young people to refl ect in family therapy sessions. In a family where for some members verbal communication could be challenging, I wondered whether the puppets might provide another means of communicating. Wilson (1998) said that: “Dialogue includes every communication possible through every sense, not an over focus on the spoken word. T e narrative metaphor has been widely applied to focus on the story above the dance”. We used refl ecting puppet shows with Alfi e and his family and all the family engaged with this. In one refl ection, the animal puppets representing Alfi e’s brother and sister were confused about autism and what it meant. T ey asked the children for advice and Teddy and Sophie shared some of their ideas about autism and how it aff ected Alfi e and their family. In a session that all the family at ended, the animal puppets wanted to play but had diff erent ideas of how to do this. One wanted to play on its own with one particular toy, whilst another puppet wanted to play together and became confused and upset when the other puppet didn’t join in with this. T e puppets then showed ways that they could play together doing activities such as chasing and looking at a book together. Again, the puppets asked the children for ideas and Alfi e and Sophie were supported to practice these together.
Tracking an episode with the family: T e complexities of communication In a pre-session, the therapists shared
that they had found it hard to get a clear understanding from the parents about what happened at home when Alfi e became distressed. Alfi e’s parents both had experienced their own learning needs and we decided that using a visual way of sculpting and showing an episode might be helpful. During the session, the two therapists
worked with the parents to visually track an episode together when Alfi e was fi nding it diffi cult to fi nish using his iPad so that his brother could have a turn. T ey drew out a plan of the family home and used beads to represent diff erent family members. During the mapping, the therapists and family could use the “stop”, “fast forward” or “rewind” symbols to infl uence the conversation. Having mapped out the episode together visually, they explored with the family how diff erent members were thinking and feeling at diff erent
Context 170, August 2020
moments in the interaction. T is then became a resource for being curious together about alternative preferred-future responses for the family. We had done a lot of work before this
session that created a context for this piece of work. T is included a session where we had read Hedges (2005) chapter on using a coordinated management of meaning framework (Pearce & Cronen, 1980) to map an episode. T is felt very positive and energetic, with both therapists communicating their increased confi dence about their work with this family and their abilities to communicate together in the session. My questions in the pre-session were to support this planning process. I asked questions about the detail of how they might create the context for this conversation with the family. I also asked about how the therapists might be curious about feeling, meaning and action linked to my experience that the team and family might be most likely to talk about behaviour and actions.
Refl ections on the work and concluding thoughts We added a range of approaches to our
team systemic suitcase through our work together with Alfi e and his family and this meant taking relational risks (Mason, 2005) in our work together. I think that the early narrative work that we did helped us to work in this way and meant that we could develop our practice in response to the dilemmas that arose for the family. We found that Alfi e’s parents, and many
other adults we work with, like the visual and playful approaches to family therapy. T is work wasn’t polished and was emergent practice and, for me, writing this article has been a valuable opportunity to develop my thinking about this work and to make further links to systemic theory. I had been thinking about diff erent
“knowledge” and of Shot er’s (1989) ideas about this. I have been infl uenced by Fredman’s (1997) ideas about how to share professional knowledge alongside family members’ own relational knowledge. T e preparation sheet provided one way of doing this that we are now using regularly in our family therapy work. T e family autism mapping exercise was another visual way that we were able to have conversations about diff erent family members and
professionals’ understanding. We hoped this was a respectful way to hear multiple perspectives that could help the family fi nd new and preferred ways to go on. I am aware that the professional
diff erences in the team mean that diff erent members have diff erent training and knowledge of working with families who are aff ected by disability. One team member commented on the pace of the session and of how much slower the process of therapy is. Lyngaard and Baum (2006) say this is an important way that therapy may need to be adapted when working with a family member with a disability. We have now done some additional work with sharing our cultural genograms, and thinking about the infl uence of (dis)ability for us in our families of origin. T is has been valuable both in thinking about the infl uences of disability and for being self-refl exive. T ere was also a real interest in continuing to develop systemic knowledge and we have now established a systemic forum for the psychologists in the service to continue making links between theory and practice.
References Boston, P. (2010) The three faces of supervision: Individual learning, group learning and supervisor accountability. In: C. Burck & G. Daniel (eds.) Mirrors and Refl ections: Processes in Systemic Supervision. London: Karnac. Brown, P. (2009) Refl ecting puppet shows: Evoking drama through improvisation. Context, 104: 33-35. Burnham, J (2012) Developments in social GRRRAAACCEEESS: Visible-invisible and voiced-unvoiced. In: I-B. Krause (ed.), Culture and Refl exivity in Systemic Psychotherapy, Mutual Perspectives. London: Karnac. Bushe, G. (2007) Appreciative inquiry is not (just) about the positive. Organisation Development Practitioner, 39(4): 30-35. Daynes, S., Doswell, S., Gregory, N., Haydon- Laurelut, M. & Millett, E. (2011) Emergent cake: A plurality of systemic practices. Context, 114: 21-25. Denman, K., Smart, C., Dallos, R. & Levett, P. (2016) How families make sense of their child’s behaviour when on an autism assessment and diagnosis waiting list. Journal of Autism and Developmental Disorders, 46: 3408-3423. Fredman, G. (1997) Death Talk. London: Karnac. Freeman, J., Epston, D. & Lobovits, D. (1997) Playful Approaches to Serious Problems: Narrative Therapy with Children and Their Families. New York: Norton. Hedges, F. (2005) An Introduction to Systemic Therapy with Individuals. London: Palgrave, Macmillan. Helps, S. (2019) Systemic story telling following childhood acquired brain injury: A family business. In: Jim, J. & Cole, E. (eds.) Psychological Therapies for Paediatric Acquired Brain Injury. Abingdon: Routledge.
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“Systemic suitcases, storms and smooth sailing”: Some of my experiences of supervising a family therapy team in a CAMHS disability service
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