Approaches to Parents and Family

Approaches to Parents and Family

In line with the experience of Vaglum'" and others, the therapist

needs to take special pains not to ally with the IP against the parents or family. His approach in therapy will be to join them so that the three of them (the therapist and both parents) can work together to straighten their young person out. He should stress to them that this treatment is different from others because the family is involved.*

The therapist needs to be convinced, and convincing, that it will help.

In addition to the general rationale described, specific approacheswere preferred by particular therapists or were tailored to certain

families. They are presented below as vignettes. They are not necessarily -typical," as some of them depict more extreme therapist efforts, but they do give a picture of what can be done, and how.

Additional vignettes that pertain to the rationale for family treat‑

ment also follow under sections on "The Nonblaming Message- and

-Therapist Factors.-

Vignette 1. Paul Riley, Family Counselor, frequently took the tack that he needed to get the family in to know more about the history of the client. Only the parents could give him the information about their son necessary for him to do the best job. He asked them, "Please come in so I can get more background."

Vignette 2. David Mowatt, EdD, had the highest rate of recruitment success among our therapists C100%). This example stems from an interview with the IP, but the content is also applicable in talking with the family. Mowatt broached the family involvement issue by stating, "One reason we do well in this program is that we involve families to help you get off this stuff." A minute later, he said, "One of the reasons the programs you were in before failed is that they didn't understand that your parents know you better than anyone. I am going to know you really well, and will go through some tough times with you, but you know your parents know you best. They saw you as a kid, they knew you when you were doing well; the way they see you will be valuable information for me in helping to get you off the stuff. So, the first thing I need is for them to come in."Vignette 3. Jerry I. Kleiman, PhD, routinely made home visits, using a number of approaches. First, he tended to ally with parents by telling them that they had the "right" to work with him to straighten their son out. He gave them hope that they could succeed. He offered them the opportunity to be more involved than they had been up until now, noting that this was their last chance and they had to bail their son out. He told them that this time treatment would be different because, "This time you will know everything that is going on and be a part of it."

Vignette 4. In one difficult case, Alexander Scott, MSW, made 4 con-tacts with the IP, 24 contacts with other family members, at least 5 failed attempts to reach the IP and family members, and 15 talks with the drug counselor and project staff. The process took 30 days. This family probably showed up for no other reason except that Scott "wore them down." It was easier just to come in and get him off their backs than to continue to resist. Cases such as this were more the exception than the rule, since in only 7 of 92 families did the engagement process involve more than 25 contacts with family and counselor. Also, in only four cases did the process take 3 or more months. Most families required much less effort than this.