Dr. Scott Sells, PhD, LCSW, LMFT is my interview guest for this post. He is the founder of the Family Systems Trauma Model, and the Family Trauma Institute, as well as the author of three books on methods for treating families and children, within the context of family therapy.
By watching this video, or reading the transcript, you will learn:
A working definition of the term traumatized family
Three essential steps you may be missing in your clinical work with families.
One thing you can do right now to improve engagement and outcomes with your family clients.
How to learn more techniques that will revive your family therapy work.
Introduction
Ili: Today, I have Dr. Scott Sells with me. He is the founder of the Family Systems Trauma Model, and most recently, the author of Treating the Traumatized Child.
Hey, Scott! Thanks for being with us.
Scott: Hey. How are you? I'm so appreciative for letting me come and chat with your community, your tribe, your village, today.
What is a “Traumatized Family?”
Ili: So, yeah. I'm really excited for them to learn more about your work. As you know, I was introduced to your writing when I, myself, was completing my master's program. And, that was your—was it your first book, Treating the Tough Adolescent?
Scott: Treating the Tough Adolescent, yeah.
What is a “traumatized family?”
Ili: Yeah. And so now we get to talk about this fully developed model, which i'm excited about. So first, could we start with the basics? I'd like you to share more about what you mean by the term “traumatized family.”
Scott: That's a great question right off the bat, because it's oftentimes not understood clearly. So, for me, right out of graduate school, I was really focused on the individual, client-centered model. That when a child had a symptom, I would work with the child. In fact, I even went way back to the beginning of just doing play therapy; very non-directive.
And so, what happened would be is, I got more and more interested in the kids that had symptoms of Oppositional Defiant, Conduct Disorder, because I myself was like that when I was a kid. And so, the traumatized family became that there was a dance going on between the parents and child. And, I'll never forget Salvador Minuchin, who started Structural Family Therapy, would ask the systemic question of the year, “How do you help your child misbehave?”
You know, so I started seeing, in my first job which was at an alternative school, that I really love cognitive behavioral therapy, and my work integrates that using anger management tools for the kiddos. But, then, when they would go home for the summer, I'd almost have to start all over again, because I saw the family as the whole is greater than the sum of the parts. And so, necessity requires change.
And so, I went back to graduate school, so I could learn high level family therapy, because it scared me to death. But I knew I had to do it if I was going to create second order change in the kids and families—where the change stuck after I was done. So that's, to me, the traumatized family, or the family is the influence the interaction between parent and child that occurs in families like a living breathing organism.
What steps do therapists often miss when working with families?
Ili: Thank you. What are the steps that therapists and counselors often miss when they're working with these families?
Scott: I think there's three:
1 | The first one is how treatment starts.
It's often a harsh startup. So, what we found is—my research is grounded theory, which means that I go to the actual clients and get their help to build the model (which is called the Family Systems Trauma Model). And, they told me that the first phone call was abysmal. Where, the idea is “people don't care how much you know until they know how much you care.”
And so, the traditional motivational interviewing was very non-directive. So, we came up with a seven question script that starts off with questions like: “If we get to know you better, what qualities would we come to admire about you?”
Parents weren't expecting that, because the tradition was parents just come in and say, “Fix my kid.” They won't engage. But, when we looked at it—even John Gottman's work is really cutting edge around how we start a relationship off—soft startup versus harsh startup. So, we developed these questions that prepare a family to come in in a soft, ready to change way. And it's amazing. For therapy to end properly, it must begin properly.
2 | Get the family engaged immediately, with actual scripts
Secondly is, we have to have a way to get the family engaged right out of the gate. So, when families come in, they're very emotionally charged up. And so, if you ask that traditional question: Why are you here? What's the goal?, metaphorically, we'd see families, like, even emotionally throw up on each other. They immediately attacked the kid, they'd attack each other, and you'd lose control of the session in 3.5 seconds. So, having the family come in soft with the motivational phone call.
And then using a technique called the FST (Family Systems Trauma) Stress Chart, allows families to look up on the board and say, “On a scale of zero to 100 percent, how stressed out are you right now with your child?” And people are able to look at the board, “I'm 90 percent stressed, a hundred percent stressed.” So, it empowers everybody's voice to look up on the board and put a mark.
And then, it helps the therapist to say, “Okay. You said 100 percent stress, Mom. Let's break it down into the top three.” So, the second tool that's missing is actual scripts for somebody who's never done family therapy, or even seasoned therapists to have a systematic, directive approach that settles the family down, and moves them to see the problem not as a kid problem, but a family solution.
Ili: That’s key.
Scott: Yeah.
3 | Offer organized, written steps, and have the family practice
And then the third thing, yeah, and the third thing is: The family now goes to “Now what? Now that you've helped us see what's driving it, now what?” And so, another technique is called an FST Playbook, and this comes from Haley's work with Strategic Family Therapy. He would self-design directives, or techniques, to change the dance. And so one of them might be the parent and child are engaged in an all-out conflict of a lack of attachment, or nurturance. So, you have to give the parent and child an antibiotic, which we call positive child report. Where the family catches their child doing something right, and hands the child a certificate. And, it's not the intervention, it's the organized step-by-step written dance move.
And then the third: You've gotta then also have role plays, dress rehearsals. You can't expect a family to dance differently without a clear playbook and a clear coach. We don't do this in the acting world, so why would we do it in the real world? And so, those are tools that are missing from families, our family work, that we saw.
Ili: Yeah. So one of the things that your model really does is explains things in a step-by-step fashion and gives tools for each step.
Scott: Yeah. Even the transition sentences. Because somebody once said to me: In order to be spontaneous, I mean, I need to be structured first. And what that simply means is “paint the fence, sand the fence.”
Ili: Yes, yes, I think that's true in every craft, skill, uh, what have you.
One thing you can do right now to improve your work with families
So, you likely already answered this, because you just gave, you know, several things that therapists can begin doing. But, as I was, you know, putting questions together for speaking with you, one of the things that I was wondering, you know: Is there one thing that therapists can do, maybe something simple, beginning today, you know, those that are watching this video, in order to either improve engagement or improve their outcomes with families? Because, I think, like you, there are many family therapists and MFTs that don't see families, because there could be a fear there. Is there even just one thing they could begin to do now that would dissipate that fear, or improve their engagement, or their outcomes.
Scott: Yeah. I think confidence rises with success. And so, I tried to make it really easy.
Obviously, people can order the book off Amazon, Treating the Traumatized Child. But that, today, when we're so drowning in information, it's really hard to sit down and read a 365 single spaced book. But some people like that, you know.
But for me, the most dynamic way to learn is to see it. And so, if you go to familytrauma.com, there'll be short articles on some of these techniques, like the motivational phone call, that has the script, and you can begin immediately.
And then, the thing I'm most excited about is: I put my sweat and toil into designing an online self-paced 12 module course, because I saw people love to see video clips of the techniques with real families, with worksheets, and then apply it immediately. And, I was skeptical about it at first, but we've had a lot of graduates, and they're like, “That's been the game changer! It's bite-sized. I can consume it easy, and I get quick results, and I'm part of a community.” Because, I have office hours every Friday, and Iget to have the benefit to be like a family systems trauma coach. And, I love that! Absolutely love it.
Ili: And, through this course then therapists are able to learn your model and these techniques that you're referring to?
Scott: Yeah. They're broken up—12 modules, 12 core techniques. So, if they want to learn the motivational phone call, they go to module 2, they watch the video—it's 20 minutes, they click on to get their CE unit certificate, and then they have a worksheet, they see it being done with a real case, and then they're ready to go immediately.
And, if they get stuck, they come on Fridays, either on demand or live, and say, “Scott, I tried the technique, and the family threw me a curveball. Now what?” And so then, they get part of a community of other students who are also there to help each other out. And so, it becomes a transformational catalyst to create a family trauma community of counselors who work together. And I get to be, you know, the facilitator of that. So, it's really fun for me.
Ili: Well, that's wonderful. Thank you so much for sharing more about that--about your work and about this upcoming course.
Is there anything else that you'd like to add that I didn't ask?
Scott: I just want to thank you guys for what you do. I mean, family therapy is on the endangered species list. Uh, Jay Haley, who's the founder of Strategic Family Therapy, before he died, said that family therapy had so much promise in the 80s. We oftentimes didn't have the research that we needed behind it; it was kind of like a rock star status type of thing. But, I think today, as we prepare for rain, and it's already coming, that we're going to see more and more traumatized families and communities that are going to need a systems approach.
And even the idea of COVID, the idea of social distancing—human beings have to have that contact, and right now, it's broken. So, our role of bringing this together, family therapy, has never been needed more than today. And so, I appreciate your group to come together and further [the work]. And if I can play one small part, I'm glad to do that.
So, I was looking forward to today, to talk and give you guys encouragement, because this is not easy work. But, nothing good comes easy. But, if you don't do it, who will? And so, I just, I'm really worried for our families, but I'm also hopeful, because I think we have an army of people who are starting to learn this approach. So, thank you.
Ili: Ah. Perfectly said and inspiring as always, Scott. Thank you so much for your time today.
Scott: Thank you. Have a great day everybody!
For more on the Family Systems Trauma (FST) Model:
Visit FamilyTrauma.com for free articles
Take a look at the FST Advanced Training course.
*Affiliate Disclosure: Amazon affiliate links are used throughout this post to recommended books. If you choose to use our links to purchase a book, Family Therapy Basics will earn a small percentage of your purchase, which goes toward supporting the free resources offered on this site. I appreciate your support, whether by purchasing, reading, or sharing!
*I only feature clinical experts whose work I believe is valuable and transformational for therapists. Please contact me with any questions.
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Feeling confident when offering therapy to families is a goal for many therapists and counselors. When we face the limitations of an individual perspective on treatment, we are left to wonder, “What theory, or techniques, can help this client comprehensively?”
Dr. Scott Sells explains two techniques from the Family Systems Trauma Model (FST) that will reframe family problems and help lead to second-order change. FST is applicable to your work whether you see individuals, couples, or families.