----- Mensagem original ----
De: "rwexner@..." <rwexner@...>
Para: claudiaoshiro77@...
Cc: newringr@...
Enviadas: Domingo, 10 de Fevereiro de 2008 11:25:20
Assunto: Re: [functionalanalyticpsychotherapy] supervision and family

Claudia,

I don't have any references for you, but I work with children, adolescents, and
families, and I have a lot of FAP training, so I recognize the difficulties you
had!  It sounds like you did a lot of things very well: getting together and
discussing the case, from each therapist's perspective; coordinating efforts
with respect to behavior change; making the effort to observe the clients in
their context. And it sounds like you had some great results, if you saw
changes in other family members after doing interventions!

I was going to say that maybe it would be easier having one therapist work with
all family members, but it sounds like your commmunication across therapists
was so good, that was not necessary, and so you avoided a lot of the conflict
of interest problems that would normally come up when seeing multiple family
members.

One struggle that I have a lot (and it sounds like you did, too) is defining
who the client is. Is it the one kid, the other kid, the parent, or the whole
family? Which is most important, the improvement of a single family member or
of the family as a whole? It sounds like you were just figuring out how to
treat the family as a whole, when they stopped coming in for treatment.

The other thing I would say is, it's natural to get discouraged about how much
you can change the system-- but hang in there!  Sometimes the tiniest change
can  make a big difference, in the long run. Supervisors tell me all the time
that even if you don't see an impact of your work, you hold onto the hope that
something you said will echo in their head at some point (maybe years later),
and you'll have made a difference.

-Reo.


On Wed, 30 Jan 2008, Claudia Oshiro wrote:

> Hello all,
>
> We have a case of a poor family at the University of São Paulo and we are
> having some doubts about how to deal with this condition: we have three
> therapists, each one is seeing different members of the family in individual
> therapy.
> Therapist 1 - seeing a 9 years old boy.
> Therapist 2 - seeing his brother, a 10 years old boy.
> Therapist 3 - seeing their mother.
>
> As we started the group of supervision, some years ago, we could notice some
> advantages discussing the case of this family because we could have so many
> informations and more access to the controlling variables of all the members
> of the family. We discussed the complementary patterns, some likeness. We
> could see that one intervention of the therapist 1, for exemple, could
> produce a change in the other member and so on. After that, we could notice
> some disavantages: what we could consider as an improvement to one client
> could unbalance the family and its dynamics and some consequences were not
> so good. Then, all the interventions needed to be synchronized (a hard thing
> to do). We went to school and to their home and what should have been good
> (to go to the enviroment and look and observe) brought some strange feelings
> to the therapists: they felt like they were impotent to deal with all the
> varibles and information. So now, we stopped the case because
> many other problems were showing (schedule problems, family without money to
> come to the university...).
>
> Well, now we are discussing the limits of this, what went wrong, what was
> good, and the role of a supervision in this case.
> We were wondering if anybody knows any reference about this kind of
> situation or if had any similar experience. I can give more details about
> the case.
>
> Thanks,
>
>
> Claudia Oshiro
> Terapeuta analítico-comportamental
> Av. Rouxinol, 1041 - Conj. 1701
> Moema - São Paulo/SP
> (11) 9631-9500
> (19) 3434-9597 (Piracicaba/SP)
>
>
>      Abra sua conta no Yahoo! Mail, o único sem limite de espaço para
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