SlideShare a Scribd company logo
1 of 8
Download to read offline
HOME-BASED NARRATIVE FAMILY THERAPY
Matts’ Knacks:
THE INTERNATIONAL JOURNAL OF NARRATIVE THERAPY AND COMMUNITY WORK 2012 No. 1 www.dulwichcentre.com.au		 19
AUTHOR
ANNE-MARIE RODEWALD
Anne-Marie Rodewald is a Swedish family therapist who is living in the United States
where she enjoys counselling individuals, families, and groups. She currently works both
with a not-for-profit organisation and a private practice. Anne-Marie has considerable
experience and great interest in work with addictions, dual diagnoses, and relationship
issues. Anne-Marie welcomes feedback and can be reached at:
rodewald@nova.edu or amrodewald@hotmail.com. Cell(954) 551-2656.
In the past decade, home-based family therapy has become an increasingly popular
approach and alternative to residential treatment for substance abuse, addictions, and
many psycho-socially related issues.This paper discusses a therapist’s experience in home-
based family therapy while working with a teenager severely affected by the impact of
substance abuse and life struggles.The therapeutic techniques illustrated are a direct
result of the therapist’s interest in narrative approaches to therapy.
Keywords: home-based family therapy, narrative therapy, substance abuse, young people
THE INTERNATIONAL JOURNAL OF NARRATIVE THERAPY AND COMMUNITY WORK 2012 No. 1 www.dulwichcentre.com.au		 20
While counselling families affected by substance abuse,
a process usually initiated by the courts, I have found
narrative therapeutic interventions to be both effective
and a refreshing approach to build rapport and elicit new
beginnings. Generally speaking, by the time I arrive at a
family’s home for the first session, the client has been
assessed and subsequently labelled with one or more
diagnoses from the diagnostic and statistical manual of
mental disorders (see American Psychiatric Association,
2000).The rhetorical language, potential internalisation,
and possible acceptance of being an abuser, or addict,
may have already impacted the person’s perception of
self. Although the assessment methods and questions
vary, they almost always contain pages upon pages of
questions that would put anyone on the defensive. As a
result, I frequently find myself attempting to undo clients’
previous encounters with the mental health care world
and have successfully united many established narrative
approaches and ideas (Monk,Winslade, Crocket, &
Epston, 1997) with my own humble ones.
Matt’s Knacks
Subsequent to scheduling the first appointment with
Matt and his mother, Monica, over the phone, I glanced
over Matt’s initial assessment and quickly realised that the
list of mental health care providers previously involved
with this family was extensive. According to the records,
Matt was 16 and court mandated to attend counselling
because he had been found with marijuana in his pockets
on school grounds. Additionally, there was a psychiatrist’s
name listed, indicating that Matt was on medication
for ADHD and a report that specified child-protective
(Florida Department of Children & Families) involvement.
With this information in mind, I was hoping to adopt a
‘backward story’ (Epston, 2010) approach during my first
encounter with Matt.
Usually, the backward story method works very well for
me in the initial approach to therapy, as it allows for a
family to revisit those times when the problem was not
a main concern.This thereby opens up sufficient space
to emphasise an alternative narrative that conveys the
skills and values of the client. My initial encounters with
kids and their families almost always involve a backward
story where I am able to sit back and take a position of
unknowing ‘curiosity’ (Flemons, 2002, pp. 46–60), thus
setting the tone for the relationship in a way that does
not allow for the problem to be the sole emphasis.
First Session: September 2010
Upon my arrival, Matt shyly greeted me only to swiftly
look down at the floor. Monica, his mother, invited me in,
and as we sat down around the kitchen-table, she quickly
informed me that she was at her wit’s end. She described
that as a school-teacher, she was familiar with the
disciplinary actions associated with voluntarily reporting
her son for cannabis possession and that his drug abuse
had to stop. She quickly relayed that unless Matt chose
to stop smoking, she would send him to a residential
rehab program.Throughout the beginning of our meeting,
Matt kept his gaze down, and after a while, started to
nervously shake one of his legs.
After Monica’s initial telling of Matt’s problems, I seized
the opportunity to start the session as I had planned.
I asked Monica if it would be okay with her to begin
spending our time together by talking about how things
had been before the problems started.‘Of course it
would’, she replied. I then turned to Matt and asked
him the same question. He nodded in agreement, still
looking down at the floor. Before moving on with the
conversation, I assured Monica that we could talk about
Matt’s ‘troubles’ later.‘Matt, can you think back to before
the troubles began?’ I asked. Matt was quiet for a while
and then replied,‘Sure, I remember being happy and
doing stuff’. Monica interrupted, recounting how happy
and loving Matt always had been, and that only in the
last year had things gotten really out of hand. Quickly,
Monica described how, last year, Matt’s father had tried
– and failed – to commit ‘suicide by cop’. Since I had
never heard about ‘suicide by cop’, my perplexed facial
expression must have encouraged Monica to reveal that
‘suicide by cop’ is a suicide method in which a suicidal
individual deliberately acts in a threatening way with
the goal of provoking a deadly response from a law
enforcement officer, such as being shot to death.
This was not the direction I had anticipated for our
first session, yet at this point there was no turning
back. I asked Matt if he was fine with his mother telling
me about dad’s incident. Matt replied that he did not
care and then nodded his head in agreement. Monica
continued to tell the story of how Matt’s dad had talked
about ‘killing himself’ a number of times over the years,
but that because of his prolonged drug use and mental
illness, she had gotten used to his ‘ramblings’. She went
on to say that as a result of the failed suicide attempt,
Matt’s dad was now more depressed than ever and in
THE INTERNATIONAL JOURNAL OF NARRATIVE THERAPY AND COMMUNITY WORK 2012 No. 1 www.dulwichcentre.com.au		 21
need of extensive rehabilitative care due to the injuries
he had sustained when shot by the police.
Once again, Matt showed no interest in participating
in the conversation, and he continued to look down at
the floor. At this point, after I acknowledged the many
challenges Monica was facing, I asked how she had found
the strength to move forward despite the tremendous
difficulties. She calmed down and spoke in a much lower
voice. She said,‘I take care of people.That is what we
do in this family.’ I enquired about the meaning of ‘taking
care of people’, and Monica replied that when you marry
someone, it is for good, and if a loved one is in need of
care, she would provide it as long as possible. Monica
discussed how, even though her husband had caused her
and the kids a lot of anguish over the years, she would
always be there for him, no matter what.We talked for
a few more minutes about the many responsibilities
that had fallen on Monica over the past few years as a
result of her husband’s problems and her mother’s death.
Gradually, she seemed more relaxed and refocused her
attention on Matt. Monica finally stood up and lovingly
ruffled Matt’s hair.‘He is my boy’ she said, and walked out
on the patio to smoke a cigarette.This conversation had
transpired over thirty minutes and I was curious to find
out more about Matt, who had sat quietly throughout
his mother’s retelling of the ’suicide by cop‘ story,
occasionally gazing over at me.
Ever since I arrived, Reese the family dog had been
seeking attention, so I asked Matt if we could go for a
walk. Matt looked at his mother for approval and then
seemed to welcome the suggestion. Monica said that she
thought it to be a great idea to walk the dog because
that was one of Matt’s chores anyway and, besides, she
needed to take care of the house. Matt and I started
walking with Reese, who eagerly pulled on the leash.
Once outside, Matt appeared more engaged and looked
over at me to start the conversation. I asked him to show
me his neighbourhood. Matt told me that this was the
neighbourhood where he had lived all his life.Within a
few minutes of our walk, Matt opened up and seemed
very eager to talk. He pointed to the different houses
and said things like ’Here is where we used to bike. Here
is where my friend lives, and the kid in this house deals.’
Matt was clearly involved now and freely elaborated
on how he knew many people in the neighbourhood.
Because of his initial silence and reserved demeanor, I
let him talk without interjecting too much. From time to
time, I would offer comments such as,‘Matt, you really
know your way around the hood’. He would smile and
confirm,‘Yeah, I pretty much know everyone around’. He
talked about how he and his family used to attend one
of the local churches and how great an environment that
had been growing up. I asked whether Matt still went to
church and he told me that ever since last year they had
stopped going because of what happened with his father.
We walked quietly for a few blocks as Reese kept pulling
on the leash. Matt told me about how he continues
to teach her how to walk properly on a leash, proudly
reporting that over time she had gotten a lot better.
‘Interesting’, I said.‘Do you think that getting better over
time applies to humans as well?’ I asked. He thought
about that for a while and agreed that most people grow
up to be better over time. I asked about how Matt had
trained Reese, and he replied that for the most part, he
would tell her no when she pulled on the leash, and then
praise her when she actually walked without pulling. I told
Matt that I found this interesting and asked him if he had
thought about the fact that he was very persistent with
his dog. He replied that he had not really thought about
it that way because Reese was only a year old, so he
expected her to pull. I asked Matt about whether some
teens are expected to ‘pull’ before they actually find their
own rhythm in life. He looked me straight in the eyes,
indicating that he understood the metaphor I was using.
He chuckled. I encouraged him to think about what skills
are important to consider when you are training a dog
(because as I explained to Matt, my dog barely sits when
asked to). Matt eagerly elaborated on the fine-tuned
relationship that exists between dogs and people and
how you have to establish yourself as an alpha leader in
their eyes.
By now, Matt was involved in the conversation, and he
explained that as a dog-owner, you have to be a fair
and consistent leader who takes control. At this point,
I replied that I thought it impressive that Matt, despite
some of the unfairness in his life, had taken such a
patient and caring interest in Reese. I asked him if he
thought he had a ‘knack’ for dog training. Matt thought
for a few seconds, understanding where I was going
before answering,‘Yes’. He expressed that he thought of
himself as a strong alpha that was really good at training.
I deliberately waited for a minute for the conversation
to sink in before I replied, as the silence only seemed to
further settle this revelation. I asked,‘Matt, do you think
that your knack for training would be helpful to you in
other ways?’‘Sure’, he answered.
At this point, we were back at the house. I was already
late for my next appointment, so I asked Matt to think
about ways in which he could use his talent for training
to resist ‘trouble’ (White, 2007, pp. 9-59) and tell me
more about it during our next meeting; Matt looked
THE INTERNATIONAL JOURNAL OF NARRATIVE THERAPY AND COMMUNITY WORK 2012 No. 1 www.dulwichcentre.com.au		 22
wary, but he agreed to come up with more than a few
ways to fight off ‘trouble’.
Second Session: One Week Later
When I arrived at the house, Matt opened the door
and appeared happy to see me. Reese was jumping up
and down, and Matt gently pushed her aside. Monica
invited me in to sit down, saying that she had to leave
soon to tend to Matt’s father who was getting moved
to a new ‘rehab’ centre. I asked how the rehab situation
was coming along, and Monica replied that her husband
was perpetually irritable and belligerent but was slowly
regaining some physical strength.‘Over the past few
years, there have been a series of illnesses within the
family’, Monica elaborated. First, her mother had passed
away after being sick for a long time.Then her father had
moved in with them. He too was in need of extensive
medical care since he was suffering from asbestosis. Once
again, I listened to Monica and carefully asked her if she
remembered to take care of herself. Monica paused for
a moment and in a joking voice answered that she does
not have time to take care of herself or the house, but
that she looks forward to that day. She said,‘For now, I’ve
got to deal with my husband’s situation’.
Mom expressed that she was fortunate to have her
nineteen-year-old daughter, Becky, still at home, because
she was helping out with a lot of things around the
house, such as making sure that Matt and their younger
sister went off to school in the mornings. I asked Becky
how this arrangement was working out for her. She said
that after last year’s incident with their father, things had
been really stressful at home, and she had decided to
take a couple of semesters off from college in order to
help her mom out.Throughout the conversation, Matt
had barely spoken. I asked him if he would like to go for
another walk, and he quickly went to grab Reese’s leash.
Once outside the house, I asked Matt to take me on his
usual dog-walk route.Then, I asked him to think back
to last week’s conversation about how he had a knack
for training. He nodded his head in agreement. I asked,
‘I wonder if you could come up with some “training-
ways” to fight off troubles’. Matt said that he had thought
about it, and that all he could think of would be to say
no to some of his friends, who, as he explained, would
suggest they cut classes and smoke weed in the school
bathroom. I chuckled and said that it seemed like a very
logical answer. I asked Matt to detail as many situations
as possible where he could use his No response,
deliberately hesitating before moving to futuristic
predictions like,‘I wonder what the outcomes might be?’
Matt elaborated at length on different scenarios where
he might be successful in saying no and seemed to enjoy
thinking about how it might play out in reality. I also
explored whether Matt thought that other people in his
family had a tough time saying no. Matt quickly replied
that he thought that his mom did:‘Although she’s tough
on the surface, she has a hard time saying no, especially
to dad’, he said. I asked Matt what he thought his mom
should say no to, and Matt answered,‘Everything. He just
uses her.’ Matt went on to say that he no longer speaks
to his dad because ‘there is nothing to talk about’.
As we were walking, Reese would pull on the leash
and try to chase anything that moved. Matt had his
hands full managing the 50 lb. puppy but remained very
calm with her and never once appeared frustrated. He
proudly showed me a new ‘give paw’ trick that he had
taught Reese during the past week. He looked delighted
as I commented on how his knack for training her was
obviously paying off. I asked if Matt thought that all dogs
learned at the same pace.‘Labs (Labradors) are easy to
train and Reese is really smart,’ he said.‘I guess the two of
you are a good match,’ I told him.‘Do you think there are
people who match up for life because of an initial level of
chemistry and attraction?’ I asked. He said that he thought
it could be the case.‘I wonder if that is the case with your
mom and dad,’ I enquired.
We came to a standstill. Matt turned to me and simply
stated,‘I’ve never thought about it that way, but now that
you say it …’ Before we headed back to the house, we
talked a little more about how being able to say no might
be important in life. I speculated that if you aren’t able
to say no, then maybe that means it’s more likely you’ll
be taken advantage of in life. Matt replied,‘That’s never
gonna happen to me because I know when to say no’.
‘Yes, you do’ I affirmed.
The Next Few Sessions
Over the next few weeks, every Tuesday I visited with
Matt and his family. Invariably, we would repeat the
now familiar pattern of Monica’s initial recount of that
week’s events, followed by Matt and me taking Reese for
walks. Mostly, we would discuss how Matt could use his
patience and ‘knack for training’ to move forward in his
life, more on his own terms. Matt would be eager to talk
THE INTERNATIONAL JOURNAL OF NARRATIVE THERAPY AND COMMUNITY WORK 2012 No. 1 www.dulwichcentre.com.au		 23
about how he had been able to manage situations where
weed was involved and how he was now able to say no
and stay in charge.
On one occasion, he described how his friend Steven
had smoked ‘laced weed’ and gone to school ‘high as
a kite’. Matt recounted how he had called his mother
and told her that he was leaving school to take care of
Steven. As it turns out, Matt had taken Steven back to his
house and, by the time Monica got back, Steven was still
‘out of it’. Mom had tried to call Steven’s parents without
any luck, and then as a precaution, she had taken him to
the emergency room. Eventually, after a few hours under
observation, Steven had regained enough of his senses to
be discharged. Matt elaborated on how much this event
had really scared him because he felt that this could easily
have happened to him when he was still using. I asked
Matt whether he thought that his ability to say no would
be helpful in case he got tempted to smoke again, and he
quickly responded,‘Of course it would’.
Over the next few meetings, Matt frequently talked
about Steven’s incident. It seemed to have made a big
impression on him. Naturally, I asked about the decisions
that he had made that day. I asked him to elaborate on
what had prompted him to remove Steven from the
school and how his decision-making process had been a
positive impact on Steven’s life. Matt explained that he
had not wanted Steven to get arrested because ‘that’s
what they do if they find weed on you at school’. He
took noticeable pleasure in his new confidence, sporting
a bright smile, and then voiced that he knew how to
handle situations now. Matt said that his role as an alpha
had paid off in unusual ways because he felt as if the
relationship between him and his mother had changed
for the better. As this was a wonderful opportunity for
Matt to ‘re-author’ (White, 2007 pp. 101–107) his identity
and to draw attention to his version of a preferred
mother-son relationship, I asked Matt to tell me more
specifically what he had noticed and why this might have
made the relationship better. Moreover, I encouraged
Matt to compare his recent reaction with Steven to that
of when he used to smoke. Matt delightfully reported
that, before, he would take much longer at reaching
decisions and that his first thoughts would not have
included his mother, as she would have been suspicious
of him as well. I marvelled at his response.‘How has this
affected your relationship with your mom?’ I asked. Matt
replied that he thought she did because ‘she no longer
keeps me grounded on weekends’. He matter-of-factly
described how they got along better now because he
was actually going to school, not skipping classes or
smoking, and he was getting better grades on his tests.
I acknowledged Matt’s accomplishments by repeating
them, one by one, and really stretching the words out. I
then asked ‘what could all of this signify?’ Matt dwelled
for a moment, closed his eyes as if reflecting on his own
words, and tentatively said ‘that I’m a reliable person who
makes good decisions …’
During our conversations, I would frequently encourage
Matt to discuss how his ‘knack for training’ was working
out in different aspects of his life. Matt, who had
embraced this way of referring to himself, would tell
me different stories about how he perceived his own
changes. Often, we would relate his changes to ‘the bigger
picture’ and how small changes can accumulate over time.
Sometime in October 2010, Matt and Monica revealed
that at school Matt was doing better as he had actually
managed to stay out of ‘trouble’ for several weeks in a
row. Monica reported that she had gotten Matt on an
educational plan due to his ADHD, and he was now
officially allowed to stand up and walk around when he
got restless or bored. I encouraged Monica to describe
the many details involved in this academic process, and
acknowledged that her decision to pursue this matter
seemed to have been a vital one.We discussed the fact
that, despite her busy schedule, Monica always took the
time to look out for Matt. Monica appeared grateful that
her actions were noticed because she said ‘I’m not letting
him get away that easy’. Matt said that this extra time
away from his desk would work to his advantage because
when he got bored in class, he would simply go and get
a drink from the water fountain in the hallway. Usually, if
he was allowed to get away for a few minutes, he could
then regain his focus. Monica described that over the past
few weeks, Matt had attended all of his classes and had
done really well on an important standardised test. She
was also quick to re-tell the story of Steven and how
Matt’s decisions had really demonstrated his ability to
be a good friend and make good choices. I noticed that
Matt seemed appeased as he listened to his mother’s
comment, and he encouraged her to describe the details
of these significant events.The session ended with
Monica’s elaborate description of how Matt was a mature
and a bright leader who could ‘hold his own in the world’.
Without a doubt, Monica’s active participation in the
counselling process had provided many opportunities for
positive changes to occur: I validated the fact that Monica
had much on her plate and wondered,‘Since Matt has
stayed away from trouble, what have you realised about
him that you did not know before?’ Monica thought
THE INTERNATIONAL JOURNAL OF NARRATIVE THERAPY AND COMMUNITY WORK 2012 No. 1 www.dulwichcentre.com.au		 24
about her answer before actually speaking and said,‘That
Matt is more like me than I thought, and I don’t want him
to get hurt the way I did’.
Because of Matt’s initial positive response to my reflective
homework assignments, each week I would leave Matt
with a question to think about until our next meeting.
Some of the reflections/questions indirectly involved the
father/son relationship he had ideally envisioned and how
the reality was different due to unfair circumstances:
•	 What type of fatherly advice do you think dad would
have given you if his own life had been drug free?
•	 What are some things you wish that dad could know
about you?
Other questions involved peer-relationships and how
drugs can be a pull:
•	 Can weed buy you friends?
•	 What kind of friendships can weed buy?
•	 What is the price of friendship?
We also fast forwarded time (White, 2007, pp. 275–280),
and in one conversation explored what type of father
Matt would like to become by asking ‘What are some
things your kids should know about you? What would be
the biggest life-lessons you would like to teach your kids?’
Matt elaborated on these questions in a very positive
way, describing his future as someone who was ‘content
and at peace with life’. He revealed that he would not
need a lot to be content and perhaps would like to learn
a trade like auto-mechanics or join the Army. Matt placed
a big emphasis on the ability to be a fun and fair father
who would be there for his kids. He also described in
great detail that he would teach his kids right from wrong
from an early age, so that they would not have to go
through the same things he had experienced. For a time,
these ‘future’ conversations became the main focus of our
sessions. As the weeks went by, Matt’s descriptions of his
future gained more and more detail, capturing some real
goals and dreams for his life.
At one point during one of our sessions around the
kitchen-table, Monica revealed how she used to smoke
weed ‘back in the day’. She openly described having
experimented with drugs ‘because of the 1960s and 70s’.
Moreover, Monica also recounted how painful it had
been to watch her husband go through every drug in
the book and progressively become a ‘total addict’. She
detailed how her husband’s drug use had robbed him of
his personality and a relationship with his kids. She also
discussed how agonising it had been for her to watch
him sink further and further down over the years. She
cried when she told the story about his medical needs
and how he was now ‘a shell of a man’. I asked Monica
where she had found the strength to go forward during
these hard times; she replied that her faith in God and
the support from her church group had provided her
with support up until last year, when her husband had
attempted suicide. However, since then, there had been
too much embarrassment and too many raw feelings to
deal with, so she had stopped going to church. Monica
took out her well-thumbed Bible and showed me some
of her favourite passages.The Bible had notes written on
almost all of its pages, and I wanted to learn more about
the significance of the notes to her.
Again, I was approaching the end of a session and needed
to move to my next appointment, so I asked Monica if I
could leave her with some questions to ponder until our
next meeting. She replied that it would be quite okay, and
curiously looked at me as I wrote down the questions
on a piece of paper and handed it to her.The questions
were:
•	 What is central about your faith?
•	 What does forgiveness mean to you?
•	 Who believes that Matt will fight off his problems?
•	 Who cares about Matt’s future?
Last session: December 2010
By this time, Matt had abstained from marijuana smoking
for over two months, and he was back on track at school,
not skipping classes, and making Bs. Monica reported that
even though Matt’s faith was frazzled, she had regained
’her boy’. During the session, she described how the
counselling process had been effective because of the
added accountability. She also discussed that she was still
struggling with her faith, but that it had more to do with
the people involved in church than it had to do with
her personal relationship with God. Her voice trembled
as she described almost losing faith in Matt’s ability to
fight off drugs and that her perception probably was
associated with the pain of her husband’s decades-long
drug abuse. Monica described how she, Grandpa, and
Matt’s sisters, all care about him and how hard it was
to watch him ‘slip through the cracks’. I interjected with,
‘So for a while you felt as if Matt was falling through the
cracks, what then made all of you realise that Matt was
actually fighting off trouble and coming in to his own?’
‘Well’, she said,‘we knew that Matt was a fighter like the
THE INTERNATIONAL JOURNAL OF NARRATIVE THERAPY AND COMMUNITY WORK 2012 No. 1 www.dulwichcentre.com.au		 25
rest of us because he really cares about people and deep
down, he has a strong sense of self’. Matt affirmed that
he had lost faith in organised religion because of how
their church group had acted after his dad’s ‘incident’, but
he was also quick to reveal that he thought of himself as
a spiritual person who ‘knows what’s right’.
Matt’s demeanour had changed over the past few weeks;
remarkably, he now rarely looked down at the floor. He
really had the appearance of a more confident person,
as his sister Becky pointed out. Becky also said that she
had noticed a positive difference in Matt’s approach to
helping out more at the house and that he would do
chores without being asked or nagged. I thanked Monica
and Becky for being part of this (court-ordered) process
and turned my attention to Matt. I told him that he
had been an extraordinary walking companion whose
conversation I had truly enjoyed. I also thanked him for
tuning me into his ‘knack for training’ and wondered
where he thought his talents might bring him in the
future.
Hindsight reflections
When meeting with families, many things are beyond
my control as a therapist. For the time being, I accept
this and attempt to creatively use a diverse spectrum of
creative interventions. Each time I meet with a family in
their home is an opportunity to reflect and to learn, and
it means a lot to me to always reflect in hindsight about
what else I could have done.
In hindsight, during my meetings with Matt and his family,
I would have liked to use better articulated letter-writing.
I would have liked to have Matt’s sister present for a few
more sessions, and although I did meet with Matt’s father
once, I would have preferred to have more time to work
out the profound effects that Matt’s father’s actions and
experiences had had on the entire family. Unfortunately,
I was not able to fully address these issues because of
agency restraints: once I successfully conclude ‘treatment’
for 10-12 weeks, I am required to fill out pages upon
pages of paperwork and feedback sessions are not
allowed, except if the agency wishes to obtain statistical
data.
In response to agency restraints, over time I have
adopted a more narrative approach to my work and this
rarely fails me.To me, the most effective interventions
consist of exploring a backward story, externalising
problems, re-authoring a preferred story of identity, fast-
forwarding time, and to the extent that I can, including
family and friends in the re-authoring process. I have
tried to outline these practices in this paper through
my descriptions of conversations with Matt, Monica, and
Becky.
My home-based narrative family therapy is a work in
progress. I continue to grapple with many contradictions
and therapeutic challenges such as mandatory urine-
testing, and case-notes and treatment plans that need
to follow a constrained format. In the midst of this, as
a soul-soother, I find the notion of narrative self-talk to
be tremendously comforting. It is common for me to
think back to an interesting conversation I have recently
shared with a family and play around with it in my head.
I ask myself ‘What I could have done differently? How
could I make a more significant impact? Could I go back
to this family and do something different next time?’
References
American Psychiatric Association. (2000). Diagnostic and statistical
manual of mental disorders (4th ed text rev.).Washington, DC.
Epston, D. (2010). Backward story. Handout during a seminar ’2 days
with David Epston‘ in June 18-19 2010, organised by BAMFT at
Nova Southeastern University (NSU), Ft. Lauderdale, Florida.
Flemons, D. (2002). Of one mind:The logic of hypnosis, the practice of
therapy. London, UK:W.W. Norton.
Monk, G.,Winslade, J., Crocket, K., & Epston, D. (Eds.) (1997). Narrative
therapy in practice.
San Francisco, CA: Jossey-Bass.
White, M. (2007). Maps of narrative practice. NewYork, NY:W.W.
Norton.
THE INTERNATIONAL JOURNAL OF NARRATIVE THERAPY AND COMMUNITY WORK 2012 No. 1 www.dulwichcentre.com.au		 26
This paper was originally published by Dulwich Centre Publications, a small independent publishing house based in Adelaide Australia.
You can do us a big favour by respecting the copyright of this article and any article or publication of ours.
The article you have read is copyright © Dulwich Centre Publications Except as permitted under the Australian Copyright Act 1968,
no part of this article may be reproduced, stored in a retrieval system, communicated, or transmitted in any form or by any means
without prior permission.
All enquiries should be made to the copyright owner at:
Dulwich Centre Publications, Hutt St PO Box 7192,Adelaide, SA,Australia, 5000; email dcp@dulwichcentre.com.au
Thank you! We really appreciate it.
You can find out more about us at:
www.dulwichcentre.com.au
You can find a range of on-line resources at:
www.narrativetherapyonline.com
And you can find more of our publications at:
www.narrativetherapylibrary.com
DEAR READER

More Related Content

Similar to Matt's knacks Home-based family therapy by Anne-Marie_Rodewald

National Council Magazine, 2010 Issue 1
National Council Magazine, 2010 Issue 1National Council Magazine, 2010 Issue 1
National Council Magazine, 2010 Issue 1
The National Council
 
423 Interview Assignment.pdf
423 Interview Assignment.pdf423 Interview Assignment.pdf
423 Interview Assignment.pdf
Shinjini Bakshi
 
423 Interview Assignment.pdf
423 Interview Assignment.pdf423 Interview Assignment.pdf
423 Interview Assignment.pdf
Shinjini Bakshi
 
Child Sex Offenders: How They Select, Seduce, Maintain & Dump Victims
Child Sex Offenders:  How They Select, Seduce, Maintain & Dump VictimsChild Sex Offenders:  How They Select, Seduce, Maintain & Dump Victims
Child Sex Offenders: How They Select, Seduce, Maintain & Dump Victims
Mike McCarty
 

Similar to Matt's knacks Home-based family therapy by Anne-Marie_Rodewald (11)

National Council Magazine, 2010 Issue 1
National Council Magazine, 2010 Issue 1National Council Magazine, 2010 Issue 1
National Council Magazine, 2010 Issue 1
 
SHE: Collection of stories
SHE: Collection of storiesSHE: Collection of stories
SHE: Collection of stories
 
rhetoric essay
rhetoric essayrhetoric essay
rhetoric essay
 
Parental experiences of children’s sexual abuse disclosures
Parental experiences of children’s sexual abuse disclosuresParental experiences of children’s sexual abuse disclosures
Parental experiences of children’s sexual abuse disclosures
 
423 Interview Assignment.pdf
423 Interview Assignment.pdf423 Interview Assignment.pdf
423 Interview Assignment.pdf
 
423 Interview Assignment.pdf
423 Interview Assignment.pdf423 Interview Assignment.pdf
423 Interview Assignment.pdf
 
Child Sex Offenders: How They Select, Seduce, Maintain & Dump Victims
Child Sex Offenders:  How They Select, Seduce, Maintain & Dump VictimsChild Sex Offenders:  How They Select, Seduce, Maintain & Dump Victims
Child Sex Offenders: How They Select, Seduce, Maintain & Dump Victims
 
Smart Note-Taking For Research Paper Writing Zenkit
Smart Note-Taking For Research Paper Writing ZenkitSmart Note-Taking For Research Paper Writing Zenkit
Smart Note-Taking For Research Paper Writing Zenkit
 
Step-By-Step Guide To Essay Writing - ESLBuzz Learnin
Step-By-Step Guide To Essay Writing - ESLBuzz LearninStep-By-Step Guide To Essay Writing - ESLBuzz Learnin
Step-By-Step Guide To Essay Writing - ESLBuzz Learnin
 
My dad
My dadMy dad
My dad
 
Ap Lang Essay Scoring Guide. Online assignment writing service.
Ap Lang Essay Scoring Guide. Online assignment writing service.Ap Lang Essay Scoring Guide. Online assignment writing service.
Ap Lang Essay Scoring Guide. Online assignment writing service.
 

Matt's knacks Home-based family therapy by Anne-Marie_Rodewald

  • 1. HOME-BASED NARRATIVE FAMILY THERAPY Matts’ Knacks: THE INTERNATIONAL JOURNAL OF NARRATIVE THERAPY AND COMMUNITY WORK 2012 No. 1 www.dulwichcentre.com.au 19 AUTHOR ANNE-MARIE RODEWALD Anne-Marie Rodewald is a Swedish family therapist who is living in the United States where she enjoys counselling individuals, families, and groups. She currently works both with a not-for-profit organisation and a private practice. Anne-Marie has considerable experience and great interest in work with addictions, dual diagnoses, and relationship issues. Anne-Marie welcomes feedback and can be reached at: rodewald@nova.edu or amrodewald@hotmail.com. Cell(954) 551-2656. In the past decade, home-based family therapy has become an increasingly popular approach and alternative to residential treatment for substance abuse, addictions, and many psycho-socially related issues.This paper discusses a therapist’s experience in home- based family therapy while working with a teenager severely affected by the impact of substance abuse and life struggles.The therapeutic techniques illustrated are a direct result of the therapist’s interest in narrative approaches to therapy. Keywords: home-based family therapy, narrative therapy, substance abuse, young people
  • 2. THE INTERNATIONAL JOURNAL OF NARRATIVE THERAPY AND COMMUNITY WORK 2012 No. 1 www.dulwichcentre.com.au 20 While counselling families affected by substance abuse, a process usually initiated by the courts, I have found narrative therapeutic interventions to be both effective and a refreshing approach to build rapport and elicit new beginnings. Generally speaking, by the time I arrive at a family’s home for the first session, the client has been assessed and subsequently labelled with one or more diagnoses from the diagnostic and statistical manual of mental disorders (see American Psychiatric Association, 2000).The rhetorical language, potential internalisation, and possible acceptance of being an abuser, or addict, may have already impacted the person’s perception of self. Although the assessment methods and questions vary, they almost always contain pages upon pages of questions that would put anyone on the defensive. As a result, I frequently find myself attempting to undo clients’ previous encounters with the mental health care world and have successfully united many established narrative approaches and ideas (Monk,Winslade, Crocket, & Epston, 1997) with my own humble ones. Matt’s Knacks Subsequent to scheduling the first appointment with Matt and his mother, Monica, over the phone, I glanced over Matt’s initial assessment and quickly realised that the list of mental health care providers previously involved with this family was extensive. According to the records, Matt was 16 and court mandated to attend counselling because he had been found with marijuana in his pockets on school grounds. Additionally, there was a psychiatrist’s name listed, indicating that Matt was on medication for ADHD and a report that specified child-protective (Florida Department of Children & Families) involvement. With this information in mind, I was hoping to adopt a ‘backward story’ (Epston, 2010) approach during my first encounter with Matt. Usually, the backward story method works very well for me in the initial approach to therapy, as it allows for a family to revisit those times when the problem was not a main concern.This thereby opens up sufficient space to emphasise an alternative narrative that conveys the skills and values of the client. My initial encounters with kids and their families almost always involve a backward story where I am able to sit back and take a position of unknowing ‘curiosity’ (Flemons, 2002, pp. 46–60), thus setting the tone for the relationship in a way that does not allow for the problem to be the sole emphasis. First Session: September 2010 Upon my arrival, Matt shyly greeted me only to swiftly look down at the floor. Monica, his mother, invited me in, and as we sat down around the kitchen-table, she quickly informed me that she was at her wit’s end. She described that as a school-teacher, she was familiar with the disciplinary actions associated with voluntarily reporting her son for cannabis possession and that his drug abuse had to stop. She quickly relayed that unless Matt chose to stop smoking, she would send him to a residential rehab program.Throughout the beginning of our meeting, Matt kept his gaze down, and after a while, started to nervously shake one of his legs. After Monica’s initial telling of Matt’s problems, I seized the opportunity to start the session as I had planned. I asked Monica if it would be okay with her to begin spending our time together by talking about how things had been before the problems started.‘Of course it would’, she replied. I then turned to Matt and asked him the same question. He nodded in agreement, still looking down at the floor. Before moving on with the conversation, I assured Monica that we could talk about Matt’s ‘troubles’ later.‘Matt, can you think back to before the troubles began?’ I asked. Matt was quiet for a while and then replied,‘Sure, I remember being happy and doing stuff’. Monica interrupted, recounting how happy and loving Matt always had been, and that only in the last year had things gotten really out of hand. Quickly, Monica described how, last year, Matt’s father had tried – and failed – to commit ‘suicide by cop’. Since I had never heard about ‘suicide by cop’, my perplexed facial expression must have encouraged Monica to reveal that ‘suicide by cop’ is a suicide method in which a suicidal individual deliberately acts in a threatening way with the goal of provoking a deadly response from a law enforcement officer, such as being shot to death. This was not the direction I had anticipated for our first session, yet at this point there was no turning back. I asked Matt if he was fine with his mother telling me about dad’s incident. Matt replied that he did not care and then nodded his head in agreement. Monica continued to tell the story of how Matt’s dad had talked about ‘killing himself’ a number of times over the years, but that because of his prolonged drug use and mental illness, she had gotten used to his ‘ramblings’. She went on to say that as a result of the failed suicide attempt, Matt’s dad was now more depressed than ever and in
  • 3. THE INTERNATIONAL JOURNAL OF NARRATIVE THERAPY AND COMMUNITY WORK 2012 No. 1 www.dulwichcentre.com.au 21 need of extensive rehabilitative care due to the injuries he had sustained when shot by the police. Once again, Matt showed no interest in participating in the conversation, and he continued to look down at the floor. At this point, after I acknowledged the many challenges Monica was facing, I asked how she had found the strength to move forward despite the tremendous difficulties. She calmed down and spoke in a much lower voice. She said,‘I take care of people.That is what we do in this family.’ I enquired about the meaning of ‘taking care of people’, and Monica replied that when you marry someone, it is for good, and if a loved one is in need of care, she would provide it as long as possible. Monica discussed how, even though her husband had caused her and the kids a lot of anguish over the years, she would always be there for him, no matter what.We talked for a few more minutes about the many responsibilities that had fallen on Monica over the past few years as a result of her husband’s problems and her mother’s death. Gradually, she seemed more relaxed and refocused her attention on Matt. Monica finally stood up and lovingly ruffled Matt’s hair.‘He is my boy’ she said, and walked out on the patio to smoke a cigarette.This conversation had transpired over thirty minutes and I was curious to find out more about Matt, who had sat quietly throughout his mother’s retelling of the ’suicide by cop‘ story, occasionally gazing over at me. Ever since I arrived, Reese the family dog had been seeking attention, so I asked Matt if we could go for a walk. Matt looked at his mother for approval and then seemed to welcome the suggestion. Monica said that she thought it to be a great idea to walk the dog because that was one of Matt’s chores anyway and, besides, she needed to take care of the house. Matt and I started walking with Reese, who eagerly pulled on the leash. Once outside, Matt appeared more engaged and looked over at me to start the conversation. I asked him to show me his neighbourhood. Matt told me that this was the neighbourhood where he had lived all his life.Within a few minutes of our walk, Matt opened up and seemed very eager to talk. He pointed to the different houses and said things like ’Here is where we used to bike. Here is where my friend lives, and the kid in this house deals.’ Matt was clearly involved now and freely elaborated on how he knew many people in the neighbourhood. Because of his initial silence and reserved demeanor, I let him talk without interjecting too much. From time to time, I would offer comments such as,‘Matt, you really know your way around the hood’. He would smile and confirm,‘Yeah, I pretty much know everyone around’. He talked about how he and his family used to attend one of the local churches and how great an environment that had been growing up. I asked whether Matt still went to church and he told me that ever since last year they had stopped going because of what happened with his father. We walked quietly for a few blocks as Reese kept pulling on the leash. Matt told me about how he continues to teach her how to walk properly on a leash, proudly reporting that over time she had gotten a lot better. ‘Interesting’, I said.‘Do you think that getting better over time applies to humans as well?’ I asked. He thought about that for a while and agreed that most people grow up to be better over time. I asked about how Matt had trained Reese, and he replied that for the most part, he would tell her no when she pulled on the leash, and then praise her when she actually walked without pulling. I told Matt that I found this interesting and asked him if he had thought about the fact that he was very persistent with his dog. He replied that he had not really thought about it that way because Reese was only a year old, so he expected her to pull. I asked Matt about whether some teens are expected to ‘pull’ before they actually find their own rhythm in life. He looked me straight in the eyes, indicating that he understood the metaphor I was using. He chuckled. I encouraged him to think about what skills are important to consider when you are training a dog (because as I explained to Matt, my dog barely sits when asked to). Matt eagerly elaborated on the fine-tuned relationship that exists between dogs and people and how you have to establish yourself as an alpha leader in their eyes. By now, Matt was involved in the conversation, and he explained that as a dog-owner, you have to be a fair and consistent leader who takes control. At this point, I replied that I thought it impressive that Matt, despite some of the unfairness in his life, had taken such a patient and caring interest in Reese. I asked him if he thought he had a ‘knack’ for dog training. Matt thought for a few seconds, understanding where I was going before answering,‘Yes’. He expressed that he thought of himself as a strong alpha that was really good at training. I deliberately waited for a minute for the conversation to sink in before I replied, as the silence only seemed to further settle this revelation. I asked,‘Matt, do you think that your knack for training would be helpful to you in other ways?’‘Sure’, he answered. At this point, we were back at the house. I was already late for my next appointment, so I asked Matt to think about ways in which he could use his talent for training to resist ‘trouble’ (White, 2007, pp. 9-59) and tell me more about it during our next meeting; Matt looked
  • 4. THE INTERNATIONAL JOURNAL OF NARRATIVE THERAPY AND COMMUNITY WORK 2012 No. 1 www.dulwichcentre.com.au 22 wary, but he agreed to come up with more than a few ways to fight off ‘trouble’. Second Session: One Week Later When I arrived at the house, Matt opened the door and appeared happy to see me. Reese was jumping up and down, and Matt gently pushed her aside. Monica invited me in to sit down, saying that she had to leave soon to tend to Matt’s father who was getting moved to a new ‘rehab’ centre. I asked how the rehab situation was coming along, and Monica replied that her husband was perpetually irritable and belligerent but was slowly regaining some physical strength.‘Over the past few years, there have been a series of illnesses within the family’, Monica elaborated. First, her mother had passed away after being sick for a long time.Then her father had moved in with them. He too was in need of extensive medical care since he was suffering from asbestosis. Once again, I listened to Monica and carefully asked her if she remembered to take care of herself. Monica paused for a moment and in a joking voice answered that she does not have time to take care of herself or the house, but that she looks forward to that day. She said,‘For now, I’ve got to deal with my husband’s situation’. Mom expressed that she was fortunate to have her nineteen-year-old daughter, Becky, still at home, because she was helping out with a lot of things around the house, such as making sure that Matt and their younger sister went off to school in the mornings. I asked Becky how this arrangement was working out for her. She said that after last year’s incident with their father, things had been really stressful at home, and she had decided to take a couple of semesters off from college in order to help her mom out.Throughout the conversation, Matt had barely spoken. I asked him if he would like to go for another walk, and he quickly went to grab Reese’s leash. Once outside the house, I asked Matt to take me on his usual dog-walk route.Then, I asked him to think back to last week’s conversation about how he had a knack for training. He nodded his head in agreement. I asked, ‘I wonder if you could come up with some “training- ways” to fight off troubles’. Matt said that he had thought about it, and that all he could think of would be to say no to some of his friends, who, as he explained, would suggest they cut classes and smoke weed in the school bathroom. I chuckled and said that it seemed like a very logical answer. I asked Matt to detail as many situations as possible where he could use his No response, deliberately hesitating before moving to futuristic predictions like,‘I wonder what the outcomes might be?’ Matt elaborated at length on different scenarios where he might be successful in saying no and seemed to enjoy thinking about how it might play out in reality. I also explored whether Matt thought that other people in his family had a tough time saying no. Matt quickly replied that he thought that his mom did:‘Although she’s tough on the surface, she has a hard time saying no, especially to dad’, he said. I asked Matt what he thought his mom should say no to, and Matt answered,‘Everything. He just uses her.’ Matt went on to say that he no longer speaks to his dad because ‘there is nothing to talk about’. As we were walking, Reese would pull on the leash and try to chase anything that moved. Matt had his hands full managing the 50 lb. puppy but remained very calm with her and never once appeared frustrated. He proudly showed me a new ‘give paw’ trick that he had taught Reese during the past week. He looked delighted as I commented on how his knack for training her was obviously paying off. I asked if Matt thought that all dogs learned at the same pace.‘Labs (Labradors) are easy to train and Reese is really smart,’ he said.‘I guess the two of you are a good match,’ I told him.‘Do you think there are people who match up for life because of an initial level of chemistry and attraction?’ I asked. He said that he thought it could be the case.‘I wonder if that is the case with your mom and dad,’ I enquired. We came to a standstill. Matt turned to me and simply stated,‘I’ve never thought about it that way, but now that you say it …’ Before we headed back to the house, we talked a little more about how being able to say no might be important in life. I speculated that if you aren’t able to say no, then maybe that means it’s more likely you’ll be taken advantage of in life. Matt replied,‘That’s never gonna happen to me because I know when to say no’. ‘Yes, you do’ I affirmed. The Next Few Sessions Over the next few weeks, every Tuesday I visited with Matt and his family. Invariably, we would repeat the now familiar pattern of Monica’s initial recount of that week’s events, followed by Matt and me taking Reese for walks. Mostly, we would discuss how Matt could use his patience and ‘knack for training’ to move forward in his life, more on his own terms. Matt would be eager to talk
  • 5. THE INTERNATIONAL JOURNAL OF NARRATIVE THERAPY AND COMMUNITY WORK 2012 No. 1 www.dulwichcentre.com.au 23 about how he had been able to manage situations where weed was involved and how he was now able to say no and stay in charge. On one occasion, he described how his friend Steven had smoked ‘laced weed’ and gone to school ‘high as a kite’. Matt recounted how he had called his mother and told her that he was leaving school to take care of Steven. As it turns out, Matt had taken Steven back to his house and, by the time Monica got back, Steven was still ‘out of it’. Mom had tried to call Steven’s parents without any luck, and then as a precaution, she had taken him to the emergency room. Eventually, after a few hours under observation, Steven had regained enough of his senses to be discharged. Matt elaborated on how much this event had really scared him because he felt that this could easily have happened to him when he was still using. I asked Matt whether he thought that his ability to say no would be helpful in case he got tempted to smoke again, and he quickly responded,‘Of course it would’. Over the next few meetings, Matt frequently talked about Steven’s incident. It seemed to have made a big impression on him. Naturally, I asked about the decisions that he had made that day. I asked him to elaborate on what had prompted him to remove Steven from the school and how his decision-making process had been a positive impact on Steven’s life. Matt explained that he had not wanted Steven to get arrested because ‘that’s what they do if they find weed on you at school’. He took noticeable pleasure in his new confidence, sporting a bright smile, and then voiced that he knew how to handle situations now. Matt said that his role as an alpha had paid off in unusual ways because he felt as if the relationship between him and his mother had changed for the better. As this was a wonderful opportunity for Matt to ‘re-author’ (White, 2007 pp. 101–107) his identity and to draw attention to his version of a preferred mother-son relationship, I asked Matt to tell me more specifically what he had noticed and why this might have made the relationship better. Moreover, I encouraged Matt to compare his recent reaction with Steven to that of when he used to smoke. Matt delightfully reported that, before, he would take much longer at reaching decisions and that his first thoughts would not have included his mother, as she would have been suspicious of him as well. I marvelled at his response.‘How has this affected your relationship with your mom?’ I asked. Matt replied that he thought she did because ‘she no longer keeps me grounded on weekends’. He matter-of-factly described how they got along better now because he was actually going to school, not skipping classes or smoking, and he was getting better grades on his tests. I acknowledged Matt’s accomplishments by repeating them, one by one, and really stretching the words out. I then asked ‘what could all of this signify?’ Matt dwelled for a moment, closed his eyes as if reflecting on his own words, and tentatively said ‘that I’m a reliable person who makes good decisions …’ During our conversations, I would frequently encourage Matt to discuss how his ‘knack for training’ was working out in different aspects of his life. Matt, who had embraced this way of referring to himself, would tell me different stories about how he perceived his own changes. Often, we would relate his changes to ‘the bigger picture’ and how small changes can accumulate over time. Sometime in October 2010, Matt and Monica revealed that at school Matt was doing better as he had actually managed to stay out of ‘trouble’ for several weeks in a row. Monica reported that she had gotten Matt on an educational plan due to his ADHD, and he was now officially allowed to stand up and walk around when he got restless or bored. I encouraged Monica to describe the many details involved in this academic process, and acknowledged that her decision to pursue this matter seemed to have been a vital one.We discussed the fact that, despite her busy schedule, Monica always took the time to look out for Matt. Monica appeared grateful that her actions were noticed because she said ‘I’m not letting him get away that easy’. Matt said that this extra time away from his desk would work to his advantage because when he got bored in class, he would simply go and get a drink from the water fountain in the hallway. Usually, if he was allowed to get away for a few minutes, he could then regain his focus. Monica described that over the past few weeks, Matt had attended all of his classes and had done really well on an important standardised test. She was also quick to re-tell the story of Steven and how Matt’s decisions had really demonstrated his ability to be a good friend and make good choices. I noticed that Matt seemed appeased as he listened to his mother’s comment, and he encouraged her to describe the details of these significant events.The session ended with Monica’s elaborate description of how Matt was a mature and a bright leader who could ‘hold his own in the world’. Without a doubt, Monica’s active participation in the counselling process had provided many opportunities for positive changes to occur: I validated the fact that Monica had much on her plate and wondered,‘Since Matt has stayed away from trouble, what have you realised about him that you did not know before?’ Monica thought
  • 6. THE INTERNATIONAL JOURNAL OF NARRATIVE THERAPY AND COMMUNITY WORK 2012 No. 1 www.dulwichcentre.com.au 24 about her answer before actually speaking and said,‘That Matt is more like me than I thought, and I don’t want him to get hurt the way I did’. Because of Matt’s initial positive response to my reflective homework assignments, each week I would leave Matt with a question to think about until our next meeting. Some of the reflections/questions indirectly involved the father/son relationship he had ideally envisioned and how the reality was different due to unfair circumstances: • What type of fatherly advice do you think dad would have given you if his own life had been drug free? • What are some things you wish that dad could know about you? Other questions involved peer-relationships and how drugs can be a pull: • Can weed buy you friends? • What kind of friendships can weed buy? • What is the price of friendship? We also fast forwarded time (White, 2007, pp. 275–280), and in one conversation explored what type of father Matt would like to become by asking ‘What are some things your kids should know about you? What would be the biggest life-lessons you would like to teach your kids?’ Matt elaborated on these questions in a very positive way, describing his future as someone who was ‘content and at peace with life’. He revealed that he would not need a lot to be content and perhaps would like to learn a trade like auto-mechanics or join the Army. Matt placed a big emphasis on the ability to be a fun and fair father who would be there for his kids. He also described in great detail that he would teach his kids right from wrong from an early age, so that they would not have to go through the same things he had experienced. For a time, these ‘future’ conversations became the main focus of our sessions. As the weeks went by, Matt’s descriptions of his future gained more and more detail, capturing some real goals and dreams for his life. At one point during one of our sessions around the kitchen-table, Monica revealed how she used to smoke weed ‘back in the day’. She openly described having experimented with drugs ‘because of the 1960s and 70s’. Moreover, Monica also recounted how painful it had been to watch her husband go through every drug in the book and progressively become a ‘total addict’. She detailed how her husband’s drug use had robbed him of his personality and a relationship with his kids. She also discussed how agonising it had been for her to watch him sink further and further down over the years. She cried when she told the story about his medical needs and how he was now ‘a shell of a man’. I asked Monica where she had found the strength to go forward during these hard times; she replied that her faith in God and the support from her church group had provided her with support up until last year, when her husband had attempted suicide. However, since then, there had been too much embarrassment and too many raw feelings to deal with, so she had stopped going to church. Monica took out her well-thumbed Bible and showed me some of her favourite passages.The Bible had notes written on almost all of its pages, and I wanted to learn more about the significance of the notes to her. Again, I was approaching the end of a session and needed to move to my next appointment, so I asked Monica if I could leave her with some questions to ponder until our next meeting. She replied that it would be quite okay, and curiously looked at me as I wrote down the questions on a piece of paper and handed it to her.The questions were: • What is central about your faith? • What does forgiveness mean to you? • Who believes that Matt will fight off his problems? • Who cares about Matt’s future? Last session: December 2010 By this time, Matt had abstained from marijuana smoking for over two months, and he was back on track at school, not skipping classes, and making Bs. Monica reported that even though Matt’s faith was frazzled, she had regained ’her boy’. During the session, she described how the counselling process had been effective because of the added accountability. She also discussed that she was still struggling with her faith, but that it had more to do with the people involved in church than it had to do with her personal relationship with God. Her voice trembled as she described almost losing faith in Matt’s ability to fight off drugs and that her perception probably was associated with the pain of her husband’s decades-long drug abuse. Monica described how she, Grandpa, and Matt’s sisters, all care about him and how hard it was to watch him ‘slip through the cracks’. I interjected with, ‘So for a while you felt as if Matt was falling through the cracks, what then made all of you realise that Matt was actually fighting off trouble and coming in to his own?’ ‘Well’, she said,‘we knew that Matt was a fighter like the
  • 7. THE INTERNATIONAL JOURNAL OF NARRATIVE THERAPY AND COMMUNITY WORK 2012 No. 1 www.dulwichcentre.com.au 25 rest of us because he really cares about people and deep down, he has a strong sense of self’. Matt affirmed that he had lost faith in organised religion because of how their church group had acted after his dad’s ‘incident’, but he was also quick to reveal that he thought of himself as a spiritual person who ‘knows what’s right’. Matt’s demeanour had changed over the past few weeks; remarkably, he now rarely looked down at the floor. He really had the appearance of a more confident person, as his sister Becky pointed out. Becky also said that she had noticed a positive difference in Matt’s approach to helping out more at the house and that he would do chores without being asked or nagged. I thanked Monica and Becky for being part of this (court-ordered) process and turned my attention to Matt. I told him that he had been an extraordinary walking companion whose conversation I had truly enjoyed. I also thanked him for tuning me into his ‘knack for training’ and wondered where he thought his talents might bring him in the future. Hindsight reflections When meeting with families, many things are beyond my control as a therapist. For the time being, I accept this and attempt to creatively use a diverse spectrum of creative interventions. Each time I meet with a family in their home is an opportunity to reflect and to learn, and it means a lot to me to always reflect in hindsight about what else I could have done. In hindsight, during my meetings with Matt and his family, I would have liked to use better articulated letter-writing. I would have liked to have Matt’s sister present for a few more sessions, and although I did meet with Matt’s father once, I would have preferred to have more time to work out the profound effects that Matt’s father’s actions and experiences had had on the entire family. Unfortunately, I was not able to fully address these issues because of agency restraints: once I successfully conclude ‘treatment’ for 10-12 weeks, I am required to fill out pages upon pages of paperwork and feedback sessions are not allowed, except if the agency wishes to obtain statistical data. In response to agency restraints, over time I have adopted a more narrative approach to my work and this rarely fails me.To me, the most effective interventions consist of exploring a backward story, externalising problems, re-authoring a preferred story of identity, fast- forwarding time, and to the extent that I can, including family and friends in the re-authoring process. I have tried to outline these practices in this paper through my descriptions of conversations with Matt, Monica, and Becky. My home-based narrative family therapy is a work in progress. I continue to grapple with many contradictions and therapeutic challenges such as mandatory urine- testing, and case-notes and treatment plans that need to follow a constrained format. In the midst of this, as a soul-soother, I find the notion of narrative self-talk to be tremendously comforting. It is common for me to think back to an interesting conversation I have recently shared with a family and play around with it in my head. I ask myself ‘What I could have done differently? How could I make a more significant impact? Could I go back to this family and do something different next time?’ References American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders (4th ed text rev.).Washington, DC. Epston, D. (2010). Backward story. Handout during a seminar ’2 days with David Epston‘ in June 18-19 2010, organised by BAMFT at Nova Southeastern University (NSU), Ft. Lauderdale, Florida. Flemons, D. (2002). Of one mind:The logic of hypnosis, the practice of therapy. London, UK:W.W. Norton. Monk, G.,Winslade, J., Crocket, K., & Epston, D. (Eds.) (1997). Narrative therapy in practice. San Francisco, CA: Jossey-Bass. White, M. (2007). Maps of narrative practice. NewYork, NY:W.W. Norton.
  • 8. THE INTERNATIONAL JOURNAL OF NARRATIVE THERAPY AND COMMUNITY WORK 2012 No. 1 www.dulwichcentre.com.au 26 This paper was originally published by Dulwich Centre Publications, a small independent publishing house based in Adelaide Australia. You can do us a big favour by respecting the copyright of this article and any article or publication of ours. The article you have read is copyright © Dulwich Centre Publications Except as permitted under the Australian Copyright Act 1968, no part of this article may be reproduced, stored in a retrieval system, communicated, or transmitted in any form or by any means without prior permission. All enquiries should be made to the copyright owner at: Dulwich Centre Publications, Hutt St PO Box 7192,Adelaide, SA,Australia, 5000; email dcp@dulwichcentre.com.au Thank you! We really appreciate it. You can find out more about us at: www.dulwichcentre.com.au You can find a range of on-line resources at: www.narrativetherapyonline.com And you can find more of our publications at: www.narrativetherapylibrary.com DEAR READER