Monday, January 24, 2011

Assessment: Understanding What's Wrong is the First Step to Making it Better

What can you expect if you come to Grace and Truth for Counseling? Assessment is the first endeavor; we need to discover what's wrong, when it went wrong and how bad things are in order to begin the process of helping you to make things better. We also ask what's right, but that's a topic for another blog.

  • What's wrong? 
  • How did you decide to seek counseling?
  • What would you like to get better? 
  • What will we talk about in our last session if you get everything you want from this process? 
  • What results from counseling will help be worth the time, effort and finances you invest in it?
  • If a miracle happens tonight that solves all of your problems, what will be better tomorrow?
  • On a scale of 1-10, how would you rate your life right now?  Explain your answer.
  • If you answer is a (2, 4, 6, etc.) share what is happening that you are glad about and what isn't happening that you would like to begin happening or happen more?
  • Symptoms are things you experience. and signs are what others see.  What are the most difficult symptoms you are experiencing?  What signs of problems are others concerned about?
  • When did the problem(s) begin? What was happening in your life at that time? 
  • What have you done to try to solve your problems? What has worked? What hasn't? 
  • Who has been most helpful to you? How did they help? 
  • If you could solve only one problem through counseling, what would it be? 
  • The main contributors to the beginning and continuation of mental and emotional difficulties are the body, the mind and relationships. 
    • We refer to this as the bio-psycho-social model
      • Bio is of the body and includes how your body works, physical predisposition to mood disorders, anxiety, addictions, etc. In other words, your family history.  How do others bodies work in your family.  If there is proneness to mental and/or emotional disorders, what shows up in your family tree?
      • Psycho is of the mind; what you think about and how you think about it and how those thoughts affect your emotions.
      • Social is your relationships. What is happening and what has happened in your closest and most influential relationships?  What is happening now? Are your relationships overall a source of stress or a blessing? 
        • Which area seems to be most responsible for the difficulties you are having? 
        • What is happening in each area that could contribute to your difficulties? 
This was pretty quick and pretty simple, but hopefully you will find it helpful to reflect on these questions before you come for your first appointment.  Our experience is that together we will solve the mystery of why problems are problems and how to make them better.

More next time on treatment collaborative treatment planning; how together we can efficiently resolve problems and some of the activities outside of session that are helpful in this process.


Jeff Williams

Thursday, January 20, 2011

Why Leadership Coaching Might Frustrate You (and ulitimately benefit you)

Recently,  a coaching client asked my opinion about some decisions they are facing.  While part of me wanted to give my opinion, I knew I couldn't because I was wearing my Leadership Coaching hat which requires honoring the fact that this gentleman is responsible to steward his own life and that giving advise would cheat him of the opportunity to build his own decision-making muscles.  Thus, I launched into the following reminder about the uniqueness of coaching, and why it might sometimes be frustrating.  The re-orientation I wrote to him is below.

Coaching might frustrate you because I might often answer questions with questions.  The reason for this is the uniqueness of Leadership Coaching which is “The discipline of believing in people that engages where they are motivated to grow, change or to accomplish goals, that keeps them responsible for the process.” 

Not only do I not have a right to tell you what I think you should do, I also don’t know.  Seriously.  I believe more in your ability to hear God than my ability to hear for you.  Plus, a core value in Christian Leadership Coaching is “Own Life Responsibility”.  If I tell you what I think you should do then I usurp your right to steward your life.  Does this make sense? 

The furthest I should ever go as a coach is to share what I have done or would do in a set of circumstances, but that only after you have exhausted your own analysis of options for a decision, and only if you ask for it or give me permission to share. After all, part of the reason you’ve chosen me as a coach is because I do have a background of unique life and professional experiences.  I won’t cheat you of perspective or learning from those experiences, but I won’t lead with it.  Focus on your life, your perspective and your goals and action-strategies will ultimately build you as a better leader of your own life rather than cloning you after me. 

Sometimes business executives (and ministry leaders/executives) become frustrated with the coach approach because they are used to hierarchical command and control from bosses/supervisors, or receiving advice from consultants.  Coaching takes more time because the leader is the one doing the hard work of critical thinking and reflection.  I’ve had more than one coaching client become exasperated and say, “Just tell me what to do!”  If I did it would be akin to taking the wheel out of the hand of a student driver, or taking the hammer away from an apprentice carpenter.  The leader who is learning to lead more effectively (in all domains of their life) needs to be the one to rack their brain for phrasing of goals, to generate action-steps and to trouble-shoot challenges.  It’s like weight-lifting; the athlete doesn’t become stronger if the coach lifts the weight. 

I’ve also heard from more than one leadership team that I’ve trained in coaching that they don’t have time to coach their employees or volunteers because it would do one or both of the following:

  1. Change the culture from hierarchical command and control which could reduce their value as a decision-maker and supervisor.
  2. Take too much time which could hinder the bottom line of the company or ministry in the short-run, (e.g., “It’s quicker and safer to tell people what to do, especially when quotas are at stake.”)
 Both of these are true!  Integration of a coach approach into one's life or organization CHANGES EVERYTHING!  People listen with heart and skill, share more transparently, envision ideal future outcomes, collaborate in problem-solving and much much more.  What could be bad about all of that?  Well, that's a topic for another blog, but let's leave it at this.  Change is challenging.  New ways of thinking and relating might ultimately be good, but making changes comes with a price; namely, time, energy, and grief about a way of being that is no longer.

Now, this isn’t all there is to be said about the uniqueness of coaching, but it’s a fair introduction to what you can expect if you hire a Christian Leadership Coach.  Oh, and by the way.  Give it a fair shot.  A minimum trial of seven sixty minute sessions over a period of three months is a reasonable span of life to sample the unique potency of this approach to building you as a better leader of your life.

God bless, Jeff

Sunday, January 2, 2011

A Recipe for Wellness

Clients come for counseling to talk about what's wrong.  It really throws them when I ask, "What's right?  What's going well in your life that you wouldn't want the counseling process to change?"

It's one thing to assess and diagnose problems.  Understanding of what the problems are and how they became problems is a necessary first step in the treatment process.  But things only get better when solutions to the problems are discovered and applied.  It's what I call "A Recipe for Wellness" 

Think about the essential ingredients for your favorite recipe.  Perhaps it's pizza, or lasagna, apple pie or homemade ice cream (am I having some cravings?).  There are very specific ingredients in very specific quantities, combined in order through a process that will render a tasty product...if you follow the recipe.  The counseling process can work in a similar way, though it might take a bit longer than preparing your favorite meal.

Research has demonstrated that there are three basic categories of variables that can cause, sustain and potentially cure mental and emotional disorders: 1. Biological (the physical component), 2. Psychological (what you think about and how you think about things), and 3. Social (relationships).

Biological includes genetic heritage, illness or enduring conditions.  Predisposition to mood disorders, anxiety, addictions are real.  But one's genetics isn't destiny.  Our biological blueprint isn't always what will be seen in reality because other variables are powerful enough to produce different results.

Psychological includes our characteristic way of thinking about ourselves, others and the world in general.  It is shaped by a variety of factors including formative relationships (with parents, siblings and other influential family members), life experiences (losses, traumas and successes).  Cognitive Behavioral treatment approaches target this area by altering what we think about and HOW we think about things.  Such changes result in changes in emotions and perspective.

Social is our relationships.  Are they life-giving or stressful: a source of pain or pleasure; helpful or harmful?  How do the most important people in our lives view us? 

This is a quick over-simplification of the basic categories of life that contribute to overall mental health (or can erode it). Why have I written about this?  Grace and Truth values a collaborative relationship with our clients.  The more you understand about how we think, the more you will be prepared to participate in the process, and the quicker you will get the results that you want.  And whether you get counseling at Grace and Truth or elsewhere, you can begin now to identify the factors that contribute to or detract from your mental and emotional health.

Let me give a quick illustration about how this works in diagnosis and treatment planning:

A 40 year old woman* comes complaining of episodes of tightness in her chest, shortness of breath, perspiration, racing heartbeat.  These began after a particularly stressful season at work where she is responsible to produce a quota of time-sensitive reviews of client applications.  She grew up with parents who didn't have a very happy marriage, and who talked out loud about their unhappiness with each other and their children.  Admittedly, she has never felt very good about herself.  To top it all off, her best friend recently began acting squirrely, like something is wrong between them, but won't tell her what it is.  Her husband might be having an affair, and her once obedient children have hit the teen years and their personalities have changed.  They are not as pleasant as they used to be. And she feels like her relationship with God is strained.

What's wrong?
  • Panic disorder (anxiety symptoms) or heart problems?
  • Negative self-worth and self-image based on how she thinks about herself?
  • Grief and loss in significant relationships? 
Again, this is over-simplification, to make a point.  It is clear that there are plenty of factors in the bio-psycho-social model to produce a painful experience.  After a thorough assessment of all of the contributing variables (ingredients) is completed, it is possible to begin working cooperatively with this client to make adjustments.  A medical physical would be in order to rule out other physical factors producing or mimicking the anxiety symptoms.  If panic disorder, medication might be indicated.  A clear understanding about how she thinks about herself and others (self-talk) would be needed before adjustments could be recommended.  And boundaries and other decisions about how to handle relationships would be part of the therapy.

I'm sure you get this breakdown of factors intuitively.  When things go awry in life most of us "assess" what it wrong and why it is wrong.  I just wanted to give you and model to break down your understanding of the key areas that counselors are looking at in assessment.

We see good outcomes at Grace and Truth when clients fully engage the assessment and treatment process.  We help this along by providing education about variables that contribute to and erode mental and emotional health, and then ask our clients to examine their lives and share with us about the balance of these factors in their life.  The overall goal is to reduce or eliminate the ingredients of pain and displeasure, and to increase the ones that contribute to a sense of physical, emotional and relational well-being.  It's a process of identifying and combining ingredients, just like a recipe.

We hope this helps.  If you or someone you love could use some help to sort this out, please call. We'd love to try to be helpful.


Jeff Williams
Professional Clinical Counselor - Supervising Counselor
State of Ohio, #E-3098
*This is a fictional scenario.  Any resemblance to any person living or dead is entirely coincidental.