My First Observation of a Therapy Session at My Placement

I like the placement arrangement at IOP. Unlike my undergraduate social work placement which happened during term vocations, it is throughout the academic year, i.e. 2 out of the 5 days in a week are dedicated as placement days.

Once a week I participate in a family therapy workshop. This is a team in which  my placement supervisor works as a team with one other family therapist and 2 mental health practitioners currently pursuing their partime family therapy courses. The team adopts the Post-Milan reflecting team approach - while 1 or 2 therapist(s) conduct(s) the family session, the rest act as reflecting therapists, i.e. being proactive observers who, once invited into the session near end of the session, convene a conversation  among themselves, with the therapist(s) and family listening. The conversation could revolve around observations and hypotheses of the covert/overt conversations, dynamics and actions during the session, as well as the observers' personal reflection, feelings or thoughts triggered from observing the session. Suggestions and questions could also be raised. After the reflective dialogue ends, the therapist(s) and family would resume the session, bringing into the session what they just heard that make sense to explore further.

This approach enriches and demystify the therapy process, bringing closed-door professional discussions in front of the family. Not only does it increase transparency but also broaden the multiple perspectives the family and therapist(s) could experience to create differences. This approach is built from the concepts of second order cybernetics and social constructionism.

As this is my first day joining the team, I was told to remain as observer and not participate in the reflection yet.  Learnt possible ways to therapeutically engage mother and young children in play and music making. I'm amazed at how the team constantly attempt to engage children as young as 3  and a toddler in therapy, even  though their attention span is short and half the time nosily playing with the toys in the therapy room. This makes me reflect back on how much I had missed out in my previous work, when younger children brought to family sessions were totally ignored or assumed to not benefit or able to participate.

Observed the flexibility and risk-taking of reflecting team - the impromptu use of dolls and motherese-talk, which captured the children's attention during reflection (for a first time for the team). Noted also how the children's attention could easily be lost over time and when the reflection is not engaging enough.

The second family did not turn up for the session but the team made use of the time to convene a case discussion. Understood the constraints of scheduling sessions to track the role and involvement of care coordinator, based on the hypothesis of him/her being possibly a homeostatic member of the referred family, as suggested by Palazzoli et al (1980).

A vintage photo of 6 siblings, probably taken in the 1950s or 60s, which happens to be the era when family therapy first started. The girl on the top left hand corner is my mother!

Reference

PALAZZOLI, M. S., BOSCOLO, L., CECCHIN, G. & PRATA, G. 1980. The problem of the referring person. Journal of the Marital and Family Therapy, 6, 3-9.