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

3. Disclosure
The presenters have a pitifully small financial interest in three of the books in your bibliography

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

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

6. 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

7. Section 1

8. Teens, Parents,
&
The Dance

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

11. “Dance for teen”

12. Dance for Parent(s)

13. 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’

14. Step 1
Notice “Centered”

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

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

17. 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

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

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

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

21. Video…
Attention to ACT processes

22. 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?

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

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

25. “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

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

27. Parenting Styles

29. “Let me help you, Dear”

31. 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

32. Video
Attention to attunement

33. 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?

34. Section 2

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

36. 36

37. 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

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

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

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

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

43. Role Play
With dyad from video

44. 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

45. 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?

46. Return to groups to discuss contrast, time permitting

47. TEEN SAYS: “FIX MY PARENT”

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

50. Leaning in and Hanging Back
Tolerance:
Leaning in and Hanging Back

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

52. TUBES

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

55. 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

56. Problems and Conditions Choices and Decisions Wanting-ness and Willingness

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

58. What to listen & look for …

59. Fusion
Parents
Teens

60. Experiential Avoidance
Parents
Teens

61. Lack of Contact with Present Moment
Parents
Teens
RFT

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

63. Values and Goals

64. Values
Parents
Teens

65. Lack of Committed Action
Parent
Teen

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

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

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

69. LLAMA

70. 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

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

72. LLAMA…..Labeling & Noticing

73. 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?

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

75. LLAMA: Allow what’s inside

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

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

78. Mindful Parent Meditation

79. Step 1
Notice “Centered”

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

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

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

84. ACT for Adolescents

85. Time for Questions

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This was presentation was session # 72