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The History of TSI and Mental Health

In the mid-nineties Ron decided it was necessary to expose Therapeutic Storytelling Intervention (TSI) to mainstream mental health. He started working at Campbell Lodge in 1996 and has worked there full time until the present. Campbell Lodge is the child and adolescent mental service for the entire South Auckland area. The clinic meets the tertiary needs of approximately 400,000 ethnically diverse people. At the beginning Campbell Lodge was understaffed so the group approach met clinic needs. The next phase of Ron's vocational life could be termed his 'group' period. The groups, up to six per week, consisted of children with all sorts of diagnosis; kids who acted in and kids who acted out. In fact about the only reason for group exclusion was kids who were presently psychotic. The group therapy learning years were interesting. At the time, he didn't realize that running adolescent groups was any big deal; he just ran groups. However in 1998 he learned that his Therapeutic Storytelling Intervention groups were special; industry journal information was devoid of other successful adolescent groups. There were simply no examples in literature of adolescent groups being consistently and effectively run over a sixteen week duration with the engagement and results of his TSI groups. Ron then started realising that his approach was unique and would be of great interest to the industry. Ron is still running groups at Campbell Lodge although his new passion is conducting family groups. Recently Ron has decided to use the same process with families. Both at Campbell Lodge and in his private practice he now sees the identified patient (IP) (client) in the context of his or her family. Now, in all but the rarest circumstances, he takes the whole family on the TSI journey. Of course it is the parents to whom this is initially proposed; however, almost without exception, they agree and the entire family begins the TSI process.

When someone feels the need to bring their children to therapy they are desperate for change. In crisis there is always great opportunity for this change. And it is because of the vulnerability of this initial moment that the therapist encourages a whole family approach. Inevitably, as the process unfolds, they learn that therapy isn’t just for the child (IP).

Some of the most amazing behavioral changes have been the changes that the parents have made. Naturally, as one of the family members begins to internalize the story and, as new thinking shifts into new behaviors, the impact generalizes to the other family members.

Family TSI is set up in the same way adolescent group TSI is set up. A family promise is made. The promise is, “each of you will get something worth more than gold.” Ron goes on to say that, “I don’t think you’ll believe me; however I don’t think you’ll forget I promised.” They are then told the rules of engagement. “If asked a question you don’t want to answer, simply pass. I’d much rather you pass than be false to yourself or the process.” He goes on to tell family members to relax and enjoy the story. Then the story begins with the first chapter of Gem of the First Water.

Ron’s post graduate education was at the University of San Francisco. He studied in the Education Department and received a Master in Counseling with a family therapy emphasis. The academic background in systemic therapy contributed greatly to the foundations of TSI. The work of Satir, Minuchin, Haley, Milton Erickson and many others has contributed greatly to how TSI works. The work of some of the great innovators in family therapy has influenced many of the techniques that make TSI extremely effective.

One of the major problems for family therapy is engagement. Therapists who believe the problems are within the system (multi-generational) and that solutions can be found there, also know how frustrating it is when one member of a family system leaves the process because it’s tough. This often kills the momentum of the entire process. In a metaphorical sense, when a therapeutic toe gets stubbed, it often means the end of therapy. Abrupt termination of therapy is frustrating for the skilled therapist and destructive for the client, because the client interprets this to mean that their situation is untreatable. “Oh, we tried that but it didn’t work!” Clients terminate right at the point of endogenous change. Clients who terminate do so because change is often difficult and many people are habituated with 'giving up' at stress, thus termination in family therapy is common. TSI is attractive to therapists because it captures the imagination and carries the family through the difficult change period. Ron often sees clients for twenty plus sessions.

The TSI stories work on the unconscious process. Listeners identify with the main character because, more often than not, his issues are their issues. To begin with, the process is a process of externalization. It is about this boy, it is safe, a little fanciful, and non-threatening. However as the journey gets going, and it does so with speed, listeners start to see themselves in it; they make a personal identification. Listeners also hear the story in an altered state of consciousness. A state of transference/rapport develops and issues can be discussed without the usual (suspects), anger, denial and projections wrecking the session. It is a very nice way of ‘invading’ the family system, of ‘entering the family dance’. Habituated scripts can be identified and changed to more healthy patterns of living.

Through the work of Milton Erickson, we understand about rapport and post hypnotic suggestion. Both concepts are integral to TSI and leave listeners with a lot of material to consider and ponder. Ideas and strategies for change are available for each family member to take home and reflect on, to talk to each other about and to help identify old scripts when they present themselves (and they do) between sessions. Because TSI is a methodology of story, those that are engaged in it form mind-pictures which can be stored in their memory and recalled and used at a later time. The story lodges in the psychology of each participant. Several years ago Ron was lost on his way to Cambridge, a town outside of Hamilton, New Zealand. In an industrial area he stopped to ask directions. Walking into an auto shop, which was very dark on the inside after the bright sunshine outside, he was stopped right in his tracks by some one from the back of the shop yelling, “Hey Ron!” He thought he’d walked into the twilight zone because, at that time, he didn’t know a soul in Hamilton. It was a kid named Cary who was in one of his groups up in Kerikeri 3 – 4 years earlier. After a brief, “Great to see you”, etc. Cary said, “Ron I’ve never forgotten the ‘Spiders web’. I still have that picture in my head. It’s helped me make good decisions.”

Ron often sees families who are also in therapy with other therapists. TSI enhances and blends with many other therapeutic orientations. For a great example of how family TSI changed a family, read the letter from the Plow family on the Internet.

Hugh Clarkson MD. Campbell Lodge Clinical Head is available to answer enquiries from senior health professionals regarding the scope of Therapeutic Storytelling Intervention within mental health services.

Read About TSI In:Youth or Adult Justice, Education, Social Work, Mental Health, Religious Education


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