Worksheet - Amazon S3 · Question #1 in the MI Script. 4 Dr. Sells: [Question #1 in MI Script] What are some of the top 3 difficulties that you have had to suffer this year or overcome

Module 2: Lesson 3

How to Deliver the FST Motivational Script

with ExcellenceWorksheet

FST Digital Advanced Training Course12 FST Techniques to Become a Family Trauma Expert

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Lesson 3How to Deliver the FST Motivational Script

with ExcellenceThis worksheet is designed to help you:

✔ Understand the key differences between process vs. content in your delivery of the FST Motivational Script

✔ Generalize a great process to your practice with five process tools.

✔ How and why “closing arguments” are so important to your practice.

As you can see from Figure 1, you cannot become a great therapist, case manager, parent advocate, school counselor, etc. without mastering a great process. Look at TED TALKS — The content or topic might be awesome. But if the delivery of that content is poor, the content falls flat.

The X-Factor is “the process,” or not what you say, but how you say it!

The same X-Factor holds for your FST Motivational Script.

My team and I supervise FST therapists who want to be FST Certified after graduating from the FST Digital Advanced Training Course.

Figure 1: Process vs. Content

https://www.ted.com/

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At times, we will request that the FST therapist send us a video clip of themselves conducting the FST Motivational Interview, live, or on the phone. We want to see both process and content.

If the video reveals that the technique failed or was ineffective, it is almost always the same reason.

The process or delivery is poor

Here are some of the common process failures that we see:

✔ No confidence in the therapist’s voice

✔ The therapist or case manager just read the script- no energy or passion

✔ No voice inflection

✔ Timing was off

✔ Did not ask the parent for clarification on their answers

✔ Did not “stick and move” but let the parent talk on and on nonstop

These same process challenges will also extend to “closing arguments” at the end of the FST Motivational Interview.

There are two action steps to help you deliver the FST Motivational Script with excellence. They are (1) Experientially learn better process delivery and (2) Learn better closing arguments delivery.

Two Action Steps#1 – �Experientially�Learn�Better�Process�Delivery

` Re-watch the “Process vs. Content” segment in this lesson using this worksheet (see Figure 2) 0:36 – 8:55

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• As you re-watch this video case example, there are five key process gold nuggets or strategies that you can immediately replicate in your FST trauma practice using this worksheet as your guide:

1. Being Fully Present

2. Mirror body language

3. Tracking

4. Utilization

5. Reframing

Please Note: Each of these five process nuggets emerged from just Question #1 of your FST Motivational Script: What are some of the difficult experiences that you have had to suffer in the last year as the result of these problems?” [Estimated time of completion = 5 min]

The key is you can reuse these same process steps again and again, regardless of the MI Script question asked. That is the beauty of systems theory. The content or question might change, but the same process strategies can be replicated. For example, it can be a healthy process strategy like “being fully present” or an unhealthy one like a parent “lecturing and nagging” in their process delivery no matter what the issue is.

Five Process Gold Nuggets

#1 – Being Fully Present: 3:22 – 5:25

Figure 2: Process Gold Nuggets from Question #1 in the MI Script

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Dr. Sells: [Question #1 in MI Script] What are some of the top 3 difficulties that you have had to suffer this year or overcome as a parent?

Kesha: Accepting my past and not letting it negatively impact my adulthood as a parent.

Dr. Sells: OK [nodding head in affirmation]

Definition: Fully present means that you are doing or saying the following:

If MI Script Being Delivered in Person (as shown here)

✔ Full eye contact (unless that culture dictates to not look in the eye) – Notice in the video clip, my full eye contact with Kesha.

✔ Mirror voice tone. If the client is soft, you are soft. If they want to get down to business quickly, you get down to business quickly as well. If they want to take a little more time (without allowing them to go on and on- stick and move as needed), you take a little more time as well – Notice in the video clip, my voice tone mirrors Kesha’s, and I was not rushing her because Kesha did not rush. And because of this mirroring, Kesha went on to disclose that she was raped as a young child (her trust level increased).

✔ Accommodation, Curious, and One-Down – You are curious here, your clients are the experts, and you accommodate to what they are saying at this moment WITHOUT offering any direct advice from a one-up expert position but rather a one-down position that seeks clarification. Notice in the video clip, my one-down, curious position that was gentle and not the one-up expert, and this point in the treatment process.

MI Script Delivered on Phone Call (not shown here)

✔ Summarizing – So that your client knows you are present, pause intermittently and ask, “Can we pause a second to see if I hear what I hear you saying? [summarize], Am I close or way off?”

✔ Don’t Multi-Task. Because clients can’t see you, it’s tempting to be doing other things like checking your email while on the phone. Don’t. People, on the other end, can sense when you are multi-tasking and will feel disrespected.

` Being Fully Present

` Yes – Check this box if you saw this process on the video lesson and

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feel that you can replicate it with your client or family.

` No – Check this box if not ready or need further help by emailing us directly at [email protected] or attending the next Facebook Group on Friday.

#2 – Mirror Body Language: 3:59 – 4:20Kesha: I was raped when I was seven and my life has never been the same

since. That was like a pivot point in my life if you will. Another problem is the lack of acceptance. Meaning that I feel different from society.

Dr. Sells: [Body language mirroring Kesha’s]- [Not saying anything but in the moment, in the pain.]

Definition: Mirror Body Language means: From the smallest movement of your hands to the way you stand, mirroring body language is a powerful form of nonverbal communication that most of us express and interpret without thinking twice. ... While body language covers a wide range of human expression, the most crucial aspects are posture, eye contact, and personal space.

If MI Script Being Delivered in Person (as shown here)

✔ Nonverbal Communication (unless that culture dictates not to mirror) – Notice in the video clip that Kesha’s body language is open and so mine. Watch the little arrows I use on the videotape to illustrate this. But it is subtle. Don’t make it too obvious, or your client will be embarrassed like the children’s story: The Emperor Has No Clothes.

Also, verbal communication can be overrated. Kesha needs me at this moment to be with her pain. No comment by me or trying to problem solve at this moment.

When I combine mirror body language with stillness, Kesha feels safe and can open up.

MI Script Delivered on Phone Call (not shown here)

✔ Be in the Moment – If not in person, your client cannot see your body language, but I contend that they can feel or sense it if you are with them. They can hear if your voice inflection has a passion or if you can sense their pain. So be in the moment with them with your voice inflection.

mailto:info%40familytrauma.com?subject=

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` Mirror Body Language

` Yes – Check this box if you saw this process on the video lesson and feel that you can replicate it with your client or family.


#3 – Tracking: 4:50 – 5:05Dr. Sells: Let me see if I am tracking you so far. You had a very traumatic

experience at age seven. And you don’t want that experience to impact your parenting…

Definition: Tracking will be by far one of your most powerful process tools in your arsenal. It happens when you do or say the following:

• You pause the client or family member after they have made a powerful statement and before they jump to the next topic.

• And you make this simple, but powerful tracking statement-question:

Let me pause for a second to see if I am tracking you so far. [then summarize what you heard them say in a brief sound bite]

Am I close or way off? [question that empowers them to agree or correct your tracking]

If MI Script Being Delivered in Person or On the Phone

✔ Tracking – You can use this powerful process tracking question, whether in person or on the phone. It is equally powerful in either context. Notice in the video how I track Kesha after her powerful statement of being raped at seven years old and her desire to not allow the event to impact her parenting negatively. Her verbal “un, huh” lets me know that I was accurate.

` Tracking





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#4 – Utilizing: 5:06 – 6:19Dr. Sells: Let me see if I am tracking you so far. You had a very traumatic

experience at age seven. And you don’t want that experience to impact your parenting. [UTILIZING] And you would like some tools and ways so that you could carry on and pass onto your next generation a life that you didn’t have because of your deep painful experience. Am I close?

Definition: Utilizing means that:

• You take whatever response that your client offers one positive step further to help them get unstuck.

• Your clients often cannot state the next logical step. It is out of their awareness, or they are stuck in their current ways of thinking or doing. Because they are stuck, you must state the next step for them through utilizing.

You can easily connect tracking to utilizing together in one statement. Here’s how:

• Step 1: Your client makes an impactful statement.

• Step 2: Before they go to the next topic, you state, “Let me pause here and see if I am tracking you …Am I close or way off?” [tracking]

• Step 3: “So a great next step might be…[name it]. What do you think?” [utilizing]


✔ Utilizing – You can use this powerful process strategy, whether in person or on the phone. It is equally powerful in either context.

In Kesha’s case, that next logical positive utilizing process step was:

[Tracking] “Let me see if I am tracking you so far. You had a very traumatic experience at age 7. And you don’t want the experience impacting your parenting…”

[Utilizing] “so you want tools and ways so that you could carry on and pass onto your next generation a life that you didn’t have because of your deep painful experience.”

Utilizing occurred above when I stated that the next positive step was:

Kesha needed tools that would directly help her stated higher calling of “breaking the generational trauma that began with being raped at 7-years-old”.

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I then end with “Am I close?” and Kesha said, “yes.”

` Utilizing



#5 – Reframing: 7:17 – 8:12Dr. Sells: The trauma has also impacted how you see yourself. And sometimes,

that explains how you see yourself as different from society. Now that is not necessarily a bad thing or good thing, it just is. But it’s also navigating those waters and how you feel about yourself. Because you don’t feel great about yourself, you can attract unhealthy people.

Kesha: Exactly.

Dr. Sells: Because it’s almost like I do not deserve to be happy. And it’s almost like you go into a room and people can sense that… predators. And how this can then lead to bouts of domestic violence. So, the two are tied together (how you feel about yourself and the abusive men you attract) And a lot of people I speak to don’t have this kind of insight.

Definition: Reframing is:

• A process strategy to help our clients or family member look at the same situation, person, or relationship from a different perspective or meaning. For example, parents might state, “my child is bad” You can then counter with a reframe, “What if instead of bad, his recent behaviors tell us, your child is sad?”

• A new reframe works when the client says or thinks, “I have never thought about it [the problem or situation] this way before.”

• From a new reframe, new solutions and hope to an old and intractable problem suddenly emerge.


✔ Reframing – You can use this powerful process strategy, whether in person or on the phone. It is equally powerful in either context.


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In Kesha’s case, here are the Reframes used:

Reframe #1 – Normalizing – When I say the following:

“The trauma has also impacted how you see yourself. And sometimes, that explains how you see yourself as different from society. Now that is not necessarily a bad thing or good thing it just is.”

Reframe is normalizing or, for Kesha, how to not blame herself for seeing herself as different because the trauma of being raped at 7-years-old would affect anyone’s way of thinking.

In turn, this new reframe or perspective allows Kesha to see hope and change because the trauma does not have to define her in the future as a helpless victim who has to say that way.

Reframe #2 – New Implications or Cause and Effect – When I say the following:

Dr. Sells: Because you don’t feel great about yourself, you can attract unhealthy people.

Kesha: Exactly.

Dr. Sells: Because it’s almost like I do not deserve to be happy. And it’s almost like you go into a room and people can sense that… predators. And how this can then lead to bouts of domestic violence. So, the two are tied together (how you feel about yourself and the abusive men you attract) And a lot of people I speak to don’t have this kind of insight.

This is a new reframe of how the two are tied together: If you feel bad about yourself as a victim, it can attract men who are predators that can eventually lead to domestic violence. In other words, it is a key reframe to help Kesha not to blame herself but see how generational trauma and the cycle of abuse are tied together. In turn, this new insight can help break the cycle in the here and now.

This theme is empowering for Kesha. Before this reframe, Kesha wanted to throw in the towel and even ask child protective services to take her children. She saw herself as a bad mother. However, after the reframe, Kesha felt better about herself and left the session with renewed hope and confidence.

` Reframing


` No – Check this box if not ready or need further help by emailing us

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directly at [email protected] or attending the next Facebook Group on Friday.

#2 – �Experientially�Learn�Better�Process�Delivery ` Read Step 5: The Use of Effective Closing Arguments in your Resource Book –

pgs. 111-113 – It answers the question: How and why are closing arguments so important to your practice?”

Read Pages 111-113 (only three pages long). It will illustrate the process steps of how to seamlessly integrate your client’s answers to the 5-MI Script and bonus question into your needs-benefit statement and call for the next action steps. It’s not how you begin a call but how you end it.

` Re-watch Closing Arguments: Tying it All Together (see Figure 3) 11:26 – 13:14

As you re-watch this video clip, please check each process delivery step below when it happens, to enhance your ability in closing arguments:

` Did I Connect Earlier Answers

Did I take Kesha’s earlier answers to her answers to previous MI questions and highlight them back to her to (a) communicate that I did not just listen but heard what they said and (b) make a clear, logical

Figure 3: Closing Arguments


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on-ramp to next steps in treatment that would specifically benefit this client based on the needs they stated?

` Client Needs and Your Benefits Mesh

Did my stated benefits for the next action steps in treatment connect to what Kesha said she wanted and needed in FST treatment?

` Setting the Terms for Next Session – (a) Who Needs to Attend First Session? (b) Benefits expected; (c) Only One More Step

Did I clearly state the terms for the next session, the benefits expected, and just the next step to not overwhelm the client or family with too much, too fast?

Success MilestonesAfter you complete this worksheet, look for these success milestones to see immediate positive outcomes in your practice.

✔ Knowledge is Empowering – Insight into a new way of seeing how to enhance your trauma treatment is empowering. And seeing the differences between process vs. content is a game-changer. I went over 15 years as a therapist before I ever understood the difference or the positive implications for my practice. So, the first step is to pause and enjoy the insight. When you are practicing, just make mental notes to yourself. Are you doing process right now, content, or both?

✔ Be Intentional, Try Out Just One – As an experiment, purposively try out just one of the following five process delivery strategies:

1. Being Fully Present

2. Mirror body language

3. Tracking

4. Utilization

5. Reframing

And if you like one, try out another and so on.

Experimentation, even if it’s clumsy, can lead to a breakthrough.

But remember this. There is no such thing “as a drive-thru breakthrough.”

So, give yourself permission for these process strategies to initially feel a little awkward or unnatural at first. This is normal!

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But once you get the hand of these, watch the needle move on your effectiveness whether you are a direct therapist, a case manager, or a parent advocate.

This is the gasoline that will make your FST Motivational Script come alive.

✔ Resource Book : Read Pages 111-113- To Become Better At Closing Arguments – These three pages in your Treating the Traumatized Child book will give you the road map of how to end your FST Motivational Script with excellence and clear next action steps for your clients

Big Ideas: Lesson 3 VideoHere is a quick summary of the Big Ideas.

Process�vs.�Content ✔ You saw the important differences between process vs. content in the delivery of

your FST Motivational Script that you can replicate with your practice.

✔ Kesha’s case example will illustrate these concepts, and this worksheet provided the process strategies you need to execute them into your FST trauma practice immediately with success

Closing Arguments ✔ I illustrated how and why closing arguments are so important to your FST

practice.

✔ Kesha’s case example illustrated how to connect the dots to her earlier answers and tie everything together with the next steps.

✔ An important crossroads decision occurred as to whether or not Kesha wanted to give up and let foster care takeover or continue the fight.

Please Note: Materials that are included in this course may include interventions and modalities that are beyond your authorized practice as a mental health professional, case manager or parent support liaison. As a professional, you are responsible for reviewing your scope of practice, including activities that are defined in law as beyond the boundaries of practice in accordance with and in compliance with your professions standards.

Documents

Worksheet - Amazon S3 · Question #1 in the MI Script. 4 Dr. Sells: [Question #1 in MI Script] What are some of the top 3 difficulties that you have had to suffer this year or overcome