Orientation to Therapy Video

This segment occurs approximately 4 weeks into the therapy. Prior to this session, Task 1 and parts of Task 2 and 3 were completed.

In the Task 1 session, Malik expressed that Gayle (mom) can be harsh and critical. Gayle sometimes tells Malik to “toughen up” and “boys shouldn’t cry,” and both the Malik and Gayle felt like Gayle let him down 2 years prior when they had to move in with maternal grandmother. Although difficult for Gayle to hear, she also agreed that these were issues or problems that needed to be addressed. By the end of the sessions, both the adolescent and mother, although they felt close, acknowledged that some things were not working as well as they could. Gayle wanted to be a better resource to Malik when he was feeling suicidal.

Since the Task 1 (the first therapist session) the therapist has met with Malik alone twice and with Gayle alone twice (Task 3). This video occurs during the third Task 2 session with Malik. Below is a recap of these first two Task 2 sessions:

• Task 2, Session 1: In this session the therapist initially focused on the bonding phase: getting to know him and his world better. During this phase she explored strengths, hobbies and hopes and dreams. Most of the session however, focused on exploring the problem narrative. This phase of the conversation focused on understanding the development of the drug use, depression and suicidal ideation. The therapist also explored how Malik understood these challenges; what did he think was causing them. The goal of exploring the problem narrative is to begin to help the adolescent begin to own these problems. These are his problems not his parents. He is unhappy, he is depressed, he is not happy with how his life if going. This puts a profound shift in the adolescent motivation for the therapy.
• Task 2, Session 2: This session focused on better understanding his attachment narrative related to his father; how he understood, explained and felt about his relationships with his father. The discussion about the father quickly uncovered his feelings of abandonment as a result of his father never having been in his life. He acknowledged that he felt abandoned by his father. Unfortunately, as many children do, he tended to blame himself for this, he wasn’t good enough for his father to want to be in his life. As a result, Malik internalized an attachment schema about himself as worthless and unlovable and about others as being untrustworthy and unreliable. Unfortunately, his current circumstance reinforced this view of himself and others. His very harsh, demanding and critical grandmother, with whom he lived, continued to make him feel unsupported and inadequate as did the constant bullying at school.

In this video segment, the therapist will focus on details about a few events where the patient has felt unsupported by his mother. The therapist will explore his feelings, thoughts and behaviors associated with these events.

Instructions:
First, you will watch the therapy video through in its entirety. Then, you will re-watch the therapy video, pausing at key moments to reflect on what is happening during the therapy session.

As you are watching:
1. Notice what types of questions the therapist asks to elicit the narrative and deepen emotions.
2. Track when the adolescent is and is not connected to his emotions.