Transcript for
Single session family consultations – part two

Joanne Donne (00:00): A lot of people say that the word single session can mean that you can only see people for a single session and it doesn’t… It’s using single session thinking every time you see a family. 

 

Narrator (00:15): Welcome to the Emerging Minds podcast. 

 

Chris Dolman (00:20): Hi everyone. My name is Chris Dolman, and today we’re bringing you the second of two episodes where I speak with Joanne Donne about single session family consultations, the service that’s offered at Relationships Australia South Australia, known as RASA. 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 Islanders peoples, their ancestors and elders past, present and emerging from the different First Nations across Australia. 

 

(00:49): In the first episode, Joanne outlines some of the key elements of single session thinking and how RASA has taken up these ideas in their work with children and families. We heard about the initial phone call, the welcome letter, and also what families are asked to consider and talk together about prior to the family consultation. Joanne’s already described the start of the consultation and ways of engaging the family and conversations about their life beyond the problem and then reaching an agreement about the problem that can be the focus of the consultation. 

 

(01:21): So in this episode, we’ll hear about ways of supporting the family to move towards taking action in responding to the problem, including therapeutic letters and the role of reflecting teams. Not an imperative, but a helpful option in this work as well here. And also the follow-up contact with the family. Joanne will also touch on some other themes around the wider applicability of single session thinking when working with families or in responding to trauma and some further reflections around what this approach offers families and staff teams. So we hope you enjoy it. 

 

(01:53): Joanne, you’ve spoken about the importance of exploring each family member’s experience of the problem, inviting their curiosity about that to really expand their understanding of the problem. How do you segue from that towards teaming up together towards taking action, further action really, in responding to the problem? 

 

Joanne Donne (02:12): Yeah, so some of the information that we glean from the engagement when we know that Johnny is really interested in soccer or footy or we know that Mary is great at athletics or she’s really good at art, we use some of those strengths in our questions. We might say something like, if this was a soccer team, who would be playing what position? And if you the centre player Johnny, who would you most likely want to be on your side? What would they be doing? And if this was at home and you were a team and you were the coach, what would you be saying would be the best thing to do when the problem arrives? Who agrees with that? So we can use some metaphors, we can use some of the strengths that we already know that are there in the family. 

 

(03:04): When you’ve come up with this problem in the past and it hasn’t been so big, what’s worked and who appreciates that? So when mum goes to you, Mary, when you’re sitting in the room, what’s special about that? “Oh, I really like it when mum does that because it stops my anxiety getting bigger.” So we talk about how working as a team can help people appreciate what each other needs from one another, and are people ready to work as a team to try and help this problem not be so influential in their lives. 

 

Chris Dolman (03:40): Joanne, you mentioned it before how you might invite a child to write on the whiteboard, the key focus of the conversation. Do you also invite them to document some of the other themes you discuss for the family as well? 

 

Joanne Donne (03:51): Yeah, throughout the session we might do things like give children a different coloured marker and each time something of importance comes up, they can write that on the board. And that can be some things that are good and some things that are not so good and different colours might highlight that. So it could be what’s really helpful goes up on the board. I might say to Johnny, “Is this a helpful thing for you to hear about mum that you really like it when mum says this to you? Do you want to write it on the board?” And conversely also, “It’s really not helpful when dad starts giving you that awful look in his eyes.” 

 

(04:29): And so that might go on the board and then towards the end we might have the family take a photo of that or we might use some of those phrases that are put on the whiteboard in our therapeutic letter that we send towards the end. So we’ve now sort of got a bit of a map of the dynamics of the family, the patterns, we’ve looked at what people are wanting different, we’ve asked is there anything else that you think that we need to know? We’ve got a bit of an idea of what the sequences are in this family and how the problem gets bigger and bigger. And hopefully would’ve also teased out what the values are from this family. What do mum and dad really want to hold strong in working out how to get rid of this problem? 

 

Chris Dolman (05:20): Okay, so there’s a number of things you’re making sure you’re clear about with the family, the problem that you’re focusing on, what they’re up against, you sought to expand their understanding of the problem and also what’s important to them, things they’ve already tried, steps they’ve taken. Where to from there? 

 

Joanne Donne (05:38): Then we would say, look, we’re just going to have a bit of a break just for a moment where we’re going to be thinking about all of the things that you’ve tried, some of the things that you’re carrying, some of the really hard things, and we’re going to swap places with the reflective team if there’s a reflective team in the room. If there’s not, I might just say, “I’m just going to have a bit of a minute to walk over some of my notes and then I’m going to get you to just have a bit of a listen to me just for a few minutes because I’m going to share some ideas with you. Is that okay?” And the families might go and get a glass of water, then I’ll say: “get yourselves comfortable, you ready to listen?”. 

 

(06:19): And then if I’m in the room on my own, I will go through a process which starts with validating why they’ve come here. “No wonder you are all up in arms about this. I would be too if I was experiencing that.” So we are normalising the problem and we’re validating the fact that they have taken the time off work, got out of school and come here. We acknowledge the dilemma. And then we look at addressing some of the strengths, noticing what we’ve seen in the room. I really noticed how dad was really upset when he heard how much Johnny was distressed when he’s left in his room on his own. And I’m really noticing how mum smiled when she heard how much Johnny likes her going in and putting her arm around him. So we’re noticing those little gestures of affection, those little gestures of special moments in the session, some of those unseen or unsaid moments. 

 

(07:29): And we are acknowledging something about each individual in the session and acknowledging some of their strengths and also acknowledging some of what’s in their backpack of worries. And only after we’d done all of that do we then move on to sharing some ideas that the family could actually practise. 

 

Chris Dolman (07:49): Okay. And what’s guiding you as you share those ideas? 

 

Joanne Donne (07:53): And those ideas need to be, we want to give the families a bit of a jolt, a bit of a, “Well, I hadn’t thought of doing that.” So the ideas have to be a little bit different to what they’ve tried, but not so different that they think that it’s impossible for them to do. And they’re their wonderings, they’re not, “I think you should do this Johnny,” or “Dad and mum, you just need to stop arguing.” These are wonderings, they’re tentative offerings. And quite often the sentence might start with, “I was just wondering if mum was able to start to whisper that it’s time to put the device away, what difference that might have.” “I was just wondering if the family had a meeting once a week and Mary was able to chair that meeting, I wonder what the family would talk about.” 

 

(08:48): It can be quite creative and sometimes if we’ve got a reflective team in the room, counsellors might have different ideas. And that conversation with a reflective team might go on for about seven or eight minutes and then we would go back to our original place and I would ask the family, “Was there anything that you heard about that, that you thought, ‘Yeah, I really could practise that at home?'” We would hear from different people what stood out for them and what will they take away to practise? So they are the two main questions that we ask at that point in time. What stood out for you and what are you ready to take home to practise? 

 

(09:30): And that is also, it’s either written up on the board or we have a little notebook and the heading is called takeaways. And so sometimes the families might write down what it is that they’re going to take away and practise, and then we also write that up in what we call a therapeutic letter, and we send that out via email or post to the family. Sometimes we might send out a smaller letter if the children are very young, if they’re five or six or seven, we might send out a shorter letter to them and a longer letter to the other family members. But quite often we send out one letter to the family, that is sent out a few days after the consult. 

 

(10:13): So that’s sort of the session structure I suppose and at the end of the session we go out of the room and the families fill out an evaluation form and they let us know what they like, what they didn’t like. And then we have a follow-up phone call two weeks later to hear what’s been different and what has changed since we’ve met. We don’t make a second appointment until we’ve had that follow-up phone call. 

 

Chris Dolman (10:43): Could you say a bit more, Joanne, about that phone call then? How you go about that? 

 

Joanne Donne (10:47): We might ask questions around the similar scaling questions that the family used in their initial form, we would ask those scaling questions again and to compare what’s different. And we also might be saying or asking, “Do you think you are ready to be your own consultants for a little while now or what would you prefer to do?” So quite often families might say, “Look, I think we’re all right for a while.” Because getting a family all together is quite a logistical challenge. Quite often found it’s children spend a week with mum and a week with dad if their parents are separated, there’s school commitments, work commitments. 

 

(11:31): So when families come, once again, this is why we have to be very purposeful, very intentional in having a family session because this can be quite a feat for mum and dad to get everyone together. And we don’t make the assumption that we’ll just start on the engagement now and we’ll get to the real problems in the second session. We want to be very focused, very client-led. We want to give the families something to leave with to take home to practise. So in that follow-up phone call, hopefully they’ve tried some of the things that we have shared with them and they have agreed to experiment with at home. That might lead to them saying, “No, we’re okay Joanne.” Or it might be that mum and dad might say, “Look, I think we need a session ourselves to get our act as parents together.” Or, “Look, I’m really worried about Mary’s anxiety. She says she wants to talk to someone on her own.” So we might talk about that. 

 

(12:31): So the door is always open, but we don’t make assumptions that people will be coming back. 

 

Chris Dolman (12:36): Yeah, I guess that’s another key aspect of single-session family consultations is putting aside that assumption that can often be a part of other work with families. 

 

Joanne Donne (12:45): Yeah. Approaching it as if it might be the first time and the only time that the family are here together. 

 

Chris Dolman (12:51): Sure. And what have you heard from families or from the staff involved that has your organisation continuing to offer this service? 

 

Joanne Donne (13:00): Well, families, we have evaluation forms, and I think everyone says that they feel very much heard and that they’d go away with something. So if I go to a specialist about a concern that I have, a health concern, I want to feel heard and I want to understand what the problem is. But I also want to know what I can do to make that concern go away or how I can manage it well. And so most of the families in the follow-up phone call say, “We really like the ideas that we were offered towards the end of the session. So those ideas, we’ve still got up on the fridge, Joanne.” Or, “We’ve still got a copy of that letter in all of our rooms in the house.” So they like the fact that they are going away with something tangible to practise. 

 

(13:53): The other thing that, so that’s for the families, for the staff that are involved, people feel I guess a sense of satisfaction that there is a structure that is really helpful to keep us on track. For new practitioners the structure enables them to go into a session knowing what their responsibilities are. “Okay, I need to move through this process.” So that helps a lot of new practitioners who might be very overwhelmed in working with more than one person in the room to know that, “Okay, there’s a sequence that I can follow.” 

 

(14:28): The other thing is that this is very much a shared responsibility. We are asking families to do a little bit of work before they come into this session. So already they have a bit of an active role in this. And then at the start of the session, we are getting everyone’s agreement about what we are focusing on. And throughout the session we’re in. So it’s very much a working together approach. And I think that it’s a very respectful approach. It does not place the counsellor in a position of being the expert and having the font of all of the knowledge and imparting that. It’s very much focusing the counsellor in the role of facilitating conversations, which invites the family to be thinking what they can do, what they can do in a very practical sense when they leave the session. And giving the family a different experiences of themselves and of each other and hopefully offering some surprises in the session. Surprises of emotion, ‘prises of statements of appreciation, and really uncovering different stories and different knowledges about themselves. 

 

(15:46): So I remember a few years ago when we looked at how many families we saw over a 6 or 12 month period, it was something like over I think 6 months we saw 20 families and 15 of those families said that they were happy with one session. The remaining five, I think, a couple of those families wanted some parent work and a couple wanted some work with their children. So that was really heartening to hear that families felt that they could come once and leave with something that they could practise. They might then feel that they could come again, it might be six months down the track or a few months down the track and that process can be offered again. 

 

(16:32): So I think a shared responsibility for practitioners knowing that they can work together and get a sense of satisfaction that clients are working just as hard as we are in the session and that we are offering something for the clients to go home and practise. It’s quite a fulfilling way of working. 

 

Chris Dolman (16:54): What do you think the reflecting team adds to practitioners’ experience of this work? 

 

Joanne Donne (17:00): I think it’s a bonus, it’s not essential. But if you can do that from time to time, what it does is it really enables a team approach that the counsellor is not holding all of the responsibility for the outcomes of the session, but the reflecting team is very much part of that as well. So the counsellor is able to really sit in that position of curiosity and the reflective team is able to come in using all of the information that they’ve heard and then offering their ideas. 

 

(17:33): It’s also a great way for counsellors to learn from each other because if you are working in a reflective team again and again, you get to know the different questions and the different phrases and the different positions that your colleagues take. And so we learn from that. So I think a lot of counsellors have really appreciated that as well. And it’s a way of learning how does this particular counsellor work and how does someone else work because we all work slightly differently. For professional development, I think that is a terrific way of offering an opportunity or a glimpse into our colleagues’ work. 

 

Chris Dolman (18:16): Yeah. Great. Thanks Joanne. Is there anything else you’d like to say to practitioners listening about working therapeutically with families generally? 

 

Joanne Donne (18:25): I think if anyone is having some hesitation on seeing a family, just remember that we all come from a family, that the children and the parents that we are seeing in the session, they have all experienced the dramas, the arguments, the conflict, they already know it. So don’t be scared to ask into that because this is known territory to the family. We can also always say, “Just put your hand up if I’m asking questions that are too hard. Just put your hand up if you think, ‘No, I’m not ready for that yet”. 

 

(19:03): So as long as we are transparent and giving the families permission to give us feedback in the session, we can be sure that if we have done a good intake call, that if we’ve engaged well with the family, that we’ve done a lot of permission seeking about the process and got agreement that people will let us know, “Hey Joanne, you’re going a bit too fast.” So go gently and respectfully but be brave and be yourself. A little bit of fun and a little bit of humour is a good thing. 

 

Chris Dolman (19:35): Indeed it is. Yeah. So many people listening to this podcast would work with children and families around the effects of trauma in their lives. Do you have any reflections about the applicability of single-session consultations when responding to trauma? 

 

Joanne Donne (19:51): We often say to practitioners is that, and a lot of people think that if we use single-session thinking we can’t work with trauma when we know that there’s a lot of similarities. For example, that with working with trauma we expect change to be possible. And when we work with trauma, we need to have a lot of predictability. So clients need to know what to expect. So that’s why the transparency of process is very important in single-session thinking. Working with trauma the priorities are decided by the client, we work where they are wanting to start with. Which is the same with single-session thinking. We are wanting to understand a subjective experience when we are working with trauma and that is what we are also doing in inviting the story in single-session work with the family, inviting other people to hear what it’s like for that person who may be seen as being the problem child. 

 

(20:50): And the main concept is trauma needs to be acknowledged. It doesn’t always have to be unpacked in historical detail by detail, by detail. For some people it might, but for a lot of people it doesn’t. And that people can recover from trauma. And trauma does not define the person you are, you more than that. So I just think it’s worthwhile to be aware that there are singularities. 

 

(21:20): It reminds me of a time over 15 years ago when I was working more family violence counselling context, and I did this training probably 15 to 20 years ago. I thought, that sounds really exciting. It won’t work for me because the clients I see in more than one sit-in and what I didn’t realise then is I could just have this thinking every time I saw those women and children then. So the similarities I think of how we work with trauma and the single session steps go hand in hand. 

 

Chris Dolman (21:52): Yeah. Thank you for that. Is there anything else you’d like to add? 

 

Joanne Donne (21:55): There’s this lovely quote by Alison Elliott, “If it is autumn, it is not time to sow seeds.” And so that’s about what is the family ready to hear? What do we need to step back from when we’re thinking of offering these ideas and reflections? What do we need to acknowledge and what are the family ready to do? 

 

Chris Dolman (22:17): So that reminds us of the importance of acknowledgement, what the family is already doing, the steps are already taking and also readiness as well. 

 

Joanne Donne (22:27): Another quote from Alison Elliott is, “They have the map, we have the torch.” And I think that is just such a respectful stance on reminding ourselves that families do have the strength, the resources, the wherewithal to get through this difficult time. And our job is to shine a light on what they’re already doing well and maybe just pointing the light down a different little path that they then can see, “Oh yeah, we can go down there.” 

 

(23:00): So we are not placing ourselves as the mapmaker, but we are following the path that they want to take, and we’re just shining this slide on all of the things that they’ve already done to help them get there. And that we can show them down this path, “You’re able to do this. Look, you’ve done this, this, this, and this.” So I just think that’s such a beautiful, respectful quote about families’ abilities to change and use their own resources. 

 

Chris Dolman (23:30): Great. Thanks for bringing that to us, Joanne, and thanks again for your time today. It’s been really interesting to be hearing about this hopeful and respectful and doable approach to working with children and families. 

 

Joanne Donne (23:42): Okay, thanks. Bye-bye. See you. 

 

Chris Dolman (23:44): So that brings us to the end of this podcast episode and the end of this two-part series on single-session family consultations. Thanks again to our guest, Joanne Donne from Relationships Australia South Australia. And just a reminder that Emerging Minds has a heap of free resources to support you and your work with children and their families. This includes our free online courses around engaging children, practise strategies for working with children, working with children in relation to trauma, and many others. So thanks again for joining us today. We look forward to your company next time. 

 

Narrator (24:19): 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 Programme.