Measures in therapy are typically a set of questions, against which the client ‘self-scores’ themselves enabling us to get some measure (pun intended) of where they are in a particular area.
Although in my clinical work with the NHS we do use widely accepted measures for depression and anxiety (namely PHQ-9 and GAD-7) I do not generally tend to use them in private practice as they can be distracting and I like to focus on the client’s immediate needs primarily; however, I am always aware of my clients general levels of well-being and will always explore Risk where any is identified.
This feature describes some of the measures which my clients have found useful in our work together. Notably a challenge in working with families and couples is that it is not always possible in these group sessions to focus on the individual at the level of depth that might be ideal. To this end I find measures can be a very time efficient and even fun way to gain more insight into my clients.
When noticing clients setting quite high standards for themselves and also describing a need ‘to keep everybody happy’, my mind often wanders towards the idea of ‘Drivers’ which were hypothesised by Eric Berne in his work on Transactional Analysis. Such drivers include idioms, ostensibly passed down from our parents and guardians, as ‘be perfect’ and ‘please others’ etc.
So if the client fancies a little self-reflective fun we might as a group fill out ‘Driver Questionnaires’, obviously as fellow member of the group I will complete one too and I feel this reduces power imbalances and allows the group to see my vulnerabilities too! This has been very useful in my work with families as it enables some of the pressure of therapy to be released, and it can be cathartic, insightful and fun.
Other very useful measures are the Association of Family Therapist’s SCORE measure which offers a measure of how the client(s) see their family, and also the Adult Attachment Interview which helps us develop insight into the way that clients have developed their attachment style including any leanings towards either more anxious or avoidant styles within relationships.
So although I see measures merely as a tool and certainly not central to my practice they can be an insightful and sometimes fun way to reflect on how we are.
Jonathan J Mitchell, 2016