Respect-Focused Therapy with Individuals, Couples and Families

I was fortunate this year to be invited to speak at the American Mental Health Counselor Association’s annual conference in Orlando.

Florida is a beautiful place, and I made my FIRST journey to a Disney park, Epcot! I had such a great time with family and with colleagues at the conference while I was visiting the Sunshine State.

My presentation topic this year was Using Respect-Focused Therapy with Individuals, Couples and Families. I’m offering the resources from my presentation in this post.

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For those who are having family struggles (or want to avoid them) or are curious about Respect-Focused Therapy, I hope you find the presentation materials helpful and insightful.

As always, be well, and as the late, great, Queen of Soul would say, respect each other.

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RFT Book Cover

Respect-Focused Therapy (RFT) is a foundation on which all modalities and techniques used in therapy can be strongly grounded, in order to produce sound, effective outcomes. This approach offers clients the opportunity to gain experiential understanding of being respected, possibly for the first time, from the therapeutic relationship and then be able to heal old wounds by creating more respect for self and others in the therapeutic process.

 

Tapping into Therapeutic Creativity

Many times, we as therapists can feel “stuck” in the process of doing therapy, either with a particular client or more generally with a certain population. It may be an adolescent not wanting to be in therapy, a very depressed older individual or a couple so entrenched in a non-stop pattern of arguing you feel a need for a megaphone just to interject some redirection.

In most, if not all, of these cases we need some moments of calm and self-clarity to be sure, but it might also be helpful to “think outside of the box” as well. Try introducing creative interventions such as art (music, visual arts, poetry or prose).

We could certainly draw from our own experiences by offering stories, metaphors or pieces of music, but I have found it to be much more profound when tapping into the creativity of the clients themselves. Their own storytelling, poetry, artwork, music, etc. can be much more compelling, meaningful and healing if they are left untouched in a respectful manner. That is, we don’t interpret or judge in any way, but instead encourage growth by allowing clients’ creative outlets to portray whatever meaning and purpose they are attempting to express.

Respect needs to come from a place of authenticity and symmetrical balance to have any true validity.

A word of caution: those of us who are not specifically trained or certified in expressive art therapies should use these modalities carefully and only adjunctively to the work we are trained in. However, creativity in all its wonderful forms, used with care, can be transformative in moving the therapeutic process forward.

RFT Book Cover

Respect-Focused Therapy (RFT) is a foundation on which all modalities and techniques used in therapy can be strongly grounded, in order to produce sound, effective outcomes. This approach offers clients the opportunity to gain experiential understanding of being respected, possibly for the first time, from the therapeutic relationship and then be able to heal old wounds by creating more respect for self and others in the therapeutic process.

Preparing for Difficult Clients

Working with clients productively isn’t always an easy road. Clinicians frequently run into clients who are challenging, frustrating, maddening or otherwise pushing our emotional buttons in some fashion.

For example, there are clients who have their own anger issues and come in ready to pick a fight. They simply want to argue with us, and question our knowledge or expertise. There are clients who are passive-aggressive, are in denial of their addictions or simply don’t engage in therapy the way we would like in order to make the progress we wish for them. Then there are clients we just don’t like for some reason; they don’t share our values and don’t respect our time or our boundaries.

Often, the rule of wisdom is to refer such clients out so that they can find a better fit and get better care. But before you do that, I have a few suggestions for preparing yourself for your next session.

To begin with, check yourself. How are you feeling? Tired? Anxious? Hungry? Already dreading this appointment or preoccupied with something you’d rather be doing? What buttons are being pushed inside of you by this client? Spend some time slowing down and acknowledging your feelings. Breathe and try divesting yourself from feeling graded (even pass-fail) on the outcome of this session. This is your client’s session, not yours.

Respect needs to come from a place of authenticity and symmetrical balance to have any true validity. copy

Then spend some time thinking about where your client is emotionally and cognitively. As I frequently say to interns, try going behind the curtain of the stage your client occupies to see the stagehands at work. What’s going on behind the behavior or attitudes you’re seeing and experiencing? Behind the anger is there fear or doubt? Behind the bluster is there insecurity or sadness? Is there a traumatized child puppeteer behind the puppet you see?

As you go into your session, attempt to drop all negative pre-conceptions, judgments and expectations into the trash can. Work with the person in front of you who is scared, sad, lonely or vulnerable from a place of authentic respect.

 

RFT Book Cover

Respect-Focused Therapy (RFT) is a foundation on which all modalities and techniques used in therapy can be strongly grounded, in order to produce sound, effective outcomes. This approach offers clients the opportunity to gain experiential understanding of being respected, possibly for the first time, from the therapeutic relationship and then be able to heal old wounds by creating more respect for self and others in the therapeutic process.

The Blame and Shame Game

When working with couples, I often run into a repeating pattern of behavior I call

“The blame and shame game.” It goes something like this:

They came in initially because they were arguing too much—at least every other day, they reported—about money, sex and children. Maryanne was concerned that hundreds of dollars had gone missing over the past six months and John pled innocence, claiming that she was “trying to pin everything on him.” He, in turn, accused Maryanne of having a secret affair with her ex-husband, which she also denied. Accusations continued to be thrown. They both began yelling and pointing fingers at one another. They were blaming one another for various unrelated incidents from the past and upping the level of each other’s transgressions in rapid succession, overlapping their voices such that the volume increased so significantly no one voice could be heard.

This pattern seems to be prevalent among couples that have not had good parental modeling for problem-solving or conflict resolution. It is within this framework that winning supersedes resolution. The result is predictably that they both hop on this treadmill that takes them nowhere, except deeper and deeper pain.

The interventions to this cycle are multidimensional in nature. That is, they overlap; they work together. In Respect-Focused Therapy, the specific needs of each individual or couple supersedes any formulated model or technique. This approach rather suggests that all known evidenced-based and reliable techniques, etc. to a therapist be utilized as best serves the needs of each client’s situation.

For example, in the case sited above, I was deeply aware that I need to gently interrupt the pattern of “blame and shame,” but I also knew that such a pattern was deeply entrenched in their style of communication over the long span of their relationship as well as the pattern each had grown up experiencing with their respective parents. This could and would not be an easy fix; to assume so would be to disregard these two people who sat in front of me. For me to assist them in effectively, I had to first acknowledge and positively regard/respect their perspectives on how and why they communicated in the fashion they did.

By asking more questions about how each had grown up, I found out that competing and never losing face in the process was a highly held value in both homes. This being particularly true in John’s home, unfortunately also meant “win no mater what the cost.” This included attacking his wife with a charge of adultery, which later it was found out he didn’t believe, in order to cover his gambling addiction.

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In order to get a foothold into any meaningful resolution, I had to openly state my awareness of how much raw pain they each endured every day and how much energy and stamina that must require.

Once it was established that I truly understood how exhausting and frustrating it was for both always needing to win and yet no one ever winning, then I was able to begin offering some tools such as active listening and non-violent communication to slowly break up the long-standing pattern. Eventually, with months of trust-building, we were able to reconsider and reevaluate the value of winning an argument vs. the value of resolving conflict.

RFT Book Cover

 

Respect-Focused Therapy (RFT) is a foundation on which all modalities and techniques used in therapy can be strongly grounded, in order to produce sound, effective outcomes. This approach offers clients the opportunity to gain experiential understanding of being respected, possibly for the first time, from the therapeutic relationship and then be able to heal old wounds by creating more respect for self and others in the therapeutic process.