Collaborative Therapy

Inner Talk

the thoughts and conversations each person has within while participating in a conversation

Outer Talk

the verbal conversation between the therapy participants

Reflecting Team Guidelines

• Only use teams with the client’s permission

• Give the client permission to listen or not listen

• Comment on what is seen or heard, not what is observed

• Talk from a questioning, speculative, and tentative perspective

• Comment on all that you hear but not all that you see

• Separate the team and the family

• Listen for what is appropriately unusual

• Ask

Only use teams with the client’s permission

The therapist should obtain the client’s permission to use a team before the session starts. When the therapist has a strong rapport with the client and confidently explains how the reflecting process works, most clients enthusiastically agree.

Give the client permission to listen or not listen

Andersen gives clients explicit permission to listen or not listen. I find it helpful to tell clients that they will probably hear some comments that resonate deeply and others that fit less well with their experience, and I recommend they focus on the comments that “strike a chord.”

Comment on what is seen or heard, not what is observed

Team members should comment on a specific event or statement in the conversation and then “wonder” or be “curious” about it. The wondering or curiosity statement should be appropriately unusual to help generate new perspectives

Talk from a questioning, speculative, and tentative perspective

Team members avoid offering opinions or interpretations and instead use “wondering” questions (“I am wondering if . . .”) or offer a tentative perspective (“I am aware that I don’t know enough to know the whole story, but it seems like there might be . . .”). If a team member offers a strong opinion, another team member may ask, “What did you see or hear in the conversation that made you think that?” to open the conversation up and invite multiple perspectives

Comment on all that you hear but not all that you see

• if a client wants to hide an emotion or not say something, the client should be free to do so.

• client privacy in therapy, believing that clients will share when they are ready.

• If a therapist notices a client getting agitated or holding back tears, they do not comment on it, allowing the client to speak about these emotions when they are ready to do so.

Separate the team and the family 

The team and family can be in the same room but should not talk to each other. Andersen believed that an important psychological space is created by the physical space between the team and client and by the two not talking directly; later research studies supported his view (Sells et al., 1994). This space invites all participants to focus on their inner dialogue, more readily stimulating new thoughts and ideas.

Listen for what is appropriately unusual

Avoid what is too usual or too unusual. To identify useful reflections, Andersen asked himself: “Is what is going on now appropriately unusual or is it too unusual?”

Ask

“How would you like to use this session today?” This question, although likely to be asked at the beginning of any session, is critical when a team is involved. If the client is nervous about using a reflecting team, the therapist can also add, “Are there particular topics you want to avoid with the team here?”