Module 3: Lesson 1

Tools to Set Up Your FST

Stress ChartWorksheet

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

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Lesson 1Tools to Set Up Your FST Stress Chart

This worksheet is designed to help you:

• Zoom out: Where the FST Stress Chart fits in Phase I of the FST Model.

• Know what to bring before the first face to face intake session or meeting.

• Rules of thumb to execute a great warm-up and then move into your first FST Stress Chart transition statement: “Do you agree all families have stress?”

• Seamlessly connect the dots to Lesson 2 and your next worksheet.

If you are not a direct therapist, you will still benefit from this technique. For example, probation officers, school counselors, and caseworkers have reported that the stress chart is easy and straightforward to use, whether you are engaging in formal direct treatment or not. The stress chart can also serve as a perfect segue for the school counselor, case manager, or JPO (juvenile probation officer) to state something like:

"Wow, you all have a ton of stress. You can see it on your stress chart. What do you guys think about me referring you to a professional counselor who uses this FST approach to help you as a coach to decrease the high-stress level?”

Family members hate the word "therapy" or "going to therapy or counseling." But they like the word “coach” and "lower our stress levels." Remember, it's not what you say but how you say it using concrete visual tools like the Stress Chart.

Hopefully, this theme is becoming apparent as you go through the course: We can work smarter, not harder when we all speak the same systems language (i.e., stress charts, undercurrents, playbooks, etc.). And when we work together as a community to pass the baton from one professional to another.

In this case, using tools like the MI script or stress chart can enable a non-clinician (JPO, case manager, parent support advocate, etc.) to help a family transition seamlessly from one point of the healing process to another. We don’t live in a perfect world. It is messy. But we have to try to create a better operating system rather than a Baskin Robbins 31 Flavors of just one new technique after another. The fewer silos and the healthier we are as a helping profession in systems thinking and application, the healthier our families will be. An oppositional kid is part of an oppositional system. But the lessons and worksheets may help oppositional systems work in tandem with one another with a universal language.

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Four Action StepsParents and kids are immediately put at ease when they can self-report on a flip chart the areas of stress at home and break it down into their top three problems. Every stressed-out child or family wants to talk about and solve three central pain points:

1. How stressed out I am with my child or each other (need to vent)?

2. What is causing my stress and child’s traumatic symptoms?

3. “Now what?” – What concrete tools will you give me to cure our stress or our child’s problems/symptoms?

The answer to the first question is accomplished through the FST Stress Chart. The other questions are answered as we progress through the other modules.

Let’s get started with a quick Zoom Out at how the FST Stress Chart fits within the FST Model and then how to set up this technique to quickly join with your families through what is called a “warm-up” or social stage.

#1 – �Zoom�Out�to�Chapter�3�(pgs.�33-40)� of Your Resource Book

Read Chapter 3 – pgs. 33-40 (just seven pages long).

WARNING: READ THESE PAGES ONLY. DO NOT READ AHEAD. WAIT UNTIL MODULE 4.

Why?• Do you remember Worksheet 1 Module 1 on Structural Mapping and Lesson 1

which stated the differences between just being eclectic (techniques only) vs. integrative (techniques + theory) and the benefits of doing both?

• To help you become proficient in both, I will strategically Zoom Out the FST Stress Chart technique to the FST Model and then dive into the step-by-step application of this technique. Zooming Out before Zooming In will help you to become better at being both eclectic and integrative.

• Chapter 3 in your Resource Book is specifically designed to connect every FST technique in your course to the 5 Phases of the FST Model. And the optimal timing of when and how they are delivered.

• In this case, pages 33-40 will connect the dots for you between the FST

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Motivational Technique to your first face to face intake session using the FST Stress Chart. The FST Stress Chart is Step 1 of Phase I: Identify Symptoms (Stressors) & Set the Goals for Therapy (see Figure 1).

• But as the warning states, please don’t read too far ahead in Chapter 3. For learning purposes, it is best to work in tandem with the release of the next FST technique Module with that part of the FST Model.

• Read the Chapter 3 pages first (pgs. 33-40) for the FST Stress Chart to Zoom Out and then complete the rest of the Action Steps in each worksheet for this module to Zoom In.

Figure 1: The FST Stress Chart and the FST Model

Behaviors & Safety

Stabilization First

Wounds and Safety First

Phase I - Identify Symptoms (Stressors) & Set the Goals for Therapy

• Step 1: The Symptom/Stress Chart – Module 3• Step 2: The Seed/Tree Diagram

• Step 3: The Top Seed and Symptom Selections

• Step 4: The Choice between Stabilization or Direct Trauma Work First

• Step 5: Setting the Goals of Therapy

• Step 6: Consolidate Gains Using Ethnographic Interviews

Structural-Strategic Theory and FST Model – Module 1• Structural Mapping

• Three Simple Steps: Toxic Seeds, Undercurrents, and FST Trauma Playbooks

• Different Roles: Stage Director, Co-Author, and Creator of Enactments

The Motivational Phone Call – Module 2• Step 1: Why are FST Motivational Phone Calls Important?

• Step 2: The SPIN Theory behind the FST Motivational Phone Call

• Step 3: The FST Motivational Phone Call Scripts

• Step 4: The Stick and Move Technique

• Step 5: The Use of Effective Closing Remarks

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#2 – �Know�What�to�BringBefore the SessionBefore you begin your session and use the FST Stress Chart technique, please bring with you the following items:

` A Stress Chart Template – See Figure 2: Before your session begins, you will want to bring the Figure 2 template and hang it on the wall or be ready to draw it in real-time when needed.

You have the choice of either replicating the symptom/stress chart template in Figure 2 on a flip chart or using a PowerPoint slide to show the family (see your PowerPoint Slide Share for this Lesson). In addition, a HDMI cable can connect your laptop computer to either a flatscreen television or a portable LCD projector to project the Stress Chart template and type in the family’s answers in real-time. Many families have flatscreen televisions today with an HDMI input that can be used in a home session.

Or you can pre-draw the template on a giant flip chart, which can be stuck on a blank wall in the family’s home or office.

The template should be covered with a blank sheet of paper to hide it from view until the tool is ready to be used.

Please Note: The term “stress” and “symptoms” are interchangeable. Our research showed again and again that family members preferred the word “stress” over the word “symptoms.” Therefore, a family member might say that the top problem that causes me to be at 100% overall stress is that my child is disrespectful, aggressive, and cuts on themselves. These stressors in mental health would be problem “symptoms.” But in the family’s world, these symptoms are called “stressors.” You will connect these two terms (stress and symptoms) for your family in the FST Seed/Tree Diagram in Module 4.

Figure 2: The Stress Chart Template

60%50%40%30%20%10%0% 100%90%80%70%

0% =

No Stress

100% =

Maximum Stress

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` Copies of the safety stressor questionnaire handout – You will make copies of the safety stressor questionnaire from Table 5.1 in your Resource Book (pg. 125-126) or Worksheet 3 of Lesson 3. At the appropriate time, you will hand it out to each family member. This questionnaire includes the seven common safety issues (i.e., threats or acts of violence, alcohol, or drug use beyond experimentation, bullying, self-harm) found with at-risk children and adolescents.

Lesson #2 and #3 will show you the timing and how to use both of these items for maximum impact.

#3 – �Rules�of�thumb�to�execute�a�Great�Warm-up�(Social�Stage)�and�then�move�into�your�first�FST�Stress�Chart�transition statement: “Do you agree all families have stress?”

As outlined in Lesson #1, #2, and #3, there are five mini step procedures to execute the FST Stress Chart Technique:

1. Ask a key transition question.

2. Obtain an overall stress rating from each family or village participant.

3. Convert overall stress into the top three problems.

4. Locate safety stressors.

5. Discover how much each problem (stressors) will reduce the overall stress level if healed.

This worksheet provides the 3 Rules of Thumb to execute a great Warm-Up (Social Stage) for:

Mini-Step #1: Ask the Key Transition QuestionRead Chapter 5 (pg. 118) for an outline of the Key Transition Question and how to deliver this step.

3 Rules of Thumb to a Great Warm-Up (Social Stage)Re-watch the warm-up with AJ and his family (12:44-19:19) with a copy of these 3 Rules of Thumb in front of you. It will connect the dots. The term “warm-up” is synonymous with the term “social stage” that Jay Haley first developed.

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` Rule of Thumb #1 – Don’t Jump in Too Quickly

• When the client or family member walks into a first session, they are often greeted with “What is the problem?” or “Why are you here?”

• Instead, as pg. 118 outlines, settle the nerves of your family, and ease them into the FST Stress Chart with this question:

“Before we get started, can I quickly go around the room and ask you about any hobbies or things you like to do?”

• Don’t just ask this question and let it lie there. You will get the sound of crickets. Instead, be proactive and go to the person in the room that seems more open to talking. That person will most likely be the person(s) you conducted the Motivational Phone Call with (the parents). Say to that person something like:

“John, what hobbies or interests do you have?” –

Once the first person answers, it opens the door for others to as well.

• Kids are often tough to crack. But they are also walking advertisement with their shirts or hats. Also, learn about the most recent gaming systems. If you say something like:

“What kind of video games are you into?”- It can jump-start the process. Also, if you are curious and let them be the experts, it will open the door for discussion.

In addition, if you find something they like, ask them to bring it into the next session (sample video game, artwork, etc.) to show you. And do the same for the parents, if the same opportunity is there.

` Rule of Thumb #2 – Mirror the Family

• Mirror your family. If they want to take a little longer talking about hobbies or interests, do so. If they choose to “get down to business,” then you mirror that as well. This mirroring will put the family more at ease because you are moving with their rhythms.

` Rule of Thumb #3 – One Strength-Based Question

I did not list this tactic on pg. 118, but I recommend moving into this strength-based question after the hobbies and interests discussion and before moving into your FST Stress Chart transition statement. Here is this question:

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Go to the parent first and ask: “As I get to know your child ________[insert name], what are some qualities that I would come to admire about him or her?

If you already asked this same question during the Motivational Phone Call, a simple modification is used:

“I know I asked this question during our phone call. But your child was not there in person to hear it so I want to ask it again so they can listen to it. “As I get to know your child ________[insert name], what are some qualities that I would come to admire about him or her?”

Don’t forget your process steps. Ask for examples and fan the flames of hope.

Review your process steps from Module 2-Worksheet 3: How to Deliver the FST Motivational Script With Excellence (i.e., be fully present, mirror body language, tracking, utilizing, reframing, etc.)

If the parent can answer this question positively, you can then go to the identified child and siblings with this statement:

“As I get to know your parent ________[insert name], what are some qualities that I would come to admire or that you like about them?

Warning: If the parent or caregiver cannot give anything positive, do not set up the child and ask this question. Instead, move on to the FST Stress Chart Transition Question.

#4 – �After�Warm-up:�Move�into�your�FST�Stress�Chart�transition statement: “Do you agree all families have stress?”

The FST Stress Chart Key Transition StatementThe transition from the warm-up or social stage to the FST Stress Chart Technique begins by asking the following question:

“By a show of hands, how many agree with the statement, ‘All Families Have Stress?’”

This is a great transition question. Everyone’s hand will likely raise.

Congratulations! You Are Now Ready to Move to:

The FST Stress Chart Mini Steps of #2 & #3 outlined in Lesson #2 and Worksheet #2.

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Success MilestonesAfter you complete this worksheet look for this success milestone to see immediate positive outcomes in your practice:

✔ Experience the Joy of the Warm-Up or Social Stage – Notice and experience the joy, comfort, and hope you experience after doing the warm-up or social stage. Your family is more relaxed and open as you gently move into the transition question of “Do you agree all families have stress?” As a personal experiment, try the warm-up for your next client and experience the shift.

Big Ideas: Lesson 1 VideoHere is a quick summary of the Big Ideas

Why�is�the�Stress�Chart,�an�Ideal�Diagnostic�Strategy? ✔ The FST Stress chart has five mini-steps that you can read about in greater detail

from pages 116-129 in your resource book.

✔ I discussed the backstory of the development of the stress chart technique and the four key reasons why the FST Stress Chart was an ideal first step to begin complex trauma treatment.

✔ The stress chart can quickly disarm family tensions and move your parents away from a “just fix my kid” problem to a systems perspective of “we all have to change.”

How�to�Get�Started:�Warm-up�With�Hobbies�and�Strengths

✔ Often, we begin our first face to face meeting with “what is the problem?” or “why are you here?”. We would never do this if we invited someone to dinner.

✔ Instead, it is best to ease into your first face to face session or meeting by asking your family members about their hobbies or interests and then about their strengths. This warm-up proceeds your transition into the FST stress chart.

✔ Here you saw the warm-up (social stage) I used to join with 14-year-old AJ and his family.

✔ I began the session by joining with AJ on his hobbies and interests around Karate that parallel with my son’s interest in Karate to make AJ the expert.

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✔ I then joined with the grandmother, AJ, and the grandfather around strengths questions: “If I got to know you better, what would I admire…”

✔ You are encouraged to replicate this same warm-up process with your family.

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.