Questionnaire on " Feedback Loops in Clinical Practice" 2 December 2007
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(1) Introduction
This questionnaire is for people who are interested in providing feedback to
me about the article:
" Feedback Loops in Clinical Practice: An Integrative Framework"
" Australian and New Zealand Journal of Family Therapy" September
2006.
In posing questions, the questionnaire restates many of the proposals of the article – sometimes more boldly than the article. You may be interested in reviewing the article in this way.
This questionnaire seeks your opinion on various propositions put in the article. Hopefully it will help identify what parts of the article particularly interest you and what parts you find unconvincing. This is to assist the evolution of these ideas. It is not part of any defined research or course of study.
Some questions ask about the respondent's experience and theories that guide them.
If you want to discuss or question the article or this questionnaire please contact me.
One way for you to get your responses to me is for you to:
. Select all of this questionnaire file (Control A)
. Copy this (Control C)
. Create a blank email to me (my address is in my home page)
. Paste this into the email (Control V)
. Insert your responses into the email and send it to me
When choosing from a scale, please insert "yes" in the appropriate
brackets:
Never [ ]; Rarely [ ]; Sometimes [ yes ]; Often [ ]; Nearly Always [ ]
In the questionnaire where I write "Comments:", I mean " If you have any comments you would like to add, please insert them here".
My aim in providing this questionnaire is to make it easier for people to let me know what they think. Please offer your feedback in a way that is easy for you. Do not be constrained by the questionnaire.
Regards
Andrew Gunner
(2) My contact address
Get my email address, along with the whole article, via my web site home page:
www.vicnet.net.au/~gunner
(3) The respondent
Name: ............................................
Position: ...........................................
Organisation: .........................................
(Please remain anonymous if you wish)
(4) Date on which questionnaire was completed
Date: .............
(5) How did you locate my article?
Email communication with the author: yes [ ]
Other communication with the author: yes [ ]
Via a colleague: yes [ ]
The Society for Chaos Theory in Psychology and Life Sciences forum: yes [ ]
Another internet forum: .........................................
The Australian and New Zealand Journal of Family Therapy: yes [ ]
A link from the web site of the Australian and New Zealand Journal of Family Therapy: yes [ ]
A link from the web site of the Australian and New Zealand Psychodrama Association: yes [ ]
A link from another web site: ................................................
An internet search engine, e.g. Google or Altavista ............................
What keywords did you use in your internet search: ........................................
Other ...................................................
(6) Your experience as a counsellor
6.1 Years as a counsellor
For how many years have you worked as a counsellor, therapist or psychiatrist?
.............. years
(Please allow "counsellor" to include therapist or psychiatrist in the rest of this document.)
6.2 Are you familiar with systems theory / feedback loops
Not familiar [ ]; Slightly familiar [ ]; Familiar [ ]; Very familiar [ ]
I use it in my counselling work:
Never [ ]; Rarely [ ]; Sometimes [ ]; Often [ ], Nearly Always [ ]
Comments:
(If you have any comments you would like to add, please insert them here.)
6.3 Psychodynamic experience
What experience do you have with psychodynamic analysis - the use of dread, anxiety, defence and interpretation?
Not familiar [ ]; Slightly familiar [ ]; Familiar [ ]; Very familiar [ ]
I use it in my counselling work:
Never [ ]; Rarely [ ]; Sometimes [ ]; Often [ ], Nearly Always [ ]
Comments:
6.4 What experience do you have with psychodrama role theory
Not familiar [ ]; Slightly familiar [ ]; Familiar [ ]; Very familiar [ ]
I use it in my counselling work:
Never [ ]; Rarely [ ]; Sometimes [ ]; Often [ ], Nearly Always [ ]
Comments:
6.5 What experience do you have with cognitive behavioural therapy?
Not familiar [ ]; Slightly familiar [ ]; Familiar [ ]; Very familiar [ ]
I use it in my counselling work:
Never [ ]; Rarely [ ]; Sometimes [ ]; Often [ ], Nearly Always [ ]
Comments:
6.6 Are you familiar with chaos theory
Not familiar [ ]; Slightly familiar [ ]; Familiar [ ]; Very familiar [ ]
Comments:
6.7 Are you familiar with network theory
Not familiar [ ]; Slightly familiar [ ]; Familiar [ ]; Very familiar [ ]
Comments:
(7) Feedback loops
7.1 " Pain, defence, damage " amplifying loops
The article suggests that pain, defence and damage tend to form amplifying feedback loops. One example of this is in figure 4 of the article. Another example follows: an injured knee forces a man out of sport and he feels like a loser (pain or dread). When he turns his determination to win towards gambling (defence) and starts losing (damage), his fear about being a loser (dread) is compounded.
What is your position on this?
Strongly Dispute [ ]; Dispute [ ]; Uncertain [ ]; Agree [ ]; Strongly Agree [ ]
The article suggests interactively identifying key feedback loops linking pain, defence and damage with clients on a white board - as in figure 4 in the article.
Can you see yourself doing this with your clients?
Strongly No [ ]; No [ ]; Uncertain [ ]; Yes [ ]; Strongly Yes [ ]
Comments:
7.2 " Problem behaviour, shocks, denial " amplifying loop
The article suggests that a problem becomes more entrenched each time the person (1) uses the problem behaviour, e.g. gambling, (2) gets shocked by consequential damage, (3) denies this shock and (4) returns to the problem behaviour. This amplifying feedback loop tends to escalate the problem behaviour, the shocks and the denial.
This can be used with clients as follows. Each time you shock yourself and keep on gambling you become more of a problem gambler. Your gambling escalates. The shocking events tend to become more damaging. Also, your ability to deny the damage increases. Over time, you build a way of thinking that supports your gambling.
What is your position on this?
Strongly Dispute [ ]; Dispute [ ]; Uncertain [ ]; Agree [ ]; Strongly Agree [ ]
Can you see yourself using this idea with your clients?
Strongly No [ ]; No [ ]; Uncertain [ ]; Yes [ ]; Strongly Yes [ ]
Comments:
7.3 " Activity & motivation" amplifying feedback loops
The article suggests that any activity and each of its multiple motivations (ideas or feelings) tend to form an amplifying feedback loop. This is independent of the consequences (damage or rewards) of the activity. (See the section of the article around Figure 5)
Each choice of an activity brings rationalisation, strengthening the person's belief that the activity is right and necessary. This strengthened belief tends to lead to further choices of the activity. This is another way of understanding how a problem mentality can develop.
What is your position on this?
Strongly Dispute [ ]; Dispute [ ]; Uncertain [ ]; Agree [ ]; Strongly Agree [ ]
Can you see yourself using this idea with your clients?
Strongly No [ ]; No [ ]; Uncertain [ ]; Yes [ ]; Strongly Yes [ ]
Comments:
7.4 Habitual behaviour constantly recreates our whole psychic structure
People constantly recreate their whole psychic structure via feedback loops like those described above. This is a dynamic understanding of pliable personality. It suggests that past events are relevant as habits acquired during those events keep the ideas and feelings of the past alive today.
What is your position on this?
Strongly Dispute [ ]; Dispute [ ]; Uncertain [ ]; Agree [ ]; Strongly Agree [ ]
Can you see yourself using this idea with your clients?
Strongly No [ ]; No [ ]; Uncertain [ ]; Yes [ ]; Strongly Yes [ ]
Comments:
(8) Psychodynamics
8.1 Defences & anxiety: damping feedback loop
The article suggests that all psychodynamic defences form a damping feedback loop linking the anxiety and defence. The defence tends to reduce the anxiety. (See section of article around Figure 7)
What is your position on this?
Strongly Dispute [ ]; Dispute [ ]; Uncertain [ ]; Agree [ ]; Strongly Agree [ ]
Comments:
8.2 Dread, anxiety defence: amplifying feedback loop
The article suggests that all psychodynamic defences form an amplifying feedback loop that links and tends to escalate dread, anxiety and defence.
What is your position on this?
Strongly Dispute [ ]; Dispute [ ]; Uncertain [ ]; Agree [ ]; Strongly Agree [ ]
Comments:
8.3 Sharing cyclic hypotheses & psychodynamic interpretation
When a counsellor discusses with a client a feedback loop linking dread, anxiety and defensive activity, this can be seen as psychodynamic interpretation.
What is your position on this?
Strongly Dispute [ ]; Dispute [ ]; Uncertain [ ]; Agree [ ]; Strongly Agree [ ]
Comments:
8.4 A defence can be a symbolic solution to a dread
The article suggests that gambling (defence) can be a symbolic solution to an underlying fear (dread). An example is given in Figure 6 of the article. Another example follows: a young man suffering schizophrenia may hate his dependence on his parents (dread) - and gambling (defence) may be a symbol of independence for him. Perversely, his gambling will tend to increase his dependency on his parent.
Can you see yourself using these ideas with your clients?
Strongly No [ ]; No [ ]; Uncertain [ ]; Yes [ ]; Strongly Yes [ ]
Comments:
(9) Psychodrama role theory & Network theory
9.1 Network of roles & feedback
A person's network of roles (intra-personal and inter-personal) is organised by feedback loops. The person's personality is the emergent feature of this network of roles.
What is your position on this?
Strongly Dispute [ ]; Dispute [ ]; Uncertain [ ]; Agree [ ]; Strongly Agree [ ]
Comments:
9.2 Internal structure of each role & feedback
The actions, ideas and feelings of each role are organised by feedback.
What is your position on this?
Strongly Dispute [ ]; Dispute [ ]; Uncertain [ ]; Agree [ ]; Strongly Agree [ ]
Comments:
(10) Chaos theory
10.1 Amplifying feedback & chaos theory
Any system that is partly organised by amplifying feedback can be described by chaos theory.
What is your position on this?
Strongly Dispute [ ]; Dispute [ ]; Uncertain [ ]; Agree [ ]; Strongly Agree [ ]
Comments:
10.2 Human functioning & chaos theory
Feedback plays a central role in human functioning and in chaos theory - and this provides a theoretical basis for suggesting that chaos theory applies to human functioning. Chaos theory is not just an inspiring paradigm for considering human functioning, it is a pertinent paradigm.
What is your position on this?
Strongly Dispute [ ]; Dispute [ ]; Uncertain [ ]; Agree [ ]; Strongly Agree [ ]
Comments:
10.3 Butterfly effect
Amplifying feedback can increase very small differences between situations that seem identical leading to very different outcomes. This is another way of thinking of the "butterfly effect" which is part of chaos theory.
What is your position on this?
Strongly Dispute [ ]; Dispute [ ]; Uncertain [ ]; Agree [ ]; Strongly Agree [ ]
Comments:
10.4 Self similarity
Feedback loops lead to repetition of pattern in people's lives. This is another way of thinking of "self-similarity" which is part of chaos theory.
What is your position on this?
Strongly Dispute [ ]; Dispute [ ]; Uncertain [ ]; Agree [ ]; Strongly Agree [ ]
Comments:
(11) Cognitive behavioural therapy
11.1 Systemic analysis can lead to cognitive challenges
The article suggests that discussing with a client how feedback organises the client's life can challenge client thinking and so is a form of cognitive intervention based on systemic thinking. (See section of the article around Figure 3.)
What is your position on this?
Strongly Dispute [ ]; Dispute [ ]; Uncertain [ ]; Agree [ ]; Strongly Agree [ ]
Comments:
11.2 Cognition is not the controller
A separate amplifying feedback loop links any action with each of its motivating ideas and feelings. Cognition (ideas or thinking) influences and is influenced by actions and feelings. Cognition is not the controller of feeling and action.
What is your position on this?
Strongly Dispute [ ]; Dispute [ ]; Uncertain [ ]; Agree [ ]; Strongly Agree [ ]
Comments:
11.3 Addressing underlying / contextual issues s& empathy
The Feedback Framework provides a theoretical basis for addressing the underlying or contextual issues (dreads) of the client. This provides a counter balance to the pressures to focus on cognition and behaviour alone. It encourages counsellors to locate the meaning for the client of difficult life events and so towards empathy.
Do you support this position?
Strongly No [ ]; No [ ]; Uncertain [ ]; Yes [ ]; Strongly Yes [ ]
Comments:
(12) Human functioning
12.1 Understanding out-of-control phenomena / presenting problems
Amplifying feedback offers a convincing understanding of out-of-control phenomena including: pathological gambling, drug and alcohol addiction, anxiety, depression, phobias, paranoia and compulsions. It can offer a way of understanding of the problems that clients present in counselling and of how the problems are maintained.
What is your position on this?
Strongly Dispute [ ]; Dispute [ ]; Uncertain [ ]; Agree [ ]; Strongly Agree [ ]
Comments:
12.2 Human functioning emerges
Human functioning emerges from the interaction of innumerable intrapersonal and interpersonal feedback loops
What is your position on this?
Strongly Dispute [ ]; Dispute [ ]; Uncertain [ ]; Agree [ ]; Strongly Agree [ ]
Comments:
(13) Overall questions on framework
13.1 What weaknesses do you see in the Feedback Framework?
Comments:
13.2 Possible improvements to Framework
Could you suggest any ways in which the Feedback Framework could be improved?
Comments:
13.3 Suggest any articles or books
Could you suggest any articles or books or bodies of knowledge that could assist the further development of the Feedback Framework?
Comments:
13.4 What is it about the feedback framework that interests you?
Comments:
13.5 Incorporate aspects of Framework into your practice
Do you think it would be a good idea to incorporate some aspects of the Feedback Framework into your practice?
Strongly No [ ]; No [ ]; Uncertain [ ]; Yes [ ]; Strongly Yes [ ]
Comments:
(14) Possible improvements to questionnaire
Could you suggest any ways in which the questionnaire could be improved?
Comments:
If it is easier, you could place comments on a particular question within the comment section of that question.
(15) Thanks for your assistance - Andrew Gunner