2.4 From Contact to Contract: Initial Interactions
Independent of how the exploratory phase is constructed, there will always be an initial contact. We suggest using a set of guidelines for such conversations. Talk-ing about initial interviews or introductory phases at the beginnTalk-ing of a scientific paper or a systemic training can be a problem: The initial interview and the in-troductory phase comprise everything that is particular to systemic therapy – its approach to interventions, its points of view, its inner attitudes. Yet all that has to be first acquired. Thus, the following represents a sort of overview for the new student of the systemic approach – to be fleshed out with the later contents of Chapter 5.
2.4.1 Structure and Possible Questions
The initial contact with a client or a client system may be broken down into the following phases:
a) Joining, warm-up, introduction of the counselor and the counselor’s organiza-tion;
b) Discussion of the referral and the nature of the concern;
c) Exploration of the client’s resources, problem and possible solution(s);
d) Arranging a contract;
e) Evaluation of the initial contact.
These guidelines and suggestions are meant to help frame the initial contact and then to expand it by introducing systemic elements. We do not think it is expedi-ent to employ all of the possible questioning methods during the initial contact.
Rather, one can pick and choose areas to be included (and/or excluded) in accor-dance with one’s own intuitive hypotheses. Depending on the setting, some phas-es and approachphas-es may be spread out over several sphas-essions or even longer. Or it may be better to set up separate initial contacts with the different members of the system.
We sometimes speak of “clients” and sometimes of “client systems” because the guidelines we use in our contacts with individual clients have also proved useful for client systems (families, groups, teams).
2.4.2 Joining: Warm-up, Becoming Acquainted and Introduction Joining means establishing a contact, connecting, getting to know someone in their present situation. We attempt to create an atmosphere that allows everyone to become acquainted with each other; we also try to find the optimal way to approach the client.
A suggestion: The first step is to engage more or less in small talk – then one can proceed to talk about more personal matters and ask questions that will further the process of mutually getting to know one another. Mutual, in this context, means: Not only do we want to become acquainted with the client system, the client should also learn something about our own personal and institutional background.
The goals and importance of joining:
– The clients can slowly get used to the counseling situation – sometimes the mind adapts more slowly than the body. They can orient themselves to the room, the counselor and the entire surroundings.
– The counselor takes on the active role of host and shapes the atmosphere and the conversation.
– The counselor attunes him- or herself to the clients, listens to them speak, ob-serves their nonverbal behavior, where they sit and how they sit, how they artic-ulate themselves, the words they use. In this way we can adapt to the client’s style (pacing) in order to conduct the conversation (leading).
– From a professional point of view we must remember that we are dealing here with the initial meeting of very different human beings. Once we have struck up a conversation with a stranger in a new situation, it is easier to extend the contact.
– We keep the threshold low for the various family members to establish contact so that we can gain contact with everyone present.
– The clients need not present themselves as somehow “problematic,” but may be seen by others as capable people with their own resources and skills.
– The conscious inclusion of children shows everyone present that children and their points of view are welcome.
Examples:
– The counselor takes a few minutes for small talk and then proceeds to shape the situation: “How was your trip? Was it difficult to find the place? Did it cause a lot of trouble for all of you to come today?” The counselor then provides some own personal information.
– The clients are not identical with their problems. Clients have jobs, they like sports, they have hobbies and other resources we should know about. Everyone, even the children, should be asked about the positive aspects of their life, daily routines, interests and opinions. The best topics to choose are those that provide pleasure.
– Directed toward the parents: “What do you do for a living? How does that work out for you? What do you do for fun? Who takes care of the children in the afternoon? How do you like your neighborhood? What do you do in your spare time? What hobbies do the other family members have? Where do you go on vacation?”
– Directed toward the children: “What do you like to do in the afternoon? What is your favorite subject in school? Do you participate in sports? Where? How does that work out for you? Do you have a lot of friends? Do you enjoy going to (nursery) school? What’s your favorite game? Who’s your best friend?”
A short introduction of the counselor and the counselor’s institution is useful to acquaint the clients with one’s work and methods. Clients tend not to ask about these matters on their own. The counselor can tell the clients
– where they are presently situated;
– how the institution functions, what its goals are and what role the counselor plays in the organization, how it is connected with other institutions, how pro-fessional discretion works, and how the counselor goes about the task at hand;
– what laws and stipulations affect the counselor’s work, the legal and ethical background, when the counselor is required to transfer information and how that is then communicated to the clients;
– who pays for the counseling and why.
2.4.3 The Referral to Counseling, Clarifying the Contracts and Concerns
One prerequisite for concluding a contract with the client system is determining the mandates. These can be differentiated as follows:
– the expectations for the initial interview,
– the expectations of the person doing the referring,
– the expectations of those present in the room for the assistance they will receive.
The latter two points will likely have to be revisited at the end of the initial inter-view when the counselor and the client/client system make up a contract. The extent to which one can already discuss such mandates at this point depends greatly on the client system. Some clients are under great pressure to report as quickly as possible about what is bothering them – to get to the “real” problem at hand. If you notice this pressure building up, don’t adhere too closely to system-atic procedures, but put them off for later discussion. The clients should above all have the feeling that they are being taken seriously.
At this point in time it is important to provide a stimulus and to make sugges-tions about how expectasugges-tions and mandates can be formulated. Of course, diffi-cult constellations sometimes crop up: expectations that cannot be fulfilled, con-tradictory or hidden expectations, systems in which everyone wants something different. In Chapter 4.1.3 we discuss in more detail the various possible man-dates and present solutions for dealing with them.
Example questions for determining the expectations of those present for the initial interview:
– How long were you expecting the meeting would last?
– What are your expectations for today’s meeting? How would you know at the end that your expectations had been met? (Ask the client for a concrete description!) – What in your opinion should definitely not happen today?
– What are you expecting of me as counselor from our first meeting?
The counselor should also express how he or she imagines the initial contact would occur (time and organization) and what needs to be discussed concerning the respective goals.
Important points to be included in agreements between the client and the counselor concerning the initial interview:
– How long should the conversation last? Who should learn about its contents?
– How far should the client and counselor go in their first meeting and when should they pull back?
– What is the counselor responsible for in the first meeting? What role should the counselor assume (or not)?
– What should be reached in the end (or not)?
The context of the referral and the mandate
The situation surrounding the mandate can be very complex since, in addition to the persons present at the sessions, others – individuals as well as institutions and functionaries – harbor their own interests and expectations.
Case example: A problem arises in the office of the company president: Three part-time employees share a position in the office. There is no clear hierarchy among the three, which leads to conflict. They can’t work together (forward information, coordinate the filing and ordering of documents, take care of daily business), yet no one wants to assume the overall responsibility – and none of the three is accepted by the others for that position. By now, the president is rather unnerved by all this and wants to clear up the matter in a few joint counseling sessions, so that peace and quiet can rule again. The goal is for everything to run smoothly again on its own. Above all the president wants one of the three (the one she finds most suitable for the job) to be accepted as coordinator.
Case example: A juvenile magistrate orders a youth to receive 10 hours of counseling and requests a report should the youth fail to fulfill the court order.
Case example: A child therapist refers a family to family counseling because she sees major problems between the parents and considers the father’s parenting methods to be inappro-priate and destructive. She expects of the counselor in the family counseling center to try to get the father to adopt another parenting style. The mother likes the support of the therapist and has the same expectation of the counselor. The father is uncertain about why he should even go to counseling, but in the end he comes along.
Case example: A company director sends his department managers to supervision counsel-ing because he has noticed deficits in the company’s personnel management and thinks cooperation between the various managers could be improved. The managers themselves would also like to receive some feedback because they, in turn, see problems in the mana-gerial style of their boss. Everyone quickly reaches a consensus that such counseling is sensible and appropriate, without discussing the exact contents and goals of such a step.
The person doing the referrals and other persons in the client system play a major role without even being present at the sessions. These examples show how impor-tant it is to determine the parameters:
– Who made the referral, who suggested, sent, forced, convinced or otherwise motivated the client to go to counseling?
– What are the expectations of those doing the referring for how the counseling sessions should be carried out? What do the clients actually know about these motives and what do they presume?
– What are the expectations of those doing the referring for the results of counsel-ing? What do the clients actually know about these motives and what do they presume?
– How much pressure (and what type) is being applied by the referrer on the client to accept the help being offered?
– What would happen if the client failed to come to the counseling sessions? What would happen if the client were to terminate counseling prematurely?
– How high is the motivation of the client to attend counseling?
– Why did the person doing the referring suggest this particular counselor and what do the clients know or presume about these motives?
The information we gather from the answers to these questions will help us to a) understand the problems and pitfalls of the contractual situation,
b) form hypotheses in light of the referral context,
c) draw up a contract with the clients which is realistic and viable.
Particular attention must be paid to clients who have been “sent” by someone else and whose inherent motivation may lag behind that of their referrer (for more on this point see Chapter 4.1.5).
Determining the client’s mandates
Here, we discuss how to determine the concerns of those present:
– What are the clients concerned about? What do they think should come out at the end of counseling? How do they envision the cooperation during counsel-ing?
– What should the helper contribute to the process? How should what sort of support be given?
– What should the counselor refrain from doing – and not do under any circum-stances – during the sessions? What subjects are to be avoided altogether?
– What is the client willing to do? What is the client completely unwilling to do?
– How much help should be given? What, for the client, is a reasonable timeframe for reaching a solution? How long, how often, for how long and with what frequency should sessions be held?
– What else is important to the client (e.g., information policy)?
The answers to these questions should be given by each individual client so that differences in the expectations for counseling become clear to all. We recommend not posing the questions directly, but circularly (cf. Chapter 5.3):
Case example: “If I were to ask your husband what he expects from counseling, what do you think he would answer?”
Case example: “What do you think your wife is expecting from me as counselor? What would I have to do so that she’s happy with my work? From the vantage point of your wife, what should I avoid doing at all costs?”
One can also size up the expectations and mandates of the clients using the mir-acle question (see the example in Chapter 5.3.2).
Mandates Change
The therapist should take the client’s mandate seriously at the beginning of coun-seling and express interest in its realization. Yet one must also remain open to modifications of mandates and reckon with the fact that not all mandates will actually be expressed at the beginning and some may never be put into words because the client is unable to. The way both the client and the counselor view things will necessarily change in the course of the intervention; some matters will become clear(er) as part of the process. As the saying goes, when the tip of the iceberg melts, the first part you see is what was below the waterline. It is not our duty to speculate at the beginning of therapy about what aspects of a possible major problem may or may not be visible. Rather, we must assume that new aspects, questions and themes will become visible on their own as clients formu-late their concerns and turn them into new mandates for future sessions.
For this process we need the following:
– Time during the course of counseling both for ourselves and for the client system to understand everything that is part of the problem,
– A willingness to say goodbye to the myth that one can determine the whole breadth of the problem from the very beginning if one is only thorough enough, – Trust in the process of concerted efforts, which allows us to realize that
“under-standing follows action.”
2.4.4 Exploring Problems and Resources
We have now reached the focal point of systemic work. All of the questions we now deal with, in fact, already comprise interventions. For that reason, we pre-sent them again in Chapter 5 together with examples. In Chapter 5.3.3 we discuss the various questioning methods used in the initial interview to explore problems and resources. Depending on the information available in advance, the counselor should decide in which direction questioning should go. In our opinion six vari-ations are appropriate for the initial interview (see also Chapter 5.3.2):
– Clearly defining the problem and the persons involved, – The dance around the symptom,
– The past: history of a problem,
– Exploring previous attempts at problem-solving,
– Differences in explanations for the problem and desirable solutions, – Questions for determining the system’s resources.
2.4.5 A Contract for Continued Cooperation
One of the main goals of the exploration phase or the initial interview is to sign a contract with the client (system) concerning the assistance to be given by the counselor. In such a contract the parties agree to what constitutes such assistance, what goals are to be pursued, and how long and under what conditions the co-operation should take place. Chapter 4.1 shows in greater detail what is included in such a contract, what it can mean to the further relationship with the client and the role such a contract plays within systemic therapy.
The basis for any such agreement is, first, that the mandates of those doing the referring and of the client have been thoroughly examined with respect to the assistance to be offered. Second, the counselor must have reached an opinion regarding what he can and will offer. Also, the counselor should have developed a first impression and have drafted some hypotheses about the client system in order to make an offer and to reach an agreement with the client. There’s nothing wrong with suggesting two or three sessions for further explorative purposes be-fore reaching a consensus about the full extent of the contract. Client systems, referrals and client histories can in fact be very complex and large. It is better to first gain some perspective – to sleep on it and maybe discuss it with a colleague – before agreeing with the client on a particular setting, on goals and on one’s own personal and professional efforts on their behalf.
Once the mandates of those present and not present – i.e., the clients and those doing the referring – as well as one’s own perspective on the case have been cleared up, the contract can be drawn up. It is helpful to write a short summary of all previous results:
– A short summary of the exploration of the problem at hand,
– A short summary of the expectations of the client and of those referring, – One’s own assessment of what constitutes a meaningful offer of assistance for
the client to solve the problem (setting; length, number and type of sessions;
goals for the process; tasks and responsibilities of all involved; information man-agement),
– The assessment of whether it may be better to refer the client to someone else.
Further, it is recommended to clearly point out where the expectations of the client, those referring and the counselor agree and complement each other – and where they disagree. If further cooperation is to occur, then now is the time to arrange a contract as stipulated in Chapter 4.1.2.
2.4.6 Evaluating the Initial Contact
Before proceeding to the next phase, one should take the time together with all
Before proceeding to the next phase, one should take the time together with all