feel is responsible for resolving this problem?" This
tests for false-self
, process
, and
structural alliances and
hostilities among nuclear-family members.
5)
"What have you already tried toward filling your needs (solving
each main presenting problem)?" Response/s reveal more about the
client family's structure and dynamics, and sets the stage for the clinician
proposing new strategies.
6)
"What's the worst thing that may happen
if this (each presenting) problem isn't solved?" This assesses for
and
.
7) "From one to 10,
how would you rate your family adults' recent ability to
permanently solve major family problems?" Option: "Would one of
you describe the main differences between fighting or arguing and
problem-solving?" This is a teaching question (intervention), and a preliminary test for co-parent awareness
of their communication
(Project 2).
8) To two or more conflicted
family members: "In this situation,
whose needs do you each feel are more important - yours or (the other person's)?"
Unawareness of 1-up / 1-down attitudes and related
is a common major source of relationship conflict and ineffective
communications. The "best" answer is "Our needs are of equal importance
to me."
9) To each co-parent:
"What
would you say your (and/or your partner's) top four priorities have been
in recent months?" This assesses for adult
reality distortion, the
probable shared
of co-parents' primary relationship,
and possible adult difficulty
The client's responses
also may suggest whether either mate made one or more
re/marital choices.
This multi-level assessment question is useful throughout the work. Kids'
opinions are very helpful too!
10)
"What resources do you feel your family members bring
to solving these problems? - i.e. what do you see are your family's key
strengths now?" Often,
co-parents aren't used to thinking of - or intentionally using - their human
strengths (personal traits, talents, knowledge, etc.) in defining and
reducing their stressors - specially if they'/re dominated by reactive
false-selves.
11)
"How
would you describe the effectiveness of recent communications (and/or
..."the quality of the relationships...") between the
adults in your kids'
?" This
_ reinforces that their kids' "other parents" are full members of their
nuclear stepfamily, and _ begins to assess
for significant
to co-parenting teamwork among divorced parents and their new partners (
and
).
12) "How would you rate the ability of each adult in your
family to
their
effectively?" This
is an initial probe for significant co-parent wounds, knowledge of
grieving basics, a toxic family
grieving
and possible
incomplete or blocked
grief.
13)
"Has anyone in your
or your mate's family and/or ancestry had (a) significant trouble with the law, (b) any of the four
or (c)
medication or treatment for psychological problems? This
is another initial assessment for inherited false-self
and low-nurturance
childhoods for any co-parents.
14) "Which
other family members would you wish to participate in our work?";
or
"I need (name specific other client adults and kids) to
participate with us. Do you see any problem with that?" This
starts to evaluate the viability of working with
,
and possibly some or all children and key relatives.
Divorcing and Re/divorcing-family Clients
15)
"Is
anyone in your home or family thinking seriously about (re)divorce? If so -
who?" If the implied or direct answer is "yes," a cluster of
related questions like these may be relevant in the first meeting:
-
"Can
you mates each name the specific key
you each aren't getting met well enough recently?" This can
lead to a more detailed discussion (in another meeting?) of (re)marital
needs, priorities, and how couples can use effective communication
skills to get them met more often.
-
"What benefits do you each see to legal
separation and/or divorce?"
-
Have
you agreed on what each of your (dependent) kids will if you
decide to (re)divorce? This can promote a discussion of
typical kids' developmental and
adjustment needs to parental
divorce and re/divorce,
and who is responsible for filling these needs adequately. The
alternative is major co-parental
-
Do
you each feel you've tried every possible option for avoiding
re/divorce? Even if the couple says "Yes," you may give them a
copy of these 29 alternatives with
or without summarizing and discussing them.
-
"Do
you have (a) a shared definition of a
'successful'
(re)divorce and (b) a cooperative
plan to achieve
that?" Expect ambivalence, confusion, guilt, and "No"
to either question; and decide if and how to begin outlining.
-
"As you know, psychological and legal
divorce causes major changes and losses for everyone.
Are you each aware of your
personal and family
and whether they're healthy?"
-
"What
do you and your kids have to help you all adjust to this major
change?"
Any
of these and/or other factors may prompt further initial assessment
questions. Unless all the participating adults are willing to focus on
divorce in the first meeting, it may be a more respectful to leave this
focus to a future meeting, after hearing more of their situation and needs.
Courting and Committed Stepfamily Clients
16)
"What
brings you here?" or "What do you each need?" or "What would
each of you like to leave here with, today?" In committed-stepfamily
clients,
the answer will suggest whether the co-parents are phase three (non-re/marital focus) or
phase four (re/marital focus)
17) "Do
your family adults and kids all agree that you are a
stepfamily?"
This begins to assess for (a)
conflicts
and/or denials, and
(b) unrealistic family
and relationship
18)
Are you co-parents and your
relatives and supporters aware that typical stepfamilies like yours differ from
intact biofamilies in over 70 ways,
and what all these differences can
to your adults and kids? Co-parents are never aware of either of
these, so a teaching question like this can raise their motivation to learn the
answers if they're not trivializing their stepfamily identity. Option -
follow this question up by providing copies of
this and this, and inviting the
co-parents to study, discuss, and apply them to their unique situation.
19)
"Have
any of your adults studied how to create and maintain a high-nurturance stepfamily?"
The usual answers are "No," or "Not much." This probes for
stepfamily awareness, and begins to alert co-parents to
(a) the concept of family
and (b) how much typical stepfamilies
differ from intact biofamilies.
More
sample questions for first clinician-client meetings...
20)
"Do all your co-parents have a
mutually-agreed plan to
your several biofamilies over time?"
Typical co-parents and relatives have never identified the 16
categories of things they need to patiently merge and stabilize over time,
specially if they discount or ignore that the new mates' commitment initiates
forming a
multi-home stepfamily together.
21)
"Are
all your co-parents clear and agreed on the long-term
of your (step)family?" or "Are all your co-parents (and kids
and
relatives) clear on why your (step)family exists?" The common answer
to this is superficial and vague, or "Not really." If so, these first-meeting
questions can interest co-parents in (a) learning the concept and practical
value of evolving a consensual family mission or vision statement, and (b)
becoming motivated to use it together to resolve complex and conflictual
family dilemmas. If client co-parents show little genuine interest in this,
assess (a) for false self wounds and (b) the adults' true priorities.
22)
"How do your
adults decide if your nuclear (step)family is 'working well'?" This
tests for adults' long-range vision, systemic awareness, and whether they're
aware of and concerned about their multi-home family's
("functioning"), See co-parent Projects
,
,
and
.
23)
"What would you say are your stepfamily's most significant
recently?" or "If you
need (step)family support, what kind, and why?" Typical
stepfamily adults lack informed support, and may not know they need it until
major crises evolve. They also don't know how to critically evaluate stepfamily
advice,
counseling, support-groups, or
materials. Option - introduce
co-parent Project 11, and give co-parents
copies of these linked articles as appropriate, and follow up to learn their
reactions.
If Presenting Problems Focus on a Primary
Relationship...
24) "On
a scale of one to 10, in the last several months, how respected by your partner
have you felt?" A common partnership problem is often disrespect, and
mates not knowing what causes that, and how to talk about rebuilding respect.
25) "On
a scale of one to 10, how well heard - vs. agreed with - by your
partner have you felt in the last several months?" Typical
dissatisfied couples have ineffective communication skills, including
inabilities to hear each other, and to talk constructively about improving that
(metatalk and problem-solve).
26) "When
you two have a disagreement, how do you usually try to resolve it, and who's
needs usually get met?" This introduces the idea that communication
occurs to fill
and begins to illuminate marital communication
and
27) "Right
now, would you say you feel like partners or opponents?" This lays the
groundwork for exploring what prevents the couple from acting cooperatively,
rather than defensively or aggressively.
28) "When
you have family conflicts
over parenting issues, who do you feel your partner usually sides with?"
This begins to test for probable stepfamily
and
conflicts and relationship
29)
"In the last several months,
what would you say your partner's top three or four
have been - as judged by his/her actions?" This begins a focus
on how important the mates' relationship is to each of them. If the relationship
is not consistently among their top several priorities, that can be a primary
problem and/or the symptom of another primary problem (like psychological
in one or both mates).
These
represent the wide range of initial assessment / teaching questions a clinician
can ask. The clients' need to vent will shape how much time will be available to
ask and process them in this first meeting. Before beginning to close the
meeting, a final summary question can be something like...
30)
"After all that we've discussed, what do you feel is blocking
the co-parents in your (step)family from resolving these
problems?" Option: after the clients respond, summarize
and illustrate the premise of surface and primary
problems (unfilled needs), and the learnable skill of
to discern the latter.
Reflect on what you just read in relation to what you believe typical
clients and
clinicians need in their
first meeting. How do these questions compare to the ones you're used to
asking? Option - edit these questions
into an intake questionnaire and/or a homework
worksheet for co-parents to complete and discuss prior to the next
meeting.
Effective clinicians will reserve 10"" or 15" to close the first meeting
comfortably. What usually needs to be covered?
