Workshops - Group C

CPC CBT (KIBB in Swedish) – Combined Parent-Child Cognitive-Behavioral Therapy for Families at Risk for Child Physical Abuse

CPC CBT is a treatment model for families where physical child abuse has occurred. The method was developed at Care Institute of New Jersey, USA. Therapists in child protection service or child psychiatry give families treatment in child and parent groups and combined, since each treatment session ends with the whole family together with the family therapists. The treatment lasts for 16 weeks.

The implementation of CPC CBT in Sweden has been ongoing since 2007. A pilot study conducted from 2010 to 2011 showed a positive treatment outcome. A more comprehensive research study started in 2013. A doctoral dissertation by Johanna Thulin; Putting words to child physical abuse has been published in 2019.

During the workshop, the KIBB treatment model will be presented together with examples from practice and some of the results of the research.

Lectures:
The treatment model and work in practice are presented by Emma Andersson and Anna Nelson. Emma is a social worker working with KIBB and licensed psychotherapist and KIBB trainer. Anna Nelson is a master of science in social work and licensed psychotherapist and also KIBB trainer.

A path will come, when we work on it.

Social and psychiatric public services in Denmark in 2020 focus on efficiency, by managing individual grants through units defined by evidence based standardised guidelines. Around this discourse lives a strong story that the highest level of evidence – and there true efficiency – is the Randomized Controlled Trial (RCT). Yet the RCT is almost always by definition blind for the effect of the world surrounding the setup up and the client’s personal preferences. Typically, the national guidelines conclude with the sentence “The method is vulnerable to client preference”.

Staff education is narrowly focused on manual-based conversation skills, if advanced: it can include structural client network management. However, in daily practice other skills become more important: resonance, compassion, accessibility, meaning, and networking.

Consequently we ask, what are the helpful focus axis that support a practise, that – on one hand can answers management questions about efficiency – a help system that can stay open and gain in professionalism; and on the other hand – a practise, that is able to collaborate meaningful and compassionate with open systems on sustainable social constellations of integration.

The workshop invites to discuss narratives on how to strengthen collaborative systemic services towards sustainable social constellations of integration, in a “new public management” world, that otherwise still awards symptom-focused fragmented delivery.

The Open-Path-Method is a topic-guided collaborative therapy setup for adolescents and can be characterized by three key elements:

  1. Subject/topic guided group sessions;
  2. In-session-collaboration between client and social worker and external consultants by using reflection loops;
  3. Stepped-care-service-setup – between social work and therapy.
The method is developed in the context of collaborative therapy (Harlene Anderson) with youngsters (age 15-25) handling psychological vulnerabilities and/or problems with alcohol or drug abuse at “Ungeliv” a social-psychiatric service for youngsters in the Danish municipal Ringsted.
Some years ago, I was looking forward to become a family therapist, who would be curious, and open minded. I had just graduated with a masters degree in family therapy, and was going to work as a family therapist in a family care office in southern Norway. Eventually, I became manager for the office.. I often find myself balance between the importance of meeting clients with a systemic approach, and in the same time I am responsible for providing measurable results! Highlight in this workshop:
  • How the New Public Management (NPM) style of governance involves my leadership
  • And, In this NPM context, what happens to the creativity, and my professional family therapy identity?
  • Where can I find leadership-theories ,that can inspire and encourage me, to continue to be the leader that I want to be?
We started HELA BARN because we found that there were no available tools or systems for working with separated parents in high-conflict relationships. Our vision was to find a way to help the children caught in the crossfire. Our mission now is to help more children by building our network of trained practitioners.

In a time of escalating complexity in relationships and heightened pressure upon the traditional family system, we built upon our extensive experience working with separated parents and theoretical models (such as system theory, solution-focused therapy and CBT) to develop a new and ground-breaking therapy model. The result was a structured five-session programme focusing on parents’ communication skills. Parents are encouraged, by having a photograph of their child in the room, to put the child at the centre of the process. Rather than allowing parents to be distracted by any kind of abstract agreed outcome, we help parents learn HOW to communicate, WHO is important and WHY change is necessary.

The model is based heavily on visualisation exercises, oriented towards education and adaptation. We help parents see past the overwhelming burden of their toxic patterns of communication in order to find the core of what needs to change – focussing on what’s really important (i.e. the child’s welfare). The goal-oriented structural model aligns with lived experience, in order to change outcomes through changed outlooks and perspectives.

We have worked the model for many years, with nearly 100 families in the greater Stockholm area. We are now building a network of licensed practitioners, with some 40 therapists and social workers trained to use our model mainly within social services. The model was launched nation-wide last year at Barnrättsdagarna and Socionomdagarna. We are now seeing interest in local training from municipalities throughout Sweden.

We invite you to a brief introduction to our proprietary model and to experience some of the visualisation exercises that we use in order to help parents shift their outlook and overcome toxic habits and behaviour. This will be a highly interactive role-play session, drawing on individual experience and differing backgrounds. We will close with an open-feedback session, describing our lived experience with the model in practice and opening the floor to audience reflections.

Presenters at the workshop will be Sandra McGinn and Patric Eriksson, both working as family therapists in social services, Botkyrka municipality, greater Stockholm.

HELA BARN© is a child-focused method and model for helping separated parents in high conflict situations developed by Sandra McGinn and Maria Sköld.
Further info at http://helabarn.com/
When I use the category ‘Familywork’ I refer to a group of professional practices named ‘familierådgivere’, familievejledere’, ‘familiekonsulenter’, ‘familiebehandlere’ and ‘myndighedsrådgivere’. What these practices do have in common besides having families on their agenda is that they don’t have any professional tradition of their own or in common to refer to. Because of that ‘familyworkers’ need to build up and keeping alive local professional traditions. I consider supervision to be a part of this process.

The fact that familyworkers don’t have a professional tradition as reference is not the same as familyworkers don’t know anything. In this workshop I will try to exemplify simple ways to
  • make implicit knowledges, practices as well as ‘truthgames’ visible in supervision in a way that makes it possible for the familyworkers to make explicitly organizational decisions in relation to these knowledges, practices and ‘truthgames’.
  • build up knowledges and practices in supervision.
And then it seems as if the   ‘healing power’ and ‘magic’  in succesfull familywork, as well as in succesfull familytherapy, separate familywork from the ‘problemsolutions paradigm’ which is well known from ‘medicine models of healing’ as well as from  the ‘background thinking’  in the danish social system. ‘The healing power’ in familywork seems not to be found in the reconstructing of an ‘original’ or ‘natural’ condition before the appearance of a problem but in the ‘transformation ‘of familymembers lives and relationships by taking back the regulation of their family. This offers sketches to a dynamic and family centered understanding of ‘problemsolution’ in ‘familywork‘, which brings  familyworkers expertice and conversational, creative and improvisational skills, in the foreground of familywork.  

But off course this workshop is also about ‘top-down management’ in Denmark and about   organizational defensive responses on ‘incompetent managed organizations’ as for example practices of ‘pathologizing clients’, ‘hero-fication of the employees’, creations of ‘babel-tower organizations’ as well as of organizations specialized in the ‘smooth killing ‘ of supervisors.

Familiesupporten is an offer in Gladsaxe Kommune for families with children aged 0-8 facing minor challenges. The families are not registered and are on average visited by Familiesupporten 5-8 times. We talk with parents facing various sorts of challenges: Crying babies, toddlers’ anger, challenges in the parents’ own relationship to each other, language development problems and more.

The project started in October 2018 with 3 therapists – today we are 8.

A particular group of children and parents have surprised and overwhelmed us: Children and parents who are having major conflicts, especially with kids aged 3 to 4.
How can it happen so often?
We talked with the parents, and they told us that they are afraid to appear as what is in Denmark condescendingly named “curling parents”.
We wondered: How could this concept stick so close to the parents?
Where did it come from?
Who brought it to the field?
Why are love and care labelled as curling?
Where did they place the mutual respect towards each other?

We reflected, we looked on Facebook and in newspapers. We had a look at the references to Familiesupporten and found sentences like these:

  • Child cannot sit quietly and eat with the family (23-month-old girl)
  • Mum struggles giving leadership to her child (9 month)
  • Parents need help making a child sleep in its own bed (12 months)
  • Parents struggling with putting themselves through as parents (Boy 3 years who has just got a little sister)
  • A child aged 10 months needs constant attention after it starts in daycare and should be able to sit alone.
  • Claim rejectioned child
  • Extremely extroverted child
From newspapers:
  • I have been tyrannized by terrible kids several times (Newspaper)
  • Your kids are uneducated youngsters (Kindergarten to parents in a letter)
  • From smoking parents in the 80s to curling parents in the 20s (Newspaper)
What discourses in our time that make it especially difficult to be a child or a parent?
How do social media, grandparents and childcare describe children and parenting?
How can we help the parents in finding a balance between satisfying the child’s needs and the “curling” discourse?
How do we work?
Through examples, reflections, facts, and film clips, we will try to make sense of the behavior of Danish children.
The FCMT-model is a brief, practical , interventive and sometimes psycho-educational method of maximal 6 sessions for a very diverse (also more or less psychiatric -oriented) type of relational questions of couples in marital distress. Compared to other marital therapy models , the FCMT is not monomethodic or proces-oriented , eg. it offers possibilities to hop from one problem area…to a task area…to another theme…to a new relevant issue. Very characteristic of the FCMT-model is the emphasis on focussing , collecting information and interviewing differently as a therapist, depending in which specific life-cycle phase (or stage) the couple finds itself . Rick Pluut distinguishes 7 phases. For every life cycle phase a specific cluster of interventions should be used . Individual and Relational Risk factors, which the couple brings along, are relevant for the choice of how to interview and of the type of interventions. Another basic aspect of the FCMT-model is to make a short evaluation at the beginning of the therapy sessions to check out if there is a discrepancy between the “calendar life cycle” and the “behavior life cycle” of the couple. This is important in order to to decide what the starting point of their marital therapy will be.

Learning Objectives of the workshop
  1. Short historical overview on the development FCMT-model since 2001
  2. Phase-Characteristics of the 7 Mariage  life-cycles phases.
  3. What is the “Calendar life cycle” and the “ Behaviour life cycle” of a couple.
  4. Which are couples/marital relational risk-factors and how to use them .
  5. How to decide starting point of therapy.
  6. Explanation of therapeutic goals tot he couple.
  7. Interventions for each phase.