relationalfunctionwebinar - california institute for ...€¦ · hour after she leaves she calls...

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California Webinar – Assessing Relational Functions

Copyright FFT LLC 2015Copyright FFT LLC 2015

BEHAVIOR CHANGE

Sessions1 2 3 4 5 6 7 >>>> End

ENGAGEMENT

MOTIVATION

Pre-Treat-ment

FFT Direct Treatment Phases ; Analysis of Intervention Model*Relational Functions as a Focus

Post-Treat-ment

Includes Assessing Relational Functions &

“Matching” Family With respect to Cultural & Individual

Realities

Includes “Fitting” Relational Functions

to Within Family & Extrafamily System(s) Behavior Changes

GENERALIZATIONEco/Multi- systemic Linking

• Elicit and analyze information about

patterns• Observation

• Within family patterns

• Extra-familial patterns

• Perceptiveness• Understanding

systems and relationships

• Formulate relational assessment

• Plan for behavior change

Goals Skills

ActivitiesFocus

Relational Assessment Phase

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Auto

nom

y

high

low

Contactlow high

1 2

4

5

Autonomy

Contact

Midpointing3

Copyright FFT LLC 2012

1: Closeness-Distance:When one family member relates to another, the typical relational pattern

(behavioral sequences, emotions, beliefs about each other within the relationship) is characterized by the relative balance of:

Closeness / Connection / Interdependency….Versus

Autonomy / Distance / High level of “Boundaries”---------------------------------------------------------------------------------

2: Hierarchy:When family members relate to each other, the typical relative balance of

overt control/influence based on differential resources, “power,” and role, reflects:

“One Up – One Down” Versus SymmetryExpressed in Three primary patterns:

Parent 1-up, Parent & Youth Symmetrical, Parent 1-down



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When X relates to Y, the overt relational pattern over time (behavioral sequences in the relationship) of X’s behavior is characterized by:

My “sense” of psychological & emotional well being seems to

not “centered” on you(Autonomy):

Most of my “connection” is “invested” elsewhere

My connectionwith you seems to

reflect both autonomy &

Connection; there seems to be a

balance (or conflict) of both

My “sense” of psychological& emotional well being

depends heavily on you :There is considerable

investment in connecting with you

Walling Off, Separating, Distancing, Autonomy

Pulling In, Connecting

Creating Intimacy

Blended: High

Autonomy & High

Interdepen-dency

high

low

Teenage runaway

Teenage runaway

Contact: closeness, dependency, enmeshment,

Autonomy:distanceindependenceseparating,Low levels of psychological intensity(Fear of Enmeshment?)


Relational functions are determined on the basis of inference from sequential patterns…not intensity of feelings or what people consciously or unconsciously “want.”

For example, two people may “love” each other a great deal, but rarely arrange their lives so as to spend very much time together. While they “feel” intense love, their behavior patternis of autonomy.


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Conversely, two people may “hate” each other intensely, and spend much of their lives trying to find ways to ensure they never see each other again. While they may be “consumed” with each other in terms of thoughts, if their pattern is one of little or no contact then their function is mutual autonomy.

The overall pattern of direct interdependent behavior represents the degree of autonomy, midpointing, or connection.


The Behavior Pattern is what happens between family member’s when there is a problem and what happens on a day to day basis when there is not a problem.

A specific story about youth coming home late is not a pattern, it is a sequence, but from multiple sequences or “stories” that the family tell you, then you can detect the pattern. For example, if youth gets mad and runs away, this may be a one time incident or it may be a part of a pattern. You will need to determine what “typically” happens when there is a problem and when there is not a problem to make the best assessment of relational function


Family tells story of last argument between youth and mom. Youth reports that he was angry about something that happened at school, but mom didn’t ask about him being quiet, so he went to her while she was working on computer and told her about story he saw on news. She said “whatever” and when he tried to talk about it, she told him she didn’t have time. Mom reported that she was in the middle of work and didn’t have time to listen to something from television. Mark said he kept coming back until finally he told her what was really bothering him, but by then she was screaming at him and stepdad was “getting in the middle of it”. Stepdad said he just wanted to try and help, but it ends up with him being blamed. Mom said that both youth and stepdad “need to grow up”.

Stepdad told story of needing Mark to clean his room, but when he tried to talk to him about it, Mark was disrespectful. Both of them went to mom to try and talk to her about it, but she told them to “deal with it”. They continued to argue until she stepped in and told them both to drop the issue. Mark then went and cleaned his room and stepdad went and watched television


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Family reports that they eat dinner together 5-6 nights a week with stepdad cooking and mom cleaning up. They have conversations at dinner and report that after dinner they tend to be in the same room with everyone watching television. Stepdad and Youth like to watch similar programs and Youth and mom have programs they like to watch together, but stepdad and mom have different interests.

Family reports that fighting occurs at the most once a week


Family typically eats dinner together every evening and then is together in same room watching television. Youth and stepdad engage around the television shows, discussing them and making comments, mom is usually on her computer, but in the same room

When youth gets upset about something that happens he goes to mom and makes a statement that is elaborate or “conspiracy theory” type statement. Mom tells him to not be ridiculous and sends him to his room. He will come back out and make statements that “no one loves him” or he will try to start fight with stepdad


Mom gets angry and tells both youth and stepdad to stop fighting and sends youth back to room. He goes back to room and comes out in 15-20 minutes and tells mom what happened that he is upset about. Mom tries to talk to him about it and eventually is able to calm him down. If stepdad tries to talk to youth they usually end up arguing. Stepdad then tries to talk to mom about his concerns, but she shuts him down

Family reports that if they ask youth to do something, he will do it

Family use to do vacations together, mom and dad use to go out once a week, but all of that seems to have gone away in the last two years


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Youth to mom: Connected (He does the majority of reach out to mom both when problem and when not a problem, you may even see youth sit close to mom during session)

Mom to Youth: Autonomous (Mom keeps youth at arm’s length, even when she knows that dealing with situation needs to occur)

Youth to stepdad: Midpointing (This one is harder to assess based on what we have written in behavior pattern, but there seems to be equal amounts of reaching out and keeping at arm’s length)

Stepdad to Youth: Midpointing Mom to Dad: Autonomous Dad to Mom: Connected


Referral reason: 17 year old female dating 23 old male and lied to family about it, when she was caught dad kicked youth out of house, but she has now returned

Story told by family about the referred behavior: Youth told dad that she was staying with a female friend for the weekend. When mom asked where youth was, father told her, stepmom questioned the story as she told dad that youth was not really close friends with this girl, so why would she be spending the weekend. Next Weekend the same thing happens. Stepmom tells dad that he needs to ask more questions and check with girls parents. Stepdad says he trusts daughter. When daughter comes home he tells her that stepmom thinks she has been lying to him, daughter denies. The next weekend youth reports to dad that she is once again staying with friend, but about an hour after she leaves she calls and is 1 hour away and has been in a car wreck. She admits to dad that she has been lying and that she is dating an older man (23). Dad gets angry and tells her not to come home that he is done. He then tells stepmom who calls and confronts youth and tells her that she can come home if she agrees to no more lies. Youth refuses to come home and family has no information to find her. There are frequent texts during this time. Youth comes home after two days


Family tells story of youth calling her grandmother and aunt to say she was sick and that her dad wouldn’t believe her and that she needed to go to emergency room. Aunt and grandma go to emergency room and find out that dad is home sleeping and that youth never told dad or stepmom that she was sick

Youth tells her mother that she needs to change her phone number because her friends call too much. Mom pays for the phone so she agrees to let her do this, afterwards dad finds out that this happened and tells stepmom who gets angry that they allowed daughter to do this instead of making her set boundaries with friends. Stepmom reports in session that both mom and dad do not make youth follow rules or give information because they both want to be the favored parent which leaves her as the villain


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Youth states she is afraid to give information to either parent as they “overreact” and that she can’t talk to stepmom because she doesn’t believe anything that she says. Stepmom agreed that this was true

Family reports they rarely do anything together other than watching television at night, most of the time it is youth and dad watching television and stepmom by herself

Mom lives out of town and not participating in therapy


Family eats dinner together one to two nights a week. Both parents work and youth attends school. At night, if stepmom is home then youth and dad are in the same room, watch same television shows, talk about day to day activities. If stepmom is home she may be in same room, but does not engage in conversation and tends to go to her room

Youth will tell dad that she going somewhere, dad says okay and when stepmom asks about youth dad reports that youth is out. Stepmom asks questions about where is youth, when will she be home, etc., dad can’t answer and dad and stepmom fight


Dad texts daughter with information that stepmom wants and daughter gets mad and yells at dad. She gives dad information and he goes to stepmom, but she is still angry and feels that nothing ever gets solved. Stepmom tries to give dad information that he should get from daughter and he agrees to get information, but then admits he does not get information from daughter

There is no interaction between youth and stepmom unless the issue is really big. Stepmom says that she quit talking because no one listens to her and she is “done” with family. Both mom and stepmom agree that if stepmom sets a rule or asks for information that youth will follow rule or give information, but that dad tends not to set rules or ask for information


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Youth to Dad – Midpointing Dad to Youth – Midpointing – dad wants to be connected and

wants to be favored parent, but he rarely asks for information or interacts with daughter other than to accept information from her, however if there is not a problem they spend time together and interact

Youth to Stepmom – Autonomous Stepmom to Youth – Autonomous Dad to mom – Connected Mom to Dad – Autonomous


Note that the examples we use are often “culture biased” in that “autonomy” and “connectedness” are “normed” differently in different cultures, genders, and developmental stages. All these distinctions are made in comparison to other members of each particular culture /comparison group


Parent 1- up Parent 1- down Symmetrica

l


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12/21/10

Hierarchy is a relational configuration between two people that is expressed through behavior, the broad range of communication channels, and the pattern of mutual influence they have on one another. Sometimes the pattern represents what culture believes “should be:” Parent(s) 1-up and youth 1-down but moving toward symmetry.

However, often families have not evolved that way, and once again FFT attempts to understand each relationship for what their patterns represent. We don’t judge them; we merely attempt to understand them on their terms –even if the pattern is dysfunctional . Then we help family members develop positive patterns.


Balance of influence “in favor” of parentExamples “Bad” versions – Parent demands respect, “controls”

coercively but is inconsistent in following through. Youth complains about parent but still depends more on parent than parent does on youth

“Good” version – parent is a resource, provides

structure & monitoring, youth asks rather than demands, youth ‘requires” parent justify position, but accepts it (even if grumbling).

Relational factors: Hierarchy


12/21/10

Balance of influence is equal/reciprocal “Bad” versions – Competition, comparing lists of injuries and/or contributions, “knocking heads” re some behavioral issue

“Good” version – “trading” responsibilities, lots of negotiation rather than setting rules


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Balance of influence “in favor” of youth

“Bad” versions – Youth is determining parent’s behavior more than parent is determining youth’s; Parent complains but can’t influence youth to stop

“Good” version – youth is a trusted resource, provides positive structure, anticipates and responds without guidance from parent



15 year old male and mom and stepdad◦ Mom is one-up to youth and stepdad, stepdad and youth are

symmetrical

17 year old female and dad and stepmomYouth is one up to Dad Stepmom and Dad are symmetricalStepmom is one up to Youth


(1) functions are sometimes not obvious, can be indirect (triangles)

(2) functions are relationship specific (a parent can have different relational functions with different kids; a youth can have a different relational functions with each parent (boyfriend, extended family members, etc)

(3) family members often mis-report(look at where the patterns typically end up… not what

they want [intend] but where they stand relative to one another…. “when the dust settles”)


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It is important that the skills we teach in behavior change assist the family in meeting their relational functions in a more healthy manner

Therefore in the case example that we used with 15 year old male who is connected – we want to teach him to talk to mom in a way that will help him to have a more positive connection with her as opposed to the negative connection he currently receives while fighting with her. Also, we want to teach mom to check in with youth and give him more positive connection to avoid the drama that takes more time and energy. This helps her to remain autonomous, but in a more positive way


In example with 17 year old female – we need to teach dad the information he needs to ensure daughter’s safety and daughter how she can share information, especially information that may be difficult for father to hear. A combination of check ins through texting, writing information down, and having information needed up front will help them to be midpointing, but in a more positive way. In addition, they tend to avoid problems since they don’t know how to solve them, so problem solving skills would also be beneficial.


Basic behavioral modification is about shifting focus to desirable behaviors and shifting interactions to increase desired behaviors thus decreasing undesired behaviors

Relational Functions in Behavior Change = achieving a QUANTITY OF INTERACTION with another family member as a result of a behavior

At the time of referral, youth and parents have been provided quantity of interaction (contact, midpointing, autonomy) in response to referral/problem behaviors rather than constructive behaviors…thus reinforcing (increasing) those undesirable behaviors


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Positive—add something Negative—take away something Reinforcement—increase behavior◦ Positive reinforcement (add to increase)◦ Negative reinforcement (take away to increase)

Punishment—decrease behavior◦ Positive punishment (add to decrease)◦ Negative punishment (take way to decrease)

Focus on increasing DESIRED behaviors (reinforcement) by adding something (contact) or taking something away (autonomy)


Positive reinforcement (add to increase) ***◦ Give i-tunes card for going to school◦ Cook favorite dinner together for going to school Youth contacting with parent

Negative reinforcement (take away to increase) ***◦ Get off grounding for going to school◦ Get kitchen alone to cook favorite dinner for going to school Youth autonomous with parent

Positive punishment (add to decrease)◦ Give extra chores when skip school◦ Youth must help parent clean up kitchen (together) when skip

school Youth autonomous with parent

Negative punishment (take away to decrease)◦ Shut down i-tunes account when skip school◦ Youth sent to room and eat dinner alone when skip school Youth contacting with parent


***Goal is to attempt to reinforce desirable behaviors rather than punish undesirable behaviors Impact is most powerful when immediately and

consistently delivered Building up to weekly reinforcements is not as

powerful as immediate reinforcements. ◦ Even if reward is “small or minor”, when delivered

immediately contingent to the desired behavior the impact can be more powerful than “bigger and major” rewards. May be best to do both (small/immediate along with

big/build-up) Get an iphone if go to school every day for 60 days

versus get to go to girlfriend’s house each afternoon youth goes to school (youth is autonomous with parent) Have more opportunity to catch youth “doing good” and

immediately reinforcing it on daily basisCopyright FFT LLC 2015

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It is called Relational Assessment – Not Relational Certainty, you are making an assessment based on the information that you have, if you are wrong, it doesn’t mean that all is lost, you can alter your behavior change skills to match to the relational function

Usually when a family gives you what seems like “new information”, it is still the same pattern, the content may be new, but the pattern is generally the same

Do not overanalyze and try to figure out “why” they are autonomous, it is not important why, but instead how do we help them meet relational functions in a positive way


Questions

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