Using the TCOM Tools in Practice


by: Ken McGill, LMFT

I have learned from and collaborated with the TCOM Collaborative for more than ten years. My formal clinical training has been in family systems, specifically in multi-generational family therapy or Bowenian family therapy.[1] A few years back I presented at an event and began to discuss the CANS and other TCOM Tools with family therapists. Several marriage and family therapists (MFTs) continued to contact me regarding the CANS and TCOM and how they can be used as part of the private practice. I shared with them how I incorporate the TCOM tools in my work with children/youth and families in my practice, and I shared how treatment planning has been significantly more successful with their use.
It is my sincere belief that both TCOM and its associated tools should be brought directly to those who are serving in the private sector (e.g. private practice).  TCOM tools are quite simply standards of effective practice.
As I prepared for the 2015 TCOM Conference an idea dawned on me. In fact, I would go so far as to say I had an ‘epiphany’. I was thinking of how to assist therapists and clinicians with truly understanding and utilizing CANS and TCOM.
I began connecting my experiences using CANS and my systemic training as a marriage & family therapist. I was melding my MFT world with my CANS-TCOM world. Suddenly real clarity came upon me: CANS/TCOM and Family Systems became the perfect pair in my framework.
During my education, I began to truly see the world and the people in it through a systems lens. My formal clinical training began with Family Systems. I studied at Seton Hall University back in the early 1990s, with a focus in marriage and family therapy. I read the theoretical work of systems theorists—such as  Virginia Satir, Jay Haley, Salvador Minuchin and Murray Bowen—who offer elegant theories on the development or causes of concerns as well as solutions to allieviate pain and suffering with regards to the human experience.
Later in my career, I first began to frequently use the CANS and TCOM as a practicing Marriage & Family Therapist (being trained and supervised from a Multi-cultural Family or Bowenian Family Therapy perspective). I was working with the individuals and families in my private practice, and school systems often sent me referrals. Often these referrals were families with children identified as having ‘special needs’—and CANS would then immediately assist in the development of partnership with both the parents and youth. Often these families would tell me that by collaborating with them, by defining and monitoring improvements or outcomes, TCOM ‘demystified’ therapy and ‘normalized’ the processes.

How can we bridge these two aligned and practice-improving frameworks to better and more collaboratively address the needs and strengths of the children and families we serve?

First it is important to get a sense of the history and cornerstones of Family Systems thinking.
Then, we will see how this aligns and bridges with the TCOM communicative frameworks.

What is Family Systems Therapy?
*Return to Post 1 for Ken’s Overview of a “system”

The goal of any therapy is to assist in transforming the lives of those we serve. A family’s patterns of behavior influences the individual and therefore may need to be a part of the treatment plan. In marriage and family therapy, the unit of treatment isn’t just the person – even if only a single person is interviewed – it is the set of relationships in which the person is imbedded.

Family therapy is:

  • brief
  • solution-focused
  • specific, with attainable therapeutic goals
  • designed with the “end in mind”
  • often practiced by Marriage and Family Therapists
    (MFTs)[i]

Ken2aFamily Systems Therapy and TCOM

How does all of this background help to bridge the goals of TCOM with family systems therapy?

I view the steps to connecting the work that we do as therapists/clinicians with TCOM and family systems therapy as a perfect continuum:

  • First, we begin to define what it is we are attempting to accomplish.
  • Then, we define the parameters from which are work is to be done.
  • Throughout, we maintain full understanding from everyone’s perspective.

Changing practice with systems thinking is outlined across the Praed Foundation website, not to mention in the many works by Dr. John Lyons:

Child and Adolescent Needs and Strengths (CANS) is an assessment strategy that is designed to be used for decision support and outcomes management. Its primary purpose is to allow a system to remain focused on the shared vision of serving children and families, by representing children at all levels of the system

The ‘system’ in this definition is the ‘child-serving system.’ In order to maintain a shared vision, this child-serving system must partner with the youth and family throughout the process. As a communication tool, The CANS becomes the conduit for getting at this partnership and building a shared vision, as well as outlining necessary steps to meet the goals of treatment.

TCOM is the framework for which this work is being done. Is not this the essence of systems theory? The systems view of an individual—within the context of their family, living within a community, internalizing life through cultural lenses—all this is connected to a larger societal influence (bio-ethno-gender-socio-economic status).

Bridging TCOM and systems frameworks provides us (in the most plural, collaborative, systems sense) with the information needed to effectively do our work.

 —

[1] Kerr, Michael E. “One Family’s Story: A Primer on Bowen Theory.” The Bowen Center for the Study of the Family. 2000. http://www.thebowencenter.org.

[i] Marriage and Family Therapists (MFTs) are mental health professionals trained in psychotherapy and family systems, licensed to diagnose and treat mental and emotional disorders within the context of marriage, couples and family systems. Marriage and Family Therapists broaden the traditional emphasis on the individual to attend to the nature and role of individuals in primary relationship networks such as marriage and the family.  MFTs take a holistic perspective to health care; they are concerned with the overall, long-term well-being of individuals and their families.

About Marriage & Family Therapists. American Association for Marriage and Family Therapy. 2017. http://www.aamft.org/iMIS15/AAMFT/Content/About_AAMFT/About_Marriage_and_Family_Therapists.aspx

 

For more information about this post and how to connect to it’s author, visit the series home page here!

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