1. Constant or frequent conflict with parents and/or siblings.
2. A family that is not a stable source of positive influence or support, since family members have little or no contact with each other.
3. Ongoing conflict with parents, which is characterized by parents fostering dependence leading to feelings that the parents are overly involved.
4. Maintains a residence with parents and has been unable to live independently for more than a brief period.
5. Long period of noncommunication with parents, and description of self as the “black sheep.”
6. Remarriage of two parties, both of whom bring children into the marriage from previous relationships.
1. Resolve fear of rejection, low self-esteem, and/or oppositional defiance by resolving conflicts developed in the family or origin and understanding their connection to current life.
2. Begin the process of emancipating from parents in a healthy way by making arrangements for independent living.
3. Decrease the level of present conflict with parents while beginning to let go of or resolving past conflicts with them.
4. Achieve a reasonable level of family connectedness and harmony where members support, help, and are concerned for each other.
5. Become a reconstituted/blended family unit that is functional and whose members are bonded to each other.
| SHORT-TERM OBJECTIVES |
THERAPEUTIC INTERVENTIONS |
| 1. Describe the conflicts and the causes of conflicts between self and parents. (1, 2) |
1. Give verbal permission for the client to have and express own feelings, thoughts, and perspectives in order to foster a sense of autonomy from family. |
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2. Explore the nature of the client’s family conflicts and their perceived causes. |
| 2. Attend and participate in family therapy sessions where the focus is on controlled, reciprocal, respectful communication of thoughts and feelings. (3, 4) |
3. Conduct family therapy sessions with the client and his/her parents to facilitate healthy communication, conflict resolution, and emancipation process. |
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4. Educate family members that resistance to change in styles of relating to one another is usually high and that change takes concerted effort by all members. |
| 3. Identify own as well as others’ role in the family conflicts. (5, 6) |
5. Confront the client when he/she is not taking responsibility for his/her role in the family conflict and reinforce the client for owning responsibility for his/her contribution to the conflict. |
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6. Ask the client to read material on resolving family conflict (e.g., Making Peace with Your Parents by Bloomfield and Felder); encourage and monitor the selection of concepts to begin using in conflict resolution. |
| 4. Family members demonstrate increased openness by sharing thoughts and feelings about family dynamics, roles, and expectations. (7, 8) |
7. Conduct a family session in which a process genogram is formed that is complete with members, patterns of interaction, rules, and secrets. |
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8. Facilitate each family member in expressing his/her concerns and expectations regarding becoming a more functional family unit. |
| 5. Identify the role that chemical dependence behavior plays in triggering family conflict. (9) |
9. Assess for the presence of chemical dependence in the client or family members; emphasize the need for chemical dependence treatment, if indicated, and arrange for such a focus (see Chemical Dependence and Chemical Dependence—Relapse chapters in this Planner). |
| 6. Verbally describe an understanding of the role played by family relationship stress in triggering substance abuse or relapse. (10, 11) |
10. Help the client to see the triggers for chemical dependence relapse in the family conflicts. |
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11. Ask the client to read material on the family aspects of chemical dependence (e.g., It Will Never Happen to Me by Black; On the Family by Bradshaw); process key family issues from the reading that are triggers for him/her. |
| 7. Increase the number of positive family interactions by planning activities. (12, 13, 14) |
12. Refer the family for an experiential weekend at a center for family education to build skills and confidence in working together. (Consider a physical confidence class with low or high ropes courses, etc.). |
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13. Ask the parents to read material on positive parenting methods (e.g., Raising Self-Reliant Children by Glenn and Nelsen; Between Parent and Child by Ginott; Between Parent and Teenager by Ginott); process key concepts gathered from their reading. |
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14. Assist the client in developing a list of positive family activities that promote harmony (e.g., bowling, fishing, playing table games, doing work projects). Schedule such activities into the family calendar. |
| 8. Parents report how both are involved in the home and parenting process. (15, 16) |
15. Elicit from the parents the role each takes in the parental team and his/her perspective on parenting. |
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16. Read and process in a family therapy session the fable “Raising Cain” or “Cinderella” (see Friedman’s Fables by Friedman). |
| 9. Identify ways in which the parental team can be strengthened. (17, 18, 19, 20) |
17. Assist the parents in identifying areas that need strengthening in their “parental team,” then work with them to strengthen these areas. |
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18. Refer the parents to a parenting group to help expand their understanding of children and to build discipline skills. |
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19. Direct the parents to attend a tough-love group for support and feedback on their situation. |
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20. Train the parents in the Barkley Method (see Defiant Children by Barkley) of understanding and managing defiant and oppositional behavior. |
| 10. Parents report a decrease in the frequency of conflictual interactions with the child and between children. (13, 21, 22) |
13. Ask the parents to read material on positive parenting methods (e.g., Raising Self-Reliant Children by Glenn and Nelsen; Between Parent and Child by Ginott; Between Parent and Teenager by Ginott); process key concepts gathered from their reading. |
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21. Assign the parents to read material on reducing sibling conflict (e.g., Siblings Without Rivalry by Faber and Mazlish); process key concepts and encourage implementation of interventions with their children. |
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22. Train the parents in a structured approach to discipline for young children (e.g., 1-2-3 Magic by Phelan; Parenting with Love and Logic by Cline and Fay); monitor and readjust their implementation as necessary. |
| 11. Report an increase in resolving conflicts with parent by talking calmly and assertively rather than aggressively and defensively. (23) |
23. Use role-playing, role reversal, modeling, and behavioral rehearsal to help the client develop assertive ways to resolve conflict with parents. |
| 12. Parents increase structure within the family. (24, 25) |
24. Assist parents in developing rituals (e.g., dinner times, bedtime readings, weekly family activity times) that will provide structure and promote bonding. |
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25. Assist the parents in increasing structure within the family by setting times for eating meals together, limiting number of visitors, setting a lights-out time, establishing a phone call cutoff time, curfew time, “family meeting” time, and so on. |
| 13. Each family member represents pictorially and then describes his/her role in the family. (26, 27) |
26. Conduct a family session in which all members bring self-produced drawings of themselves in relationship to the family; ask each to describe what they’ve brought and then have the picture placed in an album. |
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27. Ask the family to make a collage of pictures cut out from magazines depicting “family” through their eyes and/or ask them to design a coat of arms that will signify the blended unit. |
| 14. Family members report a desire for and vision of a new sense of connectedness. (28, 29, 30) |
28. In a family session, assign the family the task of planning and going on an outing or activity; in the following session, process the experience with the family, giving positive reinforcement where appropriate. |
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29. Conduct a session with all new family members in which a genogram is constructed, gathering the history of both families and that visually shows how the new family connection will be. |
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30. Assign the parents to read the book Changing Families (Fassler, Lash, and Ives) at home with the family and report their impressions in family therapy sessions. |
| 15. Identify factors that reinforce dependence on the family and discover how to overcome them. (31, 32) |
31. For each factor that promotes the client’s dependence on parents, develop a constructive plan to reduce that dependence. |
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32. Ask the client to make a list of ways he/she is dependent on parents. |
| 16. Increase the level of independent functioning—that is, finding and keeping a job, saving money, socializing with friends, finding own housing, and so on. (33, 34, 35) |
33. Confront the client’s emotional dependence and avoidance of economic responsibility that promotes continuing pattern of living with parents. |
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34. Probe the client’s fears surrounding emancipation. |
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35. Assist the client in developing a plan for healthy and responsible emancipation from parents that is, if possible, complete with their blessing. |
