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Fix My Teen, Fix My Parents Sheri Turrell, Ph.D. Chris McCurry, Ph.D. Mary Bell, MSW ACBS, Seattle 2016

Disclosure The presenters have a pitifully small financial interest in three of the books in your bibliography cmccurry@abcdseattle.com

Introductions & Audience Poll Knowledge of hexaflex Knowledge of attunement Knowledge of matrix Experience with families Experience with teens

Introductions & Audience Poll Knowledge of hexaflex Knowledge of attunement Knowledge of matrix (Matrix Captains) Experience with families Experience with teens

Agenda Section 1 Section 2 Section 3 Recognize family ‘dance’ of avoidance, control, inflexibility Section 2 Utilize ACT processes & matrix to support psychologically flexible parenting Section 3 Engage in role play to bring it all to life – although done throughout

Section 1

Teens, Parents, & The Dance

Tasks of Adolescence There are several…. We will focus on one….

“Dance for teen”

Dance for Parent(s)

Re-choreograph the ‘Dance’ The Goal of ACT with Families Each family member’s experiences and reactions will reverberate throughout the system Re-choreograph the ‘Dance’

Step 1 Notice “Centered”

Allow, Shift back to present moment “Open” Step 2 Allow, Shift back to present moment “Open”

Take Values Driven Action “Engaged” Step 3 Take Values Driven Action “Engaged”

Psychological Flexibility / Workability The ACT Model of Flexibility CONTACT WITH THE PRESENT MOMENT Be Here Now ACCEPTANCE Open Up VALUES Know What Matters Psychological Flexibility / Workability DEFUSION Watch Your Thinking COMMITTED ACTION Do What It Takes SELF-AS-CONTEXT The Observing Self

OPEN CENTRED ENGAGED Present Moment Acceptance Values Defusion Committed Action Self-as-Context

OPEN CENTRED ENGAGED Present Moment Acceptance Values Defusion Committed Action Self-as-Context

OPEN CENTRED ENGAGED Present Moment Acceptance Values Defusion Committed Action Self-as-Context

Video… Attention to ACT processes

Video Process from perspective of ACT processes Gut reaction (thoughts and feelings) towards each of the characters Guesses at what each character may be fused with, avoiding, which time zone they are in (present moment focused?) and what values may be implicitly or explicitly expressed? Function of behavior for each character?

Parent-Child Attunement Will coalesce into a predictable pattern of relating to others

“Secure attachment means you have the confidence that your message will be received” David Brooks

“Individuals whose needs for security are not met come to view the world as comfortless and unpredictable, and they respond either by shrinking from it or doing battle with it” John Bowlby 25

Internal Working Models (“schema”) of how the world operates (safe or threatening, helpful or unhelpful) develop

Parenting Styles

“Let me help you, Dear”

Parent Behaviors That Help (Authoritative Parenting) Rewarding coping behavior Discouraging unhelpful anxiety-related behaviors Modeling effective stress tolerance Developing effective family communication and problem-solving skills Warmth and acceptance Ginsburg & Schlossberg, 2002

Video Attention to attunement

Video Process from perspective of attunement How confident are the characters that their message was received / heard? Are we seeing avoidance, control, or inflexibility? Are characters doing battle or retreating? Is parent modeling distress tolerance, warmth etc?

Section 2

Why Teens come to therapy… PARENTS SAY: “FIX MY TEEN”

36

DO UNTO PARENTS AS YOU WOULD HAVE THEM DO UNTO TEEN How To… A Flexible Approach Different configurations – who is in the room DO UNTO PARENTS AS YOU WOULD HAVE THEM DO UNTO TEEN

Involving Parents Initially As… Co-Clinicians “Assistant Coaches”

FUNCTION of BEHAVIOR Important in family work Can be difficult to discern Functional analysis is very important What does this look like?

1. Sister Getting Attention Max’s Process 1. Sister Getting Attention 2. Jealousy 3. Anger 5. Hits Attention 4. “Recalls” R+ History

Functional Analysis Activator Behavior Consequence Situation Common variables Setting Events Proximal Triggers Observable Specific Others’ Private Events Observables And then….?

Role Play With dyad from video

FA – audience in TRIPLES / FOURS (2 PARENTS) FA of own relationship with a teen or one based on a client / family 1 PERSON IS PARENT(S) 1 PERSON IS TEEN 1 PERSON IS THERAPIST

Functional Analysis with Contrast Activator Behavior Consequence Given the exact same- Situation Common variables Setting Events Proximal Triggers _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ Under these same conditions, what do you want him to do? Observable Specific However infrequently, what happens next?

Return to groups to discuss contrast, time permitting

TEEN SAYS: “FIX MY PARENT”

After FA, May Involve Parents As.. Co-Clients

Leaning in and Hanging Back Tolerance: Leaning in and Hanging Back

S.O.B.E.R. Stop Observe Breathe Expand Respond

TUBES

S.O.B.E.R. Stop Observe Breathe Expand or Contract Respond

Validation Closes the communication loop: “message received” Provides accurate and nuanced emotional vocabulary Replaces ineffective reassurance in many situations Says nothing the “appropriateness” of that thought or feeling at the time 55 55

Problems and Conditions Choices and Decisions Wanting-ness and Willingness

Commitment and Acceptance: Two Sides of the Same Coin To Be A Good Parent Effort, Anxiety, Frustration, Sacrifice, Conscientiousness 57 57 57 57

What to listen & look for …

Fusion Parents Teens

Experiential Avoidance Parents Teens

Lack of Contact with Present Moment Parents Teens RFT

Self-as-Content Parents Teens Absorbed in ‘story’ Lack of observing self

Values and Goals

Values Parents Teens

Lack of Committed Action Parent Teen

TRACKING A VERY IMPORTANT SKILL FOR clinician, PARENTS, and eventually for teens

Find your Matrix Captain upon return! Section 3 Find your Matrix Captain upon return!

“I have to sit with my hands in my lap”

LLAMA

LLAMA Label (notice) what’s inside Let go of struggle, PAUSE Allow room for thoughts / feelings Mindfully return to the present – grounding Approach what matters – ACT according to values

LLAMA…..Labeling & Noticing “I’m noticing I’m having thoughts of / feelings of / urges of…..”

LLAMA…..Labeling & Noticing

LLAMA: Letting Go of the Struggle Drop the rope Struggle Switch Clean towel analogy (willingness) TRACK teen’s response to this ‘step’ –should this statement be elsewehre?

LLAMA: Allow what’s inside Works against experiential avoidance Avoidance can be subtle Things parents might be fused with / “Story”

LLAMA: Allow what’s inside

LLAMA: Mindfulness Return to present moment See each other in 5-senses world, not from within ‘Story” Responsive, not reactive Facts only!

LLAMA: Approach what matters Values “Rules” Values / Committed Action – ‘Domain conflict’

Mindful Parent Meditation

Step 1 Notice “Centered”

Allow, Shift back to present moment “Open” Step 2 Allow, Shift back to present moment “Open”

Take Values Driven Action “Engaged” Step 3 Take Values Driven Action “Engaged”

Section 3 - ROLE PLAY (With your Matrix Captain!)

ACT for Adolescents

Time for Questions

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