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An Effective Model
for Supporting Families
By:
Louis S. Allen, M.D.
Gail Brown, Ph.D.
Sterling Redd, L.C.S.W.
With editorial assistance from:
Mark Gerard Hengesbaugh
SUMMARY
The ABLE Program's mission is to assist children with special
needs who are living in families overburdened with complex problems
that have limited resources. Because these family situations are
pervasive in our communities and their problems so diverse in their
nature, ABLE has adopted non-traditional, prevention-based treatment
approaches that draw on existing client, family, and community strengths.
The ABLE team has integrated the nine principles of family support
proposed by the Family Resource Coalition of America 1 into the
innovative practice of narrative ideas for solutions to these problems.
Narrative practice, as the name suggests, elicits the stories,
themes, and preferred scripts that people carry with them and that
shape their lives. This practice proposes that the narration of
a person's treasured memories, turning points, cultural and family
traditions, and influential relationships allow them to objectively
distance themselves from their recurrent problems.
Stories are not only important in order to separate the client
from their problems, but learning an individual's stories allows
the ABLE team to find latent strengths and Resources such as mentors,
heritage, and beliefs. It is these discovered proficiencies that
direct the ABLE teams plan of assistance for the client.
Briefly, conversation with clients elicits the stories that are
most influential to them in their lives; and it's from these narratives
that a whole new solution-building conversation ensues.
Effective solution building and family support require an innovative
practice model with a fresh new language. Over the past ten years
the ABLE Program has developed and followed the following principles:
- Partnership and relationship building with clients
- Mobility of client strengths and capacities
- Harnessing the strength in differences and diversity, and
- Development of reflection groups, which ABLE calls core teams
A year ago, ABLE began to explore the collaborative and constructive
practices of solution building. We began using goals as solutions,
scaling cognitive-emotional (empowerment) outcomes, working with
exceptions to the problem, and measuring functional outcomes. ABLE
found these techniques helped quicken the appropriate response to
clients needs and helped turn talk of problems to articulation of
solutions.
More recently, ABLE incorporated a related concept of solution
building, narrative solutions, into practice. This narrative therapy
was primarily developed by Australian Michael White, who has worked
on it for the past ten years.
A brief overview of the main ideas of narrative practice follows:
- Stories inevitably reveal that people are not the problem,
that the problem is the problem. A person with special needs is
usually the victim of a chronic condition promoted by his context,
including his social-political environment.
- Narrative solutions are more experiential, passionate and contextually
poetic than solution-focused practices.
- Stories explore unique experiences, turning points, and the
special relationships that a client focuses on in the context
of his families values, intentions, and dreams.
- Stories (which may be considered the basic unit of experience)
organize information, and they constitute life, feelings, thoughts,
sensations, and actions. They contain meanings that shape life,
and consist of experiences that shape present and future action.
In this way, the narrative model is very different from the cognitive
or behavioral unit of representing experience.
- A person's identity is not fixed or limited but undergoes a
constant shaping process.
- To stimulate story thought and talk, reflective questions may
be asked to open space for ideas, give direction to the story,
elaborate on content, and to describe choices.
- Narrative stories are used to celebrate differences.
The practice of using narrative solutions has four key aspects:
building relationships, stimulating client capacities, affirming
and encouraging diversity, and using flexible and interactive teams.
1. Building
Relationships, and
2. Stimulating Client Capacities
Community care givers might well ask themselves, Do I truly believe
that by connecting with people with special needs and that by building
on their individual and family strengths, that they can turn their
own problems around? Do I hear only problem stories, or do I also
open space for evidence of success and other sparkling moments?
In other words, Do I recruit other positive voices around the child?
Dunst 2 asserted that ideas and concepts leading to family empowerment
are formed by recognizing equality of partnership relationships,
by supporting social networks, by using families innate resources,
and by acknowledging family competence and self-sufficiency. These
concepts influenced the mission statement of the nation's largest
family advocacy organization, the Family Resource Coalition. Dunst's
concepts are the premise for much of the family support that goes
on in America. Over time, the theories he proposed have become more
family friendly and are a strong influence across disciplines. Because
of his concepts, community support workers are better articulating
ideas of partnership, show more respect for families, and are accomplishing
more goals.
For example, an ABLE client we will call Jason for confidentiality
purposes, came to the program with a severe learning disorder, and
with vigilance and developmental output disorders. Through discussion
with Jason, we learned that Jason had a strong desire to play high
school baseball. ABLE linked Jason up with a coach mentor who accepted
and cared for him and who had a reputation for instilling discipline
in others. Through participation in baseball, Jason actually saw
a project through to completion, he found a sense of self-worth,
and by participation in this team sport helped to promote his learning
in other areas, such as academics. Narrative questions included,
Who made a difference for you? Who brings out your best qualities?
Who from your past would have predicted your accomplishment? Where
had your baseball competence shown itself initially, at home or
at school? What values, hopes, or dreams are stimulated by this
success?
3. Affirming
and Encouraging Diversity
Community support workers should ask themselves, What are our
own prejudices and beliefs about cultural and racial stereotypes?
How do they affect our helping relationships? Are we projecting
our values onto our clients? What social or political forces, such
as gender, class, or race contribute to the problem?
Understanding the importance of culture is critical in supporting
diversity in communities and using their latent strengths to assist
special-needs clients. Cultural interventions can foster health
promotion, engage protection processes, and prevent detrimental
secondary consequences.
ABLE programs, taking their cue from the Family Resource Coalition,
affirm and strengthen families cultural, racial, and linguistic
identities in order to enhance their ability to function in our
multi-cultural society. Cultural stories--racial, ethnic, religious,
and social narratives--embody much of what life means to families
and to individuals. These narratives become the grist and direction
for the ABLE team's work in developing strategies for assisting
families.
Use of the narrative approach is similar to the study of cultural
and social anthropology; We are partially ethnographers journaling
peoples histories. Cultures are complex systems of learned and habitual
responses, therefore, they provide direct insight into family needs
and strengths. Cultures do change over time and shift in response
to collective experience, i.e., exposure of the group to other cultures,
which can be positive or negative. Cultures have many rich influences,
but they may have a darker side as well. Some cultures have colonized
and oppressed others. For example, a narrative aspect of a dominant
culture may marginalize or sabotage the family unite specially one
with a disability with the same effectiveness that it could enhance
family resiliency. It is important to remember that the cultural
traditions, beliefs, and practices of a family reflect the values
and customs of all the different groups of which that family is
a member.
Families and communities are cultural mediators. In this respect,
ABLE is relatively unique in using narrative solutions under the
Family Resource Coalitions Family Support Practices. ABLE's premise
is that families are resources to their own members, to other families,
and to their community. Using families as a resource helps mediate,
or distance problems away from the client. In addition, by engaging
families to collaborate in such programs, families become empowered
to change and challenge community conditions.
Communities are also mediators and descriptors of culture and
ABLE's cooperation with the community enhances relations between
the community and the families within it, forming a circle in which
all benefit.
In the case of Jason, ABLE asked, What family pride is furthered
by Jason's experiences? What cultural practices help ritualize new
ways of operating for him? How might Jason's success story have
greater effects on society and the cultural community?
ABLE saw there was benefit in drawing the distinction between
what Jason wanted and the results his old behaviors brought him.
ABLE discovered what things Jason did well and contrasted them with
his disabilities.
ABLE team members need to ask themselves, Is
ABLE shaped by the concerns and values of the community? Are we
catalysts? Do we understand, value, and reflect Family Support Practice
principles? Are we stakeholders who are flexible enough to modify
our model in response to the needs of other stakeholders?
ABLE's family support systems have a team approach that is accountable
and responsive to other team members and to the families whom the
teams are assisting. Individuals within the teams are goal-directed
and reflective. The teams mobilize extended families and social
networks within the communities and promote multiple ways to exchange
resources with them.
Because core team members reflected on Jason's stories and
then retold them to him necessarily drawing on themes and experiences
of their own Jason had the opportunity to hear his stories differently,
which opens space for new behaviors, and which promotes solidarity
with the core team.
The core team brainstormed ways to help Jason set goals and
find a way to encourage his high school to allow him to play on
its baseball team. Because of ABLE's success with this, the school
benefited from Jason's pitching and Jason's school attendance and
his grades improved markedly. Because he worked with the ABLE program,
Jason graduated from high school, is registered for college, and
now has a job working for money to buy a pickup truck (another goal
elicited from Jason during conversations with his core team).
One of the ABLE core team's reflective questions for Jason
is How might your experience of success transfer to stories in other
children' s lives? Because of Jason' s own recent problems with
marijuana, he has decided to stay away from a group of his friends
who are marijuana users. Another member of that drug-using group
is looking for a way out of this chronic illegal behavior as well.
Now Jason is in a position to share his success stories in order
to help empower this other at-risk child.
What about the effect Jason has had on the lives of those
working closely with him, those who are audience to Jason's narratives?
Clearly the ABLE core team has had a positive effect on Jason's
behavior, but Jason also taught the core team. At each step, team
members asked themselves, What does this story say about my own
beliefs and values? In fact, their achievement in working with Jason
touched core team members to the degree that they felt the need
to write a paper about it. The ABLE core team now carries Jason's
story with them in their efforts to witness positive changes in
the lives of other children with special needs.
The ABLE Program understands that the client
is an expert voice when speaking about his or her own world, and
that solutions are often found by drawing the clients attention
to their own expertise and to the latent strengths in the clients
current circumstances. By using narrative practices to unearth,
understand, and retell the stories of children with special needs,
ABLE draws clients towards self-sufficiency and empowerment.
FOOTNOTES
1 Guidelines for Family Support Practice, Family Resource
Coalition, 1996.
2 Enabling/Empowering Families: Principles & Guidelines,
by Dunst, Brookline Publishers, 1988.
REFERENCES
Interviewing for Solutions, DeJong Berg, Brooks and
Cole Publishers, 1998.
Revisioning Family Therapy: Race, Culture and Gender in Clinical
Practice, McGoldbrick, Guilford Publishers, 1998.
Re-authoring Lives: Interviews and Essays, White, Dulwich
Center, Publisher, 1995.
The One-Minute Question: What Is Narrative Therapy?
Sween, Erik, Gecko, Vol. 2,1998.
Narrative Therapy: The Social Construction of Preferred Realities,
Freedman & Combs, Norton, 1996.
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