The Proapproach

Having explored the various sources that form the bases on which to build therapeutic stories in the last chapter, the next question becomes, "How do you structure those ideas into a metaphor and present it to the child?" Fortunately, the process is not difficult: just three simple steps with which, by now, I hope you are already familiar. Each story in Part Two is preceded by a heading, "Therapeutic Characteristics," detailing the Problems the story addresses, the Resources it seeks to develop, and the Outcomes it offers. I refer to this as the PRO-Approach (the acronym for Problems, Resources, and Outcomes) and find it a pragmatic basis for building metaphors as well as for maintaining focus on the therapeutic outcome.

It is very easy at times to get caught up in the problem-focused story of the child or child's parent. Their story, as yet, has no resolution—as evidenced by the fact that they are sitting in our office discussing it. Let us take the example of a mother who brings a teenage daughter to therapy. The mother tells how the daughter is anorexic, taking drugs, mixing with undesirable peers, fighting with family members, and failing to study. She has slashed her wrists, overdosed on her mother's antide-pressants, announced she is sleeping with her boyfriend (who has not won parental approval), and said she doesn't care if she gets pregnant. Her parents have tried everything, nothing has worked . . . and this teenager sits with her arms folded staring you in the eyes with a you-ain't-gonna-make-a-difference-either look.

Where do you begin? And what is the problem—the conduct issues as described by the parent, or the curtailment of independence as seen by the teenager? Even if it is possible to have a clear, em-pathic understanding of the problem—though perhaps that is an important starting place—is this necessarily going to provide the mechanisms to effect change? For this reason it is therapeutically beneficial to have a clear understanding of the outcome. Where does the client want to go? How might the client want life to be happier? What does this teenager want for herself and her relationship with her parents?

Having defined the outcome, it is easier to ask the question about what resources, abilities, or means your child or adolescent—and, consequently, the character of the metaphor—needs to reach the desired outcome. Focusing on the outcome puts you in a better position to structure a healing metaphor than if you were caught up in the client's story of seemingly endless problems. In the rest of this chapter I explore how to undertake an outcome-oriented assessment, plan your metaphor, present it to the child or adolescent, adapt it to the client's responses, and generalize the outcome into real life.

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