Transcript for
Single session family consultations – part one
Joanne Donne (00:00): My name is Joanne Donne and my role at Relationships Australia here in South Australia is the Practise Manager of Family and Relationship Counselling Services. I see families with my colleagues and offer supervision and training in all things related to counselling with children and families.
Narrator (00:22): Welcome to the Emerging Minds podcast.
Chris Dolman (00:28): Hi, everyone. My name is Chris Dolman. And today, we’re bringing in the first of two episodes where I speak with Joanne Donne about the single session family consultation service offered by Relationships Australia South Australia or RASA.
(00:41): Over the course of these two podcasts, Joanne will outline some key elements of single session thinking that can be applied in a whole range of different contexts. She’ll speak about how her organisation has brought these ideas into their own context when working with children and families. And she’ll lead us through the single session family consultation structure and process from the first phone call to the final contact. So, that’s what’s ahead and we hope you enjoy it.
(01:05): Our conversation was recorded on the lands of the Kaurna people in South Australia. In bringing this to you, we pay respect to all Aboriginal and Torres Strait Islander peoples, the Ancestors and Elders, past, present and emerging, from the different First Nations across Australia.
(01:20): So, Joanne, thanks for joining us. Could you begin by giving us an overview of the single session family consultation service at Relationships Australia South Australia?
Joanne Donne (01:29): Certainly, Chris. It’s a bit of a mouthful, isn’t it? Single session family consultation. So, maybe I can break it down. So, the single session part is related to single session thinking which is an idea that has been around for a number of decades, and more recently in Australia lived decades ago with the Bouverie Centre who did a lot of training around these ideas.
(01:55): But in a nutshell, single session thinking is offering a very focused, intentional approach with children and families with a couple of assumptions. Single session thinking encompasses the idea that clients know what works best for them. The other assumption is that we approach each session as if it might be not just the first session but the last session, that we know that families are probably less interested in therapy and hanging around in therapy than we are. And ultimately that clients have the resources themselves to be able to make the changes that they want to make.
(02:36): And whilst this sounds as though these are ideas that anyone practises, I guess the difference with single session thinking is that there is a specific structure that we offer families right from the first phone call to the end of the session that makes it a very, very clear, a very, very intentional process, so both the practitioner and the family.
Chris Dolman (03:02): Great. Yeah, I’d like to ask you more about that structure in a moment, but could I first understand what was it that prompted the introduction of this service at RASA?
Joanne Donne (03:10): So, probably about, really, eight to 10 years ago, a number of counsellors, including myself, were all seeing families and we began to get together and form a reflective team and we saw each other’s families when we as therapists felt really stuck, when we didn’t know what to do, when we were exhausting ourselves in thinking, “What aren’t I doing right or why aren’t these families changing?”
(03:40): And so, we began to form what’s called a reflective team. And then after attending the single session symposium in Melbourne in 2017, I heard how people were adapting these ideas in different ways from all over the world. And so, we had a conversation here at RASA and then we began to implement a more structured way of implementing single session thinking. And we’ve continued to do it from there onwards.
Chris Dolman (04:14): So, what was it that you heard at that symposium that drew you even more to this way of working?
Joanne Donne (04:20): I think it was the way in which everyone could take the ideas of single session thinking and adapt it to their different organisations and different programmes. So, whilst later on I might explain the process here that we use and how we adapt it to RASA, everyone can adapt some of the components to their own programmes no matter if you are in a metropolitan area or in a regional area, a rural area, whether you’re seeing children, families or adults individually.
(04:54): And so, I think it’s a framework that like a coat hanger, you can hang a coat on a coat hanger, you can hang a dress or a pair of trousers on a coat hanger. It’s an idea or a concept that anyone with a particular preference for a theoretical framework can use.
(05:15): If you’re more inclined to practise more of a narrative approach, you can use single session thinking. If you’re more inclined to use a systemic approach, you can use the single session thinking. If you have a more developmental approach, you can use single session thinking as well because it offers a very clear structure that helps both the practitioner and the family keep on track. And it’s just very, very intentional.
(05:40): So, I think it’s the focused intentionality that really struck me at that conference and how it can be adapted to different service programmes.
Chris Dolman (05:49): So, how do you describe the single session family consultation service to families? Because it’s not the only option available to them at RASA, is it?
Joanne Donne (05:59): We would say that we have a service that is called a single session family consultation. It’s a bit of a mouthful. And it’s where all of the family are invited to come. And there’s a little bit of work to do before the session and a little bit of work to do after the session. You don’t have to wait as long because you’ll be invited to a session in two or three weeks after this phone call.
(06:25): It’s a very structured session. We’ll be hearing about the problem. We’ll be asking everyone about what is this they want to have different. And we’ll be hearing from either myself or a team of people about some ideas that you can think about and go home to practise. So, it’s very much focused on the here and now. And you’ll be asked to take some ideas away and to practise those ideas. And then we’re going to offer you a follow-up phone call to see if those ideas have been helpful.
(07:00): And at that point, you can tell us if you need more sessions or if you don’t need more sessions. Quite often, a lot of families tell us that they needed the one session. But if families need more sessions, of course you can come back for more. So, we would explain it as simply as that.
(07:19): If families don’t want to come in all together at the start, that’s understandable. And of course, where there are issues of risk, we wouldn’t do that anyway. But there might be other reasons why families might not be able to come together. They might’ve had a negative experience in the past. One of the family members might feel that if everyone is there, they’re going to be the person that’s going to be blamed and shamed.
(07:49): So, we might need to have some individual sessions before a family session is offered. So, it’s certainly not the only way that you can come in to a single session family consultation. You can build up to that or you can start with that.
Chris Dolman (08:04): Great. So, could you lead us through how the engagement with the family proceeds?
Joanne Donne (08:09): So, how we use it here is that we have a number of counsellors that have availability in their DARs to take we call an intake call for a single session family consultation. So, a family rings in and they say, “We all want to come together.” And that person is booked in to a phone call to a practitioner which goes for about 30 minutes.
(08:32): And then, purpose of that call is to check a number of things. First of all, to engage it with the family because the work, we begin with that phone call. So, we engage, we explain the process very clearly that the transparency of the process is very important to explain to the client because it is a little bit different to a more traditional service. And we get agreement that the client is ready for that.
(08:58): So, we might say something like, “We’re going to spend half an hour today hearing a little bit of background, but it’s really just chapter headings that we are wanting today, not the whole life story. Is that okay?” So, there’s a lot of permission-seeking questions. We then hear a little bit about what the problem is and who it’s affecting most and least, who’s maybe most interested and least interested in coming along, who might agree with mum. It’s quite often one of the parents who ring in.
(09:27): So, who might be agreeing with the description that you have of the problem, who might see it quite differently, what might they say if I was speaking to them? So, we’re trying to position the parent in the seat of the child and looking at the problem through the eyes of the child from that very first phone call. Then we’ll ask quite a bit about, “What sort of solutions? What sort of ideas have you tried and what’s worked and what hasn’t worked?”
(09:54): And then, we will ask about risk, ensure that there are no safety issues that need to be attended to because we would not go ahead with a family session with children and parents together if there were risk issues there.
Chris Dolman (10:08): Sure. And how would you check that out during the phone call?
Joanne Donne (10:11): I might ask, “Is there anything that you would be afraid to say in the room with your partner or an older child in the room?” And then, if the person says, “Well, yes,” I would then go into detail about that, and we might need to scaffold this a little bit more. We might need to see mum on her own or the child on their own before we have a family session or if we have a family session at all. So, we would go into that.
(10:38): The family also does a process called DOORS where the adults would fill in a form where they can tick if there has been any form of abuse or control, so we’ll be well aware of that before we seek the family.
Chris Dolman (10:54): Okay. And what else do you seek to cover in that initial phone call?
Joanne Donne (10:58): Before we finish the phone call, we would ask about this idea of readiness. Who’s most ready to come in here? And what do you think you might be ready to do between now and when we meet? And then, we might talk to the parent about one very tiny thing that they could try to do differently between now and the first session. And that might be something as small as, “Before I yell at Peter to get off his device, I’m going to go and get a glass of water.”
(11:29): It’s something very small, something very achievable that we ask a parent to think of themselves. Sometimes we might help them with that. And then we would ask, “Well, who might be able to help you with this if you forget to do it? Is there someone in the family that you can talk to that might act as a reminder or a support or might also help you do this task?”
Chris Dolman (11:50): And what’s your intention in asking that question in this first phone call?
Joanne Donne (11:54): The intention is to enable the family to practise something on their own before they come in. And we will be asking into that in the session. So, we’re planting a seed of change before we see the family. And we might ask people in the session, “Did anyone notice anything different between when mum rang up and coming in here today? And has anything been different in the last couple of weeks?”
(12:24): So, it’s just planting that seed that you’re going to actually try and do something different and let’s just see what happens. And the other thing that it gives us is an idea of how heavy or how light the constraints are for that person to start doing something different.
(12:40): So, if mum wasn’t able to do that, we might ask him to write. And what do you think might’ve made it a bit easier to do that? So, we’re starting to get an idea of what mum is carrying, what’s really hard for her to do or what’s easy for her to do even before we’ve seen everyone together.
Chris Dolman (13:01): And are there other preparations you ask the family to make prior to the actual consultation itself?
Joanne Donne (13:07): Yes. So, we send a letter out of welcome out to the family. We might send sometimes a separate letter for the children depending on their ages saying, “We see children from all sorts of families. Some children have one parents living at home, some parents have both children living at home and children come to us and talk about a lot of things.” And we would be sure to put one of the things that the parent has said in that little list.
(13:35): So, we send that welcome letter out with another form which asks the family to do together or separately. And that asks people to put down the two main things that are worrying them at the moment, the things that they want to talk about. And then there’s a few questions about scaling. How often does it happen and how much are you worried about it?
(13:58): And then most importantly, there’s another question which is, “What would you like to have different by coming here?” And a little space for people to book down any other information that they would like us to know. Sometimes children have drawn pictures and that forms sort of like the contract, I suppose, the agreement or the focus of the session.
Chris Dolman (14:19): So, do you first see those forms when the family attends the session? Is that right?
Joanne Donne (14:24): Yes. So, when they come and they’re all in the waiting room, I ask, “Could I see those forms just for a moment, a couple of minutes before we go in?” So, I would go into a room. If there are other counsellors in the room, if we’re working jointly, I’ll show them those forms. If not, I just take a moment to look at those forms myself and then bring the family into the room.
Chris Dolman (14:44): So, Joanne, what does that actual single session consultation look like when the family is in the room?
Joanne Donne (14:50): So initially, it would look like what any other counsellor would do. And that is engaging, trying to find ways from people sitting on the edge in their seat with their knuckles clenched to sitting back in the chair thinking, “Oh, this is okay.” So, that might be questions around, “Well, if you’re at school today, Chris, what would you be doing? Is that a good thing that you’re here? Are you happy that you’re not doing maths? What is it about maths that you really don’t like? Is it something about the teacher? Would you prefer to be doing sport?”
(15:23): So, we have lots of conversations that are non-problem focused. And they’re really important conversations because they allow us to get a glimpse of how these children, how these mums and dads are when the problem isn’t around. Hopefully, there’s a little bit of laughing.
(15:41): So, that could go on for at least 10 minutes or even more. It’s a way for the family to feel that there’s a lot of other things that are happening in their life apart from the reason that they’re coming here today. So, I’m sure that’s what every counsellor who is listening does in their session as well.
Chris Dolman (16:05): Yes. I’m sure what you’re saying is resonating with many of the listeners. And so, where do you take the conversation from there?
Joanne Donne (16:11): Then we move on to the forms that I referred to. And I would just say, “Look, I’ve had a look at all your forms and even though you’ve written lots of different things, it seems as though you’re all here for one main thing. And I would just summarise what that issue is.”
(16:26): And quite often when it’s parents and children, it’s either less arguing. Children might say things like, “Oh, I want mum and dad to stop nagging.” And mum and dad might write down, “I’d like the children to listen more.” But ultimately, we would use the words on the paper, but we would summarise it into a sentence or a phrase then ask people, “Is this right? Have I got this right? Is this what you’re wanting to focus on?”
(16:53): So, we are sound to focus and we get agreement that that’s what we’re focusing on. And then I might get one of the children to write on the board, “Is this what we are going to be focusing on today?” I get them to write that on the board.
Chris Dolman (17:06): How important is that process of having the focus of the consultation actually named?
Joanne Donne (17:12): Yeah. So, that’s really, really important. So, that’s one of the central concepts of single session thinking that finding an agreed focus that we are all on board with is central. So, quite often as counsellors, I know that I’ve been in a position sometimes. I’ve heard about what the issue is and I might have in my own mind, “Well, I think we really need to focus on this, this, and this. But the family wanting to focus on this.”
(17:37): So, single session family consultation is very much client-led and family-led. And so, that is very, very important. That is why we’re sending out the forms. That’s why we are asking people to do some work before they come in to write down what it is that they want to talk about so that they feel that I’m going to be responding specifically to them and leaving them with something to do at the end.
(18:07): So, you don’t have to get a child to write down that focus on the board, but it gets a child to feel that they have a task that they’re actively engaged. I might get the more quieter child to do that. I might get another child to say, “Look, sometimes when we talk about things, lots of things happen in families, and sometimes we end up going right off track. We’re off the highway and we’re driving down a country road talking about something altogether different to what you’ve written on the board. So, who’d like to be the person that reminds me that I’m going off track?”
(18:43): So, we’ll be doing check-ins two or three times during the session. And that’s just a simple question of, “Can I just check in? We’re now talking about what’s happening with Peter at school, but I can see on the board that we’re meant to be talking about what happens when Peter gets really annoyed when he’s asked to turn off his device. Do we want to go to the talking about school or do we want to go back to what we agreed to talk about?”
(19:12): So, it’s very much, once again, permission-seeking from the family as to where we’re going to be going.
Chris Dolman (19:19): Great. And can I just check with you, how much time do you allow for these consultations? Because I guess that’s also influencing what you’re asking about, what you’re not asking about.
Joanne Donne (19:30): Yeah. So, typically, we would put aside an hour and a half, although you can do this very easily in 60 minutes if you want to. The session structure allows for a 60-minute session or a 90-minute session. If we have other counsellors in the room and we’re using a reflective team, we would allow about an hour and 20 minutes. If it’s myself and the family, I would just allow a little bit over an hour.
Chris Dolman (19:56): So, this can be done all with or without a reflecting team?
Joanne Donne (19:59): It can be done with a reflecting team or without a reflecting team. If it’s going to be done with a reflecting team, that would be explained at the intake call. The purpose would be very clearly explained, and we would get permission and agreement from the parents and the family to do that.
Chris Dolman (20:17): Okay, sure. So, Joanne, you’ve described how important it is to develop a focus for the consultation in collaboration with the family. How is the remainder of the consultation structured then?
Joanne Donne (20:27): So, once we’ve engaged, we’ve found a focus, we’ve got the agreement from everyone, we then talk about happens on a good day. If it was a sad day morning, what would you all be doing? So once again, going back to when the problem isn’t around.
(20:44): And then we would introduce the idea, “Okay, let’s roll our sleeves up and get to work here. Who would like to tell me a bit about when the problem comes knocking at the door and what happens?” So, we step right in because we’ve had a good foundation of getting to know each other. What happens when the problem isn’t around? And now, it’s time to roll our sleeves up and do some work.
(21:07): So, I would just ask a question of, “Who’d like to tell me what’s the first sign of when this problem starts to knock on the front door? Who notices it first and what happens then? And Johnny, do you agree with that? Really nice. Okay.” So, lots of circular questioning here.
(21:27): And what happens when that happens? And when Johnny gets upset, who notices that first? So, we’re getting a little bit of a trying to understand what the patterns are, who steps in most, who’s yelling first, who needs reassurance, who isn’t getting what they want?
(21:46): So, we’re just putting on our reporter’s hat and newspaper reporter’s hat on here. We’re being really, really curious. We’re not entering into solutions or giving our ideas here. We’re really staying in a very curious, respectful position and asking into what it’s like for everyone in that pattern of when the problem is very, very evident. What do you think it’s like for mum when this happens? What do you really hope from mum when you are feeling like this? And how long has it been going on for? And wow, if it continues on this, what might happen?
Chris Dolman (22:32): Okay. So, you are inviting curiosity by the family about the problem.
Joanne Donne (22:36): Yeah. And now and again, I might say, “Is there anything else that you think would be important for me to know?” Or, “How about I just change seats with you for a minute, Johnny? Okay. Now, you’re counsellor. What question do you think I should be asking? Can you ask me that question?”
(22:52): So, we’re a little bit playful, especially if there’s younger children, but we’re really wanting the family to tell their story in a way that not just helps me understand but helps all of the family members understand what it’s like for everyone else. So, helping people understand that Johnny doesn’t want to be angry, but he’s so frustrated because he thinks mum doesn’t listen to him.
(23:19): Helping mum understand that whilst Mary doesn’t enter the arguments, she’s sitting in the corner and she’s going into her room because she hates hearing the screaming and it makes her feel very anxious. So, we’re trying to draw people’s attention to how this problem spreads its tentacles over everyone. And then how everyone can team up together to find a way to do things differently, to take a stand against the problem and feel that each one of them can do something a little bit different to help everyone else in the families.
Chris Dolman (23:55): Well, that brings us to the end of this first episode on single session family consultations. Joanne has outlined some of the key elements of single session thinking and how Relationships Australia South Australia has taken up these ideas in their work with children and families. Joanne’s also begun to describe the areas of conversation that practitioners can focus on in these consultations.
(24:15): In the next episode, Joanne will continue to describe this work as well as some other themes around the wider applicability of single session thinking when working with families or in responding to trauma, and also some other reflections around what this approach offers families and staff teams.
(24:31): So, thanks folks very much for joining us today. Thanks again to our guest, Joanne Donne, and we look forward to your company next time.
Narrator (24:41): Visit our website at www.emergingminds.com.au to access a range of resources to assist your practise. Brought to you by the National Workforce Centre for Child Mental Health, led by Emerging Minds. The centre is funded by the Australian Government Department of Health and Aged Care under the National Support for Child and Youth Mental Health Program.