19From Parenting Training to Collaborating with Parents

Inés Sametband, Joaquín Gaete-Silva

Introduction

We work at the Centro de Estudios y Atención a las Personas (CEAP; Centre for Studies and Counselling Persons) in Viña del Mar, Chile, where we provide counselling and family therapy services at low-cost for individuals and families. Families come to see us for a variety of concerns, among which are children’s disruptive behaviours such as oppositional-defiance, aggression, and attention-deficit/hyperactivity disorder (ADHD). The CEAP is associated with the School of Psychology from the Universidad Adolfo Ibáñez, and is a training facility for students in the master’s in psychology program. Our family therapy team meets with a family once a week to offer a consultation to a family that is working with one of the counsellors at the centre. Following the consultation, members of our team provide a reflection to the client-family, a practice known in family therapy as the reflective team (Anderson, 1991). This final reflection offered to the family is intended to generate different perspectives and ideas on the presenting concern for the family to take with them once the consultation has concluded.

Inés: My training as a family therapist has taken place in different parts of the world. I am originally from Argentina and completed my undergraduate and part of my graduate education in Buenos Aires. I moved to Canada as an adult, where I completed my master’s and Ph.D. degrees, and my training as a family therapist at the Calgary Family Therapy Centre with Karl Tomm and his colleagues. Later on, I moved to Chile with my family. As a result of my international living, I had the opportunity to learn from and work with families who understood and practiced parenting in a variety of ways. I will always remember a family I worked with in Buenos Aires, Argentina, when I was part of a family therapy team trained in the Milan family therapy model (e.g., Palazzoli et al., 1989). The parents were struggling to manage their four-year-old son’s behaviour, who was hitting and biting other children at school. At the time, I remember feeling uneasy about the way the team (including me) were working with this family. We were quite directive and probably a bit confusing for them. My sense was that somehow we were missing the point, even if the family kept coming back. I had the nagging feeling that we were deciding for them what we considered to be the right steps to follow.

Some years later, during my training in Canada, my view of counselling families changed. I was exposed to a multicultural world that I had not been exposed to in Argentina in the late 1990s. Training in a multicultural society made me realize that there are different ways to understand and be part of a family, or to be parents. Recognizing and integrating this diversity into my work made sense to me. It allowed me to be curious and learn about a multiplicity of ways of living life. It also required me to balance what families wanted with what I had learned was “good for them.” Although such balancing may sound simple, it has not been that way for me. Trying to balance between my knowledge as a psychologist and clients’ understanding of how to solve difficult situations (e.g., what parents should do when their child starts acting up) has become a guiding concept for me, and I continue to learn every day how to achieve this in my practice.

Having the opportunity to study and practice counselling psychology in Argentina, Chile, and in Canada has been truly life-changing. This is not only because I had the opportunity to live and learn about different ways of living, but because I had to learn to become flexible yet persistent in my profession. I needed to learn a new language, new customs, and many times face the same bureaucratic obstacles many immigrant professionals encounter when trying to get their credentials recognized. My international experience made me aware of the importance of considering and recognizing that different perspectives are valid and explanatory for many situations. For me, being able to recognize others’ voices is part of ethical practice; a stance that requires reflection and openness to what is not familiar to oneself. The image of a kaleidoscope comes to mind. Depending on the position, the light, and the movement, you achieve a different, breathtaking, and sometimes challenging image. However, it is up to the person looking through the kaleidoscope to achieve these effects; for instance, to stay with some images that are challenging and to find ways to connect with them. Training and working internationally enriched my experience and, similar to a kaleidoscope, added colours and movement.

Joaquín: My training as a clinical psychologist also has been in different places in the world. I studied psychology at the Pontificia Universidad Católica de Chile for six years to become a professional psychologist. I then completed a three-year M.Sc. to become a registered psychotherapist in Chile. Finally, I did my Ph. D. in Canada at the University of Calgary. Throughout the years, decisions I made about my career were influenced by a sense that scientific, psychological, or professional knowledge could sometimes be treated as some kind of “capital T” truth to be imposed on people. It felt like something was wrong with the professional habit—not excepting myself—of replacing people’s own ways of understanding themselves (e.g., “It’s hard for me to be far from my husband”) with more seemingly legitimate, canonical, professionally acceptable ways (e.g., “You are dependent”). Fortunately, I now have language to render my experience of witnessing this mix of distortion and silencing practices as a form of undue discrimination (i.e., epistemic injustice). On the one hand, testimonial injustice: how some people’s preferred language to understand themselves was sometimes dismissed simply because of their alleged identities, like being casted as a “patient,” a “borderline/dependent woman.” On the other hand, hermeneutical injustice: how some people’s preferred self-understandings have been dismissed because the concept of “resistant patient” was (and still is) more popular or available than the concept of “resistant professional.” Lay people seemed to be less conceptually equipped to resist narratives about themselves when the narratives were told in an expert/scientific/professional language. At the time I was a psychology undergraduate, such professional language was presented as scientific, reliable, necessary—almost analogous to how the language of physics would be needed to build a ship at NASA. Fortunately, during my later years as a psychology student in Chile, I also learned a good deal of philosophy, particularly epistemology, which I think helped me develop a critical stance toward the often taken-for-granted “truths” within the field. I felt freer to be more curious about the local knowledge that my clients brought to counselling as potential resources for therapeutic change (such as those we refer to later in this chapter when discussing parents’ parenting preferences). I believe this background ended up influencing my inclination towards what the psychology establishment at the time would see as “rebellious” postmodern models. I became more sensitive to the ways in which psychology can become a modern form of power; that is, when psychology is used for the purposes of social control, domination, and misrecognition (e.g., Foucault, 1995; Gaete et al., 2018). These purposes prescribe what is considered abnormal and needs correction, impose how life issues should be understood and addressed (e.g., medically/pharmacologically), or situate problems inside individuals instead of considering that those problems might be a response to unjust social conditions. I think the emphasis Inés and I place on giving parents an authoritative voice when collaborating with them speaks to this postmodern influence.

My masters’ degree in Chile was quite different from the training I received in Canada. In Chile, instead of learning about many theoretical approaches, but not in any particular depth, I had the opportunity to learn about one particular approach to therapy (systemic) for two full years. In addition, since psychology students in Chile have 12 semesters of theory in their undergraduate programs, master’s degrees in Chile at the time were very focused on developing clinical competencies and on learning by doing (i.e., with an emphasis on clinical work and supervision rather than having classes, as it is common in the Canadian context). My conviction about epistemic justice, or the importance of bringing forth, legitimizing, and relying on (rather than supplanting) my clients’ local knowledge brought me to pursue my doctoral studies in Canada, where I had the opportunity to learn from Karl Tomm and his colleagues at the Calgary Family Therapy Centre. Their unique approach to family therapy invited me to further develop a critical stance towards psychological/expert knowledge and develop a tremendous respect and admiration for clients’ resourceful histories and ways of relating to one another. This emphasis on epistemic justice embraces, in my view, what both Chilean and Canadian psychologists regard as the most important ethical principle in our profession. It is what inspired this chapter, namely: respect for the dignity of persons and peoples.

In this chapter, we share with readers our work with families in Chile. We focus on relational patterns, and how these can open up conversations on parenting practices that respect parents’ preferences in raising their children. We provide a clinical example, and show how, by exploring different interpersonal patterns, we highlight possible alternative parenting practices, used by clients, and that fit better for who they are.

The Pull to Be the Best

Meet Sonia, a 42-year-old woman who consulted our team at the CEAP in Chile about her 10-year-old son, Darío, who had been showing disruptive behaviours for at least six years. Sonia explained that Darío had always been “a peculiar child.” She described him as creative, intelligent, and having to get his way for everything. Sonia said Darío had very strong and recurrent temper tantrums or “rage outbursts” (ataques de rabia in Spanish) in which he became aggressive, broke things, and hit others (including Sonia). Concerned about this behaviour, Sonia and Pedro (Darío’s father) had taken Darío to see a psychiatrist, who prescribed some medication that helped decrease the intensity and frequency of the rage episodes. However, Sonia described feeling exhausted and not knowing what else to do. She said that Darío’s father had almost “given up on him.” Sonia explained that Darío also had been seen by a psychologist in a community clinic, who had diagnosed him with autism spectrum disorder and recommended psychotherapy as well as psycho-education for the parents. Sonia indicated that, although the psychologist’s assessment made sense to her, she also hoped Darío could learn self-control over his aggression so that eventually he could stop taking medication. Sonia also mentioned that she and Pedro needed to learn to deal with the situation better and described ways in which they tried to stop Darío’s behaviour in the past. She qualified these approaches as “wrong.”

Now take a step back. How would you approach this consultation? How do you make sense of what is going on for Sonia and her family? What would you prioritize in your work with this family, and why? Who would you include in the therapeutic process? In our experience working in Chile, we have seen a dominant trend in how psychologists and other health professionals tend to approach their work with families like Sonia’s. Professionals seem to start by answering the questions posed above—deciding beforehand how to approach the situation, guided by their own ideas of what should be prioritized and done. Although we also ask ourselves these questions, we strongly believe that we need to know how the families we work with would answer them. This is why we prefer to begin by asking them how they would answer questions such as: In your experience as a parent so far, what would you say has worked best for you in dealing with your son’s disruptive behaviour? What is your preferred way of responding to his behaviour? What are some of the values you want your son to learn when you respond in that way? In doing so, we are trying to keep in mind an overarching ethical question that guides our practice: How do we ensure that our expertise does not blind us to what clients want to do with their lives, and how they want to resolve and deal with the situations about which they are consulting us? We hope to answer this question by providing a reflection on how we practice, and why we practice that way. That is, by respecting clients’ preferences when collaborating with them to change and resolve difficult situations in their lives in ways that are beneficial and oriented toward wellness for all participants. (We discuss this further later in the chapter.)

Whose Knowledge Is It?

The Canadian Code of Ethics for Psychologists (Canadian Psychological Association [CPA], 2017) recommends in its Principle II (Responsible Caring) that psychologists use their knowledge and skills to promote and protect the welfare of any individual, family, group or community with whom they relate (CPA, 2017) in their work as psychologists. Said differently, we (psychologists) use knowledge (e.g., about parenting skills) to avoid harm and provide services that will benefit clients, such as providing useful information to optimize children’s development. On the other hand, clients develop a sense of what is the good life—their “ends” as parents, so to speak—in relation to their cultural backgrounds. Their parenting preferences rise from a diversity of moral backgrounds or horizons, to use Gadamer’s (2004) metaphor. In the context of the local communities in which they live, the “horizon” of values and preferred practices within which parents respond to their children (e.g., with empathy, with guidance, with love) is the repertoire of “good reasons” parents rely on or may invoke when challenged to account for their actual responses. For us, parenting preferences are situated in socio-cultural practices for raising children that are meaningful and acceptable to the parents who engage in them (see Sutherland, Sametband, Gaete, Couture, & Strong, 2013). We assume parents “do parenting” always within such social horizons—hence we see parenting preferences never as completely belonging to just the parents or just the communities, but to both.

Benefiting clients is thus a matter of means (e.g., offering expert knowledge on parenting) and a matter of ends (e.g., attending to parents’ preferences). This is a key aspect of Principle I (Respect for the Dignity of Persons and Peoples) (CPA, 2017), which includes respecting parents’ preferences in how they parent children. As stipulated in the Code, we “strive to develop and maintain constructive and collaborative relationships that reflect the fundamental principle of respect for dignity” (CPA, 2017, Principle I, Values Statement, para 2). Our overall goal is to help parents optimize their agency—that is, their capacity to define priorities and choose the type of parenting style they value (and which also reflect the moral values of what is considered good by their local communities). In the next section, we describe one of the ways we understand and approach this dilemma.

On Parenting

In Western societies, parenting has become an extenuating, complex, all-encompassing task in which parents are expected to raise children to become model citizens. However, what parents actually do to achieve this goal has been given little attention (Hartas, 2014). Instead, parents are overloaded with information from “experts” on how to raise their children. In Chile (as well as all other parts of the world) for example, it is quite common for parents to receive most of their information about what they should do with their children through suggestions and advice from health professionals, teachers, judges, family, and friends (among others)—how they should dress them, feed them, talk to them, discipline them, when they should put them to bed, and how much TV they should allow their children to watch.

Suggestions and advice for parents is also available readily in the popular Western media. A simple Google search on parenting tips shows 52,000,000 results. Workshops for parents, teachers, and professionals, as well as self-help information (e.g., the popular TV program The Nanny, the US bestsellers The Whole-Brain Child, Raising your Spirited Child and The Happiest Toddler on the Block, to name a few). Many of these TV programs and bestsellers have been imported by, and have become popular in, Spanish-speaking countries, including Chile. In addition, within the Western mental health field, parenting training has become one of the most recommended interventions to approach children’s disruptive behaviour (e.g., Dishion & Stormshak, 2007; National Collaborating Centre for Mental Health [NCCMH], 2008/2013; Weisz & Kazdin, 2010). Some models of parenting training draw from attachment theory and social learning concepts and offer models of what is called “authoritative parenting” (Zizzer & Eyberg, 2010). Others focus on empowering and enhancing parents’ knowledge, skills, and confidence as a way to improve parenting by teaching parents what to do in particular situations (e.g., Forgatch & Patterson, 2010; Sanders, 1999).

Although these models of parenting training can be very beneficial to families, we believe that they potentially can disempower the persons involved. Imagine if Sonia went back home after her session believing that the main problem was that she needed training on how to address her son’s outbursts (i.e., that she as a parent is “lacking a skill”; see Paré 2014). How would she feel as a parent, and how might this feeling influence how she approaches problematic situations with Darío?

Most parenting training models emphasize behaviour as a separate construct, rather than viewing it as a response in a relationship (e.g., Forgatch & Patterson, 2010). Based mostly on traditional theories of behaviour conditioning, these models conceptualize children as learning through reinforcement, rewards, or by modelling behaviours. Parenting is proposed as a one-way process, in which children’s disruptive behaviours are seen as the result of parents’ coercive practices (Kuczyinski & Mol, 2015). There is little attention, for example, to how children’s behaviours shape parents’ effectiveness in responding to them.

Without question, most Chilean parents want their children to have a “good life,” to use a common expression in ethics. Paraphrasing philosopher Sen (1999), we all want to optimize our children’s capabilities or freedoms to live lives they can both enjoy and appreciate. Parenting training models may be a great contribution to parents who embrace this belief. However, we also have seen how an emphasis on “training” can compromise the parents’ right¹to define how they want to parent their children in the first place. As Hartas (2014) suggests, parents can be objectified and treated as incapable of exercising their responsibilities, “justifying micromanagement and therapeutic interventions at a family level” (p. 172) from professionals. Further, Principle II of the Code recommends that psychologists recognize and respect the ability of individuals and groups “to make decisions for themselves and to care for themselves and each other” (CPA, 2017, Principle II, Values Statement, para 2).

On Preference

Parents show preferences regarding their children’s development. Typically, these preferences are not explicit—rather, they are implicit in how parents respond to children when children shift away from something the parents value (Garfinkel, 1967). As we mentioned, we view preferences as the situated, local practical knowledge (Geertz, 1983) on raising children that is meaningful to the parents, acceptable to them, and customary in the community in which they live. For example, it may seem odd for a parent to leave their young child playing on his or her own outside of their home in Calgary, because it would be considered a parent’s individual responsibility to supervise his or her child. However, this parenting practice is not common for some families in Chile, where children are seen as a responsibility of their local community. In many cases, families live in small houses, so it also makes sense for children to play outside. This is the case in particular for families living in the hills surrounding the city of Viña del Mar who cannot afford a home of their own and tend to live with extended family members in the same land or house. Living with 16 other people in the same house, for example, means that parents, grandparents, uncles, aunts, and even common law family members raise and look out for the children.

Dominant, mainstream ideas on parenting practice can overshadow and limit local practices. Nowadays, communication technologies make it easier for some ideas or beliefs to proliferate (e.g., through the internet). Some examples are the recent North American anti-vaccination movement based on the belief that vaccinations cause autism. This movement has extended to South America. An opposite example is the change in the view of breastfeeding as a positive practice compared to how it was viewed in the 1950s. Even the recent increase in babywearing—carrying a baby in a sling or in another form of carrier—has become an international practice, though it was seen as eccentric before. The tensions between these different ways of understanding and practicing parenting can generate confusion or even uncertainty for parents who do not see their preferences represented in these practices.

Tensions over differences in parenting preferences are not only cultural, but also can arise within families. For example, mothers and fathers may differ on how to practice “good manners.” These differences could become confusing for their children, who may not have a full understanding of what “good manners” mean in the cultural context in which they live. In order to provide a coherent understanding of this practice, parents need to negotiate and co-ordinate ways in which “good manners” are practiced in their family. Likewise, how to understand a person’s development will always be part of a delicate negotiation process between the preferences of the different parties involved in children’s socialization, including the children themselves, their families, and other persons and social institutions relevant to the children’s lives. We consider this a moral negotiation, because it pertains to the values and preferred practices within which parents respond to their children. Much contemporary moral philosophy interprets a person’s view of morality in a narrow sense, insofar as it “has tended to focus on what it is right to do rather than on what it is good to be, on defining the content of obligation rather than the nature of the good life” (Taylor, 1989, p.3). To the extent that “good parenting” is part of the nature of the good life, good parenting is related to the moral realm.

When we work with families who describe their child’s behaviour as disruptive, we see them (and us) fluctuate between two positions at odds with each other. On the one hand, parents want to raise children so they develop as independent persons. On the other hand, an emphasis on parenting training can limit the parents’ creativity and sense of authority. For us, the tension between these two positions represents an ethical dilemma we face in our work with families. We use our expertise to help families deal with problems in their lives, yet we need to ensure our expertise does not overpower parents’ preferences in how to raise their children. As a result of this experience, we have come to believe that there are alternative ways to help parents articulate and practice parenting in ways that are meaningful for them.

We consider that an emphasis on teaching parenting skills may have a negative influence on parent-child relationships and work against an ethics of care (Hartas, 2014). At the same time, we acknowledge our privilege as professionals regarding access to information about parenting and would consider it negligent not to use this information to benefit clients. We also acknowledge our privilege of being aware that there are probably more ways in which clients’ experiences can be understood, other than those championed by experts or professionals (e.g., Paré, 2014). We believe that Sen’s (1999) concept of adaptive preferences can be enlightening—namely, there are things or goods people may not recognize right away as preferred, since historically they have not had access to such goods (e.g., claiming equal rights as a woman). However, we believe that exploring “what else” or “how else” clients might prefer to deal with the concerns that bring them to counselling is worthwhile. To do so, we use an approach that we call collaborating with (rather than training) parents.

Collaborating with Parents

At the CEAP, we use a relational approach called the IPscope (Tomm et al., 2014) in our work with families to deal with disruptive behaviours from one of their members. The IPscope is a collaborative family therapy approach focused on interpersonal patterns of relationships. The approach focuses on preferred relationships (i.e., ways of relating that are meaningful and oriented to a person’s wellness), through a joint exploration of social practices and discourses; ways of doing and saying that are morally charged (i.e., preferred and non-preferred). It is an approach we learned in Canada, but which we have found very helpful in working with families who live in a different culture.

Using this approach, we understand disruptive behaviours as resulting from pathologizing interpersonal patterns (PIPs; Tomm, 1991, 2014) between children and parents. PIPs are interpersonal patterns that invite or increase negativity and/or suffering in at least one of the persons interacting, or within the relationship. For example, a father may criticize his son’s performance at school, which in turn could invite the boy to defend himself, which may in turn invite further criticism from his father and so on (see figure 1). PIPs can be counteracted with HIPs, or Healing Interpersonal Patterns (HIPs; Tomm, 1991, 2014). HIPs bring forth positive behaviours that serve as antidotes to PIPs. For example, a father may notice that his son has mastered a specific ability, such as collaborating with his peers. The father noticing this ability will in turn help his son to be more aware of this capacity to collaborate with peers and increase his practicing of it. This, in turn, could invite more notice from his father, and so on (see figure 1). These kinds of interactions are supported by cultural ideas on what is appropriate in a parent-child relationship. When the cultural ideas supporting interactions become prevalent in family relationships, we call them socio-cultural interpersonal patterns (SCIPs; St. George & Wulff, 2014). For example, a common SCIP is the idea that women should do most of the parenting compared to men. This SCIP may support PIPs such as a father criticizing a mother for a child’s behaviour due to a belief that mothers are the primary caregivers or have sole responsible for parenting. In turn, this may invite the mother to defend herself, which again invites more criticism from the father, and so forth.

The IPscope, in our experience, is a useful tool to help parents prevent what they define as disruptive behaviours (e.g., PIPs; impulsivity, opposition, hyperactivity, stealing, and lying) and promote preferred ones (e.g., HIPs; respecting invites co-operation; asking respectfully invites compliance). This is not to say that we take parents’ definitions (“X is disruptive”) at face value. We invite parents to reflect on how their definitions may hinder what they prefer to see in their relationships with their children. How they define a child as disruptive may have unintended consequences and obscure the relationship they would prefer to have with their child. We think that part of our ethical responsibility is to help the parents become aware of cultural ideas on parenting, and what parenting “should” look like. We believe that by making these ideas visible, clients have the opportunity to examine how these ideas influence their family relationships. However, in our conversations with clients, we need to take special care and responsibility regarding our privileged position as professionals and avoid imposing our own ideas. For example, we may ask parents, how does calling your son’s behaviour “manipulative” influence your relationship with him? What may your son learn from having a reputation of being “aggressive”? How may focusing on the problem influence your child’s future?

Our hope is that by examining these understandings and ideas, we avoid imposing our standards of what good parenting is. This does not mean that our professional knowledge is useless; rather, we propose that it is one possible way of understanding among many. Families often report that focusing on the relational aspect of their problems and using the PIPs and HIPs language as a starting point, is useful. Our conversations aim to help them find wording that fits better for what they envision as wellness in their relationships. In addition, we found that sharing families’ relational preferences using the PIPs and HIPs language has become a helpful repository of options for other families that come to see us. In our experience, it has been useful to have, at least conceptually, relational alternatives or prototype descriptions that we frequently hear about in our sessions with families, such as nagging coupled with ignoring, which tends to invite further nagging and so on (common between parents and adolescents), or criticizing coupled with defending (common in co-parenting situations).

Let us go back now to Sonia and her family’s situation. Sonia described Darío’s behaviours as rage outbursts, in which he would either throw objects to the floor or walls, or hit, scratch, or pull hair from his younger brother or Sonia. In our first meeting, Sonia mentioned that she and Pedro needed to learn alternative ways of dealing with their son’s behaviour. When we explored with her what kinds of responses from her and Pedro she was referring to, she described that they tried “everything”—from ignoring the behaviour, trying to reason with Darío, and finally resorting to yelling at him and even trying to control his behaviour physically (e.g., restraining him). In relational terms, we conceptualized this interaction as a PIP of hitting (by child) coupled with ignoring (by parents), which invited more hitting or more intense aggression (by child), which in turn invited yelling (by parents) and so forth, to the point of parents resorting to physical restraint.

Disruptive Behaviours as Responses in Interpersonal Patterns

Historically, disruptive behaviours have been described by focusing on deficits in the child (e.g., aggressiveness, attention deficit, delinquency, disobedience; Achenbach et al., 1987). From this perspective, Darío’s behaviour could be seen as the result of impulsivity or as a deficit in impulse control. Although this perspective could be a useful way to understand his problematic behaviour, for us it is both unjust and limited. It is unjust, insofar as the child’s perspective and context are typically ignored (e.g., Sutherland et al., 2016); and limited, in the sense that it does not attend to how the behaviour impacts his relationships with others, and how change could be sought through those relationships.

Alternatively, children’s disruptive behaviours can be described relationally, as obstacles to their affiliative capacity, to their ability to live and show concern for others, to be treated as a dignified being (Nussbaum, 2000). Looking at disruptive behaviours as obstacles to a child’s relational potential is to put the emphasis on what is preventing the child from transforming opportunity into actual development. Likewise, going beyond the disruptive behaviours themselves can contribute to highlighting the parents’ preferred developmental course for their children according to their culturally embedded standards. In our view, disruptive behaviours need to be understood in a less abstract and more specific manner, to include more complex, rich descriptions (Geertz, 1973) in which children and parents’ preferences, hopes, and behavioural expectations are taken into account from within their socio-cultural relational context.

In our practice, we find conceptualizing disruptive behaviours as responses in interpersonal patterns to be useful in two ways. First, it is our experience that parents appreciate being able to understand disruptive behaviours as habits that have become recurrent within a PIP. Being able to understand disruptive behaviours as responses to others help parents to view them as something that can be changed. Rather than inviting blame and mutual accusations between family members, this conceptualization helps generate hope and collaboration among the parties involved. Second, this approach allows us to use our expertise while respecting and helping parents (and children) follow their preferences in how they want to relate to one another. These relational conceptualizations are tentative classifications of disruptive behaviours—a first approximation to the relational world we inhabit, not a “standard” to be followed. We view them as a method to map interactions, useful in a particular relationship, place, and time. Finding the right wording for these patterns often gets a “we have always known this!” kind of response. We offer these prototype examples as one possible way to conceptualize relationships, not as the “right” version of interpersonal patterns or the only one that psychologists should use. More so, we invite psychologists to explore what may be examples of interpersonal patterns more prevalent in their practice.

Most of us are unaware of our own contributions to forming and maintaining relational habits or patterns. It is easier to notice what bothers us, or what others are doing. For example, it could be easy to focus solely on Darío’s behaviour. We are more likely to notice that a child is ignoring a parent than we are to notice that the parent’s tone of voice, or the way in which we are communicating may be inviting the child’s behaviour/response. However, zooming out of the child’s behaviour to include how others respond, and how the child responds to their responses, allows us to have a different perspective. For example, when the therapist working with Sonia explored the different kinds of interactions in which she engaged with Darío, the understanding of the situation shifted. We provide next an example of how we explored the interpersonal patterns in this family. This example is based on actual therapy conversations but details have been changed to protect clients’ privacy. The conversations originally took place in Spanish and have been translated into English by the authors:

Clinical Example

* Chilean expression that denotes a very closed or enmeshed relationship between a mother and her male child.

By orienting the questions toward interpersonal patterns, we (therapist and team) were able to understand Sonia’s concern in a different way. We learned, for example, that Sonia’s hope by restraining Darío was that he would learn to control himself. However, according to Sonia, the more she tried to control Darío’s behaviour, the less he learned how to control himself (PIP; externally controlling behaviour invites less self-control). In addition, we learned that Sonia attempted to deal with the situation by “giving in” when she felt the behaviour would escalate. This interaction could be seen as a variation of the previous PIP: The more insistent Darío became to get something, the more Sonia felt she had to give in to avoid an outburst (i.e., threatening with behaviour invites giving into demands). In addition, we learned that Sonia was concerned that her interactions with Darío would make others label him a mamón, which has a negative connotation in Chile.

Exploring interpersonal patterns provided the team and Sonia the opportunity to understand Darío’s behaviour as a response to certain relational invitations. It also allowed us to work with Sonia toward generating alternative invitations to Darío to help him change his responses as well. Indeed, exploring unique outcomes (White & Epston, 1990) helped us work with Sonia in exploring her preferences about how to deal with Darío’s behaviour. For example, in lines 14–16, the therapist’s question (“What do you think helped him respond to you by calming down instead of yelling and hitting?”) seemed to help Sonia consider how her behaviour may have generated a different response from Darío (“I don’t know . . . maybe that I was calm? I didn’t yell at him. . . ”). Being able to recognize a different response (being calm) to her child could be a starting point for a new interpersonal pattern; one in which Sonia calmly asks Darío to do something, which invites him to respond in a calm manner (as he did).

Conclusion

One possible way of practicing respect for others is by being curious and trying to understand the language they use to create and recognize relationships within their own relational world. Rather than trying to translate their language into our language, we take the position that there are several languages of expression (Taylor, 1994): languages with which clients live and interpret their ethos: what the good life is for them (e.g., “being a good parent”). In this chapter, we call them parenting preferences. We believe we can severely harm others by not recognizing their language, their form of life. This is what Principle I (Respect for the Dignity of Persons and Peoples) of the Code is all about for us; to respect our clients’ dignity and acknowledge that persons (in this case the parents we work with) are “worthy of equal moral consideration” (CPA, 2017, Principle I, Values Statement, para 3). To enhance their capacity to transform opportunities into actual human development, parents search for help and support from the environment, including professional knowledge (e.g., mental health services). They may find ways to understand parenting skills as ways to transform opportunities into actual development in their children in accordance with their culturally embedded standards. This is how we interpret the gist of Principle II (Responsible Caring) in the Code. Rather than substituting or ignoring parents’ preferences, we acknowledge their ability to make decisions about the well-being and best interests of their children (CPA, 2017). Hence, far from being contradictory, and despite whatever tension we may feel between Principle I and Principle II, we believe it is useful for us as professionals to remind ourselves that these two Principles are intended to go hand in hand. Ultimately, our hope is always that our knowledge will help bring forth (rather than ignore, misrecognize, dismiss) parents’ knowledge, and help them generate and develop long-lasting parenting competencies to raise their children according to their preferences and culturally embedded standards. We view this exploration as opening possibilities for change while respecting the dignity of those involved. In sum, our international experience provided us with the opportunity of experiencing and recognizing multiple perspectives in our work, and we hope to continue infusing our work with what we have learned elsewhere—not by imposing it, but by bringing it forth as another possibility. Rather than defining ourselves and our work depending on the cultural context we learned in, we try to contribute our international experience to our current professional location.

Questions for Reflection

1. Connect with a psychology practitioner who received part of their training in a country other than Canada. Explore the differences (between Canada and the other country) regarding psychology training and the provision of mental health services. What stands out for you?
2. Do you think training and/or professional experience in a country other than Canada would be an advantage or a disadvantage in working in a multicultural country like Canada? In what way(s)?
3. Do you think that training in psychology can be transferred between different cultural contexts? For example, professionals trained in Canada who go to practice in other countries—what may be some advantages or a disadvantages they face? In what way(s)?
4. Think of a situation in which you believe that a client’s cultural perspectives and values could interfere with achieving a good outcome in therapy. How would you deal with this in a way that balances achieving a good outcome with respecting the client’s dignity?

note

1. 1 The Chilean constitution (and probably many others) designates the family as the primary socialization agent; that is, the institution in which a child develops and learns what constitutes a “good” life. That is why the State needs to support that each child develops his or her abilities, exercising his or her right to live with a family (UNICEF, 1991).

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