FOCUSING ON
CONCRETE BEHAVIOR
Both Minuchin w° and Haley6' 'emphasize the
importance of keeping the therapy
focused upon concrete, observable behavior. This em-phasis is particularly crucial in working with
addicts and their fami-lies, since
addicts can be especially slippery and difficult to pin down. Similarly, family members often appear to be in agreement until an attempt is made to get consensus on specific details,
at which point hidden disagreements
usually surface.
It is most important to have the parents and the
rest of the family focus on
"house rules,- particularly rules dealing with drug-related behavior. The therapist should also help
them to focus on positive, achievable
goals, such as specific steps the IP might take in looking for a job.
These rules and positive goals should be negotiated
in the session, so that the therapist
can observe the behavior during the negotiation
process and intervene to increase the likelihood of a successful outcome. Often the agreement will
include specific "home-work"
tasks that stem from session interaction but are performed during the interval
between sessions. If resistance in the family is high, the therapist may want to assign tasks that are small and almost unchallengeable (see Chaper 12), such as having
the IP look up two jobs or two
apartments in the classified section of the newspaper. It is ideal for the parents to participate in these
tasks, so that they feel some sense of participation in the IP's eventual
success.
One type of specific behavior that has been
especially important in our work has been the results of weekly urine tests.
They give a tangible indication of progress and do not allow family members (or
the therapist) to sidestep this issue.
They can also serve as aids in getting
the family to take responsibility and put pressure on the IP to remain clean. It usually helps to negotiate the
criteria for failure with the family at
the outset of treatment. The idea is to get advance agreement that they will believe the urine tests.
If the addict protests that someone
has switched or will switch urine samples with him, the therapist should get the rest of the family
to agree on the number of
