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A Visual Therapeutic Tool: The Clarity Chart Applied to Couples

Presenter:Glenn Thomas LCSW

2005 NASW CA Chapter Annual Conference

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Introduction

Today’s main focus will be using the Chart with couples in couples therapy.You will learn about what research tells us about graphic organizers such as the Chart. You will learn about the charting method, construct differing Charts including making a real chart.You will be participate in both individual and group exercises.

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Overview

Today’s workshop.

Review

Review

Ques.

Exercise

Therapy

Groups

How?SectionsNeed

You!

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AgendaOverview 10 min.Why the need for a Chart? 10 min.How to make a Chart. 10 min.The Chart sections. 20 min.The Chart in therapy. 20 min.15 minute break 15 min.Making a Chart w/ handout. 5 min.Training exercise. 30 min.Review: training exercise 10 min.Groups exercise 20 min.Review: groups exercise. 10 minQuestions 20 min.

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Why the need for the Chart?I personally felt the need to use some visual explanation. I liked using visual tools. Once I was using the Chart I got so much feedback by clients that they liked it. It made more sense to them. They wondered why they had not seen it before with other therapists.I went looking to see if there were reasons why the clients liked the Chart and seemed to progress more rapidly. Why they had better understanding of their problems and better outcomes. I found the answer in Research.

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Learning Theories Support

Dual Coding : If we attend to both nonverbal and verbal systems of processing information, retention and recall of information is easier.Schema Theory: Graphic Organizers helps link existing knowledge with new knowledge in memory.Cognitive Load: Working memory has max capacity of info it can process. Graphic Organizers can reduce the cognitive load and allow working memory to attend to new material.

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Research supports

Improved comprehension and understanding of ideas.Improved performance and achievement of goals.Improved development and organization of ideas.Improved seeing relationships – connecting the dots.Improved retention and recall of information.Improved critical thinking and higher order thinking skills.

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The Chart also:

Keeps the therapeutic dust in the air.Provides continuity.Helps with client’s ownership of tx plan and tx goals. Nothing is written on the chart without the permission of the client. Helps with goals related to referrals.Keeps it simple.

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How to Make a Chart.Materials, different kinds.Make it in front of the client. Use it as a teaching tool (connecting the dots).Difference between an individual and couple’s chart.How awareness of a couples’ complimentary Chart content can help the couple.Example construction.Has to be kept confidential and meets the same HIPAA and state confidentiality laws.

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The Chart Sections.

EventsIssues/FeelingsCopingGoals

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Events

When the client views a Clarity Chart, they see their emotional injuries in the Events.Putting the Events on the board can help with minimizing and denial. Where we want less expression and more reflection for the client. These Events can give rise to the repeating patterns (our next focus).

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Issues/FeelingsOur clients see their Issues (repetitive thoughts or images) and underlying Feelings arising from these Events. The Issues are their repeating patterns that give treatment more focus and efficiency.Issues can be in their unconscious cognition or thoughts.These unconscious cognitions (automatic thoughts (CBT) or thoughts have feelings associated with them. Feelings are taught with simple SHEHAS.

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Coping

Clients can observe their Coping (Behaviors) which can try to manage the uncomfortable Feelings related to these Issues.Again clients are seeing that their behaviors arise from their feelings associated with their Issues.And that often their behaviors are an attempt to manage their uncomfortable feelings.

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GoalsClients record their personal Goals (often the goals arise from changing unhealthy coping) to map their direction. Often a goal includes working on their distorted thoughts associated with the Issue through Cognitive Behavior Therapy.Explicitly states the tx. goals.Nothing is written in the goals unless the client explicitly agrees to the goal.Provides follow-up motivation.Goals are seen every time the client comes into treatment.Finally, they get the tools from the therapist to make the changes they want.

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The Chart has adevelopmental view

Past: Events.Present: Issues and related Feelings and Coping with those Feelings. Future: Goals

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The Chart in Therapy.

What client’s could benefit from a Chart?What modality?The process of ownership. Typical examples.Evolving Chart additions over time.Viewing the Chart every session provides continuity of treatment for the client and ourselves.

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The Chart in Couples TherapyCouples viewing the partner’s sections think about their partner in a new way.Couples gain deeper understanding about their complementary Chart elements.The “Oops – I don’t have much on my side of the chart.” Owning problems.Reminds each of them what they and their partner are doing therapeutically every time they come in. This increases motivation, learning, attachment to the therapy.

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Therapeutic Pacing

Introduction of the Chart occurs when the therapist would normally pace the presentation of clinical issues and psycho-educational material to the client.Generally introduce the Chart in the 4th or 5th

session with a couple. We encourage them to read the book “ You’ve Got Issues” after the first joint session. The process of discovery – pacing the client. Typical examples.

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Making a Chart W/ Handout.

Chart and examples handoutAsk for volunteersPresent the first vignetteMake a Chart together

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Training Exercise.

Creating the Chart with the first vignetteThere is no therapeutic pacing in this example. We are demonstrating the identification of Chart content and the process of Chart building.

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Review: Training exercise.

What did you notice?Explanation of client’s participation in treatment plan, and treatment goals, and outside referrals

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Groups Exercise.How to do the Group exercise.Make groups.Assign vignette.Each group chooses a recorder to write on Chart.Write Events on group chart from vignette.Write possible Issues and under each Issue possible feelings the clients might be feeling.Write Coping in Coping section of Chart.Write down the Goals the group would like to encourage the client to own.

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Review: Groups Exercise.

Groups relate the experience.What was easy? Difficult?This exercise had no therapeutic pacing.Identifying Chart contents was primary goal.

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Summary.

You learned why a Chart is useful.How to construct a Chart for an individual and a couple.Begin to know when and how to use a Chart in treatment.Be aware of developing the Chart with therapeutic pacing.Questions and feedback of workshop.