Week 113 - How to Work with a Distressed Relationship in the First Session

July 16 – July 21, 2018 . . . . .

July 16 – July 21, 2018


Monday, July 16, 2018

How to Work with Clients' Fears in the First Session

Sue Johnson, EdD shares one factor that can heighten vulnerability for couples and what to do to address it.
Running time: 08:09

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Tuesday, July 17, 2018

How to Get a Comprehensive Picture in the First Session

Stan Tatkin, PsyD, MFT shares how he works with couples to understand the bigger picture and avoid getting lost in one issue.
Running time: 11:21

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Wednesday, July 18, 2018

One Technique for Disrupting Negative Communication Cycles

Terry Real, MSW, LICSW talks about what he believes all therapists should know by the end of the first session.
Running time: 05:51

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Thursday, July 19, 2018

How to Approach a Major Red Flag in Couples Therapy

Andrew Christensen, PhD and Sue Johnson, EdD share how they navigate delicate situations between volatile couples.
Running time: 07:37

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Friday, July 20, 2018

Critical Insights

Ron Siegel, PsyD and Kelly McGonigal, PhD highlight the key concepts in this week’s videos.
Running time: 30:05

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Saturday, July 21, 2018

Focus on Application

Joan Borysenko, PhD, and Rick Hanson, PhD connect exercises and techniques with this week’s discussion so you can begin using these ideas right away with your clients.
Running time: 23:32

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Leave a Comment

6 Responses

  1. Hello and thankyou for all your honest expressions -very helpful in seeing how very individualized and uniquely we see others. Clients and therapists all seem, in one way or the other to ‘stance, stance and dance’. I liked the concept of knowing ones own feelings and disclosing just a little of those personal insecurities, in order to gain the clients confidence. I think that this in turn will result in them trusting me, as a therapist, with their issues. Earning that trust will, hopefully, help the dance between us to enable them to move a step or two further.
    I liked the concept of the ‘dance’ but felt a little uncomfortable with the ‘stance stance’ notion which brought up feelings of challenge and defensiveness which probably says a lot about me!! Thanks NICABM loving the series. Gayle

  2. Hello again, as a counsellor who recently started a new position this week has been of tremendous help. I have noticed that many of the people I see are first time counsellees and are anxious about the process. However, my supervisor told me that all of my new clients are returning and that is unheard of! This I thank NICABM for as I am continually learning new skills and ideas. Notably this week the use of self disclosure and inclusive dialogue that serves to normalize our work. I like to use humour to bring down defenses such as when one client is using a lot of curse words, which is common and usually directed toward another family member. I have said things like, just a minute I am going to get a jar so we can all place a nickel in the jar everytime we use a curse word. Then I will ask the more guilty one to talk about curse words and what his or her history is with them, Usually we all have a laugh and are reminded of getting in trouble when we were kids. This is not the case with abusiveness or hostile clients, I do not want to make light of it, I will write again soon, sue

  3. So much of what I have listened and watched so far has been mirrored in the work that follows. This week I was confronted with what Terry R referred to as the stance stance and dance. I had a very hard time trying to help my client identify it for herself and the result was a lot of tears. I am going to present it to her this week in a more compassionate manner by telling her that the stale mate they have is not just about them but about the pattern they have created. I will help her change her delivery by teaching her to establish a more open communication style with this person .

  4. My take aways (and remembers from my own sessions) for how to handle first sessions with couples is that it is really important to be able to identify destructive loops or patterns of a couple as soon as they happen, especially the first session. The skill to which anyone can do this is, as Joan Borysenko said, feeling comfortable and grounded inside ourselves.

    Terry talks about stance, stance, and dance OF THE COUPLE. But there is also the same for the therapist. I am also taking a stance, stance and then dancing, as I try to go back and forth between the two partners eliciting the pattern and confronting IT without confronting the individual.

    What I once thought was my worst couple session was where I let the couple fight the way they do, until it got so far away from me I couldn’t real it back or intervene. The couple left really angry and I was sure they would never come back. But they did. When I asked why, and apologized for letting the session unfold in that way, their response was, “It really helped us to be able to be real with each other in front of you because we trusted you so much. And it was better.” Go figure. That being said, my learning was that I need to dance a little earlier when the couple is in full blown stance. Which goes back to trusting myself, feeling confident, sitting with authority and doing the kind of reflective Rogerian listening that Sue Johnson does so well with each person.

  5. In Sue’s talk, I would, if it were possible, bring it to the notice of the husband with words to the effect that we all have some favourite self soothing tools. Could it be that he uses abusive words to handle his inner distress. If so, explore the impact of it (how he would feel or felt in some other scenario when it was probably done to him) and see if he is willing to find other non-abusive ways to self soothe. (this sounds simplistic but it would take a couple of sessions just to be able to do this)

    I see that Sue’s approach would trigger the husband’s issues even more, as he would perceive it as “picked on” or “humiliated”

    If the abusive person is not willing to be helped in any manner then perhaps we could make those directives as she has suggested.

  6. With all due respect, I think you are misunderstanding STan’s approach. He does not interrogate people – he clearly described why he crosses the quesions in order to create safety in the room. His focus on truth as you call it – is about helping the therapist really understand what is going on – mainly because we do tend to come into the room w our own orientation based on whatever model or approaches we are coming from – and we really dont know what is going on – unless we explore – and we dont know what is defense is and what is deficit. As a couples therapist w a pretty wide variety of training – EFT, Terry’s training, and PACT (stan’s approach) – I know that every couples therapist is interested in creating safety – and every couples therapist wants to help couples feel confident that they are in good hands. In my experience, Stan’s approach adds a component which helps the therapist evaluate what is going on medically, physiologically, neurologically and somatically (arousal levels) in addition to emotionally and attachment