fft webinar 3 - motivation techniquesfft webinar #3 -motivation techniques july 2013 12 behavioral...

FFT Webinar #3 - Motivation Techniques July 2013

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Motivation Techniques

Copyright FFT LLC 2013

� Review of Change Meaning and Change Focus Techniques

� Examples of each technique

� Opportunity for questions



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12/21/10

Fear / Punishment Positive Alliance, Hope

Hype, Hype, Hype, Hype, “Understanding“Understanding“Understanding“Understanding””””

SHAME

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MOTIVATION

RELATIONAL

ASSESSMENT

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GENERALIZATION

BEHAVIOR

CHANGE

S E S S E S S E S S E S SSSS I O NI O NI O NI O N

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• Change Focus

• Change Meaning• Strength-based

• Relational

• Non-judgmental

• Respectful

• Interpersonal

• Clinical

• Contingent

• Responsive

• Create context for change

• Decrease conflict

• Increase hope

• Balanced Alliances Goals Skills

ActivitiesFocus

Motivation PhaseMotivation PhaseMotivation PhaseMotivation Phase


� 14 year old African American female, parents are divorced and youth lives 90% of her time with mother. Mother had a closed head injury during adolescence and functions at a lower cognitive level. Dad is a well known drug abuser/dealer in the community. Multi-generational involvement with police/justice systems. Youth is at age appropriate level in school, but struggles in peer relationships at school and community.

� Youth’s runaway pattern before FFT included several runaways which were of short duration (less than 48 hours) and one which involved her getting on an Amtrak train and traveling to a city 2 hours away where she got off the train and gave authorities a fake name and stated that she was homeless and all family members were deceased

� Youth on probation for shoplifting and lying to police



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� Multiple referrals to Child Welfare for neglect allegations – all unfounded – most referrals from school

� History of Sexual Abuse to youth from mother’s former paramour

� Youth has had several mental health evaluations – no diagnosis

� Mother on SSI due to her closed head injury


� During the motivation phase of FFT the therapist needs to change meaning around the problem behaviors for both youth and family members

� Through changing the meaning the therapist opens up the possibility of change – going from the only situation being for the youth to quit doing the problem behavior to the family working together to reduce conflict



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• Consistent and contingent responding to disrupt blame and create hope

• Accommodate to the family without challenging individuals or relational functions

• Matching


“Match to” clients:

Working hard to respect and

understand them, their

language, norms, etc

In the Motivation Phase it is “all about them”



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� Remaining calm when mom got easily excited – my being calm helped her to calm down and helped youth feel more comfortable

� Using basic language due to mom’s cognitive abilities

� Recognizing youth’s “influence” in family and her need to assist mother in day to day activities


Techniques of the Motivation PhaseTechniques of the Motivation PhaseTechniques of the Motivation PhaseTechniques of the Motivation Phase

Change Focus Change Meaning



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� Change Focus Techniques are used to change the focus for the family. This could be from negative to positive, from individual to relational, to outside the family to inside the family or from negative to less negative


� Change Focus technique that is used to interrupt negativity and blaming – how you do this is part personal style and part matching to the family –

� So with some families you will need to acknowledge that you heard what the blaming person said and then move to another technique – Mom, I hear that you are really worried abouyyour daughter, this tells me that this is really important to you

� Diversion is simply saying something to completely change the topic – this serves to stop the blaming and sometimes to “buy” the therapist time to think of a technique to use



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� This is when therapist points out something that they see happening in front of them in the session – it must change focus –not just a statement about the process.

� For example, Mom I notice that your daughter starts crying when you talk about her father – this does not change the focus and could make mom defensive.

� However, if you say – “Sally, I see when mom talks about your dad you look down and start crying, it makes me see how important all of this is to you and also how hard it must be for both of you.


� The same as Point Processing, but from a story that the family has told you instead of what is happening in from of you. You take part of the pattern that they are talking about and shift the focus.

� So Mom, if I understand correctly – your daughter runs away and this scares you, but she always turns herself in within a short amount of time

� Or, to youth – I hear that you think that mom is constantly “nagging” you, but you also say that she is always there when you need her



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� These are statements that bring family members together and selectively attend to their strengths.

� All of you are really protective of each other

� Both of you are strong women who are willing to stand up for yourself and each other

� All of you want to work this out


Change Meaning TechniquesChange Meaning TechniquesChange Meaning TechniquesChange Meaning Techniques

Relabels and Theme Hints

- Provides an alternative, benign “labels”

- Short comment about a possible alternative domain (especially emotional / affective) that tends to arouse less blaming and negativity.

Reframes

- Introduces less intense and possibly more benignmotives or “reasons” for the negative behavior.

- Suggests noble but misguided intent with respect to a family member’s negative behavior.



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Examples of Theme Hints that can Examples of Theme Hints that can Examples of Theme Hints that can Examples of Theme Hints that can lead to Themes/Reframeslead to Themes/Reframeslead to Themes/Reframeslead to Themes/Reframes


� Relabel/Theme Hints – Mom’s nagging = her caring and concern

� Daughter’s running away=chance to escape stress� Daughter's running away=trying out new personalities� Mom’s anger = frustration at not knowing how to help

� Reframe: Mom, you say you want your daughter placed outside of the home, I think this comes from your worry that you can’t be a good mom to her, I think you are a good mom, but you just haven’t found a way to talk to your daughter that doesn’t result in hurt feelings for both of you



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Change Meaning TechniquesChange Meaning TechniquesChange Meaning TechniquesChange Meaning Techniques

Themeshemeshemeshemes

Identifies specific behavioral sequences or broad

relational patterns within the family, and develops a

story (includes relabels and reframes) that create

new meaning of the sequences and patterns…

….a meaning that is non-malevolent (even

“noble”) intent or “reasons” behind all family

members’ behaviors.


Major Types of Themes



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� Behavioral Theme: J. you start to feel bad about yourself and your lack of friends, so in some ways I think you run as a way to try and be someone “new” and someone who has the chance to do things differently and be different, For you mom this is hard to understand because you worry and are scared for her and the truth is that J – you are in danger when you are out on the streets – what is possible though – is to find ways that you and mom can talk about your feelings of loneliness and how both of you sometimes don’t feel you “fit in” anywhere and you can find ways to support each other that doesn’t put either of you at risk.


� Relational Theme: You have both trusted people in the past that have let you down and hurt you and both of you have said that you don’t really know “where you belong”, this leads to both of you trying to find a place where you feel belonging and sometimes put you at risk – I think this is from you really wanting to be a “family”, but just don’t know how to at this point.



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◦ Just Empathy…Just Empathy…Just Empathy…Just Empathy…

““““I understand your pain…”I understand your pain…”I understand your pain…”I understand your pain…”

◦ A “traditional Interpretation” ( “underlying truth”) A “traditional Interpretation” ( “underlying truth”) A “traditional Interpretation” ( “underlying truth”) A “traditional Interpretation” ( “underlying truth”) “what this really means is …”“what this really means is …”“what this really means is …”“what this really means is …”

◦ Simply “supporting” ..Simply “supporting” ..Simply “supporting” ..Simply “supporting” ..

“It just feels bad now, it will be better soon…you “It just feels bad now, it will be better soon…you “It just feels bad now, it will be better soon…you “It just feels bad now, it will be better soon…you know you really love each other”know you really love each other”know you really love each other”know you really love each other”


� 15 year old male born in Guatamala – sent to live with his maternal uncle and family when he was 8

� Uncle and Aunt have 3 biological children and consider youth their own son

� When youth was 13 he started to get into some trouble in the neighborhood, got involved in a gang – ended up on probation

� Uncle sent youth to live with another aunt – youth was there 8 months

� Biological mother tried to enter the country illegally this year and was detained – she was released one week ago and came to live with her brother(the one who had been raising youth). Uncle had youth return home so that he could be with mother



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� Therapist matched to family by having translator in session to translate for mom

� She referred to uncle as youth’s father figure as it was unclear how both youth and uncle defined the relationship

� Both youth and uncle fairly laid back, therapist tried to use more laid back approach – difficult for therapist as she is usually pretty intense


� Therapist did not have to do much interruption or diversion as neither youth or uncle were highly blaming or negative



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� FT sequenced with Mr. D and J how surprising it must have been for Mr. D that J who was the "child that did not give any problem, the one you did not worry about" suddenly is involved in crimes that warrants probation. This led to a discussion on the fear and concerns regarding the future. Though J is on the right track now, Will there be another incident that will lead to him being involved with the law and/or his former gang?

� FT commented on J’s saying that he joined the gang as a means of getting "respect“ and his saying that he does not have his father and brothers around but the gang made him feel like he had a family. FT pointed out how it may be Mr. D feels like he is like a father to J and is struggling with why his extended family was not enough.


� Therapist pointed out that mother was very quiet and this may be because she was still trying to understand the situation

� Therapist pointed out that youth always turned to face uncle when uncle was speaking and how this could be a sign of respect



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� Everyone in the family wants to be together and work this out

� Everyone is scared of things going “bad”

� Everyone in family is protective of each other

� FT expressed that she has been thinking about their family from the last time they met and one thing that struck her is how supportive and loyal they are to each other. Mr. D nodded and stated this to be true.


� Fear = not wanting to lose each other

� Concern = importance of family

� Respect = feeling as if you belong



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� FT reframed Mr. D sending J away as not a means of punishing him but protecting him and his family because of his fear of what J continual involvement in the gang may lead to. FT also reframed Mr. D anger towards J as concern and feeling like he did not know what else can be done to protect him. J behavior of staying out late with his gang was a means of protecting his family from what he was involved in so as not to hurt them. His coming home indicates that he feels safe and Mr. D staying up shows he is worried about him.


� FT reframed J wanting to belong and enjoying the respect he gets from being in a gang as similar to what he gets in his family however it has come at a cost because he paid a higher price of losing freedom and dissappointing his family particularly his uncle who has served as a surrogate father to him.

� FT expressed how difficult it must be for Mr. D to observe J take up with a gang and transfer the same loyalty he has in his family to a group that has him engaging in behavior that gets him in trouble. Mr. D expressed feeling concern that while J is not currently involved in the gang, he may be lured back in when he starts high school and sees his former gang friends.



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� FT discussed the theme of protection with Mr. D and J in the context of Mr. D wants to keep J from bad influence but he is not always going to be around (ie when J is in school) and J wanting to be "free"(serve probation requirements) but at the same time does not want to be thought of as a coward when he runs into gang members

� Mr. D is worried about J getting involved with his former gang or in illegal activity and not being able to protect him if this were to occur and J wants to continue on the right track so he can "be free" but the pressure that comes with doing the right thing all the time weighs on him. He also wants to rebuild his relationship with his uncle but knows his uncle is constantly worried about whether the current change in him is going to be long term or will the family have to deal with another incident.


� All of you have experienced the “loss” of family – when J was sent to aunt, when mom had to send J to live with his uncle, when mom was jailed and yet, you still keep trying to repair and regain the sense of “family”. Things get more intense due to the fact that by losing this once before you are almost “afraid” to try again



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� You build alliance through not taking sides – strength based relational statements are really powerful with this

� You reduce blaming and negativity by changing focus (interruption, point processing, sequencing, theme hints) and then you can change meaning

� You build a relational focus with all the techniques – but especially by using change meaning techniques

� You build hope when you change meaning and offer family a new way of viewing the problem and therefore open the door to new solutions.


� Families come to us with a long history of trying to find a way through the pain, anger, and hurt – in order to do this they try to define the problem that causes these feelings –unfortunately the way they define it can often lead to more pain, anger, hurt and lack of resolution

� We start to offer new meaning and new experience, but remember that they will fall back into old patterns of behavior because it feels “comfortable”

� You must be as relentless with your attempts to change meaning as they are with their lack of hope



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� This is hard work – there is no magic potion you can sprinkle on a family and make it easier

� Keep doing the change focus/change meaning techniques

� Repeat, Repeat, Repeat, try a different technique and repeat again


� Any questions?


fft webinar 3 - motivation techniquesfft webinar #3 -motivation techniques july 2013 12 behavioral...

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