Searching for change mechanisms in emotion-focused work with adolescents and parents: An example from multidimensional family therapy.

Abstract

Disconnection and disengagement are frequent characteristics of interactions between parents and adolescents who present with substance use disorders. Excessive blame, defensiveness, and recrimination characterize day-to-day interactions within these families. Developmental psychopathology research reveals both short-and long-term effects of negative emotional patterns between parents and adolescents on the young person's development, as well as on the parents' functioning and their parenting practices in particular. Persistent expression and experience of negative emotions are also associated with poor treatment outcome, as they act as barriers to treatment engagement and change. This article demonstrates how research-based knowledge can guide therapeutic strategy and how emotions can be transformed in an empirically supported, family-based treatment: multidimensional family therapy. Transcripts with commentary from an adolescent, a parent, and from family therapy sessions illustrate emotion-related interactional transactions and interventions.

In‐session gaming as a tool in treating adolescent problematic gaming

“…More importantly though, the approach draws out the underlying tensions between the youth and his parents more clearly than mere discussion would do. This provides the therapist with valuable insights to foster the enactment exercises needed to improve the communication between the family members (Bonnaire et al, 2020). Below, we focus on two of the advantages of in-session gaming, that is, boosting treatment motivation and tackling problems in family functioning.…”

“…Another possibility is to have the adolescent present their avatars or characters with various appearances, virtues, and skills. This often prompts parental curiosity and may lead to some chatting about resemblances and differences between the adolescent and said avatars, offering an early‐on opportunity to promote emotional reconnection (Bonnaire et al, 2020). When the actual gaming starts, the adolescents often get enraptured by the game.…”

“…If this shift occurs, a breakthrough may follow, allowing the family to move past harmful interactions and to open up to new, healthier ways to relate (Diamond & Liddle, 1996; Diamond & Liddle, 1999). This approach has been adapted for PG treatment purposes (Bonnaire et al, 2020). The proposed approach distinguishes three levels of creating positive and self‐perpetuating interchanges to combat dysfunctional family transactions.…”

Multidimensional family therapy reduces problematic gaming in adolescents: A randomised controlled trial

“…It has been argued that parental, family and other social factors (e.g., school-related) should be addressed in IGD therapies, in addition to intra-individual characteristics of the adolescent (Bonnaire et al, 2019(Bonnaire et al, , 2020Zajac et al, 2020). This multidimensional focus is a major difference between MDFT and FTAU.…”

“…Because of its multi-system nature, we assumed that MDFT could be beneficial for adolescents with IGD. MDFT clinicians from Miami, Geneva and Paris adapted MDFT for IGD treatment purposes (Bonnaire, Liddle, Har, Nielsen, & Phan, 2019;Bonnaire, Liddle, Har, & Phan, 2020). Next, we designed a randomised controlled trial comparing the effectiveness of IGD-adapted MDFT in reducing IGD in adolescents as compared with family therapy as usual (FTAU).…”