CA SymposiumCA Symposium

FFT Site SupervisorsFFT Site Supervisors

And And

CliniciansClinicians

Working With Mental Health and Working With Mental Health and Individual SymptomsIndividual Symptoms

How?How? Need to begin with understanding how the Need to begin with understanding how the

individual symptoms function in the family relation individual symptoms function in the family relation systemsystem

Need to trust that by reducing and eliminating Need to trust that by reducing and eliminating family risk factors you CAN reduce and eliminate family risk factors you CAN reduce and eliminate individual risk factors and symptomsindividual risk factors and symptoms

Need to get them ENGAGED AND MOTIVATED Need to get them ENGAGED AND MOTIVATED FIRST!!!FIRST!!!

What characterizes many (if not most) of the youth & What characterizes many (if not most) of the youth & families we help in FFT? Often There Are Powerful Risk families we help in FFT? Often There Are Powerful Risk

Factors that “Overwhelm” Protective FactorsFactors that “Overwhelm” Protective Factors

Comorbidity, Comorbidity, Depression, Depression, Hopeless; Hopeless;

Un (anti)- Un (anti)- motivated, motivated,

Hx of Hx of betrayal, betrayal, abuse, abuse, failure; failure; Physical and Physical and Emotional Emotional ChallengesChallenges

Criminal / drug Criminal / drug involvement, involvement,

High Conflict High Conflict environments environments

Limited Limited Resources, Resources, System System NegativityNegativity

Resentful, Resentful, DisrespectfulDisrespectfuland Angryand Angry

All leading to a All leading to a high probability high probability of re-of re-occurrenceoccurrence

““In your heart” how do you find yourself reacting to each family member?In your heart” how do you find yourself reacting to each family member?

Who are Who are they?they? ““Victims”Victims” ““Hurt,” Hurt,”

“Emotionally “Emotionally Damaged” Damaged”

PeoplePeople

““Organic”Organic”

e.g. Fetal e.g. Fetal AlcoholAlcohol

““Bad / EvilBad / Evil

People”People”

““Unfixable”Unfixable”

Primary Primary Focus: Focus: Engage & Engage & Motivate Motivate around ....around ......

PainPain Pain & mis-Pain & mis-perceptionperception

““Damage” Damage” dis- dis-

perceptionperception

Their Their

““Logic”Logic”

Behavior Behavior Change Change GoalsGoals

““Rescue”Rescue”

Teach / Teach / Provide Provide

Corrective Corrective Experience & Experience & Beh’l OptionsBeh’l Options

Structure / Structure / Reduce Reduce

Behavioral Behavioral OptionsOptions

Sanctions / Sanctions / Remove Remove

Behavioral Behavioral Options Options

We are not “rescuers” or “controllers” – We EmpowerWe are not “rescuers” or “controllers” – We Empower

Not an FFT Not an FFT FocusFocus

Not an FFT Not an FFT FocusFocus

Referral & Referral & Ongoing Ongoing

Problem Behaviors Problem Behaviors

Problem Family Relational PatternsProblem Family Relational PatternsRepetitive behavioral, emotional, & cognitive patterns that

maintain, support, and/or prompt clinically significant problems

Core MotivationsCore Motivationsinferred motivational factors (“Relational inferred motivational factors (“Relational

Functions”)Functions”)that serve to motivate and maintain stability in family (and other) relational and behavioral

patterns

Extended

Family

Community

Ecosystem Influences

Peer Groups

School

Intra- Individual

Biological (Diathesis)Factors

To Deal With These Challenges, FFT breaks the multisystemic nature of problems into component

domains

ProblemProblemBehaviorBehavior

Extended Family

Community

Ecosystem Influences

Peer Groups

School

Intra IndividualFactors & Processes

Family First

We begin with We begin with “Family First” “Family First” in order in order to address and intervene successfully to address and intervene successfully with the Individual and Ecosystemic with the Individual and Ecosystemic

nature of clinical problemsnature of clinical problems

Family Relational PatternsFamily Relational Patterns

MotivationsMotivations

Referral & Referral & Ongoing Problem Ongoing Problem

BehaviorsBehaviors

Family Relational PatternsFamily Relational PatternsPatterns that are changed to modify problem behaviors - decrease risk and increase

protective factorsMotivationsMotivations

inferred motivational substrates inferred motivational substrates that serve to motivate and

maintain stability in family (and other) relational

patterns FFT then reconstructs the elements in FFT then reconstructs the elements in

planned & systematic waysplanned & systematic ways

FFT BehaviorFFT BehaviorChange & Change &

GeneralizationGeneralizationFocusFocus

Intra Individual(Diathesis)Factors & Processes

Extended

Family

Community

Ecosystem Influences

Peer Groups

School

Engagement &Engagement &Motivation, Motivation, AssessmentAssessment

FocusFocus

Case ExampleCase Example