Orientation to Therapy Video

This is a continuation of the Alisha storyline from Task 3, which you viewed in Module 9.

This session occurs approximately 14 weeks into the therapy and about seven weeks from the Task 3 video seen previously. Between the previous video and now, the following sessions have occurred:

• The therapist met with the adolescent, Alisha, 2 more times alone (Task 2) to continue discussing what had gotten in the way of her going to her mother (ruptures), her experience of having an absent father, motivating her to want to talk to her mother about the ruptures between them and preparing her to do so. Alisha was reluctant to talk to mom about the ruptures out of a fear that her mother couldn’t handle what she had to say.
• The therapist met with the mother one more time (Task 3) alone to continue to help the mother process her guilt and prepare her for the joint conversation with her daughter where they would discuss the ruptures.
• The therapist met with Alisha and Lisa two times to discuss their relational ruptures (Task 4). In the first conversation, they discussed how the adolescent feels like mom can’t emotionally take care of her and does not understand her. Mom was weepy and remorseful throughout this conversation, but was able to be empathic and validating of the adolescent’s experience. In the second conversation, they discussed Alisha’s experience of witnessing domestic violence. Alisha’s mom, Lisa, struggled throughout the session and required a lot of support from the therapist. Lisa vacillated between being defensive and anxious/upset and teary which pulled for caretaking by Alisha. With help from the therapist, Lisa was able to tell Alisha that it was her, Lisa’s, job to take care of Alisha and not the other way around. In the end, Lisa was able to listen to and validate her daughter’s experience of witnessing domestic violence.
• The therapist met with mother and daughter four more times but moved on to topics not related to the mother-daughter relationship (Task 5). Topics included: Absence of father and the impact that has on Alisha, Alisha feeling like she doesn’t fit in with others, alcohol and drug use and school struggles. Over the course of the 4 sessions, mom’s ability to step up and take care of her daughter emotionally improved, although mom still struggled with this given her own mental health issues. Mom remained in therapy for herself. As a result, the daughter began to talk more about herself and rely on mom for support.
• The therapist met with the mother for part of the last session to prepare her for “today’s” conversation. – In this video segment, the therapist helps Alisha and Lisa discuss an issue of identity development: expectations of romantic partners (i.e., how they should treat you, qualities that are important). Lisa is quite concerned about Alisha’s current boyfriend and worries that Alisha will follow in her, the mother’s, footsteps. Alisha feels as though her mother doesn’t trust her and her judgement. Ever since Alisha started dating this boy mom has started imposing non-age appropriate rules about dating and Alisha feels as though she has lost her autonomy.

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 the difference in this mother from the Task 3 session.
2. Notice when and how the therapist coaches the mother and adolescent to discuss the issue at hand.
3. Take note of the kind of content the therapist infuses into the conversation.