Reflexive Diary Included in Portfolio - Essay Example

 Reflective Diary-Included in the Portfolio Introduction The therapeutic relationship is the primary determinant of the success of the counselling process. The primary aim of the therapists is to create and maintain unending ethical relationships that ensure continued exchange of ideas throughout the counselling process. I am currently a mental health practitioner based in tier 3 of an outpatient unit for children and adolescent mental health services. I have gained experience in therapy while working as a systemic practitioner in providing family therapy sessions with my colleagues. As a master’s student in systemic psychotherapy, I learn from both classroom and practice. The primary objective of this paper is to record diary entries for classroom learning and the final reflection. Diary Entries October 1 & 2, 2013 I took keen interest as the instructor explained key aspects of the therapeutic relationship that makes an effective trainee. I realised that this relationship is similar to the helping or working alliance because both parties work towards the success of each other. The instructor defined the therapeutic relationship as the means by which the therapist and a client hope to engage with each other in order to make a beneficial transformation in the client. As therapists strive to support their clients’ growth and development, they also ensure promotion of healthy relationships (Carver, Clibbens, Ashmore & Sheldon, 2014). I understood that my relationship with clients should be characterised by highest ethical standards and professionalism. I realised that reconnecting with the key systemic ideas requires proper application of hypothesising and circular questioning. Hypothesising implies creating of tentative solutions concerning intervention strategies and outcomes. Hypothesis formulation is a necessary step in the preparation of therapeutic intervention. Circular questioning aims at gathering and introducing information into the family system. Information gathering is critical because it aids in gathering information and validating of hypotheses regarding the dynamic structure of the families (McDonald & Bubna-Litic, 2012). Bateson considers information as the difference that makes a difference. After the counselling process, I may either terminate or remain in a counselling relationship. This is because counsellors have an obligation to review in writing and verbally with clients the rights and responsibilities of both to each other. I also learnt that romantic relationship between the therapist and client is prohibited for a period of five years following the last professional contact; this extends to their romantic partners and family members. The client and counsellor may initiate a potentially beneficial relationship (McDonald & Bubna-Litic, 2012). During my serving period, I will avoid counsellor-client nonprofessional relationships unless the interactions are potentially beneficial to the client. Examples potentially beneficial relationships include attending a formal ceremony, purchasing a commodity provided by the client, official visits to ill family member or mutual membership in a professional association. November 4 & 5, 2013 The two lessons concentrated on strategic and structural family therapy. I learnt that the structural family therapy stresses on the necessity of family relationship in maintaining psychological health. The instructor described the structural family therapy as a technique that uses family mapping to accommodate and join family settings. In structural therapy model, therapists define family rules as a set of functional demands that constitute the primary determinants of family interactions (Carver, Clibbens, Ashmore & Sheldon, 2014). The family rules therapists are interested in include power hierarchies, coalitions, and boundaries. The therapist acts as a catalyst for change when applying the structural family theory. The structural family therapy model of treatment has four stages; these include the family, presenting problem goal development and process change (intervention). Structural family constitutes a living open system whose parts are interdependent. Problem presentation involves diagnosing the family’s viewpoints concerning a problem by the therapist. The fundamental goal of structural family therapy model is to transform the dysfunctional structure and encourage individuals to create and maintain family support (Marc & David, 2010). After a deviant behaviour has been diagnosed, the therapist collaborates with the family members to initiate the readjustment process. December 2 & 3, 2013 The lessons introduced me to Dec Milan Systemic Family Therapy. The proponents of Milan Therapy include Mara Selvini Palazzoli, Giuliana Prata, Gianfranco Cecchin, and Luigi Boscolo (Marc & David, 2010). During the lessons, I learnt that the Dec Milan Systemic Family Therapy is characterised by recursive interviews. This implies that interviews with the clients are recurrent and repetitive; new ideas about the therapeutical process are generated in form of feedback and conversations to stimulate further revelations. The therapy is practical attempt by the Milan Group to establish the best therapeutic techniques based on Gregory’s Cybernetics theory (Reichelt & Skjerve, 2013). The techniques of the therapy include hypothesising, circularity, neutrality and curiosity. I also realised that the Milan therapy is suitable when working with families of schizophrenic and anorexic children. Second Order Thinking-Engaging with Social Constructionism The objective of the day’s lesson was to enable learners understand the concept of Second Order Thinking. Form the lesson’s discussions, I realised that second order thinking focuses on all aspects of the problem, not just at the problem alone. Therapists have the responsibility to determine the conditions under which particular behaviour occurs in order to find the best counteractive mechanism for treating such behaviour (Stanton & Welsh, 2012). Additionally, second order thinking sees advantages in problems; thus, problems provide opportunities to learn new ways of doing things. The role of therapy is to turn the identified problems into opportunities. According to Adorjan (2013), social constructionism theory examines the development of jointly constructed understandings of the world. The main assumption of the theory of social constructivism is that understanding, significance, and meaning are developed in coordination with other human beings as opposed separately within an individual. I understood that social constructionism is critical in therapy particularly when establishing grounds for caertain behaviour. My responsibility is to study the social context of the client to understand its variables so that I can diagnose the possible causes of the client’s problem behaviours. The lesson helped me to appreciate the role of rationalisation of experiences as a way through which human beings create a model of their social world and how it functions, and language as the most essential system through which humans construct reality. According to Reichelt and Skjerve (2013), therapists should not use a language that is detrimental to the client and the client’s sense of dignity and agency. Reflecting Team Model and Reflecting Team process The instructor introduced the concepts of reflecting team model and the reflecting team process. I learnt that the reflecting team model is based on Andersen’s guidelines to the process of supervision. The team process is primarily used when intervening in matters involving the family. The model of reflecting team focuses on interviews between the supervisor and supervisee (Reichelt & Skjerve, 2013). The team behind the screen or in the room with the family are usually aware of the session, but cannot intervene in the process. The therapist, in this case, is the supervisee. The lessons helped me to understand and appreciate the role of supervision as part of my career development in the counselling profession. The reflecting team process involves performing interviewing a group of therapists at the same time. The interviewing process involves the supervisor interviewing one therapist while the rest of the group listens quietly without interfering (Reichelt & Skjerve, 2013). The rest of the therapists are instructed to bear in mind the following aspects: a) the elements they like about how the therapist under interview has worked with the case b) the facts of the case and those that have not been presented c) the ways the therapist conceive problems and how they are actually conceived d) the role of the therapist working with the case I researched further in the topic of reflecting team model and reflecting team process and realised that they are critical elements in the process of therapy. This is because reflecting boosts understanding of the critical elements of counselling and enhances development of professionalism in the field of counselling. Emotion as a Systemic Issue: David Pocock I read about the personality of David Pocock and appreciated his work as a Consultant with the Oxford Health Trust in the UK. David is also a psychoanalytic psychotherapist with adults in the independent practice. During his presentation, I learnt about his extensive experience in working as a visiting lecturer to family therapy trainings at Bristol universities. The presentation enabled me realise that systemic therapy seeks to address people in a relationship, dealing with the interactions of groups in addition to their interactional patterns and dynamics in society. According to David, family therapists should recognise that emotion is a central concept in systemic thinking; it is difficult for family therapists to succeed in their functions without recognising emotion as critical to the process of systemic thinking (Carver, Clibbens, Ashmore & Sheldon, 2014). Through explanation of his initial experiences with complex emotional issues, I appreciated the remarkable power of emotional understanding as a means of healing. I read another article by Stanton and Welsh (2012) and realised that emotional understanding remains a fundamental idea for me as a systemic therapists. Solution Focused Therapies The tutor introduced the concept of solution-focused therapy (SFT) as technique of therapy that primarily focuses on the solutions and goals of the counselling process. This therapy is different from other therapies because it is solution-based and goal-oriented while others are problem-focused. I preferred adopting the solution focused therapy in my healing processes as opposed to problem-based therapies. The lesson introduced me to the basic philosophy and assumptions of the solution focused therapy; these include change is constant and inevitable, emphasis on aspects that are changeable and possible, clients are experts and define goals of intervention, and clients want change (Marc & David, 2010). Milton Erickson initially developed the solution-focused therapy based on giving clients permission who they are, validity of all behaviours, observing behaviours and utilising client information. I liked the solution-focused therapy because it acknowledges distress while focusing on success. I believed that therapy consists of discussions in which the clients are encouraged to find their own solutions to the problems as the clients focus on the final goals. Narrative Family Therapy The day’s lesson focused on a narrative perspective for working with everyday and extraordinary stories of people’s lives that shape the sense of wellbeing and identity of humanity. I learnt that the narrative family therapy works through getting clear the problems and situations that prevent people from living the kinds of lives and relationships that could be possible for them. I noted that narrative family therapy involves re-authoring the problem-saturated stories that cause despair, hopelessness and isolation of individuals in society. The therapy sounded comic to me as its proponents argue that the person is not the problem, the problem is the problem (Adorjan, 2013). I think this implies the problem identified in the client’s life is caused by historical events and other problems in the environment. The family narrative therapy traces alternative stories founded upon real lived experience and powerful stories that can transform their lives. I developed further interest in the narrative family therapy since the proponents argue that people in the environment contribute to the shaping of others’ lives and their identities through narrating the lived experiences. Final Reflection 1) Achieve high level of competence in therapeutic skill The primary objective undertaking the course constituted acquisition of the relevant adequacy and possession of the required skills, knowledge, qualification, and capacity to enhance sufficiency and effectiveness in service delivery. I can trace several competency achievements that I have made through undertaking the course. Therapy requires the therapists to have a set of defined behaviours that provide a structured guide to enable them in identifying, evaluating and developing their behaviours (Garven, 2011). I studied the course in order to acquire the necessary knowledge, skills and experience for proper delivery of therapeutic services. According to Schippers, Homan and Knippenberg (2013), therapists should uphold the highest standards of competence and professionalism. Competence, in this case becomes an ethical requirement for therapists since they handle their clients cannot ethically and legally without proper knowledge and skills concerning their field of practice. Currently, I have the ability to make realistic statements about my identity, education, experience, and credentials. When I begin offering therapeutic services, I will avoid as much as possible all unrealistic and sensational claims. I believe that competence requirements stress on the importance of refraining from working beyond limits of their competence. Likewise, I will not accept to hire untrained, unqualified or unethical counselling helpers in case I decide to manage a therapy institution. Occasionally, the clients may question the credibility of the counsellor based on inadequate life experiences. This usually occurs when the client meets with the young counsellors who might have not raised children, married, or faced other types of marital problems. When faced with questions of competence, I will try to explain to the clients that my team and I have the necessary education, training, and experience that have provided us with knowledge and skills designed to help them. 2) Achieve high level of awareness of and attention to family process Most of the content that I have studied is focused on creating awareness of and attention to family processes. It is difficult for a therapist to successful handle the client without having the proper background knowledge of the family processes. Family processes provide the fundamental background for therapeutical interventions. Family processes describe the interactions between members of family such as their relationships, communication patterns, amount of time spent together, and the extent to which family members are satisfied with the family life. Through study of structural family therapy, I understood that therapy is a process that involves the family, presenting problem, goal development and process change (intervention). Each of the in the structural family processes has a critical role to play as far as therapy is concerned (Pender & Stinchfield, 2012). I also learnt about the Dec Milan family systemic therapy; this therapy helped me to understand that therapy processes are performed through considering the family factors that could have an influence on behaviour. The narrative family therapy is also critical in my career development because it has enabled me to appreciate the necessity of considering historical background of the family and individual during intervention processes. 3) Achieve high level of awareness of and attention to therapeutic process Understanding the critical aspects of the therapeutic process constitute another critical aspect of therapy. I believe that it is impossible to carry out a successful intervention without proper knowledge of the therapeutic process. The therapeutic process comprises of stages that the therapist needs to be aware of in order to ensure delivery of effective clinical services (Krause, 2010). Therapeutic processes are a combination of all aspects of the interaction that occur during the treatment between a variety of professionals and their clients; it is actually a broader term that addresses most of the same issues in the psychotherapeutic relationship. The therapeutic process begins with the client visiting the centre and requesting the office staff to help them talk to the therapist. The therapist and the client hold conversation concerning fees, hours of service, and the cancellation process (Beers & Merck Research Laboratories, 2006). The first appointment involves filling in the necessary forms including a detailed personal bio data and insurance information. The activities of the first meeting depend on the professional; others begin the process immediately while other professionals begin with general discussions and start the therapy in the next meeting. Throughout the therapy period, the therapist and client strive to maintain a professional relationship and stick to the treatment schedule under unavoidable circumstances (Beyebach, 2014). I have learnt and appreciated every step of the process because it contributes immensely to the success of the therapy. 4) Evidence well developed application of systemic thinking to clinical practice, including evidence-based findings I have developed a potential for applying systemic thinking during my therapy processes. Currently, I recognise the necessity of addressing people as people in a relationship as opposed to an individual. I appreciate the influence of the environment, including other people, on the behaviour of an individual. The systemic thinking, as I studied it, deals with interactions of groups including their patterns of interaction and dynamics. I usually strive to understand at least the three levels of a person’s genealogy in order to strategise on how to help the person based on the findings. The forms that I have developed for admitting clients have spaces for filling in details concerning other family members have witnessed similar problems, both present and the past. I have appreciated that systemic thinking provides a foundation of couple and family psychology research and practice. Systemic thinking constitutes elements of therapeutic process; these include the therapeutic alliance, proper understanding of change systems, treatment interventions, assessment, and case conceptualisation (King, 2013). Another critical element I have learnt in connection to systemic thinking is identification of associations between apparently disconnected issues and behaviours. For example, I may note that while a couple may have identified several relationships issues that they believe are distinct because of the content domain involved, there is usually a common underlying pattern of interaction that cuts across the identified issues. I have developed the ability to elicit useful information to systemic models of practice. Through the course, I have also developed the ability to maintain focus, conduct sessions, clarify issues, and develop teams thinking concerning interactional patterns. 5) Demonstrate sustained and responsive ability to use supervision and consultation Professionals cannot operate alone in a lonely environment (Serneels, 2013). I recognise learning as a continuous process that keeps on happening throughout the service period. I believe that supervision and consultation are crucial during service because they help therapists to identify errors in their performance and institute proper mechanisms to counteract the adversities associated with delivery defects. The reflecting team model and the reflecting team process are the primary concepts that helped develop a positive attitude towards supervision and consultation (Barker & Chang, 2013). The intention of the interviews that occur during the reflecting team process produces presentation cases for supervision, which stimulates the reflecting team to focus on the concerns of the therapist without getting confused in speculative case considerations. I agree that most therapists are well trained in case discussions aiming to understand the cases, but these could be sometimes different from the aims of the reflecting team model. I always use the services of the supervisors and consultants to clarify the issues I find problematic in various client cases in order to enhance my therapeutic knowledge skills, experiences for quality service delivery. Through reflecting teams, I have been trained about important contributions towards maintaining a respectful attitude towards other therapists. It was easy for me to learn most of these skills because most training were performed and supervised in settings with live clients and reflecting teams. 6) Achieve high level of collaborative participation as member of peer clinical team. I think participative approaches towards the healing process has the potential for enabling therapists achieve greater results that individual approaches. Participative collaboration is a substantive aspect frequently discussed in health and social care services (Turpin, Rodger & Hall, 2012). I believe in the strength of team performance than when each therapist is trying to perform duties in their different ways. I recognise collective participation as a significant factor for solving problems of the profession. This is because teams facilitate integration of individual skills and interpersonal relationships, resulting in belief performance in terms of quality of service, reduced abseentism, and increased sense of confidence and accomplishment among professionals and clients (Kemenoff, Worchel, Prevatt & Willson, 1995). Additionally, intra-group and intergroup communication facilitates overcoming most psychological barriers. I have learnt learn that collaboration is both a process and an outcome that provides shared interests and conflicts that cannot be addressed by any single individual. Key stakeholders address most of the therapy conflicts; a key stakeholder refers to any party are directly influenced by the actions of other professionals to focus on solving complex and dynamic problems. A collaborative outcome is characterised by the development of integrative solutions that are beyond individual vision to a productive resolution that could not be accompanied by any single person or organisation (Barker & Chang, 2013). Approaching issues through a collective responsibility has enabled me learn to value and manage diversity since collaboration requires a focus on both task and relationships. I think collaborative participation is a cornerstone of institutional conflict resolution; as a collaborative leader, I am required to facilitate debate or conflicts over the tasks and issues of the profession in order to promote the expression of different perspectives concerned with effective ways of defining and approaching problems. Conclusion The paper focused on journal entries for the eight teaching days and topics. The topics were devoted towards making learners better practitioners as systemic psychotherapists. The paper also contains a reflective piece as a final reflection showing evidence of my own development in the field of systemic therapy. References Adorjan, M 2013, 'Igniting Constructionist Imaginations: Social Constructionism's Absence and Potential Contribution to Public Sociology', American Sociologist, 44, 1, pp. 1-22 Barker, P, & Chang, J 2013, Basic Family Therapy, Chichester, West Sussex, UK: John Wiley & Sons, eBook Collection (EBSCOhost), EBSCOhost, viewed 4 May 2014. Beers, M. H., & Merck Research Laboratories. 2006, The Merck manual of diagnosis and therapy. Whitehouse Station, N.J: Merck Research Laboratories. Beyebach, M 2014, 'Change Factors in Solution-Focused Brief Therapy: A Review of the Salamanca Studies', Journal Of Systemic Therapies, 33, 1, pp. 62-77. Carver, N, Clibbens, N, Ashmore, R, & Sheldon, J 2014, 'Mental health pre-registration nursing students' experiences of group clinical supervision: A UK longitudinal qualitative study', Nurse Education In Practice, 14, pp. 123-129. Garven, R 2011, 'Creating Dialogic Contexts for Multidisciplinary Clinical Reviews: The Reflecting Team Process', Australian & New Zealand Journal Of Family Therapy, 32, 4, pp. 283-299 Kemenoff, S, Worchel, F, Prevatt, B, & Willson, V 1995, 'The effects of video feedback in the context of Milan Systemic therapy', Journal Of Family Psychology, 9, 4, pp. 446-450. King, PP 2013, 'Solution-focused brief therapy and play scaling', Journal Of Family Psychotherapy, 24, 4, p. 312-316. Krause, I 2010, 'Calling the context: towards a systemic and cross-cultural approach to emotions', Journal Of Family Therapy, 32, 4, pp. 379-397. Marc J., S, & David K., J 2010, Personality And The Cultural Construction Of Society, Tuscaloosa, AL: The University of Alabama Press, Project MUSE. McDonald, M, & Bubna-Litic, D 2012, 'Applied Social Psychology: A Critical Theoretical Perspective', Social & Personality Psychology Compass, 6, 12, pp. 853-864, Pender, R, & Stinchfield, T 2012, 'A Reflective Look at Reflecting Teams', Family Journal, 20, 2, p. 117-127. Reichelt, S, & Skjerve, J 2013, 'The Reflecting Team Model Used for Clinical Group Supervision Without Clients Present', Journal Of Marital And Family Therapy, 39, 2, p. 244-255 Schippers, M, Homan, A, & Van Knippenberg, D 2013, 'To reflect or not to reflect: Prior team performance as a boundary condition of the effects of reflexivity on learning and final team performance', Journal Of Organizational Behavior, 34, 1, pp. 6-23. Serneels, A 2013, 'Picturing stories: Drawings in Narative family therapy with children', International Journal Of Narrative Therapy & Community Work, 4, pp. 1-8. Stanton, M, & Welsh, R 2012, 'Systemic thinking in couple and family psychology research and practice', Couple And Family Psychology: Research And Practice, 1(1), pp. 14-30 Turpin, M, Rodger, S, & Hall, A 2012, 'Occupational therapy students' perceptions of occupational therapy', Australian Occupational Therapy Journal, 59, 5, pp. 367-374. Read More