Dr. Jeremy Sharp (01:31)
Krista, hey, welcome to the podcast.
Krista Brittain (01:34)
Hi, thanks so much for having me.
Dr. Jeremy Sharp (01:37)
Yeah. Yeah. Thanks for being here. Thanks for being here.
Krista Brittain (01:39)
Yeah, I’m glad to be here.
Dr. Jeremy Sharp (01:41)
Yeah, yeah, yeah. Yeah. This is a really interesting topic that to be honest I didn’t even know existed before we found you. So this is gonna be a lot of fun, I think, to learn something new and share that with the audience. So I’ll start with a question that I usually lead with. and that question is of all the things that you could do in the assessment world with your with your time and energy.
professional life. I mean, why why dedicate time and energy to this in particular?
Krista Brittain (02:10)
Yeah, well, I’ve been doing therapeutic assessment for a long time. And before that I did traditional assessments in private practice for a long time and in hospital settings, community mental health. And there’s just something about TA, therapeutic assessment, that is really powerful and gives an opportunity to kind of combine my therapy self and my assessment self.
and really walk alongside people and families to understand themselves better and find new ways of of living life and relating with each other that work better for them. It’s it’s really profound and and such a beautiful experience to be a part of. Yeah.
Dr. Jeremy Sharp (02:51)
Mm.
Yeah. Yeah. Yeah. It’s funny the similarities in the ways that people describe therapeutic assessment. you know, there’s always like a vibe to it and you’ve got that vibe. You know, it is it is really nice.
Krista Brittain (03:02)
It is a vibe.
Dr. Jeremy Sharp (03:03)
It’s a nice way. Yeah, yeah, yeah. Yeah.
Krista Brittain (03:05)
That’s true.
Dr. Jeremy Sharp (03:07)
Yeah. I mean, I think it it’s an it’s a great solution for those who don’t want to like lose the therapy side of things, right? And kind of get
Krista Brittain (03:14)
Yeah.
Dr. Jeremy Sharp (03:15)
lost in testing and assessment. So
Love it. so we’re talking about family systems in assessment. And I’d be I I I don’t know, I’d be surprised if a lot of folks are super familiar with what that even means. so maybe we start with some definitions. We could start with just family systems. I would love to hear like, you know, how you as a psychologist slash assessor define family systems in this context.
Krista Brittain (03:42)
Yeah, that’s a great question. You know, I think a family system is a unit or a combination of units of people who are doing life together. and in a way that there’s often a lot of really close contact. Sometimes there’s you know, biological relatedness, and sometimes there’s not. There’s chosen family. And so
Dr. Jeremy Sharp (04:05)
Mm-hmm.
Krista Brittain (04:06)
You know, when we’re working with kids and adolescents, the caregivers are a really important part of that family system. And so thinking about what the assessment process is like for them as well through this systemic approach feels really exciting and important in terms of actually helping the client and helping the family.
Dr. Jeremy Sharp (04:29)
Yeah, yeah. I I think that a lot of us probably take environmental factors or family factors into account when we’re working with kids and adolescents, or I hope I hope we do anyway, right? Or thinking
Krista Brittain (04:42)
Yeah, I hope so too. Yep.
Dr. Jeremy Sharp (04:44)
about I hope so. but this seems to to take it a level or two deeper beyond that. Could you maybe talk just a little bit about how how your approach is d kind of distinguished from just
Hey, we’re doing a holistic assessment, we’re looking at the environment and family interactions and that
Krista Brittain (05:03)
Yeah, absolutely. So I think, you know, there are a lot of different models of development out there. And the one that I would say this approach is rooted in is the transactional model of development, which kind of talks about how kids are developing
Parents are developing, everyone in the family system is developing over time. And there’s been a a lot of research and writing and studying about how parents affect the development of children. But the transactional
Dr. Jeremy Sharp (05:27)
Mm-hmm.
Krista Brittain (05:28)
model is really the first one that also talks about how children affect the development of parents or caregivers in the family system. And then one of the other things that I think can be really interesting to think about is how siblings affect each other’s development and kind of that very
complex and sometimes incredibly messy systemic thinking and approach to the work. So just kind of giving a nod to that idea that everyone is constantly developing and affecting everyone else’s development in the family system. And so if we’re really going to help a family, if we’re really going to help a kid, we we need to be also thinking about what it looks like to help that system shift in the ways that will be helpful to the child or the adolescent.
And then to the parents.
Dr. Jeremy Sharp (06:11)
Right.
Right. Right. Yeah, I don’t know if you fall into this trap, but as you’re as you’re talking about this, I’m just thinking about for myself, as a parent of now two teenagers, who are certainly affecting my development in many ways. But
Krista Brittain (06:28)
Mm-hmm.
Dr. Jeremy Sharp (06:29)
you know, I think about I actually don’t really think of them affecting me or my partner.
In the same way that they are developing, if that makes sense. Like I kind of see us as parents as like static beings, you know, we’re just like parenting. That’s you just parent for 18 years or whatever. so this concept of the kids affecting the development of the parent is fascinating. Can you give any like brief examples? I know we’re gonna like dive into the clinical part in just a bit, but just for now, what does that look
Krista Brittain (06:59)
Yeah.
Dr. Jeremy Sharp (07:00)
like?
Krista Brittain (07:01)
Absolutely. Well, I think one of the things I hear a lot from parents, one thing to know is that I work with a lot of neurodiverse families and neurodivergent kids and adolescents. And I hear parents say, like, Well, there’s no instruction manual. And if there was one, we don’t think it would work for our kid. And so I think parents some and caregivers sometimes go into that process of parenting thinking this is how it’s gonna go.
And then realizing that whatever it is that they’re doing isn’t working well with their their child and their family. And so then having
Dr. Jeremy Sharp (07:33)
Mm-hmm.
Krista Brittain (07:33)
to make shifts and kind of reflect on how did their approach develop and how can they make a change away from something that maybe feels pretty natural or feels intuitive, feels like just the way it is to them.
Dr. Jeremy Sharp (07:46)
Mm-hmm.
Krista Brittain (07:48)
and and try to find strategies and
and approaches and ways of relating that work better for their kiddo. I would say
Dr. Jeremy Sharp (07:55)
Mm-hmm.
Krista Brittain (07:55)
from my experience as a parent, I’ve absolutely had that experience where I was like, well, that was not what I expected in this journey. and needing to do that self-reflection and make some shifts.
Dr. Jeremy Sharp (08:08)
Yeah, that’s a really good way to put it. Yeah. It’s just that there are so many unexpected experiences.
Krista Brittain (08:14)
Mm.
Dr. Jeremy Sharp (08:15)
I mean, yeah, hopefully hopefully we’ve adapted in a positive way. But we have to we are influenced by our kids whether we want to be or not.
Krista Brittain (08:24)
Mm-hmm.
Dr. Jeremy Sharp (08:26)
So we’re gonna get into that, like I said, with maybe some case examples or, you know, more of the clinical application. But again, just kind of like setting the stage here. You mentioned in our pre podcast chat that you kind of look at things through four family system prototypes. Can you explain what those are?
Krista Brittain (08:45)
Yeah, absolutely. So one of the goals of thinking through family system prototypes is to help us as clinicians understand some bigger picture things, but also kind of manage part of our experience of the family system through a compassionate lens and give us curiosity, but also it gives us some structure for thinking about how we might help the family change the narrative in ways that are meaningful and helpful.
going forward. So kind of thinking about that idea of narrative identity that Jonathan Adler has written a lot about and and how what’s the family’s narrative identity in
Dr. Jeremy Sharp (09:25)
Mm-hmm.
Krista Brittain (09:26)
relationship, especially between the parents and the child. So in a presentation that he gave earlier this year, Steve Finn, who created therapeutic assessment, said that every parent’s worst fear is that it’s all their fault.
When they walk into
Dr. Jeremy Sharp (09:39)
Yeah.
Krista Brittain (09:40)
an assessment with their kid. And so one of the ways I think about these family system prototypes is how parents might be sort of managing that fear and any shame that comes along with that fear. So we think about four different prototypes. And I’ll go into them each, but just so you can hear the names of them: there’s the scapegoated child, sick child, orphan child, and Solomon’s child. And so in the scapegoated child system,
The parents are really united or connected in their understanding of the child as bad. and and that’s an oversimplification, obviously, of how it shows up, but it’s kind of like the problem child or the black sheep of the family or the person with the problem. and this k is often corroborated by other systems that the kiddo is a part of, maybe the school system, maybe the care system, maybe,
the athletic team that they’re a part of or something like that. And so this gets reinforced, this narrative in the family that the kiddo’s bad or the kid has a problem. And lots of times this happens when parents have difficulty managing their own negative personality traits or characteristics, which we all have, and then they get kind of projected onto the child. And as you can imagine, the relationship between
child and caregivers gets pretty strained here. and it it can
Dr. Jeremy Sharp (10:58)
Mm-hmm.
Krista Brittain (10:59)
be really hard for anybody in the system to be vulnerable and kind of get in touch with those those challenges or maybe those negative traits that everybody has. There’s also the possibility that there’s some grief happening that that parents could be stuck in. Maybe their kiddo and their parenting journey is different than they expected. Like I was
Talking about before. And there’s in gr there’s grief inherent in that. and so in the assessment process, kind of knowing that there’s maybe this grief or or this hidden shame that’s happening in the dynamic can be really helpful to us as assessors so we don’t step on a landmine unintentionally. and often what happens in the assessments is there might be a lot of things going on, but these kiddos tend to look pretty depressed.
On the testing. And
Dr. Jeremy Sharp (11:46)
Mm.
Krista Brittain (11:47)
the parents may be sort of aware of that, but especially in a scapegoated system, I tend to see parent ratings of anger looking higher. and sometimes depression isn’t up there. And so helping parents know that anger is actually one way that depression shows up for kids can be really helpful because the goal in these systems is to help kind of reframe the parents’ view of the kiddo from sad or from bad to sad.
and so we’re helping the parents mentalize the kiddo in a different way, which when we think about mentalizing, that is understanding that a person’s external appearance, their behaviors, their words, things like that come from internal emotional states. And so as we mentalize the parents.
in the in the assessment process, kind of thinking about these systems, we can help the parents start to mentalize the child. And thank goodness the data is there to help us with that. So yeah, that’s kind of the state the scapegoated child system. Yeah.
Dr. Jeremy Sharp (12:48)
Great,
great. And you said the next one is the sick child?
Krista Brittain (12:51)
Yeah,
a sick child system, exactly right. So, you know, these systems usually have caregivers that are are united in concern for the child. and so this may also, again, be corroborated by those external systems. Maybe these kiddos really do have a medical or mental health need that requires extra attention. and so there’s an immense amount of caregiving and some sense of closeness.
between parents and children, where everyone’s kind of united in giving care and support that the kiddo needs. and what can happen in these families is that the parents really struggle to tolerate if the child starts to rebel or separate and individuate or express anger toward the parents because the parents are putting in all of this work to help take care of the child and meet the child’s needs.
And so it it feels really egodystonic to feel like the kiddo is mad when they’re doing all they can to help the kiddo. so there may be mixed messages about emotional expression. One other thing to note here is that boundaries can get kind of complicated, especially when kiddos have you know, serious medical conditions. what does consent?
look like and how do we involve kids in the consent process when they’re getting chemotherapy or if they have to get a lot of blood draws or other things that really invade their body. and and then how can kiddos really express how they feel about that?
Dr. Jeremy Sharp (14:18)
Mm-hmm.
Krista Brittain (14:19)
if they’re, you know, pretty pissed off about it sometimes, which is understandable. yes
Dr. Jeremy Sharp (14:23)
Mm-hmm. Mm-hmm. Could I ask a clarifying question?
Krista Brittain (14:26)
for sure.
Dr. Jeremy Sharp (14:28)
So when in this framework, like the or prototype with a sick child, does that mean literally sick? Like or could it mean like
Krista Brittain (14:35)
Such a good question.
Dr. Jeremy Sharp (14:37)
kind of metaphorically sick according to the
Krista Brittain (14:39)
For sure.
Dr. Jeremy Sharp (14:40)
parents?
Krista Brittain (14:40)
Yes. Yep. I would say there absolutely could be metaphorically sick or literally sick. So sometimes we see this paradigm
Dr. Jeremy Sharp (14:47)
Mm-hmm.
Krista Brittain (14:48)
show up when kids have gotten bullied, or when something
Dr. Jeremy Sharp (14:50)
Okay.
Krista Brittain (14:51)
bad has happened, when there’s been a trauma or, you know, something that we would consider to be on the aces scale, things like that.
Dr. Jeremy Sharp (14:59)
Uh-huh. Mm-hmm.
Krista Brittain (15:01)
sometimes it’s a pattern that develops when kids are shy or
they have a speech delay that, you know, maybe eventually
Dr. Jeremy Sharp (15:07)
Sure.
Krista Brittain (15:08)
kind of comes along to be developmentally normative, but there was a time when the kiddo needed extra support. or
Dr. Jeremy Sharp (15:12)
Mm-hmm.
Krista Brittain (15:14)
or maybe the kid’s just kind of struggling.
Dr. Jeremy Sharp (15:18)
Gotcha, gotcha. So sick in the sense that they the parents perceive that the kids need quite a bit of caregiving and support and you know, they gotta like pour into this kid in a way.
Krista Brittain (15:28)
Yeah, I also think one thing to to think about is how systemic oppression can contribute to this dynamic. you know, in the state where I live, there are some changes being made to laws where families are experiencing real oppression, and the ways that kids express their identity is being limited at school.
Dr. Jeremy Sharp (15:47)
Mm-hmm.
Krista Brittain (15:47)
and and so real support is needed for kiddos experiencing that kind of oppression. and
Dr. Jeremy Sharp (15:53)
Mm-hmm.
Krista Brittain (15:54)
so
I think this dynamic can also devo develop in those kinds of situations as parents find themselves not only parenting, but in advocacy roles that again, maybe they didn’t expect.
Dr. Jeremy Sharp (16:05)
Fair enough, yeah. You know, I’m aware as you’re as we’re talking through these first couple prototypes that in my mind I’ve already sort of characterized these as inherently negative. I don’t know if that’s right or not though. is there is there like
Krista Brittain (16:18)
It’s so bad you’re
Dr. Jeremy Sharp (16:19)
a continuum here or what yeah, how should we think about that?
Krista Brittain (16:22)
Yeah, absolutely. I I am really glad you pointed that out because I think sometimes we over pathologize these prototypes and these systems. And the fact of the matter is that if you have a child that has been bullied or that has cancer or that is being oppressed by by sis systems in the world, they need extra support. That’s the reality of the situation. And so sometimes
Dr. Jeremy Sharp (16:48)
Mm-hmm.
Krista Brittain (16:48)
these dynamics develop.
Through attuned parenting and emotionally responsive
Dr. Jeremy Sharp (16:52)
Mm-hmm, mm-hmm.
Krista Brittain (16:54)
parenting. Often they end up in our office when the dynamic has outlived its usefulness.
Dr. Jeremy Sharp (17:02)
I see.
Krista Brittain (17:02)
And so it’s like any strength, right? Any strength can overfunction. And so probably these prototypical dynamics that we’re talking about here can overfunction in a way that kind of you you lose the return on investment, right? Like
they’re not as helpful as they once were. and especially as kids grow and develop and mature, you know, we we wanna see that separation and individuation. And so I think through assessment and identifying these family system prototypes, we can help the system figure out how to grow and develop and mature alongside the kiddo.
Dr. Jeremy Sharp (17:37)
Got it. Got it. Yeah, this is good. Thanks for taking that little detour. We can jump back to these prototypes. Mm-hmm. Yeah. So we’ve got scapegoated and sick, and then yeah.
Krista Brittain (17:41)
Yeah, no, I’m so glad you asked. Yeah. Mm-hmm. Yeah. So
one last note about sick child is that the goal there is to help parents see that the child really does have needs and they’ve done a beautiful job of caring for those needs. And that we can also notice the kiddo’s strength, resiliency, capacity, you know, ability to start having more autonomy.
And things like that. So, and and like I said, figuring out, for example, in a medical system, what does consent look like for kids getting medical treatments that maybe they’re not a big fan of? yeah, yeah. So thinking
Dr. Jeremy Sharp (18:18)
Mm-hmm. Mm-hmm. Great.
Krista Brittain (18:21)
about the next prototype is orphan child. and so in this situation, something has happened so that parents might not be quite as
present or available or attuned to what’s going on for the kiddo. Sometimes this is because the parents have something negative going on in their life. Sometimes it’s just a function of real life. For example, I’ve seen this prototype developed for military families when when one parent goes on deployment. That’s
not a bad thing, right? Like that’s the job. And we’re so thankful for for families who make that sacrifice. And there’s effect on the family system there. and that can
Dr. Jeremy Sharp (19:00)
Course.
Krista Brittain (19:01)
can can cause some changes in how parents and kids relate to each other. also, you know, if parents are in a in a period of high conflict in their relationship or super high connection.
maybe the ways that they’re responding to the kiddos aren’t aren’t exactly what the kiddo needs. So again, kind of thinking about that these aren’t necessarily negative. They’re just things that develop in family systems. It’s likely that parents are really doing the best they can in challenging circumstances. And so it’s also true that there are factors that the kids bring to the table, right? Like maybe they’re gifted.
Or or highly verbal, or they have some incredible talent, or they’re just one of those old souls that’s really mature and just gets stuff in a way that their peers don’t
Dr. Jeremy Sharp (19:46)
Mm-hmm.
Krista Brittain (19:46)
seem to get. you know, there’s that, there’s a lot going around social media about the eldest daughter. You know, maybe this is something that shows up in that dynamic. As an eldest daughter, I can sort of laugh about that.
Dr. Jeremy Sharp (19:58)
Mm-hmm.
Krista Brittain (19:59)
yeah, and I think
You know, on assessment, these kids often look bright, especially verbally. and they’re able to to do things maybe the other kids their age can’t do. and so that’s something that the kiddo is bringing to the dynamic. And so the parents just might not realize. Also, this dynamic can show up in other systems too. I’ve certainly worked with
families where it’s actually the dynamic with school that’s the orphan child, the kids behaving well at school, learning, getting good grades, things like that. but actually then they’re they’re coming home and having a meltdown, kind of having that that burnout and that fatigue from masking or or functioning at a high level all day. and schools not seeing it or not realizing what is needed there. And so the goal in these systems is to help
help caregivers or in that example I just gave, help schools see that the child has strengths and support needs. And at the end of the day, that’s true about every child. And so, that’s a that is a piece of it. yeah.
Dr. Jeremy Sharp (21:05)
Great, great. And the last one
Krista Brittain (21:06)
So last but
not least, Solomon’s Child. I’ve presented on this topic a couple of times prior to this, and I I show video clips. And so if anyone listening has seen Mrs. Doubtfire, that is a really good example of Solomon’s child. so in in this prototype, the there’s a lot of unresolved conflict between parents, and it may be that they’re
Not parenting from the same household, maybe it’s a divorced system, or maybe they’re parenting from the same household. But at the end of the day, the parents’ views about what the kid needs are really different. So sometimes in Solomon’s child, you see a combination of the other systems. So with one parent, it’s more of a sick child system, and with the other parent, it’s more of a scapegoated child system, for example. And so
There’s some some sort of like good cop bad cop or good parent bad parent dynamics where one parent feels really aligned with the kid and the kid feels really aligned with that parent and they might feel really disconnected or even estranged in the other parent relationship. So sometimes unfortunately kiddos in these kinds of systems get triangulated in the
Dr. Jeremy Sharp (22:20)
Mm-hmm.
Krista Brittain (22:20)
parent conflict and so
There is again a lot of mixed messaging about what it’s okay to express, what it’s okay to feel, how it’s okay to behave. Is it acceptable to have connection with both parents? And so it can be really hard to balance the structure and support when parents are coming from really different perspectives. and so the goal of of assessment and working with these families is in some ways to show, again, through the through the gift of the assessment data, that both parents are a little bit right.
in their understanding of what the kid needs. and then having a sense of what that looks like as they go forward, knowing that that actually the kid needs a little bit of what both of them understand.
Dr. Jeremy Sharp (23:06)
Yeah. And this is a a complete side note, but where what what does Solomon’s come from? Is that a Bible reference or where is that?
Krista Brittain (23:14)
That’s a great
question. I think it is. I think is that the Bible story where the kid gets cut in half? Or there’s a threat that the kid’s gonna get cut in half. Yeah,
Dr. Jeremy Sharp (23:19)
You’re I’m the wrong person to ask about that. Yeah.
Krista Brittain (23:24)
I I think it’s I think that’s the reference. that there’s a Bible story where I don’t know if it actually happens or not, where a child gets cut in half because the parents are in such disagreement or there’s a threat of that. so
Dr. Jeremy Sharp (23:37)
Fair enough. Yeah.
Krista Brittain (23:38)
interesting that the the child might.
feel a little bit cut in half, right? And then as clinicians,
Dr. Jeremy Sharp (23:43)
Right.
Krista Brittain (23:44)
we can have a lot of empathy for that because maybe we’re getting triangulated or cut in half by the system too. And sometimes these can be really challenging systems to work with. So knowing,
Dr. Jeremy Sharp (23:55)
sure. Sure.
Krista Brittain (23:56)
knowing what’s going on can be really helpful to us as we manage our counter transference.
Dr. Jeremy Sharp (24:03)
Yeah, I was just thinking it is helpful just to have like a conceptualization, you know, or a framework of some sort for for how families function. if you’re not
Krista Brittain (24:12)
Mm-hmm.
Dr. Jeremy Sharp (24:12)
already utilizing something like that in the assessment process. it’s I’m you know, I’m always a fan of organization and you know looking through different lenses. So this is a great a great way to to do that. Do we have any sense of sort of the distribution of these
four systems, are are any of them more common than others?
Krista Brittain (24:34)
Yeah, that’s a great question. I don’t know if I have an answer for that actually, but I’m gonna write it down. because now you’ve made me curious about that.
Dr. Jeremy Sharp (24:43)
Mm. Yeah, that data driven part of my mind. I’m like, what’s the prevalence rate here?
Krista Brittain (24:47)
Yeah.
Dr. Jeremy Sharp (24:48)
What’s the base rate of these family systems?
Krista Brittain (24:52)
Yeah, I think another thing that’s interesting about these models and these prototypes is families might move between systems. So in one
Dr. Jeremy Sharp (25:00)
Mm-hmm.
Krista Brittain (25:00)
phase of life be in in one prototype and in another phase of life being another prototype. And actually I have a a case that I might share in a little bit where where
Dr. Jeremy Sharp (25:10)
Mm-hmm.
Krista Brittain (25:10)
something like that happened. there was
Dr. Jeremy Sharp (25:12)
Mm-hmm.
Krista Brittain (25:12)
a lot of systemic complexity going on. another thing that’s really helpful about these prototypes is
thinking about recommendations that we might make for the assessment. so in therapeutic assessment, we think about levels of information when we’re giving feedback and making recommendations. and level one information is, sorry.
Dr. Jeremy Sharp (25:33)
I was just
gonna say, yeah, if you could detour for a second and just define the levels real quick for folks who may not be familiar.
Krista Brittain (25:39)
Yeah, totally. so there are three levels of information. And level one is information that generally matches how clients already see themselves or how parents already see their child and think about themselves. So if you if you said this, you know, they would be like, yeah, that’s something we already know. If parents are bringing their kiddo in for an ADHD assessment, for example, and you tell them the child has inconsistent attention, that’s probably not gonna be a shock to them.
And then level two information is information that we get from the assessment that creates some slight shifts or reframes or reprocessing in how people understand themselves and understand their child. And then level three information is information that’s very different from how clients see themselves or how parents see their child. And so when you think about the family system.
depending on where parents are, you know, talking about a kiddo’s strengths in a sick child system is something that might feel really like level three information, or talking about a kid’s strengths in a scapegoated system might also feel like level three information. I’ve worked with families where in the first session I’m like, man, I don’t know if these parents like their kid at all. I think they love their kid because they’re here.
But I don’t know if they like their kid. And so
Dr. Jeremy Sharp (26:57)
Right. Right.
Krista Brittain (26:59)
you have to sort of half step toward being able to share about strengths and help kind of warm parents up to that idea over the course of the assessment process. For example. So kind of thinking about how these different prototypes might look in terms of recommendations.
In some family systems it it might not be a great recommendation to suggest family therapy. Might not be something they’re they’re in a place that they can do, depending on how they’re functioning systemically. yeah.
Dr. Jeremy Sharp (27:29)
Sure. Sure.
So we’re starting to dip into the clinical application, which I think is great. Maybe we back up a little bit and start from the top. I mean, I would love to hear like how your how this approach, like how these systems, prototypes come into play throughout the assessment process, right? Like does it influence what kind of questions you’re asking in the interview, for example?
Krista Brittain (30:16)
Yeah, I think that’s a great question. I don’t usually have information about the family system in such detail going into that those initial sessions, clinical interview, things like that.
Dr. Jeremy Sharp (30:27)
Great point. Mm-hmm.
Krista Brittain (30:29)
depending on the referral source or if if folks are working in a medical system and they can access a chart, things like that. There might be more data about that or you know, in a school system for a school psychs out there.
You know, there again, there might be more data about the family system, especially if if there have been older siblings coming through, but I don’t usually get to have that information. And so, you know, one of the values of TA is curiosity. And so as you go into that initial session, you go in really curious and kind of listening for how the how the system works together, making those behavioral observations. Does do the parents interact differently with me?
Do the parents interact differently with the kiddo in the room or with the kiddo not in the room? if I’ve had one-on-one interactions with parents, how do those feel compared with being with the whole system? and thinking about that. but I do think, you know, it’s important to ask about like what are the best parts of parenting your child? What are the hardest parts of parenting your child? and and gathering a thorough history will also start to inform.
how you’re how you’re seeing the system, how you’re what lens you’re looking through.
Dr. Jeremy Sharp (31:37)
Sure, sure. So are you asking questions specifically to assess which system families are working in, or are you
Krista Brittain (31:45)
Is he?
Dr. Jeremy Sharp (31:46)
kind of fitting them into a system or prototype based on the other assessment questions that we might typically ask? Does that make sense?
Krista Brittain (31:54)
Yeah, that’s a great
question. Well, so in TA, we we start with getting assessment questions from the parents and the family. And so
Dr. Jeremy Sharp (32:03)
Uh-huh.
Krista Brittain (32:03)
sometimes questions help us see. I would say probably it’s a little bit of both. Again, it’s that transactional model, right? So my conceptualization and understanding of the system is developing as the assessment is developing and we’re kind of influencing each other in some sort of way.
And so it’s something that I’m sort of holding and thinking about and being curious about. And I might ask a specific question. if I hear about, you know, bullying or if I if I’m gathering medical history, some of those things are are more likely to load on one prototype or another. I wouldn’t say that I ask specific questions, especially in that initial interview.
There are some things we can do sort of looking at test data too that can help. Sometimes we’ll give parents an MMPI and kind of see where they’re
Dr. Jeremy Sharp (32:53)
Mm.
Krista Brittain (32:53)
coming from in terms
Dr. Jeremy Sharp (32:55)
Uh-huh.
Krista Brittain (32:55)
of mood and personality and interpersonal dynamics, and that can help give us some information. I’ve been lately loving the PRQ from the Basque series of assessments, which can give us a lot of information about how parents might be feeling in their role as parents or seeing their child.
and so actually again, I love the data. And so being able to pull on some of the data as well is really helpful. But I would say in those initial sessions, really just being open and curious is my approach rather than asking specific questions to try to nail down in that first interaction. I will also I’ll say sometimes I’ve got pretty strong counter transference and that helps inform things as well. So
Dr. Jeremy Sharp (33:41)
Sure, sure. Yeah, I think a lot of us have had that experience. it’s a range of experiences, you know, in terms of counter transference and yeah.
Krista Brittain (33:48)
Mm-hmm.
Dr. Jeremy Sharp (33:51)
Into the kid. I know I’ve had that experience where I’m kind of like you mentioned earlier, it’s like, do you even like your kid? Like, why are you
Krista Brittain (33:57)
I think
Dr. Jeremy Sharp (33:59)
talking so negatively about this kiddo?
Krista Brittain (34:01)
Yeah.
Dr. Jeremy Sharp (34:01)
and I can make guesses, of course, but that’s probably one of the harder situations for me to
Krista Brittain (34:06)
Yeah.
Dr. Jeremy Sharp (34:07)
work through is
Krista Brittain (34:09)
Yeah.
Dr. Jeremy Sharp (34:09)
when the parents don’t seem to enjoy their kids.
Krista Brittain (34:13)
Yeah. Yeah.
Dr. Jeremy Sharp (34:16)
So how about the testing process? is there any impact on the actual testing process or you know battery selection or anything like that when you come from a family systems perspective?
Krista Brittain (34:28)
Yeah, I think that’s a good question. I think, you know, first of all, I want to say that we do we gotta administer our tests in a standardized way if we wanna be able to get good information from them. and so
Dr. Jeremy Sharp (34:38)
Mm-hmm.
Krista Brittain (34:38)
sometimes we might add additional tests. Like I was saying before, we might add parent testing, have parents do an MPI. I love to do an with adolescents, have parents do MPI and then have the adolescent do MPI ARF, and then we make a really fancy graph.
of all the scores and they can see where they’re alike and where they’re different. and
Dr. Jeremy Sharp (34:56)
Mm-hmm.
Krista Brittain (34:57)
showing that visual to parents and I’ve often had families in my office sort of laugh when I put it up on the screen and be like, Yep, that’s us. So yeah, I think
Dr. Jeremy Sharp (35:08)
Interesting. Okay. I was going to
ask, how do you present this to parents? How do you
Krista Brittain (35:14)
Mm-hmm.
Dr. Jeremy Sharp (35:14)
cause and I always assume the worst. I always assume people are going to react, you know, very strongly. But do you get any pushback from parents when you’re like, and by the way, you know, as part of your kids’ assessment, we’re going to give you a personality measure.
Krista Brittain (35:27)
Yeah.
Dr. Jeremy Sharp (35:27)
does that what kind of reactions do you get? And how do you present this?
Krista Brittain (35:31)
Yeah, that’s a great question. So again, you know, this is sort of like one of those weird TA things that you wouldn’t do in traditional assessment. But in that, in those early assessment sessions or early interactions, you’re asking parents to develop questions that they’re hoping you can answer through the assessment process. And when we’re working with kids and adolescents, we encourage parents to come up with what we call a systemic question. and
Dr. Jeremy Sharp (35:55)
Mm.
Krista Brittain (35:56)
so that’s our in-road.
and so often parents will ask questions about like how can we communicate better? Or why is it that we can never see eye to eye on this issue or in general? or
Dr. Jeremy Sharp (36:10)
Mm-hmm.
Krista Brittain (36:11)
how can we enjoy more time together as a family?
Dr. Jeremy Sharp (36:14)
Mm.
Krista Brittain (36:15)
how can we manage conflict differently? Lots of questions like that. So that’s always our in-road and and
it’s a consent-based model, right? So I float it to the parents as an option, as something that I think could be really helpful for for answering their systemic question or questions. and and then parents can say yes or no. and if if parents aren’t so interested in that, then I might ask if they’d be willing to do the PRQ and and just give some information about their experience.
Of parenting their child. And so often that feels a little bit less vulnerable. I think bringing your kiddo in for an assessment is really vulnerable. And then the psychologist asks you to do your own personality test, it’s that can be really scary. So I I appreciate that. and I let parents know: like you this isn’t something you have to do, but it is something that I think could be helpful, and here’s why.
Dr. Jeremy Sharp (37:07)
Great, great. I appreciate you articulating that.
Krista Brittain (37:10)
Yeah. The other thing that we might do that’s a little bit different is we do something called extended inquiry. So after the standardized administration of the test, you go in and you ask additional questions about it. So sometimes we might, especially with adolescents, use a test called the the adult attachment projective. It’s a picture storytelling test where you can use the Roberts for this. and and after after you’ve done it the way,
You’re supposed to do it for standardization. You go back, you get the cards back out, and you say, Do any of these resonate for you? Do any of these remind you of your life? Tell me more about that. and so that’s another way to get some of this systemic data. and so you can do that with kiddos, but sometimes you have parents do some of those things too. and then last we do something called an assessment intervention session and therapeutic assessment where we
have the family in the room and we we get the problem in the room. Again, usually this is tied to their systemic question. And we might use assessment tools to do that. We might have them do a consensus Rorschach. Can they agree on what they see in the ink blots? Or we might have them play a game together and and see what happens when they’re playing a family game together.
We might give them an impossible task to do as a family and see what happens when faced with something that we know to be impossible. How do they how
Dr. Jeremy Sharp (38:32)
Sure.
Krista Brittain (38:32)
do they respond in that situation? and
Dr. Jeremy Sharp (38:35)
my gosh. I’m thinking of how
our family would respond to this. Yeah. Yeah.
Krista Brittain (38:40)
Yeah, I can appreciate that for sure.
Dr. Jeremy Sharp (38:43)
Right.
Krista Brittain (38:44)
so we can kind of pull that into the room and then talk about it. We can say, is this how it usually goes at home when you’re playing a game
Dr. Jeremy Sharp (38:50)
Mm-hmm.
Krista Brittain (38:52)
together, or does it go differently? can we try a strategy here to see if you guys could have a different experience of playing this game in my office? And then what would that tell us? so
Lots of lots of fun ways of of using assessment tools creatively. Mm-hmm.
Dr. Jeremy Sharp (39:07)
Mm-hmm. Yeah,
that’s fantastic. I love those examples. Are you when you do things like that, like the observational or the, you know, the family Rorschach, for example, or the impossible task, are you essentially just looking at qualitative observations and kind of writing, you know, writing up those observations, or is there some kind of scoring rubric for these kinds of activities?
Krista Brittain (39:28)
Yeah, that’s a great question. I would say this is much more qualitative in in nature. Steve Finn and colleagues have developed a protocol for consensus roars shock. So there is kind of a standardized way to do that. and
Dr. Jeremy Sharp (39:40)
Mm-hmm.
Krista Brittain (39:40)
you can, in a way, use the scoring system to score the responses and talk about what that might mean for the family system. and but again, that’s that’s more qualitative data. Mm-hmm.
Dr. Jeremy Sharp (39:54)
Of course, of course. Okay. So how does all this kind of trickle down and influence maybe the diagnostic conclusions
Krista Brittain (40:01)
Mm-hmm.
Dr. Jeremy Sharp (40:02)
and then that kind of flows to feedback as well? yeah, I’m curious how, if at all, this might influence diagnosis.
Krista Brittain (40:11)
Yeah, I think that’s a great question. I I would I would actually say that this is sort of something that might be overlaid on top of the diagnostic process that
Dr. Jeremy Sharp (40:22)
Mm-hmm.
Krista Brittain (40:23)
you might be making diagnosis and thinking about the family system. So I think
with any of these prototypes, any diagnosis could be a piece of the pie. and so I think it’s sort of an add-on, we’ll call it an add-on code to use insurance company language. just an additional way of understanding the family system and then knowing how to talk with the family system about diagnosis.
And about what the kiddo needs and what recommendations you
Dr. Jeremy Sharp (40:54)
Mm-hmm.
Krista Brittain (40:55)
make going forward.
Dr. Jeremy Sharp (40:57)
Yeah, maybe we talk about that for a bit. the the it’s kind of the feedback component, like how you communicate.
Krista Brittain (41:02)
You see?
Dr. Jeremy Sharp (41:04)
and that also I guess raises a a parallel question of how explicit you maybe are discussing these prototypes with families
Krista Brittain (41:11)
Mm.
Dr. Jeremy Sharp (41:12)
and does that come up in feedback or is it coming up before that?
Krista Brittain (41:15)
I so I think foundationally these prototypes are for us as clinicians to understand families, understand how to communicate most effectively with families, and understand how to help the family start making shifts toward ways of being and interacting and relating with each other that are gonna work better in the long term. And
Dr. Jeremy Sharp (41:37)
Mm-hmm.
Krista Brittain (41:38)
You know, I don’t know that I’ve ever sat parents down and been like, look, we got a Solomon’s child system here. And I probably wouldn’t recommend that, especially the
Dr. Jeremy Sharp (41:43)
We got a real Solomon’s child here. Yeah, yeah.
Krista Brittain (41:48)
Solomon’s child system. But from a qualitative perspective, it the prototypes give us a lot of language to describe what we’re seeing and then how that might affect the kiddo, right? Like
If we’re seeing, for example, some dysregulated attachment and the kiddos are getting really mixed messages about how to keep parents close from each parent, we can sort of talk about like, hey, your kiddo is feeling confused. Here’s the data that shows us they’re feeling confused. And we sort of get curious and say, like, do you have any thoughts about why your kiddo might be feeling confused in this context? And try to
Dr. Jeremy Sharp (42:25)
Mm-hmm.
Krista Brittain (42:25)
slowly step them toward the idea that.
Having some of that inconsistent messaging could be contributing to it. But we also along the way weave in confirmation that they’re both a little bit right, for example, in the Solomon’s Child system. and so again, kind of thinking about what families can hear potentially, and knowing, you know, there is risk for rupture and how we might repair it as we’re talking things through.
But yeah, I I would say kind of helping parents see the dynamics as they shine through the data and through through those created and curated experiences in the assessment process. yeah, I don’t again, I I don’t know that I’m naming the prototypes with parents because as you said, the the names are kind of pejorative, right? They’re not, they’re not the
Dr. Jeremy Sharp (43:15)
Mm-hmm.
Krista Brittain (43:16)
most like humanizing, affirming labels.
Dr. Jeremy Sharp (43:20)
Yeah, yeah, that’s fair. That’s fair. Yeah, I am thinking through this. And it the way I mean it seems like the TA approach really lends itself to these conversations because you’re eliciting the family’s questions from the very beginning on a
Krista Brittain (43:32)
And yeah.
Dr. Jeremy Sharp (43:35)
maybe a deeper level than I think a lot of traditional assessment, right? So you’re kind of digging in and asking them, like, tell me what you’re concerned about, tell me what you want to work.
Krista Brittain (43:44)
Mm-hmm.
Dr. Jeremy Sharp (43:46)
about. So it’s almost like they’ve given permission to have more nuanced or emotional conversations around the family system. Is that fair, Toza?
Krista Brittain (43:55)
Mm-hmm. Yeah. I think that’s
really fair. And I would say that to some extent, that one of the differences between TA and more traditional assessment is that description of symptoms and diagnosis is the aim of traditional assessment, whereas that understanding, that maybe deeper level understanding, more vulnerable understanding is the goal of collaborative and therapeutic assessment.
Not that either is bad because diagnosis is important for for lots
Dr. Jeremy Sharp (44:24)
Mm-hmm.
Krista Brittain (44:25)
of things. and understanding is important. It’s just a little bit of a different focus. But yes, I would
Dr. Jeremy Sharp (44:30)
Mm-hmm.
Krista Brittain (44:31)
agree that by by entering into the therapeutic assessment process, there is this permission to take it a little bit deep.
Dr. Jeremy Sharp (44:40)
Right, right. Do you find any families where this does not go so well? I’m not sure. I don’t have anything particular in mind, but you know, where this model doesn’t fit or you know, you try to have these conversations and it just it doesn’t it doesn’t work. you know, you get negative reactions, anything in that realm.
Krista Brittain (45:01)
Yeah, absolutely. I mean, it doesn’t always go perfectly. That I want to be really clear about that.
Dr. Jeremy Sharp (45:06)
sure.
Krista Brittain (45:07)
Even if you’re really intentional and trying to be thoughtful and systemic about it, it doesn’t always go perfectly. And and that’s okay when that happens. We can still do things that are helpful and useful for the family. there are definitely some situations where this approach probably wouldn’t be appropriate. So
If if you’re doing custody evaluations, you know, this it that’s not necessarily the moment for parents to be super vulnerable. and so this approach may not be a great option in those moments. and you know, when you’re doing IQ testing for a kiddo who just needs their IQ score to get admitted to a a charter school in their area for a
Dr. Jeremy Sharp (45:48)
Mm-hmm.
Krista Brittain (45:49)
you know, you’re you’re this isn’t really the approach that you’re gonna take necessarily. So it wouldn’t be appropriate in those situations. But I’ve also had had moments where I I thought we were going forward and in in our discussion sessions, the parents really disagreed with what I had to say, where I hadn’t done whatever it was that needed to be done to help.
help the family see the data in the way that I was seeing it. And in that case, they take that humble approach and I help ask the parents to help me figure out what I missed and what I’m not seeing or what I am seeing that’s different from what they’re seeing. but I I think, you know, you’re not gonna you’re not gonna bat a thousand and that can be tricky.
Dr. Jeremy Sharp (46:35)
Yeah, yeah. No, I like the way you phrase that, to invite them to let you know what you may have missed or
Krista Brittain (46:41)
So
Dr. Jeremy Sharp (46:42)
you know, something like that. Yes, yes. Well
Krista Brittain (46:44)
Yeah, or what the tests may
have missed, ’cause I guess they’re not perfect either.
Dr. Jeremy Sharp (46:49)
Of course, of course. Yeah, that’s that’s a great point. That’s a great point. Well, I wonder if this might be a good time to talk about a case example, if you’ve got something to share that could bring this to life a little bit more.
Krista Brittain (47:03)
Absolutely. Yeah. I’d love to talk about a client that I’m going to call Jenna. and Jenna came to me for a second assessment. and with Jenna and their family’s permission, I’m gonna share also a little bit about the first assessment that Jenna did four years before I met her. a little bit of background is that
Jenna was in high school at the time that I saw them. and they were adopted in infancy and assist by white female. And their parents were both white and had been married for over 20 years at the time I saw them, but had experienced infertility and so took the route of adoption. and so initially the family had sought assessment.
with a different provider, because parents had some concerns about emotional intensity, especially anger, ADHD concerns, big feelings. and then also Jenna had a history of migraines. and then Jenna was really just not feeling understood and had a lot of arguments with parents and had a lot of fears and felt like she really loved school but couldn’t focus the way she wanted to.
So in the first assessment, kind of the the conclusions were that she was really bright. so scores in the gifted range for sure. GAI of 141 on the whisk. Yeah. So
Dr. Jeremy Sharp (48:27)
that’s notable.
Krista Brittain (48:28)
it is, it is indeed. but cognitive
Dr. Jeremy Sharp (48:30)
Yeah.
Krista Brittain (48:31)
proficiency, 114. So some big splits there, some big differences in functioning.
She had a lot of overexcitabilities. and one of the things that was kind of inconclusive in that first assessment was whether or not she was really experiencing diagnosable disrupted attention. there was some anxiety there, some inconsistency in attention. and when that f family came in for that first assessment, they were really coming from a sick child perspective of, hey,
There’s something going wrong for our kid. She’s having these emotional outbursts. She’s having these meltdowns. We’re really united, all three of us, and wanting to figure out what’s going on and and wanting to help her feel better and function better at school.
Yeah.
Dr. Jeremy Sharp (49:16)
How did you distinguish between sick and scapegoated in this case? Like the way you
Krista Brittain (49:20)
Mm.
Dr. Jeremy Sharp (49:21)
describe it, it almost feels like scapegoaty kind of, but
Krista Brittain (49:24)
Yeah.
Well, at this moment in the family system, there was not a lot of conflict. They were all
Dr. Jeremy Sharp (49:30)
Okay.
Krista Brittain (49:30)
feeling open and curious. And nobody was at that moment envisioning Jenna as bad. They were envisioning her as having a hard time. Mm-hmm.
Dr. Jeremy Sharp (49:41)
Okay. Fantastic.
Krista Brittain (49:43)
Yeah. There were, you know, just not a ton of behavioral concerns at that moment in time, except for the emotional aspect.
Dr. Jeremy Sharp (49:52)
Mm-hmm, mm-hmm.
Krista Brittain (49:54)
Yeah, that’s a great question. and a a good good segue into the second assessment, which we’ll talk about in a moment. so one of the things that felt, I think, to the family like they might have wanted or needed a little bit more dialogue about after that first assessment was they actually learned that Jenna was exceptional. and and
didn’t feel like they got a good explanation for why she was struggling. So if we think about the sick child dynamic, having a different balance there where we’re bringing in both of those pieces a little bit more might have been helpful to this family. but also, of course, hindsight’s 2020, and we’re Monday morning quarterbacking that. So yeah. Yeah, I think the the assessment was well done. and
Also, not maybe considering all these systemic factors. So yeah.
Dr. Jeremy Sharp (50:49)
Okay, I’m with you.
Krista Brittain (50:51)
as time went on and Jenna got older, she became a teenager. and school continued to talk about how bright she was, how well she was learning. Jenna finds found some ways to kind of like hold in her strong emotions at school. and so at school, they were sort of like, what are you talking about?
Jenna’s not struggling here. and so in the time between the first and second assessment, school kind of moved into that orphan dynamic with Jenna. and we’re really questioning the parents when they were asking for a 504 plan and asking for supports at school. And school was sometimes giving pushback about Jenna missing school for appointments and things like that.
So that was another kind of interesting layer to things, which I think compounded the dynamic that started to develop at home. Yeah. So when I saw Jenna for the second assessment, she had questions about why her brain was different, why her emotions kind of went all over the place, and why her family struggled with communication.
And the parents had questions about how they could communicate better, about what Jenna needs, about whether or not she might have ADHD, and about does Jenna even want our help and how can we actually parent her? Mm-hmm. Yeah.
Dr. Jeremy Sharp (52:18)
Questions.
Krista Brittain (52:19)
So I’m sorry.
Dr. Jeremy Sharp (52:21)
I just said good questions, yeah, from their standpoint.
Krista Brittain (52:23)
Really good
questions. Almost all of their questions were systemic. So at this point, we kind of start to see the distress is coming into the system, right? It’s it’s harder to know how to parent, how to communicate. Whereas the previous questions were, you know, does Jenna have ADHD? And why did why is she having
Dr. Jeremy Sharp (52:44)
Mm-hmm.
Krista Brittain (52:45)
these emotional outbursts?
Dr. Jeremy Sharp (52:46)
Mm-hmm, mm-hmm.
Krista Brittain (52:49)
Yeah.
So we can kind of see things are maybe heating up a little bit in the system. And so through the second assessment, we could see again, Jenna’s very gifted. She’s got super high scores, especially in terms of verbal comprehension. she had a very complex roar shock. And
At this point, parents are reporting a lot of emotional and behavioral concerns. Parents seem less convinced that it’s ADHD that’s going on, and more worried that Jenna doesn’t seem to be able to follow the rules, that Jenna doesn’t seem to be able to manage her activity and energy levels, that Jenna doesn’t seem to care about relationships with family and things like that. So
Dr. Jeremy Sharp (53:31)
Mm-hmm.
Krista Brittain (53:32)
We did family MMP eyes and I showed them the graph. And one of the things that one of the parents noticed right away when they looked at the graph was that Jenna’s score on family problems was elevated. And the the parents asked what that meant, and we talked about it. And the parent was so surprised that Jenna was actually distressed.
By the conflict she was experiencing in the family system. So, what that told me as we talked about it and did some extended inquiry on it is that the parents had come in to this second assessment, believing that Jenna didn’t care about how things were going in the family. But by doing this family testing, they saw she is concerned about this. She is distressed about this. That’s how they understood the elevation.
And they were able to make a pretty significant shift. now of course we also had some elevated depression scores and things like that. And they were able to pretty quickly make a shift from seeing Jenna as not caring, as being, you know, kind of a pain in the butt to being somebody who did actually care about the family relationships and was feeling pretty down about how things were going. So
Dr. Jeremy Sharp (54:52)
I see.
Krista Brittain (54:53)
they came in kind
Dr. Jeremy Sharp (54:53)
That’s a big shift.
Krista Brittain (54:54)
of has that scapegoated system. like why why are things going so badly in our in our family? and being able to see like, she does care. We’re just not understanding.
Dr. Jeremy Sharp (55:07)
Yes.
Krista Brittain (55:08)
Mm-hmm.
Dr. Jeremy Sharp (55:08)
Okay, that’s important. I mean that’s important, I would imagine. That was kind of an unlock for the family.
Krista Brittain (55:13)
Yeah, we we slowed way down when that came out. And we we spent a lot of time talking about that and processing that and helping connect that to their experience. These parents were lovely and really willing to kind of step into that vulnerability. and I think over time they’d also had a number of interactions with Jenna’s individual therapist. and so they came to me pretty ready to shift.
And so that was that was lucky for me.
Dr. Jeremy Sharp (55:43)
For sure. Yeah.
Krista Brittain (55:44)
Yeah.
So then they had a lot of questions about how to support Jenna at school because they really felt like school wasn’t seeing some of the concerns that they had.
Dr. Jeremy Sharp (55:54)
Yeah, yeah. That reminds me of I’m glad we’re getting into this because this dynamic comes up frequently, I think, in our practice where yeah, parents are seeing a lot more concerns than school is seeing. And it’s
Krista Brittain (56:06)
Okay.
Dr. Jeremy Sharp (56:07)
always kind of challenging to to reconcile those two and give a good explanation. So I’m yeah, I’m interested to hear how you tackle this.
Krista Brittain (56:15)
Yeah. Well, so one of the things that we did is we we helped the parents figure out how they were gonna talk about the assessment with school and which data they wanted to make sure to highlight in that conversation. and
Dr. Jeremy Sharp (56:31)
Mm-hmm.
Krista Brittain (56:32)
one of the things they did was they were able to connect some of the data, specific data points, scale elevations, things like that, to specific things that had happened at school.
so Jenna was experiencing some challenges in her social relationships. and she also had a struggle in an extracurricular activity that she was a part of. And so being able to connect the assessment results to to those real experiences that school had been a part of was really helpful for them. And so kind of figuring out how to translate our data into that conversation that they were gonna have, and then me being able to highlight it as well.
in the documentation for school
Dr. Jeremy Sharp (57:12)
Mm-hmm.
Krista Brittain (57:12)
really helped to to provide that continuity and and that through line. And Jenna
Dr. Jeremy Sharp (57:19)
Mm-hmm.
Krista Brittain (57:19)
was able to get a 504 plan at that point in time.
Dr. Jeremy Sharp (57:24)
Yeah, yeah, that’s fantastic. So to
Krista Brittain (57:26)
Mm-hmm.
Dr. Jeremy Sharp (57:26)
what degree did you coach the parents on talking with the school versus explicitly putting that in the documentation?
Krista Brittain (57:36)
Yeah, I I would say it was a both and situation. So lots of times when I’m writing documentation for school, I’ll do a list of the strengths and differences that came out in the assessment process and then talk specifically, again, using those examples with the permission of the client and the family, about how some of those strengths or differences might have manifested over the years in school. For example,
Dr. Jeremy Sharp (58:02)
Mm.
Krista Brittain (58:03)
this situation in the extracurricular activity is how this combination of traits or characteristics seems to be affecting Jenna at school and in a school environment.
Dr. Jeremy Sharp (58:14)
Yeah, yeah, that’s great. That’s great. Okay.
Krista Brittain (58:15)
So yeah. And
then helping the parents and empowering the parents that, you know, even if school has kind of pushed back on this before, you can push a little bit on it too, to help Jenna get what she needs at school. Like you can ask for a 504 plan and for some assessment around that. In the state where I live, we the the schools don’t do any standardized assessment outside of like the typical twice yearly
District assessments. So that all gets outsourced to IEs and stuff like that. So mhm. Yeah. Yeah.
Dr. Jeremy Sharp (58:45)
okay. Okay. Gotcha. Yeah. Yeah. So
then the way you describe it, it’s like it kinda circles back to where they are able to care for her and support her in a like a positive, productive
Krista Brittain (58:58)
Mm-hmm.
Dr. Jeremy Sharp (58:59)
way.
Krista Brittain (59:00)
Yeah, exactly right. I think one of the things for this family that nobody had ever put on their radar in a way that they could hear it. maybe people
Dr. Jeremy Sharp (59:10)
Mm-hmm.
Krista Brittain (59:10)
attempted, but in a way that they could hear it was some of the impact of attachment, with Jenna’s infant experiences and maybe even in utero experiences and and feeling really different from her family.
Dr. Jeremy Sharp (59:23)
Mm-hmm.
Krista Brittain (59:24)
And so we talked a lot about attachment and what that looked like. And for the parents, it really felt like they were hearing that information for the first time. and for them that had been a missing piece of trying to understand what Jenna needed from them now and how they could make shifts to to meet her needs in a different way than they’d done in the past. Yeah.
Dr. Jeremy Sharp (59:45)
Yeah,
yeah, yeah, certainly. Certainly. Yeah, I mean I love the the approach here. It just it adds I feel like depth and richness to to this work that we do. And I I would imagine helps the parents feel like they have more agency and you know, and I
Krista Brittain (1:00:03)
Mm-hmm.
Dr. Jeremy Sharp (1:00:05)
don’t I don’t maybe I’m maybe I’m inventing this, but yeah, it it seems like the outcome
Krista Brittain (1:00:14)
Yeah, I think you’re spot on there that really giving that pa parents and kiddos that sense of agency, that sense of like n knowing themselves and each other better so they can take steps forward and do things differently in a way that’s
Dr. Jeremy Sharp (1:00:27)
Mm-hmm. Yeah.
Krista Brittain (1:00:29)
gonna work well because there’s nothing more demoralizing than doing all of the work to make a change and then having it crash in
Dr. Jeremy Sharp (1:00:36)
Right. Right. Right. Yes.
Krista Brittain (1:00:37)
Mm-hmm. Yeah.
So as we think about recommendations, some of the things we keep in mind are how the how the system is functioning. So, you know, in a scapegoated system, when you’re making recommendations, you might consider like what is the parent’s level of curiosity and openness to vulnerability. With Jenna’s family, the parents were super open to that. but you could imagine that not all parents are open to that, and that’s okay.
So taking that into consideration, right? So I I did recommend family therapy for Jenna’s family because
Dr. Jeremy Sharp (1:01:11)
Mm-hmm.
Krista Brittain (1:01:11)
I thought that the family was ready for it by the end of the assessment process. They were not ready for it at the beginning of the assessment process, but at the end, they were. And then another consideration in the scapegoated system is how much can parents see the child’s sadness? How accessible is that to them?
And and so then that sort of speaks to whether and how they’ll be able to make that shift in in conceptualizing the child as sad rather than bad. and then, you know, as we’ve been talking about with the school, what’s the impact of the larger systems? Because I think the fact that Jenna was functioning so well at school reinforced in some ways that scapegoated system.
At home, because like, well, you can you can follow the rules and listen and be good and be respectful here. Why can’t you do that?
Dr. Jeremy Sharp (1:01:59)
Sure, sure. Yeah,
Krista Brittain (1:02:00)
Hmm. Yeah.
Dr. Jeremy Sharp (1:02:01)
I appreciate that perspective. Again, that’s a tough I think that’s tough for parents to understand sometimes. So nice.
Krista Brittain (1:02:06)
Hmm. Yeah, definitely. Yeah. So
in the scapegoated system, I make a lot more recommendations for things like psychoeducation or really concrete, almost scripted shifts in how they might communicate about things. if they can see the child’s sadness, then we talk about what kind of supports does the kiddo need to address this concern, whether we call it depression or not.
And then sometimes it’s a little bit more accessible to talk about parent coaching for parents in a scapegoated system than it is to talk about family therapy. So do kind of depending on where they are in that openness to vulnerability, those are some options. And then especially when we’re working with neurodivergent kids, parent coaching can be a great option because again, there’s no instruction manual, and if there was, it might not apply.
Dr. Jeremy Sharp (1:02:56)
Yeah, yeah, for sure. For sure.
Krista Brittain (1:02:58)
Mm-hmm.
Dr. Jeremy Sharp (1:02:59)
I totally agree. Yeah. This has been super helpful. are there any other points, at least with the case example, before we start to wrap up?
Krista Brittain (1:03:11)
Yeah, no, I think that’s about it with Jenna’s case. Yeah, any
Dr. Jeremy Sharp (1:03:14)
Yeah.
Krista Brittain (1:03:15)
questions you have or I mean, I have a lot of data here that I could talk about if you have any questions, but I think we hit the highlights.
Dr. Jeremy Sharp (1:03:24)
Sure. Yeah. Yeah. No, I mean I’m just kind of taking it all in. I really I really appreciate you bringing a case example just to just to illustrate in real life how these concepts can apply. And again, it just just more observations than anything, and sort of reflecting on how this process is a little bit different than kind of a typical assessment or the way that I might approach the case. Yeah.
Krista Brittain (1:03:48)
Yeah. Yeah,
I I appreciate that reflection a lot because I I’ve talked about how we use this pretty specifically to the TA model. I think it’s possible to apply bits and pieces of this to to a more traditional assessment model. and just kind of getting curious about the broader factors that might be affecting kids and then thinking about, you know.
How can we understand the system a little bit better to make recommendations that really stick and resonate for families?
Dr. Jeremy Sharp (1:04:19)
Right, right. I mean that’s the ultimate goal, right? Like we yeah, we wanna
Krista Brittain (1:04:22)
Exactly.
Dr. Jeremy Sharp (1:04:23)
deliver the information in a way people can hear and
Krista Brittain (1:04:25)
Mm-hmm.
Dr. Jeremy Sharp (1:04:26)
provide recommendations that are actually gonna be helpful and doable for people. And this is like another tool or perspective to be able to do that. Sure.
Krista Brittain (1:04:34)
Yeah. Yep.
Dr. Jeremy Sharp (1:04:36)
Yeah, and I mean full transparency it’s not like we’re gonna convert over to therapeutic assessment and family systems work, you know, overnight or anything, but I mean I could that would
Krista Brittain (1:04:43)
I mean you could. No, I’m I’m
Dr. Jeremy Sharp (1:04:47)
Yeah. Give me two weeks. We’ll be there. No. But you know, but like you said, like these bits and pieces and even just like the framework,
Krista Brittain (1:04:53)
Yeah.
Dr. Jeremy Sharp (1:04:54)
there’s some like subtle mind shifts that
Krista Brittain (1:04:57)
Mm-hmm.
Dr. Jeremy Sharp (1:04:58)
I think are gonna be really helpful in,
Krista Brittain (1:05:00)
Yeah.
Dr. Jeremy Sharp (1:05:01)
you know, just describing what’s going on for families, like the lens that we look through with parents and and kids’ interactions and relationships are helpful.
Krista Brittain (1:05:10)
Yep. I think for me it’s also helps me just continue to have so much compassion for the families I’m working with. If if I’m thinking about, you know, a system that’s struggling with grief or struggling
Dr. Jeremy Sharp (1:05:22)
Mm-hmm.
Krista Brittain (1:05:22)
with shame or struggling with systemic oppression or other sorts of situational variables, you know, it’s easy to sort of be like, Ugh, why are they doing this or why are they doing that?
Dr. Jeremy Sharp (1:05:34)
Mm-hmm.
Krista Brittain (1:05:35)
kind of step it back and think about where do these patterns come from, right? We’re mentalizing
Dr. Jeremy Sharp (1:05:39)
Mm-hmm.
Krista Brittain (1:05:40)
the system and realizing this comes from their own emotional and internal states. And that’s
Dr. Jeremy Sharp (1:05:46)
Mm-hmm.
Krista Brittain (1:05:46)
a really lovely foundation for compassion, which I think is vitally important in our work.
Dr. Jeremy Sharp (1:05:53)
Mm, that’s a good way to put it. Good way to put it. And maybe a nice note to end on as well, you know? Hopeful,
Krista Brittain (1:05:59)
Yeah, sounds great.
Dr. Jeremy Sharp (1:06:01)
positive, yes. So if people want to like learn more about you, like see more of your work, reach out, how can people find you and find the work that you’ve done?
Krista Brittain (1:06:12)
Yeah, thank you for asking. folks can go to my website, which I think you’re putting in the show notes. I also do a lot of work with the therapeutic assessment institute. And we have our fall webinar series coming out starting at the end of this month. So September
Dr. Jeremy Sharp (1:06:28)
Okay.
Krista Brittain (1:06:28)
twenty-fifth, Dr. Matt Beatty’s gonna present on using the PAI and therapeutic assessment. and in October we have some
Folks who are going to talk about the AMPD, the altern alternative model of personality disorders, and what that looks like. And what’s really compelling about that model is it’s more relevant and applicable across the lifespan. And it’s another way of getting data about family systems. So there is a way to assess for different personality dynamics.
So
Dr. Jeremy Sharp (1:06:58)
Mm-hmm.
Krista Brittain (1:06:58)
and then November 13th, we’re gonna have a presentation on attachment and the EMP. And December 11th, I’m gonna be presenting with some colleagues on using parent testing to help us understand family systems. So you’ll you’ll get to hear more about this from me. and so any of those can be you can get more information at therapeuticassessment.com for those. I’ll also
hopefully be doing a presentation or two at the Society for Personality Assessment Conference in March
Dr. Jeremy Sharp (1:07:28)
Isn’t
Krista Brittain (1:07:28)
in Long Beach. And I think one of the topics we’re hoping to present on is attachment and neurodivergence. And so you could, you could bet good money that we’ll be integrating some family systems conversation in there as well.
Dr. Jeremy Sharp (1:07:44)
Nice, nice. Okay. So lots of places to look and lots of resources. That’s great. We’ll put all of those in the show notes. And just for depending when this releases, I am curious about the the presentation in September. Will there will there be a recording available if folks don’t catch that live?
Krista Brittain (1:08:03)
Yeah, great question. So yes, there will be. depending on when when this episode comes out, there may be a a little bit of a wait, but what we usually do with those recordings is we make them available in the store on the therapeutic assessment website. and they’re it’s they are a bargain price, usually like I think about thirty dollars. and you get two two units
Dr. Jeremy Sharp (1:08:24)
it’s steal. Yeah.
Krista Brittain (1:08:26)
of continuing ad. So
Dr. Jeremy Sharp (1:08:28)
Great, great.
Krista Brittain (1:08:29)
Yeah.
Dr. Jeremy Sharp (1:08:30)
That sounds good. Well, Krista, thanks so much for coming on and having this discussion and bearing with my questions. Yeah, this is fascinating and really helpful to just get a different different perspective and dig into this model.
Krista Brittain (1:08:42)
Thanks, Jeremy. It’s been a delight. Thank you so much for having me. I love talking about this stuff. So if folks out there have questions, they can sure reach out to me by email and I’m happy to happy to keep talking about it.
Dr. Jeremy Sharp (1:08:54)
Perfect. Thanks again.
Krista Brittain (1:08:56)
Thanks. Bye.
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