The Therapeutic Alliance

The primary objective of this course is to define and describe the nature of a therapeutic alliance in family therapy and explain why it is critical to successful outcomes. Friedlander, Escudero, and Heatherington’s empirically-based SOFTA model for understanding and assessing the strength of the therapeutic alliance is described as it relates to intensive, in-home services. This model includes four relationship dimensions, which include a sense of safety, an emotional connection or emotional bond, a sense of being contributing partners, and a sense of shared purpose. This course describes how to use individual subsystem work with caregivers and youth to develop balanced therapeutic alliances with all family members.

This is an introductory level course. The target audience is all behavioral health professionals working with children and adolescents.

Objectives:

As a result of participating in this training, participants will be able to:

Describe four dimensions of the therapeutic alliance and how to recognize them when they are present.
Describe how to use individual subsystem sessions to develop therapeutic alliances with caregivers and adolescents.
Describe basic principles for cultivating a therapeutic alliance

This course uses an online distance-learning self-paced format. It includes recorded audio, recorded video-based webinars, and selected readings. There are post-tests to ensure comprehension of the material. Participants can communicate with the instructors via the online moodle interface. Real-time communication with the instructor in our online, self-paced distance learning courses is not possible. However, participants can send an email to the instructor via the online moodle interface within the course and expect to receive a response within 48 hours. All course content, including post-tests, should take approximately 2 hours to complete.

Frequently Asked Questions
Visit our Self-Paced, Online Continuing Education Policies & FAQs for additional information regarding the CFBT online learning center, accommodations for disabilities, reporting problems with the course, instructions for viewing webinars, etc.

Creating Emotional Safety in Family Sessions

The experience of emotional safety is a key component of a therapeutic alliance in family therapy, particularly when working with family members who have trauma histories, like those typically treated in intensive, in-home programs. It all begins with active listening, which helps family members feel heard. In addition to feeling heard, family members must feel calm and regulated in the presence of one another and with the therapists. Families in conflict often feel a sense of emotional danger in family treatment, not only from the therapist but also from one another. This course describes five therapist-led actions that decrease anxiety and discomfort and lead to a sense of safety. These actions, which are described in some detail, include: 1) creating a predictable structure for each session, 2) attuning to family member distress and acting as a co-regulator as needed, 3) humanizing family members, 4) maintaining a strength-focus, and 5) interrupting judgment, blame, and hostility.

This is an introductory level course. The target audience is all behavioral health professionals working with children and adolescents.

Objectives:

As a result of participating in this training, participants will be able to:

Identify four fundamental active listening skills
Describe two actions involving boundary setting that creates emotional safety in family sessions
Describe three relational actions that create emotional safety in sessions.

The Treatment Tasks of Creating a Therapeutic System

The first stage of treatment in ESFT is Creating the Therapeutic System. It is all about establishing working relationships with family members and, as needed, extended family members and other professionals in the community. This course describes in detail the four clinical tasks comprising this treatment stage. These tasks include: 1) orienting families to ESFT and explaining how it works, 2) using the ecomap to identify important people to include in treatment, 3) cultivating the therapeutic alliance, and 4) gaining buy-in and engaging family members in treatment. Successful completion of these four treatment tasks requires therapists to adopt a relational, collaborative approach to working with families. This course demonstrates how to employ “partnership talk” with families to create a collaborative treatment context and to solidify working relationships within the therapeutic system.

This is a Beginning Level course. The target audience is all behavioral health professionals working with children and adolescents.

Learning Objectives

Use ecomaps and an ESFT orienting script to begin the process of building a therapeutic system
Describe the relationship between a therapeutic alliance and treatment engagement
Identify the characteristics of a collaborative, relational interviewing approach with families

Power, Privilege & Trauma: Implications for Family Treatment

Click here for Instructor Bio.

Children and families treated in intensive, in-home programs regularly experience marginalization based on social class, race, ethnicity, disability, religion, health status, and/or sexual orientation. This workshop focuses on the often overlooked but highly impactful issues of power and privilege that result in marginalization, which shapes family member relationships to one another, with their communities, and with helping professionals. The content in this course is derived from an edited version of a series of live zoom workshops presented in December 2020. Ms. Christian uses a discussion-based format to teach this content. She introduces key concepts and principles then engages participants in an open discussion of them. The 12 webinars below have incorporated selected portions of these discussions, which not only help to further elucidate the concepts and principles but also help translate them into day-to-day practice.

This first module of this course describes characteristics of power and privilege and explains the importance of using a trauma lens when trying to understand the hidden impacts of chronic marginalization or oppression. Cultural humility is explained and promoted as an attitude that can be developed to help therapists appreciate the complexity of social identity and combat induction into reductionistic, culturally insensitive relationships with patients who are from a culture, SES group, or ethnic group very different from their own.

The second module focuses on trauma and how it shows itself among children and adolescents. Too often these symptoms of trauma are misunderstood as simply behavioral problems. A case study is presented involving a family living in an unsafe neighborhood which is negatively impacted when their teenage son witnesses a homicide at the hands of a neighborhood gang.

The third module begins with a TEDx talk by Dr. Camara Jones who differentiates race from racism. She identifies three levels of racism: personally mediated, institutionalized, and internalized. There is also a webinar that describes three different types of microaggressions. The third webinar in this module provides the historical context for understanding the stigmatization of mental health treatment in communities of color, with a special focus on males of color.

The fourth module in this course explains the reasons it is important to use an expanded form of the ACEs when working with ethnically diverse families across the socioeconomic spectrum. The concept of a generational embodiment of historical trauma is introduced and described, along with stigmatized and disenfranchised loss. A case study is presented involving trauma related to parental drug addiction.

This is a Intermediate Level course. The target audience is all behavioral health professionals working with children and adolescents.

Learning Objectives

1. Identify the reasons it is important to view marginalization, oppression, and disenfranchised loss through a trauma lens.
2. Explain cultural humility and how it helps therapists stay open to the complexity of social identity in self and others.
3. Identify common symptoms of trauma among children and adolescents that are often misinterpreted as behavioral problems
4. Identify three levels of racism and three types of microaggression.

Course Outline

Module I: Dimensions of Power & Privilege (60 minutes)
- Slide handouts
- Webinars
  - Power & Privilege – An Introduction
  - Social Identity
  - The Importance of Cultural Humility
Module II: Recognizing Trauma (65 minutes)
- Slide handouts
- Webinars
  - Recognizing Signs of Trauma
  - The Trauma of Community Violence – A Case Study

Module III: Racism, Microaggression, and Attitudes Toward MH Treatment (30 minutes)
- Slide handouts
- Webinars
  - Microaggression
  - Historical Roots of Attitudes about MH Treatment Among Men of Color
- Resources
  - Allegories on Race and Racism
  - How to Respond to MicroAggressions & Bias

Module IV: Recognizing Common but Overlooked Adversity (70 minutes)
- Slide handouts
- Webinars
  - An Expanded View of Adversity
  - Stigmatized and Disenfranchised Loss
  - The Trauma of Parental Addiction
  - Vicarious Resilience
- Resources
  - ACE Slide
  - ACE Survey
  - Examples of Disenfranchised Grief

Recognizing & Treating the Authoritarian Family

Published 1/29/21

Authoritarian families are focused on maintaining order, control, and compliance. Coercion, bullying, abuse, and violence are common in these families. This workshop provides an eco-systemic framework for understanding these families, the caregivers who head them, and the types of problems they typically encounter with their children. Common traps therapists make when working with these families are identified, as are strategies for avoiding them. An in-depth discussion of a classic PCGC training video, Family With a Little Fire, is used to highlight methods for introducing more softness into interactions between authoritarian caregivers and their children, as well as fostering greater tolerance for imperfection. This online course is an edited version of an extended live training presented on November 7th 2019 at the Pennsylvania Counseling Services conference center.

Objectives:

As a result of participating in this educational activity, participants will be able to:

1. Identify the structural characteristics of authoritarian families
2. Identify authoritarian parenting patterns and their impacts on children
3. Recognize coercive interactional patterns and how to interrupt them
4. Identify personality and social context variables that leave parents vulnerable to authoritarian parenting
5. Describe common traps when working with authoritarian families and how to avoid them

This is a beginning level course, introducing therapists to complex developmental trauma and its implications for treating families.