New York Office of Childrenand Family Services

Putting Hope in MotionAchieving Outcomes in Families

Bob Bertolino, Ph.D.Assistant Professor, Rehabilitation Counseling

Maryville University – St. Louis, MissouriSr. Clinical Advisor, Youth In Need, Inc. – St. Charles, Missouri

There is More to See

“You must be the change you wish to see in the world”

– Mahatma Gandhi

No More Boxes Expanding Our Worldviews

Expanding Worldviews1. What are the core beliefs you have about the

people with whom you work (Children and Families)?

2. How have you come to believe what you believe and know what you know? What have been the most significant influences on your beliefs?

3. How have your beliefs and assumptions affected your work with clients? With colleagues? With the community?

4. Do you believe that change is possible even with the most “difficult” and “challenging” clients?

5. How do you believe that change occurs? What does change involve? What do you do to promote change?

6. Would you be in this field if you didn’t believe that the clients with whom you work could change?

H. O. P. E.

HHumanism

OOptimism

PPossibilities

EExpectancy

“Optimism is the faith that leads to achievement.

Nothing can be done without hope or confidence.”

- Helen Keller

The Presence of H.O.P.E.

• What inspires or moves you?What inspires or moves you?• How does that increase your sense of How does that increase your sense of

hope?hope?• What does an increased sense of hope What does an increased sense of hope

allow you to do?allow you to do?• How can you promote hope with others?How can you promote hope with others?• How do you maintain your sense of hope How do you maintain your sense of hope

when you are struggling with clients?when you are struggling with clients?

“Let the world change you and you can change the

world.”– The Motorcycle

Diaries

“Let the world change you and

.”– The Motorcycle Diaries

Strengths-Based Engagement

Collaborative Casework in Action

What is Strengths-Based?

A Strengths-based perspective is not a theory, but an overarching philosophical point of view. It is one in which people are seen as having capabilities and resources within themselves and their social systems. When cultivated, activated, and integrated with new experiences, understandings, ideas, and skills, these strengths help people to reduce pain and suffering, resolve concerns and conflicts, and cope more effectively with life stressors. This contributes to improved sense of well-being and quality of life, and higher levels of relational and social functioning. Strengths-based practitioners promote change through respectful educational, therapeutic, and operational processes and practices that encourage and empower others.

Strengths-Based Principles

Client ContributionsThe Relationship and Alliance

Cultural CompetenceFocus on Change

Expectancy and HopeFactor of Fit

Client Contributions• Clients are the most significant contributors to

outcome• Recognize caregivers as competent, capable of

change, and capable of keeping their children safe

• Identify and employ internal strengths• Identify and assist with developing supportive

social systems, resources, and networks• Identify exceptions, moments in the past or

present, even if fleeting, when problems have been less present or absent altogether and the client’s role in those exceptions

• Identify ways that clients will utilize abilities to face up to future hurdles

• Encourage personal agency and accountability

The Relationship in Context…

Even for those who are convinced that the therapeutic relationship is healing by and of itself, there are strategies that can foster its impact. In other words, since not all kinds of relationships are likely to bring about change, one needs to be aware of interventions (including modes of relating) that should be encouraged or avoided for the relationship to become a corrective experience. (Castonguay & Beutler, 2006, p. 353)

Castonguay, L. G., & Beutler, L. E. (2006). Common and unique principles of therapeutic change: What do we know and what do we need to know? In L. G. Castonguay & L. E. Beutler (Eds.), Principles of therapeutic change that work (pp. 353-369). New York: Oxford University Press.

The Relationship and Alliance

• Initiate services by offering options that are respectful of clients and their cultures and incorporate their perceptions and preferences

• Collaborate with clients (Keys to Collaboration) (Elicit and incorporate client feedback)

• Separate experience from action• Summarize, validate, and soften• Use active listening, attending skills, and

engagement processes while recognizing that caution toward professionals may be an appropriate response to past experiences

• Consider the influence of words• Acknowledge and validate while promoting

accountability• Use possibility-laced language

The Influence of Words

The Influence of Words

Sad. Helpless. Inconvenience. Defeat. Tired. Oppressed. Doubtful.

Uninterested.

Life is so hard. Nothing seems to go my way. There is no one to turn to. It feels

like I’ve been forgotten. Times are hard. Nothing seems to help. Things will not

get better. In fact, they will probably get worse. There is no hope.

The Influence of Words

Exciting. Fun. Laughter. Joy. Anticipation. Possibility. Aliveness.

Love. Peace.

When I think about the future I become energized. There is so much I can accomplish. Life is wonderful.

There are so many possibilities in the world.

Possibility-Laced Language

1. Reflect client statements in the past tense.

► From: “It’s always that way.”► To: “It’s been that way.”

2. Move from global (“everybody,” nobody,” “always,” “never”) to partial (“recently,” “somewhat more,” “a lot”).

► From: “He’s always in trouble.”► To: “He gets in trouble a lot.”

3. Move from truth/reality to perception (“It seems to you,” “You’ve gotten the idea”).

► From: “Things will never get better.”► To: “From where your standing it really seems

that it will never get better.”

Possibility-Laced Language

1. Assume the possibility of future change and/or solutions by using words such as “yet” and “so far.”

► From: “It’s always going to be this way.”► To: “So far you haven’t found any evidence that things will be

different than the way they are now.”

2. Recast the problem statement into a statement about a preferred future or goal.

► From: “I’ll never be able to have the life I really want.”► To: “So you’d like to be able to move toward the life you really

want.”

3. Presuppose that changes and progress toward goals will occur by using words such as “when” and “will.”

► From: “I just want my kids back home.”► To: “So when you when you are in a place where we agree that

it is safe for your kids to be back home with you what will be different?”

Possibility-Laced Language

Include any parts, objections, feelings, aspects of self, or clients’ concerns that might have been left out or seen as barriers to change/goals.

From: “Nothing will change until people get off my case.”

To: “Things can change while people are continuing to work with you.”

From: “I can’t focus on anything when these kids are screaming!”

To: “You can find a way to focus even during times when your kids are being loud.”

The Relationship and Alliance (cont.)

• Use respectful, nondepersonalizing language and descriptions of problems and avoid unnecessary professional jargon

• Offer options and choices in services and processes• Incorporate processes for learning clients’ views of

service-oriented relationships and integrate feedback into all aspects of services

• Complement clients for positive intentions and actions• Collaborate with clients on determining goals and tasks

to accomplish goals (service planning) (3 Point Process)

• Incorporate the views of involved helpers (for example, extended family, social service workers, medical personnel, educators, law enforcement, educators) in setting goals and determining directions

3-Point Process1. Problem Description: What

needs to change?• Scaling questions (with all 3 points)

2. Vision of the Future: How will we know that change has been achieved?

• Miracle question, crystal ball, time machine, etc.

• General future-oriented questions3. Movement: How will we know

that progress is being made?

Cultural Competence• Maintain cultural self-awareness to one’s own cultural

heritage, background, and experiences and their influence on attitudes, values, and biases

• Recognize sources of personal discomfort with differences that may exist between workers and their clients in terms of race, ethnicity, culture, gender, and other influences

• Emphasize a multi-level understanding, encompassing the client, family, community, helping systems, culture, and other influences

• Recognize limits of multicultural competency and expertise; consult others who share cultural similarities and expertise with clients being served

• Individualize services (avoid “one-size-fits-all” approaches)

• Acknowledge clients as teachers and experts on their own lives

• Empower clients and others through practices that identify and employ their unique capabilities

Change as a Process• View change as constant• Focus on meeting the basic needs of clients (i.e., food, sleep,

safety)• View meaningful change as attainable and problems as

challenges to progress, not fixed pathology• Focus on maximizing the impact of each interaction and/or

meeting• Monitor change from the outset of services (most change occurs

early on in services)• In lieu of positive change, engage in conversations with clients

earlier rather than later to make adjustments in services• Maintain a future focus• Explore exceptions to problems; how change is already

happening• Focus on creating small changes, which can lead to bigger ones• Scan clients’ lives for spontaneous change and build on those

changes• Approach assessment as an opportunity to initiate positive

change• Allow reentry or easy access to future services as needed

Expectancy and Hope• Demonstrate faith in clients• Demonstrate faith in the restorative effects of services• Build on preservices expectancy• Create expectancy for change by focusing on what is

possible and changeable• Believe and demonstrate faith in the procedures and

practices utilized• Show interest in the results of the procedure or

orientation• Ensure that the procedure or orientation is credible from

the client’s frame of reference• Ensure the procedure or orientation is connected with or

elicits previously successful experiences of the client• Work in ways that enhance or highlight clients’ feelings of

personal control• View clients as people, not as their problems or difficulties

or in ways that depersonalize them

Factor of Fit• Assess the client’s readiness for change• Use methods as a vehicle for activating and

enhancing the other core principles of engagement• Use methods that fit with, support, or complement

the client’s worldview and expectations• Use methods that capitalize on client strengths,

abilities, and resources• Engage clients in conversations and feedback

processes to learn their thoughts about methods being considered

• Use methods that positively reinforce healthy behaviors and functioning

• Use methods that increase the client’s sense of sense of hope, expectancy, or personal control, and contribute to increased self-esteem, self-efficacy, and self-mastery

““It’s not enough to be It’s not enough to be compassionate.compassionate.You must act.”You must act.”

– Tenzin Gyatso14th Dalai Lama,

1992

What Do the Most Effective Workers Do?

• Maintain a posture of awareness, being alert, observant, and attentive in each encounter

• Compare new information and what is learned with what is already known

• Remain acutely attuned to the vicissitudes of client engagement—actively employ processes of gaining and incorporating ongoing formal feedback

• Consistently achieve lower scores on standardized alliance measures at the outset of services because they are more persistent and perhaps, more believable, when assuring clients that they seek honest feedback, enabling them to address potential problems in the alliance (workers with lower rates of success, by contrast, tend to receive negative feedback later in services, at which point clients have already disengaged)

What Do the Most Effective Workers Do? (cont.)

• Spend more time on strategies that might be more effective and improve outcomes as opposed to hypothesizing about failed strategies and why methods did not work

• Expand awareness when events are stressful and remaining open to options

• Evaluate and refine strategies and seek outside consultation, supervision, coaching, and training specific to particular skill sets

““Never doubt that a small Never doubt that a small group of thoughtful group of thoughtful

committed citizens can committed citizens can change the world; indeed it’s change the world; indeed it’s

the only thing that ever the only thing that ever does.”does.”

– Margaret Mead

ThankYou

Bob Bertolino, Ph.D.TCCT, LLC – P.O. Box 1175 – St. Charles, Missouri 63302

+01.314.852.7274 – bertolinob@cs.com – www.bobbertolino.com

Maryville University650 Maryville University

DriveSaint Louis, Missouri

63141 USA+01.314.529.9659 (Phone)

+01.314.529.9139rbertolino@maryville.edu

www.maryville.edu

Youth In Need, Inc.516 Jefferson

Saint Charles, Missouri 63301 USA

+01.636.946.0101 (Phone)+01.636.925.0125 (Fax)

rbertolino@youthinneed.org

www.youthinneed.org