Family Therapy Learning Lesson & Forum I

FAMILY THERAPY LEARNING LESSON AND FORUM I Teresa McDowell,

Ed.D., LMFT

INTRODUCTIONS Who is here?

Why have you joined the forum?

What do you hope to learn?

LEARNING GOALS At the end of Family Therapy Learning Session and Forum I, participants will be able to:

1. Articulate a beginning understanding of family therapy as a mental health discipline,

2. Describe several effects of problem gambling on families, 3. Describe several ways in which families may impact problem gambling,

4. Identify several reasons it may be helpful to include families in treatment for problem gambling, and

5. Formulate initial thoughts on who should be invited to problem gambling treatment and why.

OVERVIEW First 45 minutes presentation What is family therapy? Why include important others in treatment? Who should be involved in treatment? When should family engage in treatment?

Second 45 minutes discussion – Discussion starters What are some of the barriers you face in including family members in problem gambling treatment? What successes can you share? What topics would you like to see in future lessons and forums?

Between Call Consultation Schedule a call Answers by email Limits – 2 hours total allocated, no specific case supervision or consultation

WHAT IS FAMILY THERAPY? Systemic and Social Constructivist Perspective Patterns and Connections Process v Content First and Second Order Change Not Defined by Who is in the Room Includes Individual Sessions, Couple Sessions, Family Sessions, Sibling Sessions

More than 16 Major Family Therapy Models Requires Different Ways of Thinking and Doing Therapy

WHY INCLUDE FAMILIES IN PROBLEM GAMBLING TREATMENT? Increased Retention in Treatment Better Long Term Outcomes Families are also Suffering Direct Access to Change

RELATED TASKSView gambling from a systems perspective regardless of who seeks treatmentEngage multiple family members and caring others in treatmentJoin with all members of the therapeutic systemFollow ethical and legal guidelines for working with families Determine who should attend sessions based on therapeutic goalsBalance focus on individual and family systems

DISCLOSURE, CRISIS AND TRUST Disclosure can be traumatic Families often faced with financial and legal crisis Secrets and lies have eroded trust Anger, hurt and initial responses to disclosure can make it Difficult to engage familiesUncomfortable for counselorsLead us to think “either or” v “both and”

Gaining skills and theoretical perspectives on how to work with families

in crisis can increase likelihood of successful engagement, retention, and effective treatment

RELATED TASKSEnsure professional disclosure statement covers working with familiesBalancie practical support with relational, process focusInspire realistic hope by focusing on strengths & confidence in recovery processScreen for family violence and intervening as neededDetermine presence of abuse or neglect and report while still engagingFacilitate high conflict conversations knowing when to see family members individually, when to engage in highly structured conversations through the therapist, and when and how to create successful enactments directly between family members

MORE RELATED TASKS Assess for risk of harm to self or other and engaging family in safety planningAssess family structure and power dynamics and preparing to intervene accordinglyEstablish money barriers and helping family members secure financial safetyEngage children, adult parents and other supportive others in treatmentDiscover and prepare to move ctoward disclosure of gambling and financial secrets Structure treatment

PROBLEM GAMBLING AND FAMILIES•Common sense solutions contribute to the problem•Families make decisions based on the belief that gamblers can stop•Families are pulled in to the dream world – gambling schemas•Family members develop their own symptoms•Power and relational dynamics can trigger gambling episodes•Children are affected but often left •on their own to deal with gambling

RELATED TASKSEncourage readiness for change among all family membersGet family members “on board” to fight problem gambling togetherProvide education about problem gamblingTrack the influence of problem gamblingHelp family members avoid common sense solutionsProvide support for all family members individually and collectively Interrupt power imbalances in favor of adult relational equityTrack relational patterns around gambling Help families identify triggers and consider alternative interactionsFacilitate expression of feelings and thoughts between family members

MORE RELATED TASKSIdentify patterns of interaction around problem gamblingConnect/reconnecting family membersRestructure family dynamicsIdentify gambling triggers and engaging family members in reducing triggersInterrupt non- ‐solutions that may be exacerbating the problemSolve underlying relational issuesBalance power to create more just relationshipsEncourage connection and attachmentFacilitate discussions of difference/resolution of conflict

FAMILIES AND MONEY Families may be the source of money for gamblingFamilies are affected legally and financially by gamblingFamilies can help stop financial bleeding caused by gamblingFinancial abuse of family members is not uncommonEthical and legal responsibility as counselors

RELATED TASKSStop the flow of money from well meaning family membersEstablish money barriersFacilitate disclosure of gambling related debtEngage in financial planning, get families to establish and follow a budgetRefer families for legal and tax advice, financial planning, and so onEnsure vulnerable others are as financially safe and secure as possible

WHO SHOULD BE INVOLVED IN TREATMENT AND WHEN? Think systems from the first phone call Invite adult significant other for the first appointment if possible Plan on spending time with individuals from the “get go” and throughout

Learn about children, parents, siblings, all others in system and invite to meet therapeutic goals

QUESTIONS? FORUM CONVERSATION STARTERS 1. What are some of the barriers to involving families in problem gambling treatment?

2. What are you interested in learning about and/or discussing in future Family Therapy Lessons and Forums?

3. How can we be helpful to each other between and beyond quarterly calls?