Approaches to Mothers
Compared to fathers, there seemed to be more
variability in the difficulty
entailed in engaging mothers. More mothers than fathers responded positively to
the opportunity to become involved in their son's treatment. Some appeared to want to control what happened to their sons, especially if the sons were improving.
They wanted to know what was going
on, so they could take charge of it. This was fine with us. We could "fly" with it. Our main concern was to get
them in, no matter what their motivation.
On the other hand, there were mothers whose
resistance equaled or exceeded that of their husbands. They might not oppose
the idea openly, but instead would use the intransigence of their husbands as an
excuse for not participating. Some techniques that could be used for recruiting
mothers have been described. Others are discussed in the next section. Only one
vignette will be presented here, partly due to its uniqueness.
Vignette In this case the addict had a 6-year history of drug
problems. He started heavy drug use at age 16, injecting ampheta-mines and taking
barbiturates regularly. By age 19 he was addicted to heroin. He had failed two
prior treatment attempts and at intake was still addicted to heroin
(10 bags per day), supplementing this with regular use of barbiturates
and marijuana. It also appeared that the family had many problems and
was clearly making the situation impossible for the addict to improve. Samuel M.
Scott, the therapist,
The family was a large one, with
seven children. For such a sizeable group, the payment for participating in the
evaluation ses-sion gained salience. This unusual aspect provided the therapist
with a means
for (1) gaining attention, (2) downplaying the possible nega-tive implications of family
involvement in treatment, and (3) under-scoring the urgency of the situation.
The following is a reconstruction of Scott's first phone call to the mother.
participate, however, so she was not looking for reasons
to back out.
The humor in this vignette should not obscure the sound theo-retical base underlying
Scott's approach. It derived from his prior
knowledge of the family. Scott was aware of
their increasing re‑
luctance. He attempted to create a sense of urgency and surprise in
order to catch them off guard and cause them to focus on a
positive aspect of their participation.
The money served as a convenient vehicle for taking the family's side against an
"impersonal- institution. While financial incentive
seemed important in this
case, a similar tack could have been taken using a different source of leverage.* For instance, the
therapist could have called with a different scenario, saying, "It's finally
come through! They're gonna let us do it!" [-Do whatfl " They're finally gonna let the family help with the treatment! It's fantastic! We've been trying to convince
them for years that they should let the family know what's going on. My God, let's get it set
up before they change their minds. We can't lose this opportunity! I'm
really glad for you,- and so forth. This particular
variation of the approach might be appropriate for a family who had previously
experienced treatment for their son and had felt closed out. It should
be recognized that the specific content chosen should be in response to
a given family and its
situation, rather than an indiscriminate application of a
series of -pat" or -canned- phrases.
An important point in this handling of the recruitment process is that it reframes as
positive an event that has the potential to be
prospect of having their dirty linen examined by a -bunch of shrinks,-
they are presented with an opportunity. This opportunity is portrayed as beneficial and no
blame is attached to it. Consequently, the -reality- is shifted. The
tone of urgency, enthusiasm, or concern only supports the importance and
the positive features of the event, thereby fortifying the shift.
