Family Intervention With Severely Disturbed Inpatients

Anderson, Carol

doi:10.1001/archpsyc.1977.01770180083007

Cited by 43 publications

(21 citation statements)

References 32 publications

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“…Since the 70s, however, there has been an increase in awareness of some of the differences between inpatient and outpatient family therapy, and of what the particular features and requirements of inpatient family therapy might be. (See 2, 7, 8, 22, 40, 56, 58). Writers in this field, Anderson(2), Beels (8), Harbin (22), McFarlane (40), and Stewart (56), are unanimous in their findings that work with families of patients is necessary to effective reintegration of that person into his or her environment and essential to prevent recurrence of future crises necessitating rehospitalization (4).…”

Section: Introductionmentioning

confidence: 99%

Beginning Work with Families of Hospitalized Adolescents

Hanrahan

1986

Family Process

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Section: Introductionmentioning

confidence: 99%

Beginning Work with Families of Hospitalized Adolescents

Hanrahan

1986

Family Process

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“…This paper examines some of the issues arising in the context of a long‐term psychiatric hospitalization of one family member 1 . There is a compelling body of clinical literature (but little in the way of systematic research) documenting the usefulness of including family members in the admission process, involving them in the ongoing, long‐term treatment, preparing them for the patient's discharge, and supporting them subsequently (1). It has become increasingly apparent, as Fetterman (8) observed as early as 1948 in an article calling for better doctor‐family cooperation in the treatment of the mentally ill patient, that “to neglect the family is to neglect the patient” (p. 631).…”

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confidence: 99%

On the Boundary: Family Therapy in a Long‐Term Inpatient Setting

Hunter¹

1985

Family Process

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The paradigm for inpatient family therapy presented here is intended both as a description of, and a means of thinking about, family therapy in a long-term inpatient setting. It is meant to contribute to a delineation of treatment goals and strategies within a conceptual framework that is rooted in and expresses the complex clinical realities of inpatient treatment, where the locus of family therapy is the family-hospital boundary. The four functions described here are hierarchical in their relationships to each other, each function emerging only in the context of the logically prior function. Although, clearly, inpatient family therapy moves through stages parallel to those of other treatment modalities (14), the purpose of this paper is to explore therapeutic functions rather than present a prescriptive, linear description of successive phases of treatment. Joining, once achieved, cannot be left behind: it needs constant attending to, though more so at some times than others. Similarly with the other functions. It is helpful when pausing to examine one's work to note those functions that, at any given time, seem to be most at issue. For instance, the family of a patient well along the road toward discharge may promote a crisis (e.g., another family member may become symptomatic, the parents' marriage might suddenly seem in danger of falling apart, or the whole thrust of the treatment may be rejected peremptorily). On such occasions the inpatient family therapist must look for precipitating factors, not just in the domain of the family and its functioning and not just in his or her relationship with the family, but also in the context of the family's relationship to the hospital. Is the hospital riding roughshod over the family's feelings? Has important information from the family been ignored? Or, has important information been neglectfully withheld from the family? Is the treatment team moving too quickly toward discharge? Are staff, then, subtly pulling back from the patient or other family members as a way of coping with their feelings of loss? Have staff somehow communicated disappointment or pessimism or despair to the family? Has the family therapist somehow inadequately represented the family's needs to the treatment team or floor staff? Do treatment decisions therefore strike the family as insensitive or thoughtless? Has the family therapist been unable to frame treatment decisions in a way the family can accept and use constructively?

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“…On an in-patient unit the family may attempt to avoid involvement, or reject the identified patient, or attempt to restore its precarious equilibrium by trying to discharge him. We believe that our procedures parallel the guidelines offered by Anderson (1977) for involving resistant families when the in-patient is a severely disturbed adult. She recommends the following : establish immediate contact with the whole family, insist on their involvement, ensure availability of staff to the family, create a good working climate, conduct regular family meetings, provide a variety of treatment formats and plan adequate aftercare.…”

Section: Responsibility and Resistancementioning

confidence: 75%