Module 12: Lesson 2

The FST Progress Scale and Mini ScalesWorksheet

FST Digital Advanced Training Course12 FST Techniques to Become a Family Trauma Expert

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Lesson 2The FST Progress Scale and Mini Scales

Lesson #2 worksheet will show you Step 1: Scaling to Assess Overall Progress (Progress Scale) and Step 2: Mini Scales to Consolidate Healthy Undercurrents. These steps are detailed in Chapter 13 (pgs. 336-345) in your Resource Book. This worksheet will serve as your quick reference guide.

In this worksheet you will:

• Learn how to create both a Progress Scale and Mini Scales in Phase V.

• See the templates of both the progress scale [Figures 2 & 3] and the mini scales [Figure 5] used for Dexter’s Family.

Three Action Steps#1 – �Read�Chapter�13�(pgs.�336-345)� Why?These are two of the essential steps in the entire FST Model. Please read these pages for additional case studies and details to onboard these techniques with excellence. This chapter complement this worksheet.

#2 – �Progress�Scale�or�Scaling�to�Assess�Overall�Progress�� ✔ Immediately before the appointment, you (the FST therapist) will draw on a

giant flip chart page or dry eraser board a scale from 0% to 100%. 0% = the

Phase V: Evaluate Progress and Relapse Prevention Step 1: Scaling to Assess Overall Progress Step 2: Mini Scales to Consolidate Healthy Undercurrents

Step 3: Review Decision Tree for Next Steps

Step 4: Co-Create Red Flags Checklist

Step 5: If Graduation: Callbacks and Tune-Ups

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playbook is not working at all, and 100% = the playbook is effective all the time. If online, you will type out the answers in real-time (see Figure 1).

✔ It is ideal to begin your face to face or online session in Phase V with the Progress Scale technique, as illustrated with Dexter’s family in the video lesson.

✔ It acts like a laser beam to provide both you and the family a road map of what is working, what is not, and what is needed to improve in the future.

✔ Scaling overall progress has a secondary benefit of providing a foundation for the subsequent steps in Phase V. For example when the FST therapist is giving a rationale for their decision tree recommendation in Step 3, they may state something like, “Earlier you presented an overall score of 80% for your playbook success. According to our decision tree options, this makes you (the family) a great candidate to graduate and to create what is called a ‘Red Flags Checklist’ to prevent future relapses.” As this example illustrates, the overall scaling scores provide the perfect foundation to segue to the other relapse prevention techniques.

The following transition statement is used to introduce this step:

What you see on the flip chart is somewhat similar to the stress chart that we used during our first meeting.

The difference is that the first 0% to 100% scale measured your overall stress in the form of a stress chart.

This time, the 0% to 100% scale is used to measure the overall progress of how well each of you personally thinks your playbook has worked since the last time we met.

Your rating will be somewhere between 0% and 100%. (Point to scale) 0% means that you think that the playbook is not working at all, and 100% means that it is working great 100% of the time.

Starting with the kids first, I will go around the room and ask each of you for the first score that comes to mind. I will then write your first name directly over the percentage number you select.

Figure 1: The FST Progress Scale of Playbook Effectiveness

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After everyone gives their overall score, I will circle back around, starting with the kids again first, and ask this question: “If we can improve how your playbook works by just 10%, what do you or others need to do to make this happen?”

Then I will this second question: “What is happening now to account for the fact that the number you gave is not lower?

This information is essential because it helps tell us where we go from here or our next steps.

Case ExampleAs Figure 2 illustrates, Dexter’s mother first answered this question:

What are you doing right now that is positive that is preventing that number from being lower?

And then this question (see Figure 3):

What are the concrete steps needed to raise the contract or playbook’s overall percentage?

Figure 2: What is Happening Now to Prevent the Number From Being Lower

What are you doing right now that is positive that is preventing that number from being lower?1. Soft communication – break the cycle; did not take the

bait; not taking it personal when he pushes your buttons2. Consistency of the rule everything in writing – concrete

definition of disrespect and it’s in writing; “matter of fact”3. Nurturance – Making a more conscious effort to be more

nurturing; MORE INTENTIONAL; UNCONDITIONAL LOVE; FIRST PLAYBOOK HELPED

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Cynthia for Maxon

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Adam for Maxon

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Cynthia for Dexter

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Adam for Dexter

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FST Progress Scale

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As illustrated in your video lesson, Dexter’s mother was energized by these back to back questions after providing her overall percentage rating from 0% to 100%.

For the first time (in her many years in treatment), a mental health professional asked her to brag on herself and her family with strengths-based and visual questions! This was empowerment.

And this session was entirely done online through Zoom. The visuals on the screen made the session come alive and drew the mom into the story. Online work must be visual, directive, and entertaining to work well. The FST Model, with these visuals, is built well for an online therapy environment.

Something magical happens when your family reports on tools acquired throughout FST treatment and what needs to happen in the future. Family members have an “ah-ha” moment. They see how far they have come and the reasons why. And it starts to consolidate their treatment gains.

You will replicate this same process with the FST Mini Scales. Rinse and repeat the strengths-based process of Steps 1 and 2 is intentional on my part. It is done to reinforce new and healthy undercurrents. I want to dramatically increase the odds that a second-order change can happen after FST treatment is over.

Figure 3: What Concrete Steps Are Need to Raise the Overall Percentage?

What concrete steps are needed to raise the contract or playbook’s overall percentage?1. Address School Issue – 80% watering down effectiveness2. Calendar where they get they marks – Keep a copy – New

Calendar and its all positive3. Adam with not getting buttons pushed – Better Boundaries

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Cynthia for Maxon

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Adam for Maxon

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Cynthia for Dexter

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Adam for Dexter

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FST Progress Scale

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Re-watch this technique again in your video lesson. This time notice the energy, excitement, and hope in mom’s voice as she comes alive. And then, when you replicate the same process, see how the same thing happens with your family. It is so exciting to be a part of this new narrative or storyline.

#3 – �Mini�Scales�to�Consolidate�Healthy�Undercurrents ✔ The next step in Phase V (Step 2) uses a technique called mini-scales. The

primary goal is to spotlight the effectiveness of healthy undercurrents for that family. As stated earlier, it is like the progress scale. But it is a much more laser beam focus on healthy undercurrents. Undercurrents are the DNA or direct bridge to take your client or family from first-order or temporary change to second-order or permanent change.

✔ You will draw the mini-scales in real-time on a blank flip chart or a whiteboard. The scales go from 1 to 5 (1=no improvement in the healthy undercurrent; 5 =a lot of gain) (see Figure 4).

✔ As Figure 4 illustrates, the mini scales of 1 to 5 will be used to document two different periods before FST treatment started and then after FST treatment, that is, at present.

✔ This before vs. after context is not done with the intent of saying, “look how great FST treatment is!” Instead, it is done to serve as an anchor point to help your family members see how far they have come in a relatively short time.

✔ In turn, the hope is that this will help your family take credit and pride for any key undercurrent changes and keep it going.

The following transition statement is recommended to introduce your FST Mini Scales:

Thank you for giving me your opinions on how well your playbook is working and concrete suggestions to make it work better in the future.

Figure 4: Sample FST Mini Scale to Consolidate Healthy Undercurrents

Healthy Undercurrent Before FST After FST (Now)

Forgiveness 2 out of 5 4 out of 5

Accountability 1 out of 5 4 out of 5

Attachment 1 out of 5 3.5 out of 5

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I now want to take things a step further and take about the next 20-30 minutes to ask you a question around what we call “mini-scales.” These will be used to see how much progress we have made with each of the healthy undercurrents we targeted to help your child. So here is the question:

On a scale of 1 to 5 with “1,” meaning little to no improvement in ________(insert healthy undercurrent) before we started counseling to “5,” meaning 100% positive change since counseling, where do you think you started and where are you today?

Let me write out each one of your healthy undercurrents in a table format (see example in Figure 4). We will get your ratings one at a time. Because of time constraints, I will not be able to ask everyone. I will pick out one or two of you to answer. If I don’t pick you and you want to add something, feel free to jump in.

After you answer, I will ask you, “How do you account for this improvement? Or “What has been happening in your family to account for this improvement?”

Remember, these healthy undercurrents are important to look at. If we heal them, it will help heal your child’s wounds long after counseling ends.

Case ExampleAs Figure 5 illustrates from the video lesson, the FST Mini Scales represented a significant turning point. In pre-treatment, the mother was unable or unwilling to show soft communication or nurturance with her son, Dexter.

This is important because of the constant lack of nurturance from both parents was the critical unhealthy undercurrent of Dexter’s extreme problems of aggression and disrespect. Dexter felt abandoned. And over the years, this abandonment turned into unhealed trauma. Also, this family had multiple treatment failures. So, they had been stuck for a long time. In turn, this abandonment metaphorically “calcified” over the years meaning that it would be difficult to change entrenched undercurrents.

But as mom states in the video, the playbook combined with the role plays and support of her extended family was the difference-maker. Without the FST Mini Scales, the key healthy undercurrents may never have been “spoken out loud.” In turn, this family may not have taken credit for the changes. Therefore, at the first major stressful event (post-treatment), the likelihood of a return to the status quo and relapse would have skyrocketed.

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Success MilestonesAfter you complete this worksheet, look for these success milestones in your practice:

✔ Watch for Family Empowerment and Its Positive Impact – These two techniques combined, pack a powerful one-two punch. It provides your client or parent the step-by-step tools they need to become not only the expert but take credit for the changes. Look for these signs. Body language, voice tone, energy, confidence, and ownership. It will be like you lit a stick of dynamite of hope. You have to see it to believe it! But the good news is that you will have a front-row seat. Get your popcorn ready

Figure 5: A Mini Scale Example from Dexter’s Family

Mini Scales: On a scale of 1-5 (1 being the worst it could be and 5 being the best), where were you on this undercurrent before FST began and now?

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Cynthia for Maxon

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Adam for Maxon

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Cynthia for Dexter

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Adam for Dexter

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FST Mini Scale

Healthy Undercurrent Before FST After FST

Avoidance of Button Pushing – Education Knowledge is power – role plays, breaks habits with practice 1.5 4

Consistent Discipline/Nurturance – same process – having strategies 2 3.5 (4)

Soft Communication – step-by-step 1 5

Maintaining a Supportive Village 1 3

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✔ The Possibility for Second-Order Change Increases – Watch for this milestone after the FST Mini Scale technique. If it goes well, your clients will self-report in your ethnographic interview, “that the mini scales were one of the most helpful tools out of all of the others combined.” Then ask, “why?” and listen to their answers. It will show hope but more important confirmation that your family is taking ownership of the healthy undercurrents as their own.

Big Ideas: Lesson 2 Video#1 –The FST Progress Scale

✔ The first relapse prevention technique called the FST Progress Scale.

✔ The first step is to assess the family member’s perception of how well their FST Playbook is working overall on a scale of 0% to 100%.

✔ After providing a rationale for using the progress scale, Cynthia, Dexter’s mother, provides answers for the entire family through the use of circular questions.

✔ There is a considerable discrepancy between Cynthia’s perception of how their FST Playbook is working for the adults vs. how it’s working for the kids.

✔ I challenge this perception as to whether or not it’s the FST Playbook that at fault or the need for more time to work.

✔ This is a crucial tension point in treatment that you will likely face with the clients in the future. Is the lack of progress the fault of the playbook or the parents delivering it? Perception is everything, whether it’s true or not.

The Progress Scale: A Crossroads in Treatment ✔ When there is a discrepancy in perception as to how the playbook is working,

you must hit the pause button and work through it before moving onto the next relapse prevention technique. Otherwise, your treatment can stall and be ineffective if an inaccurate narrative from your parent goes unchallenged.

✔ I sidebar with one of the FST community members and Michael, the family’s therapist, possible next steps, and why this is such an important crossroads in treatment.

✔ After the sidebar, I illustrate what happens next in the consultation session with mom to challenge mom’s narrative or perception. In the process, we uncover a significant theme that keeps this family stuck. Parents do not stick with any intervention long enough to see change.

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The�Progress�Scale:�The�Top�Reasons�for�Success ✔ Here we saw how to breakdown the overall progress percentage into the top

three reasons for this progress.

✔ When you completed the stress chart at the onset of FST treatment, it was breaking down the overall stress into the top three problems. Now, it is time to breakdown the top reasons for FST success using the FST Playbook.

#2 –The FST Mini Scale ✔ The second relapse prevention technique is called the FST Mini Scale.

✔ This is arguably one of the most important moments in FST treatment. The reason is that this technique allows your family members to take actual ownership of their healthy undercurrents and self-report their progress.

✔ When this happens, a powerful stickiness factor takes place too quickly; you’re your clients or family members to second-order change. Or that their healthy undercurrents can be the new normal or operating system.

✔ Watch how the mom’s voice tone becomes more excited and hopeful as she takes credit for these new and healthy undercurrents and connects the dots as to what caused them.

#3�–The�FST�Decision�Tree ✔ The third relapse prevention technique is called the FST Decision Tree.

✔ After the FST Mini Scales, you must make an important decision with your client or family. Move towards graduation using a red flag checklist and callbacks or continue with FST treatment with new playbooks or tweak existing ones.

✔ In traditional treatment, this important decision is often made verbally or informally. In sharp contrast, an FST decision tree handout is used so that graduation steps are clear and transparent.

✔ It invites a co-ownership and collaboration from everyone as to the next steps. Here we see how Cynthia, the mother, responds and is empowered. In turn, we see humor and playfulness emerge caused by this empowerment.

#4�and�#5�–The�FST�Red�Flags�Checklist�and�FST�Callbacks ✔ The fourth and fifth relapse prevention techniques are the FST Red Flags

Checklist and FST Callbacks.

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✔ Here you saw that even though Dexter’s family is not yet formally ready for graduation, the family still benefits from what it will look like or movie trailers of upcoming attractions.

✔ These last two prevention techniques work together to give Dexter’s mom, Cynthia, hope for the future.

✔ I show the FST Red Flags Checklist that was used. You will then see the session where the concept of callbacks is outlined, and Cynthia’s response. Callbacks are discussed in detail within pages 360-367 of your resource book. You will see how to end your FST treatment with excellence.

Please Note: Materials that are included in this course may include interventions and modalities that are beyond your authorized practice as a mental health professional, case manager or parent support liaison. As a professional, you are responsible for reviewing your scope of practice, including activities that are defined in law as beyond the boundaries of practice in accordance with and in compliance with your professions standards.