All posts by johnsommersflanagan

Transforming Therapeutic Relationships into Evidence-Based Practice

Here are the ppts for today’s Webinar: v2 TherapySites 2019 Final
The handout linked below is an in-depth supplement to a webinar I’m providing for TherapySites.com on March 13, 2019. Although it’s designed to go with the webinar, it’s also a standalone resource for learning more about how to integrate evidence-based relationship factors into counseling and psychotherapy practice.

Webinar Transforming Therapeutic Relationships into Evidence-Based Counseling

 

Upcoming Webinars (without Spiderman)

Spiderman II

As a Marvel Comics fan since 1963, I’ve always felt uncomfortable doing webinars without mentioning Spiderman. Now that I’m on record for my Spiderman-influenced childhood, I feel my comfort-level returning to normal.

Somehow, in the next month or so, I’ve gotten myself involved in a plethora of webinars, as long as you define “plethora” as five.

Although it’s sticky business, the purpose of this blog post is to gently promote said webinars. You might be interested. I think they’re mostly free, or accessible through a particular professional association (e.g., WSASP).

Here’s the line-up (starting tomorrow!), along with webinar titles and links.

  1. Wednesday, March 13 – 2pm EDT (12pm MDT):

Transforming Therapeutic Relationships into Evidence-Based Practice: Practical Skills for Challenging Therapy Situations

Sponsored by TherapySites. To register, go to:    https://register.gotowebinar.com/register/2888908924358696194?source=Association

Many counselors and psychotherapists deeply believe in the therapeutic power of relationships, but feel mandated to practice using empirically-supported technical procedures. In this presentation, John will illustrate how relational approaches to counseling are also specific treatment methods.

Specifically, in this webinar, Dr. Sommers-Flanagan will be discussing:

– 9 different evidence-based relationship factors with practical examples of how to use these factors in challenging situations

– Using self-disclosure effectively and how to respond to difficult questions

– Recognizing relational ruptures and make repairs

– How to respond to clients who are not cooperating with the counseling process

– What to say when clients have suicidal thoughts and feel hopeless

All participants will have access to a handout describing and illustrating how to use evidence-based relationship factors to enhance counseling and psychotherapy practice.

  1. Friday, March 15, 2019, from 1pm-4pm PDT (12pm to 3pm MDT):

Tough Kids, Cool Counseling: Part I, Assessment and Engagement

Sponsored by the Washington State Association of School Psychologists (WSASP). To participate, you’ll need to be a WSASP member. https://www.wsasp.org/event-3158525?CalendarViewType=1&SelectedDate=3/12/2019

Counseling adolescent students can be immensely frustrating or splendidly gratifying. To address this challenge, participants in this workshop will refine their skills for managing resistance and implementing specific brief counseling techniques. Using video clips, live demonstrations, and other learning activities, the workshop presents four essential principles and 10 assessment and engagement strategies for influencing “tough students.” Group discussion, breakout skill-building, and other learning activities will be integrated.

  1. Thursday, April 4, 2019, from 12pm to 1pm (somewhere, TBA).

Adlerian Psychology and Cognitive-Behavioral Therapy

Sponsored by Adler University. To participate, go to: https://www.adler.edu/page/community-engagement/center-for-adlerian-practice-and-scholarship/calendar/upcoming-events

Most Adlerian theorists view Individual Psychology as the foundation for modern cognitive-behavior therapy. But most modern cognitive-behavior therapists rarely credit Adler or know much about his theory. In this webinar, John Sommers-Flanagan, author of Counseling and Psychotherapy Theories in Context and Practice (Wiley, 2018) will present two short case vignettes, while engaging in a lively debate with himself over the similarities and distinctions of Adlerian therapy and CBT.

  1. Thursday, April 18, 2019 – 1pm EDT (11am MDT): “Breathing New Life into Your Dead, White Counseling and Psychotherapy Theories Course”

Sponsored by WileyPlus. To register, go to:  https://www.wileyplus.com/wiley-webinar-series/

Teaching traditional counseling and psychotherapy theories courses can feel dull and boring. In this webinar session, John Sommers-Flanagan will share pedagogical strategies for integrating culture into theory, and engaging students with here-now activities that bring the dusty old theories to life. This webinar will include specific recommendations for how to integrate culture and feminist ideas into traditional theories. Learning activities will be demonstrated, including: (a) early intercultural memories; (b) sex, feminism, and psychoanalytic defense mechanisms; (c) empowered narrative storytelling; and (d) spiritual and behavioral forms of relaxation. Handouts for each activity will be available on https://johnsommersflanagan.com/.

  1. Friday, April 19, 2019, from 1pm-4pm PDT (12pm to 3pm MDT):

Tough Kids, Cool Counseling: Part II, Specific Counseling Techniques and Strategies

Sponsored by the Washington State Association of School Psychologists (WSASP). To participate, you’ll need to be a WSASP member. https://www.wsasp.org/event-3158525?CalendarViewType=1&SelectedDate=3/12/2019

In this advanced workshop, participants will learn 10 (or more) specific counseling techniques designed to promote positive change in middle and high school students. Using video clips, live demonstrations, and role-playing practice, participants will refine their skills for implementing change strategies with students. Techniques include problem solving, empowered storytelling, cognitive storytelling, cognitive–behavioral therapy for anger management, the three-step emotional change trick, early interpretations, and the fool-in-the-ring. Diversity-sensitive approaches will be highlighted.

In closing, I randomly selected the words of Spiderman (from 1966, #36, p. 20). “You’ll have to make it a solo the rest of the way down, Lootie! This is where I get off!”

Wow! I never realized Spiderman was a quotation machine or that he used so many exclamation points!

Have a great week!

John

 

 

Suicide Assessment and Treatment Planning: Resources for Professionals

The Road

As you probably know, suicide rates are and have been on the rise. Here’s what the Centers for Disease Control said several months ago: “From 1999 through 2017, the age-adjusted suicide rate increased 33% from 10.5 to 14.0 per 100,000” (CDC, November, 2018).

Although the CDC’s report of a 33% increase in the national suicide rate is discouraging, the raw numbers are even worse. In 1999, an estimated 29,180 Americans died by suicide. As a comparison, in 2017 (the latest year for which data are available), there were 47,173 suicide deaths. This represents a 61.9% rise in the raw number of suicide deaths over the past 17 years.

Along with rising suicide rates, there’s also a palpable rise in anxiety and panic among mental health and healthcare professionals, teachers, and the public. Even though suicides still occur at a low rate (14 per 100,000), it’s beginning to feel like a public health crisis. We don’t have much evidence that current intervention and prevention efforts are working, and the continued tragic outcomes (about 129 suicide deaths each day in the U.S.) are painful and frustrating.

The purpose of this post is simply to offer resources. I’ve been working in this area for many years; my sense is that having additional resources to help professionals feel more competent can reduce anxiety and probably increases competence. Here are some resources that might be helpful.

  1. In 2018 I published an article in the Journal of Health Service Psychology. The purpose of the article was to provide clear ideas about how psychological providers can be more effective in how they work with clients or patients who are suicidal. You can click here to access a pdf of the article. Conversations About Suicide by JSF 2018
  2. I’ve been working with some of my doctoral students on alternatives to the traditional (and failed) approach of using client risk factors to categorize or estimate suicide risk. One product of this work is an evidence-based list of eight potential suicide dimensions. These suicide dimensions can be used with other models (e.g., safety planning) to guide collaborative treatment planning. To see a description of the eight dimensions and a treatment planning form based on the eight dimensions, you can click on the following links. Suicide TPlanning Handout            Suicide TPlanning Handout Blank
  3. Barbara Stanley and Gregory Brown developed the “Safety Planning Intervention.” For information about their intervention and access to their safety planning form, you can go to their website: http://suicidesafetyplan.com/Home_Page.html
  4. Along with Victor Yalom and some other contributors, this past year I helped produce a 7.5 hour professional training video titled, Assessment and Intervention with Suicidal Clients. You can buy this 3-part video series through Psychotherapy.net and can access a preview of the video series here: http://www.psychotherapy.net/video/suicidal-clients-series
  5. I’m a big fan of David Jobes’s work on the collaborative assessment and management of suicide. You can check out his book on Amazon: https://www.amazon.com/Managing-Suicidal-Risk-Second-Collaborative/dp/146252690X/ref=sr_1_1?crid=29DN6ZM2BUCV3&keywords=david+jobes+suicide&qid=1551837394&s=gateway&sprefix=david+jobes%2Caps%2C177&sr=8-1
  6. Later this spring and this fall, in collaboration with the Big Sky Youth Empowerment Program and the University of Montana, I’ll be offering several low-cost six-hour training workshops in four different Montana locations. These trainings will include research data collection, as well as an opportunity to participate in follow up booster trainings—booster sessions that will happen about three months after you attend an initial six-hour session. If you’re interested in participating in these Montana Suicide Assessment and Treatment Planning Workshops, you can email me, send me your email via a comment on this blog, or begin following this blog so you don’t miss out when I share the dates, times, and locations, and registration information in an upcoming post.

I hope this information is helpful to you in your work with clients struggling with suicide. Together, hopefully we can make a difference.

My Acceptance Speech for the George M. Dennison Presidential Faculty Award for Distinguished Accomplishment at the University of Montana

Dennison Award

Last Wednesday I received an award on Charter Day at the University of Montana. Getting the award was a big deal and I am humbled and happy. Unfortunately, I couldn’t be at the Charter Day event because I was presenting workshops at the National Association for School Psychologists in Atlanta. Below, is a slightly extended version of the acceptance speech that I video-recorded for the event. I’m fairly certain that the following version is more coherent than the video. What surprised me most about the whole thing (and made me feel silly) is that when I rehearsed this acceptance speech, I couldn’t make it through without crying.

********************

It’s an honor and a privilege to receive the George Dennison Presidential award for distinguished accomplishment at the University of Montana. A big thanks to Roni Johnson my department chair and Adrea Lawrence, dean of the college of education and human sciences, for their nomination.

Back in August, at the State of the University address here at the University of Montana, the theme was about how the college experience transforms lives. To give you a sense of how honored I feel about this award, I want to briefly share with you how my college and graduate school experiences have transformed my life.

I grew up knowing virtually nothing about college, except that it was where you went to play college sports . . . and that was all I wanted to do. After high school, I attended Mount Hood community college in Gresham, Oregon, to play football and baseball. At that point, the only work I had done was manual labor. I had no identity linked to being intellectually capable.

I was a mediocre college student who initially cut corners, fell asleep in class, and was terrified about speaking up in groups. Oddly, my Linebacker coach (who doubled as a ceramics and jewelry making instructor) at Mount Hood was probably the first person who helped me realize I was smart. Very quickly after meeting me he started referring to me as “the rocket scientist.” Seriously, this was the first time in my life that I thought I could do something with my brain, other than slam it into other people.

And then I went on to Oregon State University, to, of course, play football. By then I had begun feeling more comfortable in college; I was building my academic identity. The most important thing is that I had learned how to learn. I remember bragging to my best friend and roommate who was taking a large undergraduate nutrition class with me: “I’ve studied this and I know everything that could possibly be on the exam.” I told him I would be getting a perfect score on the upcoming midterm. I can still feel the experience of the professor personally handing me my paper (in a class of about 75) and whispering, “I never thought anyone would get this score.” This was all new to me. Before, all my peak experiences had to do with sports. After taking human nutrition at Oregon State University, I suddenly had a peak experiential memory related to academics.

Although I had grown more confident about my intellectual ability, I was still very uncomfortable in lecture-type classroom settings. In 4 ½ years of college I only spoke up once during a lecture class, and when I did, the professor shamed me. I felt shy, nervous, and unable to translate thoughts I had in my brain into words and sentences in front of groups. Fortunately, in my small pre-practicum and practicum classes, I had a Native American psychology professor who was amazing, encouraging, and who helped me believe in my counseling skills and abilities.

After getting my undergraduate degree at Oregon State and working a year at a psychiatric hospital, I chose the University of Montana over several other institutions, including the University of Virginia. And then, when I stepped onto campus in the fall of 1981, I found myself. I also found best friends, my wife, and in less than a year had my first publication in a shabby little journal called the New England Journal of Medicine. In a turn of events that I cannot explain, I also found my voice. My anxiety about public speaking went away. In the fall of 1982 I asked to teach Introductory Psychology; I told stories, I made jokes, I danced, and sang in my classes, and I loved it. I found my career home.

Now here I am getting an award named after former UM President George Dennison. Thank you George.

Earlier in my life I had no idea these sorts of awards existed; I never would have imagined being in the running. I never would’ve imagined being able to hang out with cool and smart people like Roni Johnson and Adrea Lawrence. I never would have imagined looking out and seeing the faces of faculty, staff, and administrators here at UM and getting to say that somehow I’ve found myself in this club, in this community, and in this Academy. Before I got here I didn’t even know academies existed. Now, I get to think of you all as friends and colleagues. This is what a college education did for me. I have loved my graduate student and faculty experiences at the University of Montana. I am grateful far beyond what I can express.

I know the words “Thank you” seem very small. I hope you know that I mean them in a very big way.

Thank you.

#NASP2019 Extra Handout

20150313_141701

Hello NASP Workshop Participants (and other interested people). Below I’ve pasted an “extra” document to go along with the workshops you attended today in Atlanta. As always, I’m amazed and humbled by the dedication of all School Psychologists to the well-being of your students. I hope you know how important your work is to the students. They don’t often say “Hey. Thanks for working with me!” But, I’m confident that you’re making a crucial difference in the lives of many students across the U.S. And so, on behalf of students everywhere, let me say: Thanks for being a fabulous School Psychologist!

Here’s the extra handout: NASP 2019 Extra Handout

Talking about “Teen Love” on the Practically Perfect Parenting Podcast

Hand holding

The latest Practically Perfect Parenting Podcast just went live. You can listen on iTunes: https://itunes.apple.com/us/podcast/practically-perfect-parenting-podcast/id1170841304?mt=2

Or Libsyn: http://practicallyperfectparenting.libsyn.com/

The description of the Teen Love episode is below.

When John mentions the title of this episode of the Practically Perfect Parenting Podcast, Sara emits the sophisticated professional response of “Eewww gross.” Don’t worry. Things get better from there, because you get to hear a wide range of strategies for teaching children about healthy relationships, including Sara’s super-secret and bizarrely named strategy called “the spinach in the muffins technique.” You also get to hear several inappropriate self-disclosures, unfair accusations (as in when Sara says John just wants to reminisce about his Teen Love experiences), the Romeo and Juliet effect, and how much Sara’s teenage boys look forward to her talking with them about sexuality and intimacy. In the end, we agree that healthy relationships are the number one predictor of happiness and offer fantastic resources like the Dibble Institute https://www.dibbleinstitute.org/ and the CDC’s Teen Dating Violence webpage:  https://www.cdc.gov/violenceprevention/intimatepartnerviolence/teen-dating-violence.html.

The Practically Perfect Parenting Podcast (PPPP) is brought to you in part by the Charles Engelhard Foundation and the National Parenting Education Network . . . but you should also be aware that the views expressed on this and every episode of the PPPP do not necessarily reflect the views of our sponsors, our listeners, or anyone other than Sara Polanchek and John Sommers-Flanagan. . . and, of  course, sometimes we’re not even certain that we agree with what we just said.

The PPPP provides general educational information designed to promote positive parenting practices, but this podcast should not be considered a source of professional advice. If you have questions about specific parenting or caretaking scenarios, we recommend that you seek professional services with someone who can help you address the unique situations that you’re facing in your life.

How to Make a Collaborative Plan for Terminating Counseling without Ever Using the Word Termination

Stone Smirk

Not long ago I noticed some of my excellent and well-intended supervisees talking with their clients about “termination.” They would say things like, “We need to prepare for termination” or “Let’s talk about termination today.” When this happened, I’d get nervous, squirm a bit, and eventually find a way to tell my supervisees that, although we use the word termination all the time when talking with each other ABOUT counseling, we shouldn’t use it when talking with clients DURING counseling.

Instead of saying termination, it’s preferable to talk about final sessions, or the ending of counseling, or to use normal and jargon-free words that speak to the reality that all good things—including counseling—must end. Sometimes the number of counseling sessions possible is dictated in advance by employee assistance program guidelines or insurance companies; other times, clients and counselors have more freedom to work together as long as the work is helpful or productive. Either way, ongoing conversations linking goals to progress is a part of an evidence-based approach to counseling and psychotherapy. Effective counselors connect the “ending” of counseling with the goals that were, in the beginning of counseling, collaboratively identified (and then possibly modified as needed).

Although you should use your own words, statements like some of the following can help you talk with clients or students about termination without using the word termination.

  • “Let’s talk about how our counseling is going and whether we’re making progress toward your goals”
  • “How do you feel about our counseling together?”
  • “I’d love to talk about what I can do differently to keep helping you move forward toward your goals.”

Speaking of termination—and now I’m speaking to you and not my clients—below you’ll find a Termination Checklist that you might find helpful as you talk with your students about preparing for termination. As will everything, this checklist is imperfect, but it’s a good start to help all of us address the ending of counseling, before counseling actually ends.

Termination Checklist

[Adapted from Sommers-Flanagan, J., and Sommers-Flanagan, R., (2007).
Tough Kids, Cool Counseling: User-Friendly Approaches with Challenging Youth.
Alexandria, VA: American Counseling Association]

This is a guide to help you think about termination—even though some of the details will be different for you and your client(s).

_____ 1. At the outset and throughout counseling, identify progress in the movement toward termination (e.g., “Before our meeting today, I noticed we have 4 more sessions left,” or “You are doing so well at home, at school, and with your friends. . . let’s talk about how much longer you’ll want or need to come for counseling”).

_____ 2. Reminisce about early sessions or the first time you and your client met. For example: “I remember something you said when we first met, you said: ‘there’s no way in hell I’m gonna talk with you about anything important.’ Remember that? I have it right here in my notes. You weren’t exactly excited about coming for counseling.”

_____ 3. Identify and describe positive behaviors, attitude, and/or emotional changes. This is part of the process of providing feedback regarding problem resolution and goal attainment: “I’ve noticed something about you that has changed. Do you mind if I share what I’ve noticed?” [Client gives permission]. It used to be that you wouldn’t let adults get close to you. And you wouldn’t accept compliments from adults. Now, from what you and your parents tell me and from how you act in here, it’s obvious that you give adults a chance. You don’t automatically push adults away from you. I think that’s a good thing.”

_____ 4. You should acknowledge, in advance, that the end of counseling is coming up, but there’s a possibility you’ll see each other in the future. “Our next session will be our last session. I guess there’s a chance we might see each other sometime, at the mall or somewhere. If we do see each other, I hope it’s okay for me to say hello. But I want you to know that I’ll wait for you to say hello first. And of course, if we see each other in public, I’ll never say anything about you having been in counseling.”

_____ 5. Identify a positive personal attribute that you noticed during counseling. This should be a personal characteristic separate from your client’s goals: “From the beginning of our time together, I’ve always enjoyed your sense of humor. You’re really creative and really funny, but you can be serious too. Thanks for letting me see both those sides. It took courage for you to get serious and tell me how you’ve been feeling about your mom.”

_____ 6. If there’s unfinished business (and there always will be) provide encouragement for continued work and personal growth: “Of course, your life isn’t perfect, but I have confidence that you’ll keep working on communicating well with your sister and those other things we’ve been talking about.” You may want to say that even though your client doesn’t “need” counseling, choosing to come back for counseling in the future might be helpful: “You know some people come to counseling to work on big problems; other people come because they find counseling helps them be a better person; and other people just like counseling. You might decide you want start up again for any of these reasons.”

_____ 7. Provide opportunities for feedback to you: “I’d like to hear from you. What did you think was most helpful about coming to counseling? What did you think was least helpful?” You can add to this any genuine statements about things you wish you’d done differently. For example, if your client got angry at you for misunderstanding something and this was processed earlier, you might say: “And of course I wish I had heard you correctly and understood you the first time around on that [issue], but I’m glad we were able to talk through it and keep working together.”

_____ 8. If it’s possible, let the client know that he or she may return for counseling in the future: “I hope you know you can come back for a meeting sometime in the future if you want or need to.”

_____ 9. Make a statement about your hope for the client’s positive future: “I’ll be thinking of you and hoping that things work out for the best. Of course, like I said in the beginning, I’m hoping you get what you want out of life, just as long as it’s legal and healthy.”

_____ 10. As needed, listen to and discuss how your client is feeling about ending counseling. Don’t make this into a big deal, but offer opportunities for the client to say “I can hardly wait for the end of this counseling crap” or “I wish we could keep meeting.” Whatever your client is feeling about termination warrants respectful listening.

_____ 11. Consider a parting gift. Although I don’t routinely recommend this with adults, with young clients you might give a meaningful gift at the end of counseling. It could be anything from a painted rock to a blank notebook for writing or a written card. The point is to give a gift that’s not especially expensive, but that might hold meaning for your client in the future.

For more information on termination with youth, go to: https://www.amazon.com/Tough-Kids-Cool-Counseling-User-Friendly-ebook/dp/B00QYU630Q/ref=sr_1_7?s=books&ie=UTF8&qid=1550512844&sr=1-7&keywords=sommers-flanagan