How does the SMART Therapy work?
Assessment
The SMART program believes the action of the assessment already includes the treatment function. The intention of initial session is to gather client’s information in three levels. Even though it is an initial session, the therapist does not miss the opportunity to offer treatment when the need of the client is present as an emergency intervention.
Treatment
The SMART combines the Process-oriented approach to treating clients presenting issues. As a result of following the process, it naturally guides therapist to offer most effective modality of the treatment at that session. The balance between structured treatment and creative therapeutic flow is crucial to implement treatments method. The most effective treatment is determined by a timing of client’s presenting process not only the method itself.
Weekly sessions are most common for our clients.
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MFTs practice short-term therapy; 12 sessions on average. Over 65% of cases are completed within 20 sessions and over 87% by 50 sessions.
The SMART therapy helps you to integrate your whole brain. The newest Neuro-biological research and more than 1000 years of Eastern wisdom also show the same domains for the treatment.
#1- Thinking Brain (Cognitive Brain) #2- Emotional Brain (Feeling brain)
#3- Sensational Brain (Guts Brain) #4- Relational Brain (Sense of Relationship Brain)
Non-Judgemental Holistic Assessment
Thought Level: Identity and Behavior assessment.
The pretreatment session starts from an assessment of thoughts level, including assessment of presenting problems and goals, past and present life-threatening behaviors, diagnostic evaluation as needed and systemic assessment using Genogram and Family therapy methods. Western developmental view helps clients to intellectually understand that their family of origin is one of the causes of their presenting problems, uncomfortable feeling and a fear of attunement of an emotion. The assessor should also take a general history of previous therapy experiences and in-depth personal information as needed, such as sexual orientation, religious/spiritual experience, and cultural identification.
Emotion Level: Emotional Attachment and Attunement ability assessment.
The stage of change and the level of emotional acceptance are the key assessment in this level. In order to assess this level, a therapist needs to have a presence, which is a state of being open to any emotions. An attunement requires presence but its process of focused attention and clear perception. A therapist uses presence and moves it into the social sphere of taking in client’s internal state for interpersonal attunement. While the definitive neural correlates with attunement are yet to be elucidated, the discovery of mirror neurons at the end of last century offers us new insights into a possible path of energy and information flow that may occur with attunement. Our mirror neurons interact with neurons in the superior temporal cortex to create a map of the sensory implication of motor actions (SIMA). This mapping let us know what is happening next in the pattern of predictable behavioral sequences. As this mirroring is never actually a true replica, we could even dub this a “sponge system” as we soak up what we see in others and actually make it uniquely our own. The assessment of the ability to recognize own emotion as well as others is a possible cause of presenting issue.
Sensation Level: Bodily sensation, mental activity, and relationship assessment.
When we focus on sensations, we are putting attention on something more basic and more fundamental than emotions and thoughts. Whether we are talking about evolution or individual human development, it seems accurate that physicality comes first, followed by emotionality, and then the capacity to use thoughts and symbols. From this point of view, sensations are very reliable, very human, and basically impersonal- that is, they aren’t heavily shaped by personal history. Interpretations, on the other hand, are often deeply shaped by our patterned, conditioned history. After assessing thoughts, and emotional level, the therapist assesses the physical location of the emotion in client’s body as a bodily sensation or movement. Just asking this location offers therapeutic effect but need to pay attention for client’s rejection and processing speed. This process needs to be aligned with client’s flow of processes and not forced by the therapist. Sensation level of symptom sometimes manifests as a non-verbal communication, such as a movement and gesture.
Research shows that more than 75% of communication is conveyed nonverbally in sensation. SMART offers techniques to assess those movements, gestures, expression of emotions and microexpression, which expresses through neuromuscular activations. This level may collaborate with another specialist such as Physical Therapist and Medical Doctors to gather information about pre-existing physical conditions.
Who can benefit from SMART Therapy?
The SMART Therapy is good for individuals, couples and families. These are specific applications of our Static Movement Treatment.
Reunification Therapy
Reunification Therapy (RT) is a therapeutic intervention for separated families when the children find difficulty visiting with the noncustodial parent, but depending on the circumstances, the purpose and goals of reunification therapy vary. RT may include an intake assessment of parents and children to develop an appropriate treatment plan and in-office treatment for all family members affected by alienation or high conflict divorce.
The reunification therapist spends time individually with the child and with the reunifying parent before meeting with both of them together. Moreover, the therapist acts as a container for the reunifying parent and child to safely address their relationship and makes contact with the individual therapists as needed to coordinate treatment.
Reunification efforts subsequent to prolonged absence should be undertaken with service providers with specialized expertise in parental alienation reunification. A number of models of intervention have been developed, the best-known being Warshak’s (2010) Family Bridges Program, an educative and experiential program focused on multiple goals: allowing the child to have a healthy relationship with both parents, removing the child from the parental conflict, and encouraging child autonomy, multiple perspective-taking, and critical thinking.
It is often quite difficult to discern who is the alienating and who is the targeted parent in alienation cases. Thus equal or shared parenting is clearly preferable to the primary residence or sole custody orders in potential alienation cases, as courts are ill-equipped to assess the dynamics attendant to parental alienation, and co-parenting is preventive of alienation.
Parental Alienation
Parental Alienation is Psychiatric Disorder in children. Particularly the context of divorce, children 's refusal to visit the parent. A parent who is angry at the spouse or ex-spouse accomplishes this estrangement by painting a negative picture of the other parent in deprecating comments, blame and false accusations shared with the children. They may also hoard the kids, doing all they can to thwart the other parent's attempts to have parenting time.
Feeling perpetually angry at your spouse or ex-spouse? Anxious about your co-parenting relationship? Depressed about the situation?
Better check out if either of you is involved in trying to turn your children against their other parent. If so, think again.
Pathway to Neural Integration.
1. The initial domain is creating a rapport from collaborative assessment with the client. The therapist’s unbiased/non-judgemental approach helps to provide “Therapeutic Assessment” opportunity. Non-judgemental assessment means that ability to accept judgment not denying a judgemental observation. Therapeutic Assessment items include client’s presenting issues and intention, reality check, the family of origin, suicidal thoughts, and uncontrollable behavior history. Providing a therapist’s unconditional kindness for issues helps to raise more awareness for client's’ thoughts pattern and unconscious behaviors. After unconditionally assessing thought record of a client, the therapist encourages the client to see both negative and positive thought from their perspective. More and more research is showing that trying to block or suppress thoughts from clinical and personal bias actually makes them worse. Accepting already existing thoughts, when we see things as they are, thoughts are already there and no need to for us to think more than face value. The treatment for obsessional thoughts involves consciously focusing on the obsessional thoughts over and over at this phase until it becomes acceptable and move to emotional level when the client is ready.
2. The second domain of the treatment includes presenting an emotional level of symptoms. Especially opening up the emotional attachment style and honest emotional status stabilizes client’s mental states. Especially when the client has relationships conflicts and aggressive attitude to herself from over-activation of the limbic system, especially amygdala, explaining attachment style and brain science help to create a safe environment at the treatment. Psychobiological and Neurobiological treatment are effective at this stage.
3. The third domain of the treatment is focused on sensation level, which usually experienced as a bodily sensation. The treatment focuses on a bodily sensation of the triggering moment for substance abuse and uncontrollable behaviors. When couple client is presenting relationship issue, starting from eye-to-eye communication helps to produce oxytocin and easier to move forward to attunement treatment. The therapist needs to have an advanced skill to treat body sensation and movement as well as channels of experience of the client expression. Finding client’s experiencing channels and unfold it from that channel require the therapist’s creativity, sensitivity, awareness of countertransference and a wider window of tolerance for both therapist and clients in order to accept client’s ongoing process of emotions. The therapist needs to hold safe and trustworthy environment with her presence to complete the treatment to establish linkage between emotion and sensation level. The clients show resistance when the brain starts to create a bridge between emotion and sensation. It appears as bodily experience and can be guided from asking “Where do you experience your feelings in your body?”. From my clinical experience, one-third of clients shows some kind of resistance to going down to sensation level. The resistance includes trying to “talk” about the experience instead of “being” with the experience, which pushes back Static Movement into thoughts level. Substance use, alcohol and any kind of dependency can be used as a resistance strategy including relationship co-dependency. Even Yoga, meditation or exercise can be an avoidance strategy to escape from experiencing the sensation level if the client is losing a balance of the amount of the practice and putting too much value on specific dogma or practice without reality checking.
For those clients who has a resistance of owning certain emotions and sensations, it is helpful to “name” that emotions and sensations using drawing, mimicking sounds if it is experienced with a sound, or making movement using Play and Art Therapy techniques. These are evidence-based intervention in emotional level as “Name it and tame it” but it can be applied to the sensation, Static Movement level.
Static Movement Practice (SMP) accesses subtle level of the bodily sensation. SMP can be used for pretreatment for “warm up” client’s ability to track inner experiences as well as generic practice at home. In order to perceive a micro-sensation of the body, the therapist uses Mindfulness-based SMP to produce “Zero-point Static Movement” of the client's’ bodily sensations. It is zero physical movement but clients’ starts to experience the inner movement of the body, which is “Static Movement”. This state generates more emotional and contextual intelligence for clients and develops an own soothing technique of own uncomfortable bodily sensations. The treatment at Static Movement level is an etiologic treatment for presenting issues of the clients. The effects include reduction of uncontrollable behavior and physical symptoms as well as improvement of relationships, which promote positive systemic changes.
The aim of using Static Movement Practice is to attempt to regulate autonomic nervous system (ANS) in Mindfulness-based practice. It is effective when the treatment organically helps to balance between arousal and relaxation neurotransmitters. The arousal neurotransmitters include Monoamine neurotransmitter, which transport dopamine transporter (DAT), serotonin transporter (SERT), and the norepinephrine transporter (NET) and relaxation neurotransmitter include gamma-aminobutyric acid (GABA).
