Children in Families at Risk: Maintaining the Connections / Edition 1

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Over the last two decades, there has been an increasing appreciation of the importance of the family context in child therapy. In her previous, highly acclaimed book Children in Family Contexts, Lee Combrinck-Graham and her colleagues bridged the fields of child therapy and family therapy with an exploration of basic issues. Building upon that work, this volume describes actual programs that are based on the notion that family connections are substantial resources for healing and recovery even when the family is a very troubled one. With a particular focus on work with severely fractured families, most of these programs attempt to keep children connected with their own families, even when circumstances prevent them from living together. Detailing a wide variety of situations, chapters cover cases involving children who are emotionally and behaviorally disturbed, children with psychiatric disorders, abusive parents, and parents with substance abuse problems. Where family preservation is not possible, chapter authors discuss new strategies to keep families involved in the treatment process. Taken together, the programs described in this book represent a significant shift in focus for mental health professionals working with children. Further illuminating the key role played by family connection in child health, Children in Families at Risk is essential reading for all practitioners who work with children and families. Written in an accessible style, it serves as a teaching text for advanced courses in family therapy, child psychotherapy, and school professionals. The book will also provide valuable insights for child welfare workers, policymakers, teachers, and attorneys and family court judges.

Deals w/family-based mental health services/children & adolescents in psychiatric hospitals/foster families, etc.

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Editorial Reviews

From the Publisher

"At last, an exciting look at what programmatic interventions work to maintain or reunify families at risk as well as to further child-family connections when institutionalization, incarceration, or foster care exists. Children in Families at Risk is an inspiring book which engenders hope and confidence in the inherent competence of families and communities to work together against great odds. Administrators and clinicians who struggle to address the seemingly unsolvable concerns of fragmenting families will find here a remarkable combination of practical advice and clear conceptual thinking about treatment programs which effectively maintain family ties." --Marion Lindblad-Goldberg, Ph.D., Director, Family Therapy Training Center and Associate Professor of Clinical Psychology, Department of Psychiatry, University of Pennsylvania School of Medicine

"Dr. Combrinck-Graham has done a magnificent job....She has created a work that offers a wide array of practical possibilities for address to this most vexing of social problems, the anti-social child and the troubled family, possibilities that inspire thinking and allow for the entry of hope. Her authors, 26 of them, each the innovator or the manager of a novel program, tell of a wide spectrum of efforts to apply the best in science and in clinical skill along with the most compassionate of ethical efforts toward the melioration of the personal, familial, and social distress arising from the troubled backgrounds of so many youngsters....The many pages of clinical description are in themselves an education for the practitioner. How to structure treatment for a fragmented and abusing family, how to deal with the multiple complex agency issues, how to address a highly disturbed family, what to emphasize first, what to say and what not to say, what to skirt at the outset so as to strengthen the family enough that it will be able eventually to face what it must, these and many other basic considerations are illustrated through the rich servings of therapeutic exchange offered in many of the chapters....The richness and the variety of the attempts to find answers and the readiness to structure programs around things that work rather than doctrinaire ideas give this book its energy and its bounce." --Joseph D. Noshpitz, M.D., Clinical Professor of Psychiatry, George Washington University, Washington, D.C.

"Children in Families at Risk is a challenging state-of-the-art source book for practitioners, scholars, teachers, and policymakers. By assembling useful, candid reports from those in the field, the Editor has recognized that when families are under siege their children are at risk of being destroyed or blocked severely in their forward development. These reports describe the efforts of children and their parents to adapt, to survive, and to assert their needs; and they describe the painful, merciless costs to them, their families, their communities and to all our society. Each section and chapter of this book searches for and reports on the rich resources of all these children and their families, whose potential is being distorted and destroyed by a society that knows how to thwart but does not know how to preserve and prioritize its wealth of cultural, economic, and human resources. Each program, in its own way and with its own resources and limitations, attempts to maximize the healthy assets and recovery potentials of the multigeneration, multiproblem families to which they relate themselves in respectful, inviting ways. We are indebted to Lee Combrinck-Graham for fascinating and challenging descriptions of the choices we make and the choices we could make." --Albert J. Solnit, M.D., Sterling Professor Emeritus, Pediatrics and Psychiatry, Senior Research Scientist and Commissioner, Department of Mental Health, State of Connecticut

"There is a rumor abroad in the land that children with severe emotional, mental, or behavioral disorders are best treated in their families--even families in pain or under severe stress. It is a spontaneous discovery that is being made by professionals, providers, advocates from across the spectrum of child-serving agencies and programs--and by the families themselves! It is thought of as a paradigm shift in our thinking about troubled and troubling children. Lee Combrinck-Graham has orchestrated a remarkable set of essays that comprise both a handbook of creative and innovative practices in children's mental health, and an exposition of these profound changes by workers in the trenches' of our child-caring agencies. This is evidence from the front line that the paradigm has shifted!" --Robert F. Cole, Ph.D., Director, National Resource Network for Child and Family Mental Health Services, Washington Business Group on Health

"Combrinck-Graham has done an outstanding job of exploring "family connections" programs across the country. This highly readable book is a compendium of those programs and constitutes essential reading for all mental heal professionals...will also be useful to judges, child welfare workers, teachers and policy makers...Combrinck-Graham's perspective is positive, oriented to partnering and family strengths rather than problem-centered. If her goal is to involve her readers in a 'hands-on" rather than a detached approach, she is successful." --Beth Bonham, MSN, RN, Indiana Juvenlie Justice Task Force, Readings, September 1996

"...has pragmatic value to front-line workers and students as well as those higher in the hierarchy. While managing to effectively explain the big picture of system of care reform, Combrinck-Graham and her colleagues have succeeded in adding the depth and detail that have been missing. In doing so, they make a valuable contribution. Readers of this book will likely be inspired and informed. ...This book has something for almost everyone interested in system of care reform and improving the services available for children and families." -- David A. Dosser, Jr., PhD, LMFT, School of Human Environmental Sciences, East Carolina University.

Describes programs for disturbed children that are based on the belief that even very troubled families can be substantial resources for healing and recovery, and so seek to maintain a connection even when the family cannot live together. Discusses changing how therapists think about engaging families, families of children placed in institutions, foster care options, and reunification. Annotation c. Book News, Inc., Portland, OR (
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Product Details

  • ISBN-13: 9780898628524
  • Publisher: Guilford Publications, Inc.
  • Publication date: 6/16/1995
  • Edition description: New Edition
  • Edition number: 1
  • Pages: 429
  • Product dimensions: 6.36 (w) x 9.24 (h) x 1.29 (d)

Meet the Author

Lee Combrinck-Graham, M.D., is a child and adolescent psychiatrist. She is Associate Professor of Clinical Psychiatry at the University of Illinois at Chicago. The editor of Children in Family Contexts, she is the author of numerous articles and book chapters on children, families, and the systems in which they live.
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Table of Contents

1. Working with Inner City Tribes: Collaborating with the Enemy or Finding Opportunities for Building Community?, Jim Nelson
2. Families in their own Evaluations, Steve W. Rathbun, Daniel R. Lord, Faye A. Koop, and Vickie Burgess MacArthur
3. Psychiatric Emergencies and Family Preservation: Partnerships in an Array of Community-Based Services, Stephen Christian-Michaels

4. Eastfield Ming Quong: Multiple-Impact In-Home Treatment Model, Laura Fraser
5. Family-Based Mental Health Services, Cynthia Archacki-Stone
6. Helping Families Become Places of Healing: Systemic Treatment of Intrafamilial Sexual Abuse, Raymond X. De Maio

7. Children and Adolescents in Psychiatric Hospitals, John Sargent
8. Organizing the Hierarchy around Children in Placement, Michael R. Fox
9. The Role of a Home-Based Mentor Program in the Psychiatric Continuum of Care for Children and Adolescents, Julie McKenzie, Edwin J. Mikkelsen, Wayne Stelk, Gerald Bereika, and Donald Monack
10. Substance-Abusing Mothers and their Children: Treatment for the Family , Francine Feinberg

11. Foster and Natural Families: Forming a Cooperative Network, Patricia Minuchin
12. Foster Family Clusters: Continuum Advocate Home Network, Marcia A. Eckstein

13. Sibling Therapy: One Step in Breaking the Cycle of Recidivism in Foster Care, Karen Gail Lewis
14. The Stages of the Reunification Process and the Tasks of the Therapist, Lindsay Bicknell-Hentges
15. Preparing Child Welfare Agencies for Family Preservation and Reunification Programs, Rocco A. Cimmarusti

16. Project Exodus: The Corrections Connection, Judith A. Falk
17. Working with Families in the Schools, Barbara King, Lora Randolph, William A. McKay, and Markus Bartell

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