Helping our parents to trust in us and the process of NVR when they are down trodden, exhausted and, at times, bitter towards professionals is a central question for practitioners, not just of NVR, but in many therapeutic endeavours. The question of where to start with families in crisis is very much on the agenda and this is a question I have discussed many times in training and supervision contexts and have considered in my own clinical practice with distressed parents. So often, newly qualified NVR practitioners worry about how to start with parents, perhaps feeling rather overwhelmed by the unfamiliarity of the NVR approach and unclear about the process, as well as confused by the multiple stresses and demands of the family and pressured by expectations of their agency.
I think it is always worth slowing down and then just breathe…A good place to start, I think, is to look at the research on common factors in therapeutic outcomes, which delineates the 4 common factors central to all forms of therapy-therapeutic technique, therapeutic relationship, expectancy and placebo, and client factors. (Hubble, Duncan and Miller 1999). The research shows that clients tend to highlight non technical aspects of therapy as significant to them, which is perhaps counter to what most of us who trained long and hard to master complex techniques might wish to hear!
Clients are more likely to experience a connection with therapists who are able to listen, be curious, ask questions and stay optimistic about change, and who cultivate hope and positivity within the conversation as opposed to emphasizing the difficult and intractable nature of the problems. The research shows that the therapeutic relationship contributes a significant 30% to the outcome of therapy and that clients are more likely to form a bond with therapists who are genuine, respectful and empathic. Client factors contribute 40% to treatment outcomes, underlining that it also really matters how the client participates in treatment, what they think of what the therapist is doing, their environment, duration of the problem, ongoing life events and social supports.
The client is the biggest resource and therapists can make a good start with their clients by asking questions which highlight their resources, strengths and competence, by speaking in the clients language and demonstrating a thoughtful appreciation of their situation. By focussing on defining goals for treatment, creating an expectation of change and hope and working collaboratively to define and agree on homework tasks the therapist can create the foundations for change. It may come as a relief to newly trained NVR practitioners that the techniques of NVR, though significant, actually sit within a much larger therapeutic domain, and that they already possess the skills necessary to help their distressed parents develop the trusting bond which will enable them to risk embarking on this new and unfamiliar path, and to try the active methods which are central to the NVR approach.
As Systemic Psychotherapist Barry Mason emphasized in his equation for change model, change = commitment to experiment with difference, plus action, plus time.
I would like to offer encouragement to new NVR practitioners to cultivate genuineness by being open with parents about being freshly trained in NVR; ask permission to make mistakes as this models the inevitability of setbacks and avoids falling prey to the tyranny of perfectionism. Find a mentor in a more experienced practitioner and/or supervisor and keep it simple for yourself and the parents. NVR is simple but not easy, so be kind to yourself, get support from someone who sees your resources and potential and be kind to the parents you work with who may be easily discouraged and self critical.
As Martin Luther King famously said: “Have faith in your clients, have faith in your own ability, be kind, give yourself time and be brave!”
Happy New Year and good luck with your practice of NVR. Your parents need you – and remember this good advice to get you started in utilising NVR more confidently in your work in 2022
Reference: Hubble, M. A., Duncan, B. L., & Miller, S. D. (Eds.). (1999). The heart and soul of change: What works in therapy. American Psychological Association.
By Jill Lubienski, Accredited NVR Practitioner and Supervisor