Author: Sstephan

Family Focus

How do you engage families before the first session?

Research corner

Practical applications

What the research says about engaging families before the first session:
Using phone calls or e-mail to contact families helps reduce perceived barriers obstacles to service access. (McKay et. al., 1996)
Demographic characteristics are not associated with level of family treatment involvement. (McKay et. al. 2000)
Caregiver beliefs and attitudes toward mental health influence access to services for children. (Szapocznik et al.,1998)

What the research means in terms of your practice with children and adolescents:
Utilize all available resources to communicate with families: e-mail, home and cell phone, fax, and hand-written letters.
Attempt to engage every family, regardless of their socio-economic status.
Honestly address caregiver concerns before treatment. Ask them about their past experiences and how you can improve upon them.

Helpful hints

Ask parents if it’s okay for you to call them at work or on their cell phone.
Learn the family routine. When/where do parents work? Who’s at home when the kids leave from school? Are the kids unsupervised in the morning/evening? If so, for how long?
Establish open-communication channels. Give them your contact information and allow them to call you during their free time.

Questions to ponder

When was the last time a parent called you without a prompt? How can you create an environment in which parents feel free to contact you?
How many parents have access to the Internet at home or at work? Is there a way for you to utilize text messaging services to reach parents now?
How do you engage families so that they are comfortable with services?

Family Focus

How do you establish a therapeutic alliance with families?

Research corner

Practical applications

What the research says about establishing a therapeutic alliance with families:
Positive expectations about the possibility of therapeutic benefit served as the main predictor of therapeutic alliance. (Hawley, 2003)
Therapeutic relationship problems accounted for the largest variance in reasons for ending treatment. (Garcia & Weisz, 2002)
Parents’ alliance with therapist predicted actual use of skills emphasized in intervention (Tolan, McKay, & Dickey, 2002)

What the research means in terms of your practice with children and adolescents:
Ask families to openly discuss their expectations about mental health treatment for their child. Be optimistic, but realistic about outcomes that can be expected in a given time frame.
Establish clearly defined short and longer term goals that can be addressed in therapy.
Be willing to directly address problems in the therapeutic alliance with families and work together to improve the relationship.
Deliver on your promises related to the treatment and maintain open channels of communication.

Helpful hints

Acknowledge that some families have had negative experiences with mental health services. Find ways to frame treatment goals in terms that encourage positive expectations and promote family buy-in.
Get to know the family and the dynamics at home (i.e., single parent, multiple jobs) to anticipate potential barriers to successful outcomes.
Set aside time to touch base with families on a regular basis. Consider having an “open office” hour for calls and visits.

Questions to ponder

Do you adopt a “shared-learner” framework in which both you and the family can learn from each other? Do you present yourself to families in an accessible, inviting manner?
How do you address negative attitudes about the treatment process? What strategies do you use to bring families “back on board” when treatment goals are not met?
When do you communicate with families? Before or after school hours, during class, during session time? How do you communicate with families in a meaningful manner?