1. Interventions with Families Chapter 10

2. Background Ecological systems perspective guides social work practice and calls for intervention on multiple levels to achieve treatment goals. For family interventions it is helpful to involve any family member who is connected with or influences a client’s reason for seeking help. Family intervention was not a formal treatment modality until the 1950’s. Systems theory is concerned with the social, structural and interactional foundations of behavior. Tools that developed from early treatment approaches are still commonly used to understand family interactions are: – Family Roles: positions each member holds in the family that govern their interactions with other family members. – Homeostasis: tendency among family members to balance out efforts to change interactions. – Triangulation: Occurs when two people in a family focus energy on a third to relieve tension – Rules: are spoken or unspoken agreements about the behavior and interactions of family members.

3. Family Assessment Overview Assessment techniques inform treatment planning and selection and may be qualitative, quantitative or a combination of the two approaches. Common features of social work assessment models include: – emphasizes both individuals and their social environment – Includes the strengths and resilience of clients – Integrative and rely on more than one underlying theory – De-emphasize long history taking – Organized around task-centered planning or goal orientation – Share common types of information – Use a collaborative process between client and practitioner – Emphasize brief, time limited perspectives

4. Overview of Quantitative Measures Client self-recording and monitoring: used by the client to collect and record their thoughts, feelings, or behaviors. Self-anchored and rating scales: Measure constructed by the social worker and client family together when a standardized scale is not available. Each family member fills out a self anchored scale after a specific event to rate what took place Questionnaires: may be used to obtain information of a specific or of a global nature depending on the information needed. Direct behavioral observation: direct observation is most used in residential or institutional settings due to the expense and time required to do it. Role-Play and analogue situations: Enactments of the families’ problems allowing the practitioner to observe the problem as they are reenacted. Goal-Attainment Scaling: Measurement of client change as defined by treatment goals. Standardized measures: Ready made and available for most family problems, and contain uniform scoring and interpretation. The best ones have cutoff scores so that problems may be compared with a reference group.

5. Treatment Planning Treatment planning is the process of moving from assessment to intervention. Steps for treatment planning include: – Client readiness: may be assessed by considering the quality of the relationship between the family and the practitioner. – Alternative interventions: may exist to treat a particular family problem and the practitioner must choose in which direction to proceed. – Use of a treatment planning framework: Steps include-problem selection, problem definition, goal development, objective construction, intervention creation and diagnosis determination.

6. Family Interventions Brief Strategic Family Therapy (BSFT)-12 to 15 sessions that focus on building communication and problem solving skills in families The Incredible Years-intervention for families with younger children and targets multiple settings for intervention and training. Family Psychoeducation-offered to individual families or in groups of families. Through modeling and rehearsing social skills the practitioner assists the family in learning skills that will help them maintain strong support networks. Multisystemic Therapy (MST)-home based intervention that intervenes on multiple system levels to effect change in adolescents’ behavior within their own environment. Multidimensional Family Therapy (MDFT)- consists of 5 core components and combines individual sessions with the adolescent and parents as well as family sessions CBT Interventions with Parent Component Functional Family Therapy (FFT)- prevention/intervention approach that includes engagement, building motivation, assessment, behavior change and generalization. Parent-Child Interaction Therapy- parents are taught skills to interact with children in a warm, responsive manner. Parent-Management Training (PMT)- Practitioners provide information about social learning principals and techniques and model the techniques for parents. Emotionally-Focused Therapy (EFT)- Assumes that negative patterns of interaction cycles result from fear of losing one’s primary object of attachment. Solution-Focused Brief Therapy- Throughout the intervention the therapist defines the situation and goals using clients’ perceptions and language. The practitioner continuously emphasizes clients’ strengths and compliments them for every success.