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| Scotland, 2010 |
“The map is not the territory” – a systemic term apt to describe my struggle to summarize a year’s learning within word limits. Yet there is a need to tell better stories within the constraint of the real world (Pocock, 1995). While there are multiple ways to do this, I decided on the following:
Clinical and Academic Changes
Even though I learnt family therapy theories in my Social Work degree, I forgot most details because of the lack of opportunity to apply in practice. The closest I got subsequently was from my full-time job opportunity in early 2009 when I was oriented via a short USA study trip to the Multisystemic Therapy and Functional Family Therapy. My volunteer work, on the contrary, gave me more exposures; learning from a workshop the application of Structural model for same-sex couples (Greenan, 2009), reading books/ papers such as Greenan and Tunnell (Greenan and Tunnell, 2003), Tomm’s Interventive Interviewing ((1987a, 1987b, 1988) and Pearce’s Coordinated Management of Meaning (CMM) (2004), as well as group supervision experiences of Reflecting Team and Internalising the Other. My understanding of the concepts, however, remained superficial.
Present Perception1
Academic
Three learning outcomes I am pleased with:
1. An ability to explore and give account of personal learning over time
Self-rated increase from 7 to 9
Being able to sustain this in writing and discussion consistently overtime and feeling less anxious or overwhelmed by details, lack of time or discipline at times!
2. An ability to place the development of family therapy in an historical context
Self-rated increase from 2 to 8
3. An ability to describe differences and similarities between approaches in systemic therapy including the theory of change.
Self-rated increase from 3 to 7
The exam preparatory process, especially, pushed me to gain clarity to both 2 and 3, such as Family Life Cycle, Transgenerational, Milan, Post-Milan, Structural and Strategic Models.
Clinical
What I found most privileged is having the placement that exposed me to three different settings, from children, adults to older adults mental health services. I appreciate my supervisor’s receptiveness to my attempts to apply theoretical learning such as Transgenerational coaching, circular questioning and reflecting conversations, as well as demonstrating her Narrative approaches. I am also encouraged by her support and active participation in my self-reflexive exercises through supervision, case discussions and commenting on my blog.
Coming from an English language-based education in Singapore, language is not an issue for me in therapy work. However, working primarily with British-White families in this placement, I faced some difficulties in understanding some accents and topic of interests that families referred to that maybe very British culture specific. While I dealt by pretending I understood or relying on my supervisor to engage in these conversations, I hope to be more honest and independent in the coming year, especially if I were to face a more culturally diverse clientele, to situate myself in a more comfortable position of not-knowing and use it therapeutically, either as a form of curiosity for further questioning or applying Burnham’s relational reflexivity (2005).
Present of Future Expectations1
Academic
Three areas I feel I need further work on at the MSc Level:
1. Familiarity with a broad range of literature relating to family therapy and systemic practice. I hope to read not just specific journals, but more original sources of the approaches.
2. An ability to evaluate critically some areas of relevant research. As mentioned in my reflection on research, I am still guilty of skipping the parts of methodology and results!
3. Knowledge and skills required in engaging a range of client groups and working with them effectively. I hope to know more about CMM and integrated approaches to work with Social Services and families with same-sex individuals/couples, such as unbalancing, interventive interviewing, relative influence questioning, etc.
Clinical
I appreciate my supervisor’s pacing allowance for my slow progression from an observer, a reflecting therapist, a co-therapist to eventually a lead therapist. I became aware I had been overly dependent on her as the lead therapist during a session in Jun 2010 when I was asked to be the lead therapist. I felt incompetent when leading the initial engagement and small talk with the family despite – very basic aspects of therapeutic relationship that I had taken for granted as a co-therapist! This reminded me of my role in my family, being the youngest, often reliant on my parents and siblings to initiate talks and make decisions. My past work and volunteer experiences had made me realised that when given the responsibility, I would be able to take up leadership role overtime. This is demonstrated in my ease and competence in taking the lead in the same month with another family I have been seeing for seven months together with another therapist. Moving forward, my challenge is to build and sustain confidence for initial engagement with families I am new to.
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| Scotland, 2010 |
Personal and Professional Changes
A review of my personal and professional changes through the lens of time categorised in three segments:
Oct- Dec
I started this learning journey questioning myself about risk-taking and picked up the term “de-skilled”; I liked my description of this as the need to feel naked before donning fresh clothes. What inspired me initially was how quick and apt two seniors, within the first hour of knowing me at the first Personal and Professional Development (PPD) session, helped create new meaning to my use of planning skills as an overcompensation of my lack of self-confidence, yet I was often impaired by my anxiety and lack of prioritisation. In a way it is a projection of a level of clinical sensitivity I hope to attain in a year’s time when I reach their MSc level.
Jan-Mar
January was the official “launch” month of my blog online. I purposely chose to publish entries two months later to allow time for post reflection and editing. Publishing my clinical learning points and reflective diary on a public blog challenged me to strike a balance between maintaining professional confidentiality and recruiting “witnesses” in my learning, especially with those interested in systemic practice and hopefully extended beyond the geographical boundary of London.
There were more reflections of my academic learning including research, Structural and SFBT models. These are rather impersonal aspects of me, just like the way my coursemates’s first impression of me - being “technical”, which I agree! A more most personal portion is the record of my therapeutic letter to my Genogram I wrote at a PPD session, the only part of my whole journal that I explicitly mention about my family. While I felt I have known not much more than what I already know about my family before I started this family therapy course. I experienced a difference in my interaction with my parents during my vocation back home late December, which I chose to share at PPD but not in my reflective diary. This is out of respect for family, who have high regards for privacy thus it would not be appropriate to disclose too much in my public blog. This certainly creates a paradox for me, wanting transparency yet retaining parts of it opaque. I chose to reflect the more sensitive portions separately with only my tutors and course mates in two of my academic assignments and reflections of tutors’ comments.
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| Scotland, 2010 |
I also reflected about time drawing learning from my tutor’s Academic Seminar about Time. I noted my learning enthusiasm dipped six months after starting the course. This, I reflected, was because of my disappointment from the lack of experiential learning experience (apart from the clinical placement) I preferred. In March I saw a leap from that “rock bottom” when I grasped the more recursive process of inputs (observing, listening, reading) and output (mainly writing and reflecting).
Apr-Jun
This part of the journey maintained the more “technical” side of me, with further reflections on academic learning, such as systemic work with an individual, questioning techniques and integrating ideas. I especially like this portion:
1. Very often I tend to jump straight to think what therapeutic techniques to apply at what point of a therapy session or with which client, eg. use scaling question, circular question, etc. What’s often missing, is the conceptualizing stage - what theoretical ideas and cues gathered from clients that inform me what to say or do, aptly described by a course mate as “putting the thinking behind the doing”.
2. The process described above may come rather intuitively or too fast for one to be aware immediately. In fact, the thinking often happens in retrospect. This post realization is important too, most clinical models are created from what clinicians did in practice to begin with anyway.
I have never been able to register these three terms Perceptual, Conceptual and Executional skills my tutor taught because they are really long and hard to remember. I derived the chart below instead to help myself remember in more simplified words: See May 2010 entry.
The final reflection in June was an unusual one – the politics experienced by the family therapy team I had my placement at. There were feelings of anger and injustice during the incident but post-reflection helped to surface a sense of relief and appreciation for the valuable learning experiences.
Overall, I could now see my learning process not as a linear but a circular process, always returning to the original point where I started, just like walking one round a park in Autumn, Spring and Summer. I am still who I was who started the journey but loaded with more photos of memory and experiences, in preparation to begin another walk around the same park but with more familiarity and wider perspectives to navigate and explore.
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| Scotland, 2010 |
Bibliography
BURNHAM, J. 2005. Relational reflexivity: a tool for socially constructing therapeutic relationships. In: FLASKAS, C., MASON, B. AND PERLESZ, A. (ed.) The space between: experience, context and process in therapeutic relationships. London: Karnac.
GREENAN, D. E. 2009. Same Sex Couples - How Practitioners Can Help. Singapore: Oogachaga Counselling and Support.
GREENAN, D. E. & TUNNELL, G. 2003. Couple Therapy with Gay Men, New York, The Guilford Press.
PEARCE, W. B. 2004. The Coordinated Management of Meaning (CMM). In: GUDYKUNST, W. B. (ed.) Theorizing about Intercultural Communication. UK: Sage Publications Ltd.
POCOCK, D. 1995. Postmodern Chic: Postmodern Critique. Context, 46-48.
TOMM, K. 1987a. Interventive Interviewing: Part I: Strategizing as a Fourth Guideline for the Therapist. Family Process, 26, 3-13.
TOMM, K. 1987b. Interventive Interviewing: Part II. Reflexive Questioning as a Means to Enable Self-Healing. Family Process, 26, 167-183.
TOMM, K. 1988. Interventive Interviewing: Part III. Intending to Ask Lineal, Circular, Strategic, or Reflexive Questions. Family Process, 27, 1-15.
