How Wearing a Social Justice Lens Can Support You, Your Clients, and the Larger Community: An Intersectionality Workshop With a Twist

Counsellors may not comprehend fully the impact of their blind spots as a result of unconscious cultural encapsulation. The authors propose a self-reflective method by which counsellors can self-examine their assumptions about diversity and intersectionality. They invite readers to engage with the contents of this article to identify their blind spots, biases, and assumptions through self-reflective exercises. This article summarizes an intersectionality workshop with a twist that was offered by Melissa Jay, Jason Brown, and Rebecca Ward at the 2019 conference of the Canadian Counselling and Psychotherapy Association. The intention of the workshop was (a) to raise consciousness about systemic oppression, (b) to explore Collins’s (2018c) culturally responsive and socially just case conceptualization as the framework for the workshop, (c) to bring client intersectionality to life using four vignettes they created, (d) to reflect on client intersectionality and cultural identity, and (e) to propose a method by which counsellors can self-examine their assumptions about diversity and intersectionality, leading to more culturally competent counselling.

The 15 Minute Case Conceptualization

Once understood as useful but optional, case conceptualization is now considered essential and one of the most important of all clinical skills and competencies. As clinicians look for resources to assist in learning and mastering this competency, they must choose among different case conceptualization approaches. They would do well to give serious consideration to those that are both clinically effective and clinician friendly. A truly clinically effective approach explains and guides treatment, and most importantly, predicts challenges and obstacles that are likely to arise over the course of treatment. Most approaches emphasize the functions of explanation and guiding treatment, but seldom include third function which help anticipates likely challenges, which if not proactively addressed are likely to result in therapy interference or premature termination. This function is essential in determining the course and overall effectiveness of therapy. A truly clinician-friendly approach is one that is quick to use and easy to master, and very few approaches can make this claim. The 15 Minute Case Conceptualization is the only approach that is both highly effective and clinician friendly. Research confirms that such case conceptualizations can be completed in only 15 minutes. It is an evidence-based, step-by-step approach that therapists and other mental health professionals need and want.

Full-Scale Case Conceptualization Practice

This chapter demonstrates the eight-step full-scale case conceptualization strategy using two case vignettes. The chapter summarizes the following eight-step strategy: Step 1: Specify presenting problem and precipitants; Step 2: Identify maladaptive pattern; Step 3: Identify predisposing factors and perpetuants; Step 4: Specify a cultural formulation; Step 5: Specify the client’s relevant protective factors and strengths; Step 6: Specify treatment goals; Step 7: Specify treatment interventions; and Step 8: Specify obstacles, challenges, and facilitators. The readers will formulate the cases through the full-scale case conceptualization worksheet and then will write a full-scale case conceptualization narrative for each case. Exemplar responses for each of the two case vignettes are provided.

The Clinical Value of Couple and Family Case Conceptualizations

Clinicians who work primarily with individual clients and have developed competency with case conceptualizations can provide effective treatment. However, when they work with clients for whom couple and family dynamics are prominent, having an individual case conceptualization can be useful but limited. This chapter discusses the value of adding couple and family case conceptualizations. It describes how to incorporate couple interaction patterns and family interaction patterns in the case conceptualization process. A case example that captured and held national attention for more than 1 year is presented. It illustrates the pattern-focused approach for incorporating individual, couple, and family patterns into a composite case conceptualization.

The Pattern-Focused Case Conceptualization Approach

In this era of accountability, therapists and other mental health professionals are expected to employ evidence-based interventions to achieve therapeutic change. Case conceptualization is an intervention that many consider one of the most essential clinical competencies. A useful case conceptualization approach, at a minimum, should explain the presenting problem and guide the planning and implementation of treatment. Approaches that are more clinically valuable will include a third function: anticipate and predict challenges in the treatment process. Analogous to the paradigm shift toward personalized treatments in precision medicine based on biomarkers is a similar shift occurring in psychotherapy practice. It will be based on behavioral markers like the ones in the pattern-focused case conceptualization approach and can explain, guide, and predict treatment challenges, as well as optimize treatment outcomes. A case example illustrates key points.