Mar 8, Narrative therapy, above all, aims to understand problems and their effect on Consulting the problem about the problematic relationship: An. Sep 26, If your sexual relationship problems can't be resolved on your own, Fay recommends consulting a qualified sex therapist to help you both. It is typically easier to advise others how to react in a particular problematic situation This is a main reason individuals seek solutions by consulting others for.
However, screening should be conducted routinely with other presenting adult family members e. Even in the context of individual therapy, it is useful to routinely gather information from the client about the alcohol use of their spouse or other adult family members who are not present to determine whether a family member's drinking may be contributing to the client's problems.
Screening Instruments A number of standardized screening instruments are available to help you quickly identify current and potential alcohol problems. These brief screening tools are designed to identify as many potential cases as possible, while at the same time minimizing false positives.
Screening generally takes less than 5 minutes.
Problem Defining and the Consulting/Intervention Process
Screening questions should be addressed to each adult family member, with collateral reports used when necessary, or in addition to self-reports.
The instruments can be either self-administered, for clients who have sufficient reading ability, or used in a face-to-face structured interview format.
Based on the presenting problem, time constraints, family constellation, and other factors, you will need to determine whether the screening protocol is most effectively delivered in an interview format during the session, or whether it would be more effective to have individual family members complete paper or computer-assisted assessments.
The interview format allows you to probe further and reconcile inconsistencies, but it may not be an efficient use of limited session time — especially when multiple family members need to be assessed. Screening alone does not provide enough information to make either a diagnosis or an informed treatment decision. If an individual or family screens positive, i. Since screening instruments are designed to err on the side of inclusion, i.
Primary goals of the problem assessment are to: Determine whether the drinking is related to the presenting problem — either directly or indirectly. Determine the severity of the alcohol problem, and in some cases, provide a diagnosis. Obtain a detailed picture of the cognitive, affective, and motivational aspects of the drinking behavior.
Determine which of the available treatment options is most appropriate. Guide decision-making related to the treatment plan.
Three essential domains that any alcohol assessment should cover are: Although our overview is limited to a review of assessment strategies and instruments related specifically to alcohol problems, a broader assessment that covers other areas of psychological and interpersonal functioning is recommended prior to clinical intervention.
Clinician skill and preference, as well as client literacy, will determine whether self-report instruments or interviews are selected.
Seven Ways to Problem Solve
Level and Pattern of Alcohol Use Self-reports of the frequency and quantity of recent alcohol use remain the most reliable indicators of alcohol consumption patterns available. However, if the person is intoxicated at the time of assessment or has a severe drinking problem, consumption measures may not be accurate 25 and should be corroborated with other markers of drinking behavior, such as biomedical markers or collateral e.
Standard questions about how much and how often someone drinks yield typical frequency number of days drinkingtypical quantity amount consumedand derived from these, a quantity-frequency index representing the average amount of alcohol consumed in a specified time period.
One advantage of this type of assessment is its brevity. Daily diary records tend to eliminate much of the bias associated with retrospective recall. However, they are often kept during a narrow window of time e. A major strength of diary reporting is that it may be used simultaneously to assess contextual information related to the respondent's drinking occasions e. Prompted Daily Recall and Timeline Methods.
Problem Defining and Consulting | Kilmann Diagnostics
It would also be difficult to distinguish whether new problems arose or whether the initial problems were incorrectly defined if no evaluation were conducted and the organization still sensed the existence of problems following the implemented change program.
Of particular importance concerning the implications of Figure 1 is that most consultants probably enter the consulting process in Step 3 and not during Step 1 or 2. In other words, consultants are often contacted to solve already defined problems.
Basically, they are asked to utilize their expertise to derive solutions for such predefined problems. Perhaps this is why a consultant of a particular specialty was contacted by the organization since it had already been determined what the problem is.
In the latter case, the consultant is brought into the organization in Step 4 to help plan and implement a change program, only because of his or her expertise in implementing just that type of program. The more that the consultant enters into the process shown in Figure 1 at the later steps, the more likely that the organization and the consultant will commit a significant Type III error. It thus seems reasonable to expect that bringing in the consultant in Step 4 implementation is more likely to result in a Type III error than having the consultant enter in Step 3 deriving solutionsif only because the earlier the entry the less commitment and inertia have developed to a particular problem definition.
But the best approach, according to the philosophy and intentions of the processes shown in Figure 1, would be for the consultant to enter in Step 1, while the organization is sensing that something is wrong or at least during Step 2, as efforts or assumptions are being made of the problem definition. This story takes place in a large hotel where the hotel manager began receiving more and more complaints from hotel guests, concerning the long waits for elevators.
Having sensed there was a problem from the many complaintshe contacted an engineering consultant for a solution to the problem. Naturally, the consultant defined the problem implicitly as a technical one, in fact it seemed as though the problem definition was not even an issue, it was simply assumed. The engineer suggested two alternatives for a solution: Both of these involved a very high cost.
As the hotel manager was weighing these alternative solutions, he shared the problem with another person—a consultant with a background in psychology. This person suggested that the problem might be a human one, that the perception of time is subjective and perhaps the guests complain about the wait for elevators because they do not have anything else to do while time passes.
Defining the problem in these terms suggested two solution alternatives: These latter alternative solutions were much cheaper than the first two. Using this anecdote illustrates how a different problem definition human versus technical not only addresses the problem situation quite differently, but does so with entirely different solution alternatives.
Choosing the psychological-type definition or engineering-type definition is an example of a Type III error consideration such as choosing a whole decision treewhereas once a given definition is chosen, the choice of alternative solutions is an example of Type I and II errors such as choosing a branch of the given decision tree. While the rightness or wrongness of the problem definition in this anecdote may come down to money considerations primarily, in other problem solutions the issues might also include morale, public image, ease of implementation, and other intangible yet real consequences of alternative problem definitions.
As shown in Figure 1, however, implementation Step 4 can also fail to achieve desired results. Basically, the members in the organization, for many reasons, may not accept the implemented solution, may resist it, modify it, or even sabotage it.
By not planning for implementation and by not anticipating obstacles, resistances, and forces operating to keep things the same, results in the Type IV error: However, most approaches to planned change actually concentrate on the implementation of solutions, explicitly recognizing and dealing with the various resistances and problems with change. Certainly the assumption behind installing the mirrors and managing the Type III error was that the mirrors would be used while people waited for the elevators.
By ignoring the logistics and psychological factors that affect the use of the solution, a Type IV error is committed. Alternatively, even if the solution of installing more elevators were chosen, it would be important that the new elevators would be experienced as safe, pleasant, and efficient; otherwise, the people in the hotel may prefer to wait for the old elevators—thereby demonstrating a Type IV error on top of a Type III error.
Incidentally, the hotel manager in this anecdote did choose the psychological definition for his problem and actually installed the mirrors. This seemed to solve the problem, since the great volume of initial complaints no longer was evidenced. This also suggests that the mirrors were installed properly during implementation.
It would be nice, for example, to have some well-defined statistic that indicates the correct problem definition of several proposed ones, but this is not the case. Problem definition by its very nature is an ill-defined, complex, and ambiguous problem in its own right, and consequently, only subjective estimates can be made regarding the likelihood of a Type III error.
Given the current state of the art of problem definition methods, the best that can be done is as follows: These guidelines are founded on the philosophy of science, inquiring systems , which examine the alternative ways of inquiring into the nature of human phenomena.
However, d is supported by the literature on participative management , and the need to generate valid information, free choice, and commitment in order to bring about effective problem solving and change efforts . In general, the better that abcand d are conducted and generated, the less likely a Type III error will be committed. In particular, having different groups of individuals develop different problem definitions, having these groups debate across groups their reasons for defining the problem in such different ways, and then having representatives from the groups meet to synthesize the different viewpoints into a single problem definition has proved to be an effective consulting approach .
The synthesis step c is probably the most difficult to achieve, but under the right climate and setting, an effective intergroup resolution of differences can take place . The question then becomes, how should the groups be composed to define, debate, and synthesize the problem definition? As noted under d above, it is important to include all individuals or their representatives who may have expertise in the areas relevant to the sensed problem domain, whose commitment is necessary for any change program to be implemented, and who may be affected by the outcomes of the change program.
Naturally, this would involve individuals throughout a particular department or the entire organization depending on the expected scope of the sensed problemperhaps representatives from certain environmental concerns or clients, and one or more consultants. Once the participants for the problem-defining process are identified, there are still a number of ways of composing the groups.