Clients Aren’t Sick, They’re Stuck: Using Strength Based Culturally Informed Integrated Model to Understand the Client’s World and Create Change

In this episode, Terry discusses his experience initially being trained psychodynamically and psychoanalytically, but finding that it did not seem to be a good fit for the population whom he was working with, which were families in Chinatown in San Francisco, many of which were immigrants. He discussed how a training at the Mental Research Institute (MRI) had a profound impact on him when he heard the person teaching saying that people are not sick, they are stuck. The therapist's job is to help them get unstuck. Terry discusses the four elements that he feels are important to working with clients and families, which are related to the relationship, being humanistic in approach, understanding the client’s cultural context, activating the clients’ strengths, and the placebo effect, which is the client’s belief that positive change is possible. We discussed the differences between the Brief Strategic MRI model and Jay Haley’s Strategic Family Therapy model, and the 180 degree shift in solution. This is based on the idea that the attempted solution has become the problem. We discussed one example of a session Terry had written about, and how both the cultural competency and the MRI model came into play. The case involved a Vietnamese woman who was encouraged by her previous therapists to stop taking care of her sick father and instead individuate and take care of herself. She flatly rejected this idea. Terry understood the importance of certain roles in collectivists cultures. Instead of encouraging her to take care of herself more, he helped her to become more effective in caring for the father. He used different metaphors to step into the clients’ worldview and shifted the system, which worked within the client’s cultural context. The intervention was a success and the father and the client experienced great improvement. Terry discussed his approach called, Strength Based Culturally Informed Integrated Model, and how the two most important parts are adaptability and flexibility, and collaborating with your clients on creative interventions to disrupt the stuck cycle and generate new more effective solutions.

Terry Soo-Hoo, PhD is currently professor at the California State University East Bay in the Marriage and Family Therapy Program, and was the Clinical Director of MRI in Palo Alto. He completed his Ph.D. in clinical psychology at the University of California, Berkeley and is Board Certified in Family and Couples Psychology (ABPP). Prior to university teaching he devoted over twenty years as a psychologist in Community Mental Health Services in San Francisco working with a diverse range of people with many different psychological problems. Terry's publications include topics on multi-cultural issues in psychotherapy and consultation, brief therapy and couples therapy. He has special interests in the area of innovative culturally relevant approaches to psychotherapy. He has also provided extensive presentations, training, supervision and consultation on these topics to agencies and other professionals in many countries around the world.