Therapy With Treatment Resistant Families

Overview

Here is the only book advocating specific methods for dealing therapeutically with high-risk clients?families that are prone to crises and that resist treatment. These families can create major difficulties for therapists and represent one-third of the caseloads of public institutions. With the help of this remarkable volume, family therapists and counselors will learn to identify high-risk families at the first interview and target them for brief therapy, breaking the cycle of crises and subsequent treatment ...
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1993 Hard cover New. No dust jacket as issued. Sewn binding. Cloth over boards. 328 p. Contains: Illustrations. Haworth Marriage & the Family. Audience: General/trade. BRAND ... NEW. gift quality. Read more Show Less

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Overview

Here is the only book advocating specific methods for dealing therapeutically with high-risk clients—families that are prone to crises and that resist treatment. These families can create major difficulties for therapists and represent one-third of the caseloads of public institutions. With the help of this remarkable volume, family therapists and counselors will learn to identify high-risk families at the first interview and target them for brief therapy, breaking the cycle of crises and subsequent treatment non-compliance. This groundbreaking therapy method for dealing with high-risk families is illustrated with extensive clinical histories, demonstration cases, and therapy transcripts.

McCown and Johnson detail valuable methods for preventing high-risk families from consuming a tremendous amount of mental health resources while sabotaging the best intentions of their service providers. Therapy With Treatment Resistant Families provides a wealth of applicable information for family therapists and covers important topics such as crisis intervention, crisis prone families, treatment resistant families, brief family therapy, and family therapy with medical patients. Cases included and related to behavioral medicine will be useful for mental health counselors working with medical patients in a hospital setting. It is also one of the few volumes addressing family therapy, neuropsychological deficits, and cognitive decline. Its recommendations for crisis prone and resistant persons make it a helpful guide for substance abuse workers as well.

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Editorial Reviews

Booknews
Presents a method by which family therapists and counselors can identify high-risk families at the first interview and target them for brief therapy, breaking the cycle of crises and subsequent treatment non-compliance. Illustrated with extensive clinical histories, demonstration cases, and therapy transcripts. Paper edition (unseen), $32.95. Annotation c. Book News, Inc., Portland, OR (booknews.com)
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Product Details

Table of Contents

Contributors and Associates
Preface
Ch. 1 The Treatment Resistant Family 1
The Concept of Resistance 1
Varieties of Family Treatment Resistance 3
The Impact of Resistance 10
Early Therapy Termination: The Most Extreme Process Resistance 11
Treatment Resistance and Family Crises 15
Systems Intervention with Highly Resistant Families 18
Ch. 2 Families and Family Therapy
A Brief History and Current Status 23
Historical Concepts of the Family and Family Therapy 23
Contemporary "Family Problems" and the Rise of Family Therapies 27
The History of Family Therapy: The Developmental Analogy 29
The Future of Family Therapy: Dynamical Systems Theory 44
Ch. 3 Family Resistance, Stress, and Crises 49
Resistance and Crisis Intervention 49
Crises and Stressors 50
Family Stress 53
Typologies of Family Stressors 54
Responses to Normative and Catastrophic Stressors 55
Perceptual and Instrumental Stresses: An Alternative Formulation 57
Perceptual Crises 62
Instrumental Stress 64
Perceptual Crises and Treatment Resistance: An Empirical Study 68
Familial Differences in Stress Coping 71
Hill's ABC X Model of Family Resiliency 72
The Hill/McCubbin Model and Treatment Resistance: An Empirical Study 73
Family Stress and Opponent Processes 76
The Perception of Stress as a Critical Variable in Crisis-Proneness and Treatment Resistance 80
Ch. 4 Family-Oriented Crisis Intervention 85
An Overview to a New Method of Defeating Resistance 85
Family-Oriented Crisis Intervention: A Brief History 87
Theoretical Rationale for Family Crisis Intervention 88
Crisis Intervention with Treatment Resistant Families 98
The Goal of Crisis Intervention with Resistant Families 101
Dysfunctional Coping and Treatment Resistance 103
Models of Family Crisis Intervention 106
Crisis Intervention and Consultation Roles 108
The Stages of Therapeutic/Consultational Intervention 110
Conclusion: Summarizing a New Strategy to Undercut Resistance 111
Ch. 5 Assembling the Family During Crisis: The First Session 113
Family Crisis Intervention: Who Should Be Seen? 113
Who Should See Resistant Families? 117
Location of the Crisis Session 121
Timing and Length of Sessions and Crisis Intervention 122
Handling Anger of the Resistant Family 124
Communication Principles During Crisis Intervention 125
Payment of Fees 128
Hospitalization 130
Ch. 6 Crisis Defusion and Evaluation 135
Crisis Defusion (D): Making the Crisis "Workable" 135
Family Crisis Evaluation (E): The Framework for Empowerment 149
Ch. 7 Family Problem Solving: A Crisis Intervention/Consultation Approach 167
Developing and Communicating Tentative Crisis Formulations: The First Step Toward Family Problem Solving 167
Decision Avoidance: The Principal Obstacle to Family Problem Solving 174
Problem-Focused Coping: The Family Generates Its Own Answers 178
Ego-Lending: Making Decisions for the Family 187
When the Family Decides Poorly: The Consultant Stance 191
Ch. 8 Translating Problem Solving into Specific Actions: Empowerment of the Resistant Family 201
The Behavioral Contract 202
Integrating Family Assessment into the Behavioral Contract 205
Specifics of the Behavioral Contract: Interventions to Change Dysfunctional Coping 209
Identification of Potential Compliance Problems 219
Subsystems Therapy: Link Therapists and the Behavioral Contract 225
The Decision for Future Therapy 230
Terminating the Crisis Interview 231
When All Else Fails: Reiterating Reality to the Resistant Family 233
Beyond the Crisis Session: What to Do with the Resistant Family After ADEPT 237
Ch. 9 When the Resistant Family Is Incestuous 243
General Principles 244
Initial Intervention 246
Family System Factors 251
Individual Factors 253
Family of Origin Factors 255
Socio-Environmental Factors 255
Precipitating Events 256
Coping Mechanisms
Dimensions of Intervention
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