Engaging “Resistant” Families in Treatment

Abstract

Many families, when presented with the option of family therapy, are less than eager to participate. This paper comprises the second and third parts of a series on engaging "resistant" families. Part II presents 21 principles and a number of techniques and strategies that have been developed for successfully recruiting such families. These techniques should be applicable for engaging resistant families with all types of presenting problems. Part III provides an analysis of the important variables involved, along with data on cost efficiency and administrative costs. It was found that when therapists had administrative control of their cases, serving in dual roles as both therapists and drug counselors, the recruitment effort was (a) more effective (i.e., complete families, including both parents or parent surrogates, were recruited in 77 per cent of the cases), and (b) twice as cost efficient. Two-thirds of the non-engaged families were not recruited because the index patient would not allow family members to be contacted. Black families were more difficult to recruit than whites. Data on cost efficiency and on the actual administrative costs of recruiting families are also provided.

Brief Strategic Family Therapy: Engaging Drug Using/Problem Behavior Adolescents and Their Families in Treatment

“…While social workers and other human service professionals as well as public health institutions targeting adolescent drug use such as healthcare and juvenile justice systems have acknowledged the necessity of involving families in treatment, engaging family members remains a serious challenge (Armbruster & Kazdin, 1994; Hornberger & Smith; 2011; Kazdin & Mazurick, 1994; Kazdin, Mazurick, & Bass, 1993; Stanton & Todd, 1981; Szapocznik et al, 1988). Often families do not show up to the first intake or therapy session, for instance, or drop before treatment goals are achieved (Flicker et al, 2008; Szapocznik, Kurtines, Foote, Perez-Vidal, & Hervis, 1986).…”

Family treatment of alcohol and drug abuse.

“…Many therapists find it difficult to convene the whole family for therapy (Stanton, in press;Stanton & Todd, 1981). The families of addicts are particularly difficult to engage in treatment.…”

“…In less seriously disturbed families, one telephone call may enable a therapist to reassure family members that their contributions are important to the solution of the substance abuse. In more disturbed families, it may be necessary to meet family members on "neutral turf," like a restaurant, to write multiple letters, or even to pay family members for participation in treatment (Stanton & Todd, 1981).…”

Measuring levels of family stress and engagement in child protection social work: an explorative analysis of parental stress and social worker practice skills

“…Steffenson and Colker, 1982) or resistance (e.g. Stanton and Todd, 1981). This view has been challenged in more recent literature, which has emphasised the potential of the context of child protection (CP) or the approach of the worker to create resistance and make engagement challenging (Featherstone et al , 2014; Munro, 2011; Forrester et al , 2008; Forrester et al , 2018, 2019).…”