Monday, October 29, 2012

Creating Mutually Effective Affirmative Strategies

Creating Mutually Effective Affirmative Strategies                         Thomas Carver LMFT

This family systemic therapy model is used during an assessment phase while the therapist determines if the child can be treated in family therapy rather than being referred to an outpatient or inpatient program. 

The Therapist must ascertain the parents degree of adolescent world sophistication.

Adults who fail to recognize this are considered ignorant by their children and therefore unilaterally dismissed.

The Therapist helps the parent to ‘get’ the world of an adolescent and therefore gain credibility.



*Child:  “Mom, can I go to a concert with my friends

*Mom:  “I trust you, but I am worried.   What band is it?”

*Child:  “uuuuuhm, BDS”  

*Mom:  “What is BDS?”  

*Child:  “Bloody Death Sex”

*Mom:  “Whaaaat!”

Mom had said in therapy that her true intention is to have her daughter make choices as she gets older and that she wants her to become an independent thinking teen.

When Mom baulks at the idea of BDS her daughter can highlight Mom’s hypocrisy.

AND The Game begins again… unless the Therapist shows them a new paradigm.



The Therapist works individually with the parents to identify family-of-origin trauma from their own experiences as children being parented by their parents.

Mom does not want to be an Authoritarian parent, rather an Authoritative parent. 

Authoritarian parent:  Setting boundaries without sensitivity to their child’s feelings.

Authoritative parent:  Setting boundaries with sensitivity to their child’s feelings.

Mom’s parents dictated her life goals, limited self-expression, determined her friends, and usually preferred actions that were most convenient to the parent(s), BUT claimed to trust her.

This caused her to feel helpless when she submitted to it.

Mom actually rebelled herself by choosing friends that were known to have poor behavior as a reaction to her parent’s rigidity.   YET her initial/instinctive response to her own daughter is to deny her without explanation just like her own parents.

The Therapist shows Mom the difference between the teenage Mom and her teenage daughter and the difference between how Mom had to deal with her parents and the way that her daughter has to deal with her.

Mom’s willingness to be introspective enabled her to decide to act collaboratively with her daughter.


As an over-correction to her own trauma Mom has co-created The Game with her daughter.

The Game:                                              “Make Me An Offer So I Can Spit On It”: 

Mom tries to appease child over and over to no avail by offering solution after solution that would all be rejected.  The daughter learns that she can exhaust Mom by frustrating her therefore enforcing that negativity begets power and control.

Negativity as a way to be in control is a strategy will carry on to a child’s adult relationships.


The Therapist does not always remain neutral because it can inadvertently validate the family’s dysfunctional patterns by reinforcing each other entrenched roles. 

Instead the Therapist enforces the responsible boundaries that each member has to fulfill. 


*Mom:  “I believe that you and your friends do not intend to do anything inappropriate”

*Therapist:  “It sounds like you want to be able to say YES, but that you are being a worried mother”

*Mom:  “YES”

*Therapist;  “Mom, you want to say ‘yes,’ and daughter, you want to hear ‘yes.’  How do you two make it so Mom can say yes?”

Child:  “Just say YES!”

*Therapist:  Mom just can’t say YES.  She needs motivation to say YES, because you are asking her to let the girl she loves the most, who she wants to trust so badly, and believes she is responsible.. go to a Bloody Death Sex show!”  “Make your Mom an offer she can’t refuse.  Mom, do you want an offer?”

*Mom:  Yes, help me out here!  I am willing to say YES”

*Child:  “Why do I need to make her an offer just because she worries!”

*Therapist:  “Well, you don’t have to.  You don’t have to go to the concert.  But Mom is willing to let you go if you can come up with something… or you will not come up with something and not go.  Right, Mom?”

Indecision creates anxiety and keeps families in relationship purgatory. 

By the Therapist setting a default consequence it eliminates the indecision purgatory.  The default consequence is not going to the concert if the daughter chooses to not participate.

Paradigm Shift From First Order Change To Second Order Change

First order changes are small or minor improvements/adjustments that do not alter the family system.

Second order change alters the fundamental structure from everything resetting itself when the child gets their desired decision to the child getting their desired decision by making it workable to the parent.


*Child:  “Why can’t you just chill!”

*Therapist:  “Your Mom is being a mom.  That’s what moms do.  They worry; they can’t help it.  It is not possible for her to stop being a mom.  Mom, is it possible for you not to be a mom?”

The Therapist is enforcing the responsible boundaries.  Usually in therapy the child can get to a point where they admit that their parent cannot just stop being a parent and that they even need them to be parents (sometimes!).

*Child:  “Just don’t worry’

*Mom:  “I am trying to let you be a teenager by being willing to let go, but don’t tell me to not be a mother.  Don’t tell me I can’t be a mother especially when I’m trying to let you be the teenager that you are.”

*Therapist:  “By being allowed to be who you need to be as a teenager also means that you allow your mother to be who she is.  If you want to assert power and control you must give up some power and control (to your mother).”  “By the way, Mom, there is nothing that your daughter can say that will totally alleviate your worry.  All you can ask for is for her to come up with something that will alleviate your worry enough so that you don’t worry too much.  Daughter, make Mom an offer she can’t refuse.”

Children will often go into despair if they think that they have to come up with an idea that will totally alleviate their parent’s fear, because they all know it is impossible.

*Child:  “Why should I have to!”

*Mom:  “You don’t have to.  If you don’t, the answer is NO.  If you can, you can go.”

Children will offer ideas like:  they won’t nag you anymore, they won’t hang out with the wrong people, they won’t do drugs, etc.  They offer a deal of things they know they should not be doing anyway, therefore not valid.  This is because the have practice in staying in the negative.  The affirmative is practiced in therapy. 

The Therapist reminds the parent(s) that they do not have to justify themselves anymore at this point.

The child will continue to be oppositional.  The parent keeps saying, ‘make me an offer.”  The Therapist continues to help the child to understand what is a reasonable offer. 

They may need breaks and or to continue the discussion later.  Deescalate and allow each person to regulate their nervous systems down.

*Child:  “How about I call you at (prearranged) times throughout the show to let you know I am safe.”

*Mom:  “I think that is a very good idea.”

The mom was allowed to be a worrying mother and the child was allowed to be an independent teenager.

True power and control obtained not through negativity, but through creative, mutually respectful affirmative strategies.

This developmental strategy teaches a child that power and control is gained with responsibility to each other’s needs.

Parents who continually restrict and restrain their children take away developmental experiences of experimenting appropriately with power and control.  This can lead to rebellion and defiance. 

When a child is given choices they are more willing to accept boundaries.


Ronald Mah, The Therapist Magazine, July/August 2012