Step 5: Post-Team Metalogue (or Reflection) about Family Reaction, and Intervention Construction

During this step, the supervisor lowers the imaginary “invisible wall,” thanks the family for coming in, and the team and supervisor leave the therapy room. The team and supervisor return to the observation room, and the lead therapist then asks each family member what they noticed from the team’s comments. The therapist uses the information from the family’s reaction to the team’s comments to construct a final message to the family and interventions to take home. The therapist then leaves the family in the therapy room and returns to the observation room. Step 5 usually takes about 15 minutes.

Step 6: Appreciative Inquiry Interview with Family

At the beginning of Step 6, the supervisor returns to the therapy room to ask the family a few questions about their experience with the therapist. The following is a typical explanation provided by the supervisor to the family:

If you don’t mind, I would like to take a few minutes to ask you a few questions about your experience with your therapist. These questions don’t have anything to do with your case, but are focused on feedback you have for your therapist. I am your therapist’s supervisor, and we are always working on improving things so we can provide our clients the best service possible. With this in mind, your feedback is very important to us. Your therapist is observing our conversation from the observation room, and I’m sure will be very interested in your thoughts. Is it OK with you that I begin?

The three questions asked of the family focus on what they appreciate, and include:

  • 1. What are characteristics of your therapist that you appreciate?
  • 2. What are the things that your therapist did that helped with your problem?
  • 3. What advice would you give your therapist?

This approach is modified from Cooperrider and Srivastva’s (1987) work on “appreciative inquiry” (AI). Instead of criticism and problem solving, it is a strengths-based and positively focused way to gather feedback and promote meaningful change. This part of the interview helps the family to see themselves not only as people with a problem seeking help from “experts,” but also as people who are experts themselves in helping the therapist and the team become better in their work. The fact that the therapist’s supervisor is the one conducting the AI interview reflects a hierarchy that fits with Chinese culture. Chinese culture tends to revere teachers as holding a special place in society. As opposed to typical Western values, Chinese cultural values tend to have a more established and clearly delineated hierarchical structure regarding these roles. We find it useful and demystifying for the clients to see this hierarchical structure by meeting with the supervisor in this way. Also, the Al discussion with the supervisor encourages the second-order type thinking we described in the metalogue discussion of Step 4 (e.g., asking the clients to think about how the therapy is going, versus the content of the therapy itself). At the conclusion of the interview the clients are thanked for their feedback and depart the therapy offices.

It is possible for families to return, but we have not had that happen yet. The therapists choose which family to bring. The therapists brief the family on what to expect. They describe it as a one-time consultation opportunity. The team method and setup are explained and consent gained before the session. We encourage the therapists to follow up with the families with regard to the outcome of the SSTFT.

Step 7: Post-Session Supervisory Discussion with the Lead Therapist and the Team

During this final step, the supervisor returns to the observation room to discuss the clients’ feedback about the lead therapist, the lead therapist’s thoughts about the session, and any final supervisory feedback to the lead therapist and the team. The advice the family provides to the therapist is usually productive, and often involves encouragement from the family for the therapist to push them more or take more direct action in their interventions. This step usually takes about 15 minutes.

 
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