Intro to marr/fam couns

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“take-aways” from guest speaker presentations 

submission of a two-page, double-spaced paper – “Highlights from Guest Speakers.” You are expected to upload to Canvas a two-page (maximum), double-spaced paper that summarizes your “take-aways” from each of the guest speaker presentations. Your writing about each speaker accounts for 4 points of the total 12 points

 a) (3 points of grade) By 11:59 p.m. on Monday, May 30, 2022, email the instructor ([email protected]) three (3) questions for the guest speakers, who have experience providing couple and family therapy and will come into specific class periods during the course. Your three questions can be related to anything about which you are curious, when you think of providing family therapy to children, adolescents, and their families and couple’s therapy to adults 

Maria Moua, MA, LMFT

Guest Speaking at Intro to MFT Course – University of St. Thomas

My 3 S’s

1. Set-up (aka Structure)

2. Supervision

3. Safety protocols

I believe there is a difference between a good therapist and a GREAT therapist. 10 steps to being a GREAT therapist.

1. Know your theoretical framework – a great therapist knows what they are doing and can explain why. Their success rate is higher bc their work is evidenced based practice. Intuition and natural gifts are good, but can only go so far. In order to get respect in your job and have a higher chance of trust is by standing on the foundation of the well- established. No one is going to listen to you initially if you start off “this is what I think.” But if you say “from a Structural Theory perspective…”

2. Be selective of your ability to help clientele. How I start off every intake is “I would like to see if this is a good fit; and if it is a good fit, we’ll talk about scheduling” – ex: 3 Michelin Star sushi verses buffet style sushi that’s not even Japanese . Don’t try to be the one who tries to sell everything. You’ll be watered down. There’s a type of clientele that is looking specifically for you.

3. Be willing to be stretched. Most of you will be doing your first jobs/internship on an intensive level. Know that it pays off in the long run. 1 year of in-home = 5 years outpatient. There is no easy pathway to becoming the best.

4. Stand firm to your morals: Honesty, Respect, & Do No Harm. There are people who are going to try to compromise you. If you give in, you’re not going to like what you see in the mirror. You might become suicidal

5. Meat of the sandwich: Leave work at work and home at home. Know your self-worth is not defined by your work performance. Create a cleansing ritual. Set your priorities: Self-care first. Marriage second. Children third. Everything else after.

6. Walk the talk. It’s hard to sell something you’re not willing to buy. Your colleagues won’t refer patients to you. Your patients aren’t stupid. You can tell by your caseload and your retention rate

7. Learn how to have the highest success rate: getting patient buy-in; high retention rate; and no repeated complaints/issues after working with them after discharge.

8. Structure of therapy: systems issue instead of problem child; parent empowerment; know how your next 6-8 sessions are going to look like.

9. Empathy. Empathy. Empathy. Everyone is going to hate at least one of their patients. Everyone experiences transference and countertransference. Increasing Empathy is your #1 tool to Decreasing irritation & Frustration.

10. Let go of your pride. This is something even 10-years and doctors still struggle with and never refer a patient out. Be willing to say “I don’t know.” Ask for help. Get your own counseling. As a newbie know that your supervisor doesn’t expect a 10-year. Don’t beat yourself up.

Therapeutic Presence

Carry the SPIRIT of Your Mentor

Grounded in Your Foundation of MORALS


CURIOUS-Listening Approach


Maria Moua, MA, LMFT

New Recording 150 (Haifa’s iPhone (null))

New Recording 151 (Haifa’s iPhone (null))

New Recording 152 (Haifa’s iPhone (null))

New Recording 152 (Haifa’s iPhone (null))

· Yes.

· 00:02So thank you everyone once again I.

· 00:08Just the invitation to be here, this is my sixth or seventh consecutive year, being a guest speaker I asked.

· 00:17And it’s always an honor to be invited back again.

· 00:40i’m happy to share my.

· 00:43My contact information, sometimes students after.

· 00:48today’s discussion, and I say this discussion because feel free to interrupt any time to ask additional questions.

· 00:57But sometimes after today’s discussion students will follow up with me and they might have additional questions or they might be interested in networking based on.

· Maria Moua

· 01:20um it’s the one with the maplewood wellness Center email on it.


· Maria Moua

· 01:29Okay yep other otherwise I am at the end of this year I I my goal is, I am going to plan to fully transition into my own solo private practice so yay me.

· 01:42So right now i’m going to practice which has been wonderful, but i’m yeah i’m excited to continue into this chapter of being 100% soul So hopefully there’ll be the beginning of 2023 here.

· 01:58yeah i’m also the coordinator for the Mon MFA support group.

· 02:04Before the pandemic, we would have.

· 02:07monthly or you know every two to three months, we would have quarterly.

· 02:12Meetings gatherings where we would connect and we would talk about significant topics that were in relationship to the Hmong community and how we could look at it from a.

· 02:25marriage and family therapy lens so this group is specifically for people who are passionate about marriage and family therapy, but also have a keen interest.

· 02:35In knowing how to use marriage and family therapy, to the Hmong community, specifically, so you don’t have to be.

· 02:40ethnically Mon, to be a part of this group, right now, our main facet of communication is through our Facebook group so you can type Mon mfg support group and you’ll find us there.

· 02:53The reason why I found the group I thought it as a student actually when I was in Grad school for marriage and family therapy was mainly because when I first entered.

· 03:03Grad school.

· 03:06There was only one course about diversity at that time and then in that one course was a single chapter about Asian studies.

· 03:14And then, in that chapter about Asian studies was a single sentence that spoke about southeast Asians so needless to say, I was very emotionally devastated and feeling like.

· 03:27You know what am I doing paying all this money for this education and i’m not able to serve the people group that i’m actually passionate about.

· 03:37So you know, I was crying at our our empty department chairs.

· 03:45door and and she she was gracious enough to actually invest into me as the only monk student there in the only Asian student in their in their course.

· 04:00Until they hired Dr painful inroads.

· 04:05Over the summer to come and mentor me and by the end of the summer I was like this is wonderful, because at the time I knew less than five people that were either practicing.

· 04:17There were Hmong and practicing empty or a student of empty, so I didn’t really know anybody and so she said, Dr painful you enrolled said, if you really.

· 04:28enjoy this, what are your thoughts about starting this group, people have been asking me but I don’t have time to do it, I would love for you to do it, so that was.

· 04:38That was 10 years ago almost 11 years ago now, so it’s been such a joy and now we have like I think 60 people in our email us and our Facebook group so it’s pretty amazing to see how much we’ve grown since then.

· 04:55um so yeah i’m moving on to the question, are there any questions about that, before I begin.

· 05:04Okay, very good.

· 05:06So once again feel free to jump in and ask for questions, if anything, does arise, but we’ll get on with the questions for today.

· 05:16i’ll start off with the first one, so why did you choose this field versus other areas of counseling so.

· 05:25When I was when I graduated from undergrad I, I was interested in counseling I knew that that was something that I wanted to do, I did see myself initially eventually becoming a therapist but I wasn’t sure about like.

· 05:39Which field to to pursue, so one of my early jobs post post college was working in a crisis children’s Craig working for children’s crisis basically in ramsey county and.

· 05:55We would respond in teams of two so we would go out to people’s homes and there was always a licensed provider and unlicensed provider, which was me and so usually the licensed provider was.

· 06:08Any any degree licensed counseling licensed social worker and licensed marriage and family therapist so I actually got to experience, all three facets was which was really interesting for me.

· 06:19And I got to see all three styles and when it really came down to the work you know at that point in time, to educate a little bit about the Hmong community i’m.

· 06:31pretty much all of the therapists that I saw working in the field at time were either licensed social workers are licensed psychologists were licensed counseling.

· 06:41And, and I I didn’t see anyone who had a licensed marriage and family therapy.

· 06:46And when I was learning about that facet, when I was working with my colleagues and I saw their approach and that their approach was more of a systems approach of a family relationship based approach.

· 06:57I was like baffled I was like how come, no one knows no one was mom is a licensed marriage and family therapist because in the monk community.

· 07:06How we promote change is through relationships, so I just don’t understand why nobody is an LM FT I want to be enough to me, and if i’m we’re going to work with the Hmong community because.

· 07:18The monk people lack support and mental health at at that time this this was 15 years ago right like we’ve grown so much since then, but you know even then I would say the monkey is now finally at the younger generation my generation is finally starting to.

· 07:34be aware of mental health and and the necessity so i’m basically I was trading myself for.

· 07:43From from my people and and from I was treating myself because i’m always be kind of person that I wish that I had growing up right and I saw that the best ones was through a family relationship systems lens who knew how to understand and work through family relationships.

· 08:02Hopefully that makes sense, are there any questions about that, thank you for the knots.

· 08:10All right, okay well i’ll keep moving.

· 08:13So second question is what misconceptions did you have about marriage and family therapy when you first began your dream well honestly I really didn’t know how long this journey was actually going to be and how much money.

· 08:28was going to be invested and how much time I needed to really invest into it so i’m not sure if all of you are aware of this but.

· 08:39Just graduating from Grad school is it’s not the end all be all because after you get your master’s degree and marriage and family therapy there’s a.

· 08:48Written exam that you need to pass and then there’s a oral exam that you need pass and then and then, finally, you you become licensed and in that in that process, you also have to get a certain amount of supervision hours client on the field hours.

· 09:07yeah yeah yeah so that’s a lot it’s a lot you basically have no social life for the next five years, not sorry not to discourage you but it’s well worth it, it is the sacrifices will work.

· 09:21and

· 09:24And the discipline is well worth it.

· 09:27I say it’s really costly, because you know you really are going to have to.

· 09:32Think about what kind of qualitative therapists you want to be you’ll see this in the handles that 10 will be sharing with you from me.

· 09:40versus like hurry up and just get license for me, I was trying to find a healthy balance of both right because you, you know you only have so much energy to.

· 09:52within a timeframe to to give and then after a while you get burnt out and after a while you want to move on with your life right on the other hand, if you don’t focus on being as qualitative sure you get your license but you really.

· 10:05don’t really know much if that makes sense, you really comparative to your your peers or other people you you don’t have much to offer, and that that can be very daunting as well.

· 10:17So um anyway after you get your license that’s not the end sorry I forgot to mention that.

· 10:24Then, if you want to build health insurances you have to go through a conditionally process and that can take about three to six months and maybe even up to a year, depending on the health insurance company.

· 10:36And you have to convince them why you should be in network with them and then, if you want to do, private practice like me.

· 10:44You have to learn how to build these health insurances, which is a headache itself and you don’t get a paycheck through health insurers like like you usually do you actually have to.

· 10:57You actually have to send them a bill and then health insurances takes like four to six weeks for eight weeks ago yeah we’re going to pay you and then they’ll they’ll send you.

· 11:08The money and they’ll send you less than what you you build just tell you that you know that’s how health insurance is right, so you say i’m going to build 200 and they say well we’ll give you 100 and and so.

· 11:22Oh, my goodness, so um yeah but, but just so you know that that was 10 in the 10 years in the making, for me, I think I you know i’m so.

· 11:33Just so you know that it’s a long journey but um I would say, for for for some of you, if not all of you.

· 11:40you’ll find it worth your while For those of you who eventually go oh my gosh this is really scary I can’t believe this this woman is telling me like how far this is going to be I should reconsider.

· 11:50You know don’t be surprised I had some classmates in my cohort who, at the end of it, they said this was a really wonderful experience, but you know, maybe the universe, is sending me, let me somewhere else too so.

· 12:04be aware of that as well just just to be realistic about about this process.

· 12:11I would say the best chances to stay.

· 12:15And to be in this marathon is to be able to pay.

· 12:20invest into a really, really good supervisor, I think, at one point in my post graduate internship and trying to accumulate hours, I had like five supervisors.

· 12:32And the best one was the one that I paid out of pocket, and she was the most expensive one, and she was one of my professors at Bethel seminary.

· 12:41And I don’t regret, a single penny of it, she gave the best advice, the best support and that that’s what kept me alive and afloat, I think the second piece is also having a really healthy.

· 12:55relationship with my with my.

· 12:58With my husband so with you know with with someone someone that you know as close to you as my advice is.

· 13:04You know just having that accountability to having that support.

· 13:08is also very important, making sure that you’re you’re having a really healthy relationship in your personal life.

· 13:14Are there any questions follow up questions for that.

· 13:19Okay, all right very good.

· 13:22So i’ll move on to Question number three.

· 13:24What is the best way to gain a parent’s trust when working with their teenage child as in how to give the child more privacy and confidentiality within therapy sessions well.

· 13:38What you’ll see on my.

· 13:39professional profile on on on my website.

· 13:44Is that one of my forte’s is parent coaching and so.

· 13:50When it comes to seeing a teenager yes, I am happy and willing to meet with them individually, but I do have a rule of thumb with that, so what I tell families, you know when when a parent is bringing their children, I say well parent mom is very important to me.

· 14:12We need to have a healthy balance of the parents parents involvement.

· 14:16And if there’s a healthy balance and there’s a greater chance of success and I think a lot of you who probably are currently experiencing the mental health field, I think a lot of you would agree with me that.

· 14:27If the less the parents involved or if there’s lack of involvement it’s really hard to help the kid.

· 14:34In fact, a lot of times when you’re working with a teenager who’s really upset having anger issues depression, anxiety suicidal whatever.

· 14:42A lot of times you actually see it’s because the parents not Walt they’re not consistent right there just kind of like here take my problem child and fix them right so.

· 14:52So I like to have a healthy balance.

· 14:55So my rule of thumb for me professionally I know this is not true for everybody, but for me because i’m really big on parent coaching.

· 15:02Because I want to get the parents involved in to help them be successful in raising their child I say is that.

· 15:09Until they’re at least 16 and even at that point, it depends on the maturity level of the person.

· 15:17is actually a requirement that I make that at least one of the parents is present.

· 15:24At either the beginning or the end or both the beginning and the end of the of the therapy session, and the reason why that is because, at the beginning, maybe the parents want you know, usually the parent might.

· 15:36want to tell me something, and so I say that’s great I want to hear what’s important for you, so that we could bring it up in therapy with your teenager because sometimes the teenager may not bring it up.

· 15:47So the parent sets the tone and then definitely at the end, I always want parents, at the end, so that we can have a wrapper around and say you know.

· 15:55You know, give a brief summary of like this is what we worked on, and this is what your child has agreed to disclose to you, and what we worked on basically and.

· 16:06This this is, I want you as a parent to keep your child accountable on the self care we always ask a question like you know what’s one self care thing that you’ll be working on.

· 16:16So with regards to the teenagers privacy and confidentiality what I usually say to them as well you know, unless it’s student safety concerns.

· 16:26I don’t share anything with your parents, however, sometimes even if it’s not a safety concern if I think it’s an important topic that maybe your your parents should be involved in.

· 16:39i’ll address the two i’ll i’ll i’ll talk to you and basically what i’m trying to do is i’m trying to get buy in from the teenager.

· 16:47To have permission to share that information with a parent and usually I try to empower the team to share it themselves, but if they feel that it’s difficult than I volunteer to be advocate to say i’m happy to.

· 17:03i’m happy to share it with your parent but let’s do it together, basically, how do you how do you want to do this, but I will never share something that is not you know safety concerns account without the team teams permission.

· 17:18Does that help answer that question, or is there any additional questions to that.

· 17:23Okay, all right oh yeah go ahead Emily.


· Emily Cheasick

· 17:27Sorry, I was trying to figure out how to unmute myself.

· 17:30For a second.

· 17:31um What about a situation in which you have like a teenager and you know you’re trying to maintain confidentiality, but they’re expressing that their self harming their parents don’t know or they’re expressing that they are feeling suicidal have intent, what would you do in that situation.


· Maria Moua

· 17:48yeah so self harming and suicidal is underneath the safety concern bracket That is something I have to share um and so um.

· 18:01You know if it’s kind of well definitely if they are are.

· 18:07If they’re just doing superficial cuts, I would, if if it’s hmm no that’s actually no I don’t want to say that.

· 18:16If if they start bringing the topic of a self harm and suicide alley I will dive into it, I want to know about it as much as possible, if they start diving into topics of potentially like.

· 18:31I might be, I might be someone might be abusing me.

· 18:37I kind of pause them for a second and I let them know hey I just want to remind you i’m a mandated reporter.

· 18:45I just want to double check if you are ready to go down that route because i’m going to have to i’m going to have to follow the report, so if it’s your parent that’s hurting you or somebody else that’s where to you.

· 18:55If someone else’s hurting that’s not your current i’m going to have to tell your parents right.

· 19:01But if it’s your parent just know that i’m going to have to call child protection services and so usually pause them or if they have a friend who.

· 19:12Is is hurting themselves or suicide, or whatever I say hey I have to do something about that, so I kind of process but definitely for sure if they’re hurting themselves.

· 19:23yeah I do want to dive into that and I say hey that’s that’s a really serious topic let’s let’s dive into that I want to know more about that, how can I help you and remember this is a safety thing, so we need to get your parents involved.

· 19:36Okay.

· 19:38Is there any follow up questions to that Emily or.

· 19:41That makes sense okay anybody else.

· 19:44Okay, all right.

· 19:47um.

· 19:49So let’s go to question number four what important qualities or habits, not to do or have that may not be so obvious you know I get this question.

· 20:02Every year, and it always someone always asks it in a different way and I love this question, by the way, and I always give the same speech and it usually takes me an hour.

· 20:14Because i’m This is my soapbox This is my yeah so what i’ve done instead instead of going through the entire speech I I typed out a handout sheet and it’s titled how to be a great therapist.

· 20:28And so I always give this feel i’m not going to go through the handout i’m TIM, you can you can give it to them, but i’ll just kind of give a summary basically today, so I what I just want to say is this is my spiel I will say I believe there’s a difference between a.

· 20:47Good therapist here okay versus a great their bus and how you know they’re great therapist is that your your clients actually come back and they actually stay with you longer.

· 21:01When I say longer they stay with you more than five sessions, I have this colleague who will not be named, but they seem to like lose their patients after five sessions and they just don’t know how to retain them and i’m sitting there, and you know the consultant i’m going.

· 21:18Well, you know in my head, because I don’t want to step on toes very professional, but in my head i’m thinking well have you tried this because, on average.

· 21:26On average, when I get a new when I get a new patient I see them for six six months and that’s how much time, you need to actually promote change.

· 21:37You know at least six months, but most of the time I see them up to a year and then usually after that they’re like.

· 21:45Well problem solved and then your tools when they really want to dig in deeper they go I really like this and want to dig in deeper.

· 21:53And so, then you’re too we dig even with Steve now remember this is private practices people voluntarily coming in to see me this is not.

· 22:00The type of work that you probably will be doing when you’re first in the field when you’re first in the field.

· 22:04you’re probably going to be signed people that don’t want to be there, but they have to be there right um and so.

· 22:12Usually you’re kind of forced to work with them for at least six months to nine months and then you’re lucky if you can keep them for a year, so that’s a different different modality, but even then even then you’re not pulling your hair.

· 22:26To have to be a great therapist you’re not pulling your hair and going oh my gosh oh my gosh I can’t I don’t know how I don’t know how i’m going to be able to help this family, and you know you’re you know.

· 22:38You know, trying to figure out, so the handle sheet that I sent to you or yeah that you’ll see talks about several habits, to do and to not do i’m going to highlight a few to answer this question what are qualities habits to not do that may not be so obvious so number one, I would say.

· 22:57You know I think just putting myself in your position back back in the day when I was first starting and you know, I was starting my first internship my first job I was really eager to please, not to say that.

· 23:10You know well, anyway, I really wanted to prove myself, I was, I was very competitive at that time, and I want to say hey I deserve a place in this world or in this professional world.

· 23:21And I think one mistake is to water yourself down and to just take on every client it’s taken and it’s it’s kind of hard right it’s kind of hard to say that, because you are desperate for clientele but.

· 23:34You also want to be careful, because if you take too much on or if you say yes to everything.

· 23:38You begin to water self doubt or if you try to do every every single approach with the family, so you you meet this family first time.

· 23:45you’re you’re new and you don’t know what to do, and so you just try everything underneath the sun and it just feels really watered down so.

· 23:53My suggestion is don’t water yourself down meaning don’t oversell yourself because you’re desperate for clientele, this is the time to start knowing yourself to start building yourself to be confident in what you do and learn to do it well.

· 24:10And to not compromise your quality over quantity, I had a supervisor, who would just keep giving and giving and giving and say hey I have another project that you had another project for hey try this try this try this.

· 24:22And I was just such a yes person that I would just say yes, yes i’ll do it and that just burnt me out, so I would say, try your best to not water your quality down.

· 24:35On the other hand, I would also give a pushback because they’re they’re both two sides of a coin is don’t be overly rigid, I have a colleague who.

· 24:45After becoming licensed was like i’m just going to meet with couples only and and he wasn’t doing that, just because he was passionate um.

· 24:54I read that he was doing that because he was too anxious and he didn’t know and he wasn’t willing to stretch themselves, and so what I would be really encouraging of is, you are going to be given cases you’re you’re going to be given.

· 25:09strategies that are going to push you a little bit and and you’re going to be unfamiliar and you’re going to feel uncomfortable and you’re going to have to do some research.

· 25:17And you’re going to have to really do some inner working in here, so I would say, be open for girls find the right people who will give you the appropriate support with some guidance um and and and that’s going to help you be a better therapist and in fact you actually might learn to.

· 25:39Be more open and more fun and then, and then you have a greater clientele window, you can actually take in more.

· 25:46clients, because you actually become more familiar with with that type of work, so you know I can’t tell you how many times, even now doing this for 13 years someone comes in.

· 25:57And there’s something new it’s rare now because I keep taking a new things but someone comes in and gives me something new, or they give me a harder case or project to do.

· 26:07And I have to reevaluate myself and say well do I have the energy and time to research, this to grow on this to actually you know.

· 26:16understand this and if I do, then you know i’m willing to make an investment because this might be a new avenue for me this might be a new facet that I might.

· 26:25I might I might become an expert and then everybody looks for me, because no one else is doing it in the field and that’s what I do I look for something in the field that no one else is doing.

· 26:35or not a lot of people are doing and if I feel like i’m passionate and I can grow and become better at that’s that’s what I pursue.

· 26:44Another suggestion in that again, this is a question about what are the qualities or habits, not to do that might not be obvious again, this is also on the handout sheet that.

· 26:55is sent to you, so you don’t have to remember all this, you can look up the paperwork is this, I would say this is like one of the most part, I say that to all all 10 points actually.

· 27:06you’ll see why, and I put it in order to like you’ll read in an order and you’ll see like my thought process but.

· 27:14For me, is don’t forget to aim for how to build a good reputation in the Community, all that you do is connected to all these intricacies to a larger system.

· 27:27think like a system service, you are pursuing to be a marriage and family therapist your systems therapists you’re working with a family system but you’re also working with a system in the Community.

· 27:37A greater Community so think about that, broadly okay expand your mind and understand that not only are you being a great therapist to this family but you’re being a great therapist is community.

· 27:48If you build a good reputation with your clientele with your colleagues with referral systems, who are referring to, with insurance companies.

· 27:57I had this wonderful experience with this insurance company that I worked closely because I had to keep asking for permission for for renewal basically for this one specific.

· 28:07patient who needed a specific need and I, and I had to constantly talk to the health insurance representative, I had such a positive experience, I was able to provide.

· 28:18reasoning behind what I did and guess what at the end of that case and I said yeah i’m going to move on to private practice now right, this was like a really.

· 28:26Intensive in home kind of work that I was doing at the time and said yeah i’m going to go private practice now I finally got license and i’m ready to do that and then insurance represents said wonderful what i’m gonna do is i’m going to put you as a top tier.

· 28:40therapists in our insurance companies but anytime a patient calls in or we’re trying to refer therapists out to your in our top you’re in our top tier.

· 28:50yeah.

· 28:52Right so like that’s that’s what you want to think about you want to think about.

· 28:57Having a good reputation, you also want to think about what would what would a good reputation look like so i’m going to give you some few tips okay.

· 29:05When you meet with your patients patients like to know that you already have in mind a good idea of what the next six to eight sessions are going to look like so guess what I did.

· 29:17I would take different modalities, I was really anxious and nervous, but I did this, so that I could feel less anxious I looked at different modalities if i’m working with a parent and a child.

· 29:29teenager kid if i’m working with a couple if i’m working with the individual different modalities and I, I wrote down what the next six to eight sessions would probably look like.

· 29:40And this is after practicing and getting spirits, but i’ll give you some tips usually the first session is the introductory session, you have to do your diagnostic assessment.

· 29:51And you have to do a really good introduction in that introduction you want to tell them.

· 29:55What who you are obviously why you’re there and what your role is because a lot of times, especially when you’re new in the field and cases dropped on to you a lot of times parents are promised by the referral company.

· 30:09Something that you’re not you’re not there for.

· 30:13And so they just assume all you’re just you’re just the you know you’re just a very expensive babysitter or something like that right and I go no, no, no, no, no, I want to sit down with you.

· 30:21mom and dad, first I want to explain to you, who I am what i’m doing and what kind of what what to expect from my services right what the structure is going to look like what what I can do what can’t do.

· 30:33Really, you want it, you want to you want to be that specific I was mentoring, a young person who was interning or at their new job and.

· 30:44At one of their one of their patients homes, the parent was physically disciplining the child and was asking for her to hold the child down so that she could physically display Michelle.

· 30:56No, no, no, no, no i’m not here to hold her child down I set up your account i’m not here to.

· 31:03If you start physically, you know discipline your child i’m going to tell you to stop i’m not going to allow you to do that in front of me right, like.

· 31:10I understand that you can do that, but you know in mental health, we also understand that that stimulates fear and the back of your brain at the reptilian survival programming it doesn’t teach your child to learn.

· 31:22If you want your child to learn a new behavior and you want them to learn it and to have a positive memory, but.

· 31:27You actually want them to come and focus, so that they can insert it here the frontal lobe where we intake new information, but if you just want your child to be afraid of you, and to have harbor anger against you go ahead and hit them.

· 31:39And it will insert in the back of their brain and they’re not going to learn anything new they’re going to repeat the behaviors in fact they’re going to get worse.

· 31:46Science proven right so that’s that’s the kind of stuff that I told people so sorry.

· 31:51rabbit hole good coming back so good reputation means having a good setup good introduction patients like to know what the next 68 sessions going to look like it’s good for you decrease your anxiety.

· 32:04Patients like to know what you can and cannot do what your role is actually is that’s going to clear up a lot of stress.

· 32:11Later on patients also like to feel safe, knowing that they can learn to trust you this is especially important, one of the biggest mistakes i’ve seen people do is they come in and they say you can trust me automatically, no, no, no, no, no, no, no.

· 32:26it’s really healthy for your patients to not trust you when you first come in, there is some kind of trust, because.

· 32:33They assume that you’re a safe person or you should be safe person because of your background right and your and your job there right.

· 32:41that’s Okay, but it doesn’t mean that they can suddenly disclose everything to you and you become their best friend that’s not healthy.

· 32:47So patients like to feel safe, knowing that they can learn to trust you and so that’s what I tell my patients, I say.

· 32:52I want to earn your trust I don’t want you to trust me full blown automatically that’s not healthy for you.

· 32:58You know, you might become embarrassed you might self disclose too much, and then you might withdraw and that’s not healthy I might I might step on a internal mental health mental bomb and I had no idea I was there, because you should share too much right.

· 33:12On that stuff so I want to earn your trust.

· 33:16And how you earn their trust is they want to know that you have values and morals, that you can carry on your seeds so like, for example, my three morals that I.

· 33:27I carry so transparently is number one I will always be honest with you so i’m a pretty blunt person and I I try to be more gentle and apologetic like hey i’m going to tell you something it’s going to hurt.

· 33:39Here, he goes rip the band aid right so that’s that’s how you do, I will always be honest with you so that you know a lot of people like that I will always respect you and I always I will always require respect from you.

· 33:52When I was really early on in this field, I was like a punching bag, to be honest with you, so I allow patients to disrespect me verbally.

· 34:01Because I thought in my head that oh if they if they get to be their free selves even if it’s disrespectful towards me.

· 34:10that’s Okay, and I had a colleague who witnessed us and said I don’t think that’s that’s good that’s not healthy.

· 34:17that’s not good modeling you shouldn’t be a punching bag oh right so that changed morality inside of me of like.

· 34:24Oh, so I will always respect you and I should also always require respect So if you start verbalizing assault to me if you swear swear at me if you whatever.

· 34:34I will end the session I will call you out, I will end the session and I will not let you come back unless you’re apologetic and we make an agreement.

· 34:42This was really helpful.

· 34:45For a recent case of mine this happened a couple years ago um right before the pandemic so three about three years ago, so I had this narcissistic mother, working with this very, very.

· 34:58Anxious and depressed teenager and.

· 35:04She was very manipulative and she was also like in a high position at work or something right something important right and so like you know.

· 35:14She.

· 35:15Initially, was very charming as a lot of nurses are right, it takes a while to get to know them and to see through there sometimes you can feel it on the back fear you know hairs of your neck, but she was she was kind of slide so there was a situation where she.

· 35:31She.

· 35:33She kept not scheduling as I, as I suggested so she would just call me when there was emergencies and then I was like booked out three to four weeks, so I was like well I can’t see you for three or four weeks and i’m not a crisis therapist anymore.

· 35:47So if you want that go find a different therapist she wouldn’t leave as a lot of personality disorders, people do just so you know is that they have a tendency to contradict themselves.

· 35:59And so.

· 36:01She.

· 36:03So she wouldn’t leave she wouldn’t see a different purpose so she she kept scheduling with me, but then she got mad at me and she’s she was like she was like you know, this is not working, because every time I need to see you right manipulative.

· 36:15and try and guilt trip every time I need you to see you you’re not available you’re not readily available, and she kept trying to ask to see hours that I wasn’t.

· 36:24You know, on my on my professional like I say hey i’m only working from this and this time she always kept asking for different hours, and I was like no I don’t provide that.

· 36:31I don’t provide that and she was really upset and so she said, a really racist comment she basically said she was she wasn’t of my city, she said, basically said well since you’re not one of our time and I guess, we need to find someone, that is.

· 36:45of our kind and maybe that would work better and she she left, and I was shocked I was shocked, because at this point in my head i’m in private practice.

· 36:55You see my office, this is not my office Okay, but you see my office you see my plaque you see the plants, I water like I hold the realm here, you know, like.

· 37:05it’s different when you go in someone else’s home like you’re a lot more like humble you know because I used to work in people’s homes.

· 37:11But now you’re in my room so like I thought, like, no one would ever come in and say something disrespectful to me well, it happens, sometimes I think.

· 37:19When I was working my office Now I do telehealth, but when I was working mouth, I think it happened twice one was a patient had a meltdown and.

· 37:27cut me off with the other patient the other, the mother was like huge racist comment.

· 37:32Needless to say, I was like so shocked I cannot believe that she did that, and he has to say, as a person with a personality disorder she came back they always come back they always come back so she came back and she wrote this really, really.

· 37:48Long message to me glorifying me praising me, and you know her kid, of course, her Ted wanted to see me and only me because I actually was keeping them accountable right so she’s like nope she won’t you know my kelsey anybody else, and so I consulted with a colleague and.

· 38:08And I you know I felt really thankful for that and I respond to them, and I said look.

· 38:12The last time that we met you and I spoke, this is what you said that is recess, this will never happen again, and if it happens again.

· 38:21And you will schedule on a more timely basis if you don’t schedule and kind of basis.

· 38:26i’m firing you like I set up this like guideline, like, I was very strict and harsh and I said this is going to happen moving forward, and if you can’t if you can’t abide.

· 38:35i’m not going to see you anymore i’m not gonna see your kid anymore.

· 38:38and your kid is going to eventually find me, I mean that’s the faith that I have again remember don’t water yourself down I know a lot of us are like oh my gosh but the kid the kid can work it’s like.

· 38:50there’s a part of you that you have to kind of balance about moral respect and parent manipulation and remember that you know you remember the resources for the kid has and eventually.

· 39:01You know this kid was not actively suicidal and a lot of things there’s a lot of details that you don’t necessarily out but but at that, in the context of this case I was like i’m not gonna i’m not gonna let mom disrespect me.

· 39:12This kid is almost an adult this kid can find me this kid can come and reach out to me if they want without mom kind of thing so sorry long story long story long, but hopefully that helps explain habits that i’m.

· 39:27Not to do any questions.

· 39:31Okay, great.


· Emily Cheasick

· 39:33I had a question did you end up having to discharge that patient or that you know mother and child because she was not willing to follow the guidelines that you set out.


· Maria Moua

· 39:45yeah because i’m.

· 39:47Because, because I was not going to put up with it again there’s a lot more context, now I was not afraid for the child safety of the kid was not going to see me anymore, it was not that kind of situation right.

· 39:59And I was not willing to let this mom Fuck me around basically for lack of better term I apologize, but but really That was the situation.

· 40:06And, and I was going to be an enabler that’s the basic point if if I got involved again on mom’s terms, I was going to be an enabler I was going to let this child.

· 40:17participate and letting the child be being you know fucked up my mom right and I wasn’t going to do that this kid was a bright brilliant kid this kid was sharp and this kid knew exactly what I was doing yeah any questions.

· 40:35Okay alright.

· 40:37So next question is, how do you integrate multicultural approaches conducting therapy with couples or families from diverse communities, for example.

· 40:46parents who get separated from their children, due to the children being assimilated into a different culture unrelated to that their parents.

· 40:55Well, this is my so I already have 15 minutes left so i’m going to try my best to sum it down so that’s one of my passions being.

· 41:06Among person who is a marriage and family therapist is that I knew growing up that there wasn’t an advocate among another therapist winner cinema culture, who could help bridging the gap between first generation.

· 41:19Immigrant parents who are raising children who are born and raised here in the United States and so now there’s a gap there’s a huge gap and the problem is.

· 41:30In our parents who are immigrating here who are among we don’t necessarily have a country we’re coming from a place of persecution right, and so the issue with, that is, they really.

· 41:41suck into their family their country of origin culture right.

· 41:46And then these kids are stimulating and trying to survive and are americanized there’s nothing there’s no nothing wrong no shame that you just that’s just how it is because guess what our parents did that to.

· 41:55Their from Laos and Thailand and they they have a mixture of Laos and Thailand and their culture.

· 41:59long story short, generally speaking, that’s kind of that idea with with all families who are who have different cultures so.

· 42:06I wanted to become an expert and understanding, both languages and being able to translate.

· 42:12So what I like to do is first immerse myself into the parrot culture, whatever that culture is if i’m willing to take the case on okay.

· 42:21and make sure that I know what i’m getting myself into this might be really difficult for a lot of you, and you might you might not be an expert not that’s not what i’m looking for.

· 42:29it’s just about making sure that you are educating yourself, and you have a colleague or somebody else that you can consult with so hello, you know me know so if you need to reach out to me about the Mon culture here I am it’s been it’s been my passion for the last 13 years okay.

· 42:44So decrease that anxiety.

· 42:47I also want to get a good grasp of everybody’s lens, so I would I like to meet with each family members separately, the parents separately.

· 42:56The kids separately and understand what type of lens that they’re carrying then it’s my job to play the finesse role of bridging the gap between the two.

· 43:05it’s really about providing education and empathy.

· 43:10When you’re empathetically educating the other person to better understand where the other family members, coming from.

· 43:18And then you try to tie the the knowledge to a common value or base basically trying to find a common ground there’s a really good handle sheet.

· 43:35But basically that’s like one of my number one sheets that I live to give to families and say look.

· 43:41You love each other right you want to have a healthy relationship well, let me educate you about the power of emotions, and this is what happens when when we’re not.

· 43:51In our primary emotions when we get overwhelmed and stressed what presents itself our secondary emotions and those push relationships away.

· 43:59Those those decrease intimacy, but if you want to grow closer to each other, this is how you do it by managing your emotions and, and this is why so that’s where the handle sheet will help you out there any questions about that.

· 44:14Okay, very good.

· 44:17Oh yeah.


· Giovanni Higuera

· 44:18Sorry, I wanted to jump in with a question.

· 44:19So you talked about seeing the the the parents and the child separately.

· 44:25You know I know from some of our most recent readings, they would encourage or there’s this this encouragement to see the family as a whole and then separately, how do you operate the do you do that in reverse separately and then as a whole, what is your approach to that.


· Maria Moua

· 44:40Yes, that is correct, so the initial intake introductory session, you see the family as a whole, and you give everybody a chance to.

· 44:50To explain why they’re there what’s going on, after that initial assessment, and I say or even maybe even during the initial session I say.

· 44:59No, especially to the teenager teenagers usually don’t they’re not talking from their parents right, so I acknowledged, and I say.

· 45:05hey i’m happy to set aside some time for you either today or in the follow up session.

· 45:10where you can meet me meet with me one on one if that makes you feel more comfortable because sometimes there’s things that you want to share that you don’t want my my mom and dad have here.

· 45:17The same is true to parents there’s a lot of grown up conversations that especially younger kids don’t want to hear.

· 45:23A lot of processing I my forte’s parent coaching so there’s a lot of adult conversation that’s just going to trigger the child.

· 45:29And they’re going to go no I don’t want that, because what i’m going to say is you need to put them in timeout need to put them in title for women, for your vision.

· 45:36You know it’s like you don’t want you don’t want a little kid to hear that right like they don’t need to hear that a parent needs to hear that and then, and then I provide provide the logic behind that.

· 45:45And so, yes, initially you meet with the family unit, you see how they are as a whole, and then you break it apart, so that you build alliances and and as a structural therapist I like to self the device that I like to build alliances with the easiest person first.

· 46:02Who is the person who is most excited and willing to be there, usually it’s the parent or sometimes the kid right, but I also recognize the importance of.

· 46:11Building a relationship individually with each person so like the parent role is especially important to me.

· 46:16And and connecting and building trust with the team, but but also recognizing my space that i’m not here to be a replacement parent for you.

· 46:25I want to make sure that you understand that i’m helping your parents, just as much as i’m helping you so I really am thinking about this as a marriage and family therapist i’m not thinking about this as an individual.

· 46:37clinician i’m really going i’m your family, marriage therapist even if i’m working with you individually i’m always going to involve your your family your parents somehow or somebody so How does that kind of help answer your question to you is.


· Giovanni Higuera

· 46:49Certainly does Thank you.


· Maria Moua

· 46:50Okay you’re welcome.

· 46:51Anything else.


· NorKhadijah Lindgren She/Her

· 46:54I have a question so when there is a family that needs therapy, but half of the family shows up to therapy.

· 47:01yeah you take to help family members who did not show up.

· 47:05Yes, therapy and methods different in the southeast Asian lens.


· Maria Moua

· 47:12yeah so that that’s actually one of the questions that’s on my sheet here, so thank you for bringing that up, so what what i’m what I like to say about that is that.

· 47:25So whoever shows up i’ll take what I can get for for the time being, but it really depends on on who the family member is that’s showing up.

· 47:32And what is the key issue if the missing person plays a key role eventually they’re going to have to show up and i’ll prove a point to it i’ll say well well.

· 47:40You know, really can’t do much until this person’s here, we really can’t do much with great great eventually we’re going to have to invite this person in and.

· 47:49Again, if it gets that point, I would, I would really try my best to convince the person who has a close.

· 47:57Alliance to the missing person so like this one case study, where I was working with his teenage boy, and the real issue is between him and dad and it was just mom and the boy coming in.

· 48:07So the person who holds this person was mom that could events dad come in, so, then I had to have an individual session with mom I had to.

· 48:15You know, talk to her like what are the factors that it’s keeping dad from coming in, how can I help you to be as convincing as possible process through that coaching.

· 48:24And then we were able to get dad to come in one or two sessions and it come to find out, you know all these other things, but.

· 48:31it’s not always successful if it is great, but if it’s not then you you teach the family to learn to accept and to decide what to do if the person is not willing to be part of the sessions.

· 48:41Because you can still help the family and i’m really big about resources that’s Another good thing about me.

· 48:46Resources in the Community, so I say, well, if this person is not willing to participate here are your options you’re never stuck you’re never stuck there’s always options that you can do this is what you can do to move forward with or without this person does that help answer your question.

· 49:03Any other questions about that.


· NorKhadijah Lindgren She/Her

· 49:06All right.


· Isabella Restrepo Toro

· 49:07Very good.


· Unknown Speaker

· 49:08I have a question oh.


· Isabella Restrepo Toro

· 49:10You were just talking about getting like family members to come in, how do you work with individuals that might be part of like mixed family so like parents may be divorced, and they might be remarried.

· 49:23And kind of getting everybody involved if they’re still involved in kind of like a child’s life and it’s kind of affecting them, how do you get all those parties involved.


· Maria Moua

· 49:32yeah well if there is no legal obligation for me to to contact the other parent, so if it’s if there’s like a joint.

· 49:43custody of the child, I have to let the other parent know that i’m treating them for therapy services right and then at that point that’s where I can invite them in that process.

· 49:54Once again it’s kind of a similar answer, once again I I either ask for permission to communicate with other parents or the other person where is involved.

· 50:04If if there’s if there’s issues between the two parties like we’re not on communication grounds between the two parents, but the child really you know values both and so either asked for permission to come to outreach to their parent or.

· 50:20Or again i’ll have the other parent contact other parent and and really see why don’t we invite both parties to come in, or.

· 50:28You can even see me separately and i’ll explain to you i’m happy to provide provide cycle ED.

· 50:33parents who are really eager to hear hear that and understand that, in my experience, I want to provide cycle at of my assessment of what’s going on with your child and how you can play a role in helping your child so usually that gets fired.

· 50:46mm hmm does that kind of help answer your question, or is there something else I really want to be, I really want to help you guys so.


· Isabella Restrepo Toro

· 50:55Thank you.

· 50:56you’re welcome.


· Maria Moua

· 50:57Any other questions.

· 51:01All right, very good so that that answered that question, so it looks like I have a few old three more questions here So how do you.

· 51:10know, I think we already answered that nevermind.

· 51:14i’m oh if you’re working with both parents and young children during family sessions, how do you balance the language.

· 51:22So that younger family members, understand and adults aren’t offended or insulted by your language presentation well lucky for you i’m a parent i’m a parenting coach so.

· 51:32When i’m talking to the child I turned to the adults in real time and explain to them what i’m doing.

· 51:38And also explain to them what i’m noticing, so the child really young i’m like hey do you notice that this is a language i’m doing so that you know the child is kind of like in their own play.

· 51:49And they know that i’m there to teach them and I explained that to kids to that you know when you see me because young kids don’t really know what they’re for star sometimes I say.

· 51:57Well, you know how you go to school, and you have an art teacher and a music teacher and a math teacher well you know you can kind of say that i’m a mom feelings teacher i’m here to teach you how to have healthy feelings.

· 52:07And how to how to share your feelings and healthy weight, but the good news is I don’t give you a great so that’s nice straight I might give you a sticker.

· 52:15But like I don’t give you a great so.

· 52:19So that’s what kid kids understand that so i’m like i’m also here to teach your parents, so when i’m working with you sometimes I might turn your mom and dad say see did you see what they did there.

· 52:27And you know it’s the language that i’m using so that’s how I bring in inclusiveness there’s a really nice handle sheet called full body listing.

· 52:34That you can refer to, and this and I utilize that and I coach parents on how to work with your kids and how to model, how to use your entire body to.

· 52:43Show someone that you’re you’re focusing your attention and that’s the best way to communicate and make sure that the other person’s hearing you okay any questions about that.

· 52:56All right, I think we are in the last one.

· 52:59Is it ever intimidating being in the room, have a family fighting, how do you personally handle conflicts and yelling and session to this very day, I still have couples that y’all have in front of me and I go hey hey hey hey guys, do you want me to help you usually someone will say yes.

· 53:20Okay, well then, I need all of us take a break before this though before that happens, I.

· 53:27A I start the session early on, when I first meet with them I say you know we’re going to get into topics where it’s going to get pretty heated pretty escalated.

· 53:35I don’t want you to feel like you just argue the whole time and then leave feeling disgruntled that’s not fun that’s fun enjoyable and then you’re not going to come back, why would you come back because you’ll say all we do is argue.

· 53:45we’re not getting you know we’re not getting any productivity, so what I say is I want your permission, if I noticed any of you are escalating or things are getting heated.

· 53:55I would like to ask for permission that I can intercede on your behalf, and we all take a break, and then I provide psycho at about the brain to really, really drive it home, and I say.

· 54:04When we’re escalated we trigger the survival part of our brain, which is the reptilian part of our brain for for for just to quickly you know summarize it and.

· 54:15That part is a reaction survival piece it’s the whole partner brand if you if you’re a fan of the adventures right you a little bit mean green a little bit more GM.

· 54:25And you and you don’t really communicate well and you you’re no longer in this private brain, which is the frontal lobe, which is the rational part of rain, which is the problem solving Program.

· 54:33Which is where you can take new information and learn new behaviors, so we need to calm down.

· 54:39And the rule of thumb is it takes literally takes one minute per year of age, after you’re flooded to come, all the way down.

· 54:46I don’t want you to get to the point of being flooded when you’re triggered let’s try to stop yourself from becoming flooded flooded means is when your entire brain shuts off and your full on Hulk mode great survival mode.

· 54:56that’s not that’s not helpful so we’re going to take a break, if I need to separate you someone’s going to go to a different room and and then i’ll check in on each of you we’re going to do calming strategies and session.

· 55:10And, and what I like to give to everybody, and I know TIM, you have to head out now.

· 55:15Okay, did you want to say anything to him or.



· Maria Moua

· 55:27Alright, thanks so much time.


· Unknown Speaker

· 55:28Okay.


· Maria Moua

· 55:30So there’s this there’s this wonderful handouts called therapeutic press.

Student’s Name: Haifa Ahmed

Professor’s Name: DR Tim Balke

Course: CPSY 650-01: Introduction to Marriage and Family Counseling

Due Date: 05/30/2022

1. I belong to a religion that recognizes every individual as God’s creation and condemns sin. How do I handle the adoption of a minor from the LGBTQ community and blend into the family without compromising my religious principles?

2. I was born in a family with different social classes, with a good number experiencing upward social mobility in adulthood while others are yet to. What should I do when I experience differences in the family stemming from the different social classes which threaten to divide the family?

3. For parents who get separated from their resulting into their children being assimilated into a different culture unrelated to that of their parents, how should they reconcile the cultural differences and handle the situations where the cultures mismatch during their reunion?

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