By Gary Direnfeld, MSW, RSW
Special to NurseZone
You’ve been to counseling and are not sure if it is working. Part of you feels nothing has changed and another part feels like something is different. You are probably right on both counts.
When seeking change, most folks look for dramatic differences. When results are not seen or considered significant enough, some feel hopeless and perhaps give up. Many tend to concentrate on only one aspect of change. Hang in and learn to assess change more broadly. Here is what you need to know.
Change actually happens in several dimensions: intensity, duration and frequency.
Intensity refers to the strength of behavior. A slight emotion is manageable, whereas an intense emotion may be overwhelming. A child may cry or whine and at other times may tantrum, flopping to the ground wailing. These are examples of different levels of intensity or strength of behavior.
Duration refers to the length of behavior or how long the behavior lasts. One can feel sad for a day, a week or longer. A tantrum can last a minute or an hour. These are examples of different durations or length of behavior.
Frequency refers to how often behavior occurs or how many times in a given period the behavior is experienced. Tantrums may occur daily or weekly. Depression may come and go cyclically or, in some cases, may persist so as to be perceived as steady. These are examples of differences in frequency or how often a given behavior occurs.
The key to assessing change, then, is to determine along all three dimensions if something is different and understanding that change does not always occur equally across all three dimensions.
For example, when a child throws tantrums parents use a time-out procedure to address the tantrum behavior. Over time, the frequency of tantrums goes down, but the intensity, strength and even duration of the tantrum remains. The parents feel frustrated, believing nothing has changed. However, when reviewing frequency, it is detectable that the actual number of incidents has diminished. Parents are encouraged to stay the course and over time, while intensity or duration may never change, the frequency can continue to decline to the point where the child stops having tantrums. Goal met.
In another situation, a person feels depressed. With treatment and over time the patient still feels down and thus believes the treatment is not working. However, when gauging the intensity of depression on a ten-point scale the person may now see the intensity has reduced to a five. Before treatment the intensity was rated a nine. The person also has less suicidal thoughts and is better able to cope and manage life on a daily basis. Thus the person is encouraged to continue treatment in view of clear change.
While most folks would like to see behavior improve in all three dimensions equally, this doesn’t always happen. Behavior may improve in one or several dimensions at different rates. The key is to carefully assess change across all dimensions to best determine if change is actually occurring. Focusing on only one dimension can provide the misguided impression that nothing has changed when indeed it may have. If things are changing, then stay the course. Expect and plan setbacks along the way. If it feels like change follows the two-steps forward and one-step back path, the good news is things are still moving ahead when you look at the entire course and not just the step back.
Perspective is everything when assessing change. Hopefully the above will help you keep a broader perspective when determining change and keep you from feeling discouraged. Hang in there. Things may indeed be changing!
Gary Direnfeld is a social worker. Courts in Ontario, Canada, consider him an expert on child development, parent-child relations, marital and family therapy, custody and access recommendations, social work and an expert for the purpose of giving a critique on a Section 112 (social work) report. Call him for your next conference and for expert opinion on family matters. Services include counseling, mediation, assessment, assessment critiques and workshops. Visit his Web site at: www.yoursocialworker.com or e-mail him at: gary@yoursocialworker.com. Mr. Direnfeld can also be reached by phone, (905) 628-4847.