How to Empower Clients for Change

Andrew C. Gillespie, PhD, MSW, LISW-S, LICDC-CSTraining and Development Coordinator,Behavioral Healthcare Partners of Central Ohio, Inc.77 Granville Street,Newark, Ohio 43055.1-740-616-7157

Laying the foundation…

• Why are we here?• To communicate.

Both content and process.Verbal 7% (the words we use)

Para-verbal 38% (tone, volume, cadence)Non-verbal 55% (body language)

Introduction

• Carl Rodgers introduced the idea that clients are capable of change, and can achieve just that.

• We behave in accordance with our perception of reality.

• We are motivated by our innate primary drive to self-actualization

• The individual has a basic need for love and acceptance.

• The individual’s self-concept is dependent upon the nature of the acceptance and respect they experience from others.

Choice Responsibility

• I make choicesYou take responsibility

(You could be a victim)• You make choices

I take responsibility(I could be the victim and you a

violator)• You make choices

You take responsibility(You are the VICTOR)

Choice Responsibility

• What motivates a person to want to take responsibility for their behaviors and recovery?

• A person has to be able to make decisions about their life

• Do we get the chance to make choices

• If we do, do we use that wisely

The Basics of Ego Identity

2 year oldNO (favorite word/independence)

5 year oldLie (No magical thinking)

10/teenRebellion and Beliefs

AdultConfident and mature

THEEGO

The Basics of Ego Identity

Basic Tenets of Confidence

1) Security and Survival2) Affection and Esteem3) Power and Control

THEEGO

The Basic Defense Mechanisms.

Basic Tenets of Confidence1) Security and Survival2) Affection and Esteem3) Power and Control

THEEGO

Defenses:1) Conform2) Passion3) Rationalize

When our ego is challenged.

The Basics of Ego Identity

Basic Tenets of Confidence

1) Security and Survival2) Affection and Esteem3) Power and Control

THEEGO

What is beingThreatened?

What is beingSupported?

What areYou feeling

Why are you feeling this?

Four Factors for Goal Acquisition

• Attention Seeking – appropriate and inappropriate.

• Conflict – if we win, do we really win?

• Revenge – slamming doors, breaking things.

• Withdrawal – social isolation, alienation and SI/HI.

William Glasser’s Car Model

• Four factors that move us to our goals:

• Basic needs.• Feelings.• Thoughts.• Actions.

William Glasser’s Car ModelWhich components drive the car,

and which should tag along?

GOAL

• Transactional Analysis.• Child• Adult• Parent

If you treat an individual as he is, he will stay as he is, but if you treat him as if he were what he ought to be and could be, he will become what he ought to be and could be. Johann Wolfgang Von Goethe.

ROLES

Child

Parent

Adult

Nurturing

Compliant

Critical

Defiant

Constructive Theory• Each human being is a “sealed” entity, learning

about the world through the five senses and intuition.

• The world IS as you see it. • We belief the life experiences that we have lived,

not recognizing that someone else’s life experience is just as valid, and different.

Negotiation Theory

• A small yes leads to others.• How can we find something that they can say yes

to?• How can this be applied to the families and

clients that we work with?

First Order & Second Order Change

What’s the difference?

First Order Change

• Limit setting is an example of first order change. If a patient does not “respond favorably” to our limits, we set them again only a little more firmly. “More of the same”

• Doesn’t bring about permanent change. • Doing the same thing and expecting a

different result is one definition of insanity. (Freud)

Second Order Change

• This is more lasting change and brings about learning that a person can use to become more independent.

• Second Order change involves a change that influences the environment, such as “paradox” or “spontaneous” change.

• It can be produced by prescription, doing the opposite of what we may initially respond with, redirection or reframing, or other techniques that bring about instant unbalance to the normal expected course of action.

• The Two Worlds• “Conceptual” versus “Sensory”• What do you believe?• What do you defend?

The Two WorldsSurvival.Fear of dying motivates living.Heartbeat & breathing are automatic.Body has drives, needs and cravings.

Pleasure Principle.Seek pleasure and avoid pain.Pleasure – all is well.Pain – danger, change needed.

The Two Worlds.Sensory and Conceptual (Thoughts).Sensory–information from our senses.Conceptual – dreams, ideas, visions

and possibilities.

Patrick Henry:“Give me liberty or give me death”

THE NEED TO BE RIGHT.One cannot hold onto an idea unless it

seems right.

Life is being right.Death is being wrong.

SURVIVAL IN THE CONCEPTUAL WORLD, BEING RIGHT, IS MORE POWERFUL THAN SURVIVAL IN THE SENSORY WORLD.

• Mind Theory.Message units. 1 ½ hrs.

10-12% Gatekeeper. 16-24 hrs.

88-90% Knowns – Positive. Unknowns – Negative. Fight or Flight Rest/Balance.

Conscious: Logic, Reason, Decisions, and WillMessage Units: Environment, People, Objects, Ideas and even Thoughts and Feelings.

CONSCIOUS

CRITICAL

SUBCONSCIOUS

+ + Beliefs - - PRIMITIVE

• How We Learn.• Suggestibility:

• Physical: Speaks inferentially, learns directly.

• Emotional: Speaks directly, learns inferentially.

Physicals have learnt from their primary caregiver, that what is said is done, while Emotionals have learnt from their primary caregiver, that what is said is not done, hence they learn “to read between the lines.”

• Relationship Style:Physical Sexuals: Right brain ruled, need to be told “I love you” constantly, and needs lots of physical touch, hugs, and kisses. They fear rejection, and their priorities are: intimacy, family, hobbies and then work.Emotional Sexuals: Left brain ruled, are analytical, aloof, introvert, and logical. Their greatest fear is “Loss of Control”, while their priorities are: work, hobbies, family and then intimacy.• Each person will have Primary characteristics

of relating, and then secondary traits, which play a significant role in allowing successful relationships.

• Example: 70 % Physical and 30% Emotional.

Change!• Change happens at the Unconscious Level.• The only person that you can change is

yourself.• Help your clients and families by inspiring

them to change within themselves, by leading by example.

• Allow then to experience opportunities.• Change is spiritual growth that

“Transcends and Transforms.”• Reach your potential, and allow others to

reach theirs.• Be really you, so they can be really them.

Bibliography• Fisher, David D. V. 1991. An Introduction to

Constructivist Theory for Social Workers, Praeger Publishing, New York, NY.

• Kappas, J. G. 1992. Relationship Strategies. Panorama Publishing Co. Tarzana, Ca.

• Krill, Donald. 1978. Existential Social Work (Treatment Approaches in the Human Services). Free Press, New York, NY.

• Krill, Donald. 1996. Existential Social Work Ch 11 pp 250-282, in Social Work Treatment, 4th Edit. Francis J. Turner (Editor), Free Press, New York, NY

• Glasser, William, 2000. Choice Theory and Reality Therapy, Ch 15, pp 126-135, in The Human Services Counseling Toolbox, William A. Howatt (Editor), Brooks/Cole Thomson Learning, Belmont, CA.

• Bibliography Cont’d• Harris, T.A. 1967. I’m OK—You’re OK, A Guide to

Transactional Analysis, Harper & Row, New York, NY.

• Watzlawick, Paul. 1967. Pragmatics of Human Communication (A Study of International Patterns, Pathologies and Paradoxes). W. W. Norton and Co. New York, NY.

• Watzlawick, Paul. 1974. Change: Principles of Problem Formation and Problem Resolution. W. W. Norton and Co. New York, NY.

• Watzlawick, Paul. 1977. How Real is Real? Vintage Publishers, New York, NY

• Watzlawick, Paul. 1983. The Situation is Hopeless, But Not Serious (The Pursuit of Unhappiness). W. W. Norton and Co. New York, NY.