Mary Nord Cook
In the setting in which it was developed, the program presented in this book was effective in improving the psychosocial and family functioning of adolescents with emotional and behavioral problems. The program bolstered parent–teen relationships and strengthened family communication patterns, leaving participants feeling encouraged and empowered. It was especially tailored to adolescents, aged 12–18 years, with histories of mood, anxiety, and disruptive behavior disorders. The child psychiatrist involved in the program was often able to reduce or discontinue psychotropic medications, as the families become more masterful in their affect regulation, communication, problem-solving, and behavior management skills. In the end, the mantra “More Skills=Less Pills” rang true, as common sense would predict. After all, the fundamental elements that sow interpersonal connectedness are universal across all relationship types, races, cultures, ages, and genders. Each of us is longing to be wholly and deeply understood and accepted, exactly as we are. With that condition in place, a child is then liberated to grow and change, confident that whatever path they choose, they can always draw solace from the anchorage that unconditional positive regard perpetuates.
Psychosocial skills; parent training; family; adolescent; Intensive Outpatient Program; IOP; evidence-based; problem-solving; communication; empathy; conflict resolution; manualized; efficacy; outcome measures
In the setting in which it was developed, the program presented in this book was effective in improving the psychosocial and family functioning of adolescents with emotional and behavioral problems. The program bolstered parent–teen relationships and strengthened family communication patterns, leaving participants feeling encouraged and empowered. It was especially tailored to adolescents, aged 12–18 years, with histories of mood, anxiety, and disruptive behavior disorders. The youngsters served often met criteria for more than one psychiatric disorder, typically presenting with a mixture of symptoms of mood, anxiety, and disruptive behavior disorders.
Enhancing psychosocial skills of program participants required that they first became familiar with the background paradigms and rationales for the strategies recommended. Teens and their parents had to initially understand the concepts and psychological underpinnings of adaptive behaviors on an intellectual basis. Comprehension of the theoretical frameworks facilitated “buy in,” as well as empowered participants to intuitively craft their own pro-social attitudes and behaviors when faced with future novel situations, extending well beyond the workshops. The model for the workshop followed a course of psycho-education, discussion of skills, demonstration of skills, and then participant rehearsal of skills during sessions with active therapist coaching and between sessions, with a goal of mastery, generalization, and durability, throughout whole families.
The program increased the robustness, generalizability, and durability of effect by requiring the parents of enrolled teens to concurrently participate in parent-training workshops. The emphasis in the parent workshops was on techniques designed to parallel and complement the psychosocial skill sets covered in the teen curriculum. Examples of strategies taught to parents included methods for lowering arousal, building an alliance, solving problems cooperatively, and communicating empathically with their adolescents. In order for youngsters to retain and generalize newly mastered psychosocial skills to widespread settings, it was essential for their parents to hone the same skills, as well as model and reinforce them with their teens, in an enduring way.
The child psychiatrist involved in the program, who also assumed medication management for many of the youth while they were enrolled, was often able to reduce or discontinue psychotropic medications, as the families become more masterful in their affect regulation, communication, problem-solving, and behavior management skills. As families demonstrated increasing levels of mastery across a broad range of psychosocial competencies, they increasingly reported enhanced functioning in all domains as well as improved overall health and sense of well-being. Many parents who had divorced (often contentiously) commented that had they known the skills they acquired via participation in the program, they might never have divorced! Many divorced couples benefitted by applying optimal communication, collaborative problem-solving, and conflict resolution skills to all relationships, including that involving their ex-spouse. Secondarily, the increased cohesion and alignment across households within blended families benefitted the adolescent patients, their siblings, and both sets of parents. A number of parents endorsed increased effectiveness and confidence in their professional lives and frequently related success stories describing program strategies applied in work settings. In the end, the mantra “More Skills=Less Pills” rang true, as common sense would predict. After all, the fundamental elements that sow interpersonal connectedness are universal across all relationship types, races, cultures, ages, and genders. Each of us is longing to be wholly and deeply understood and accepted, exactly as we are. With that condition in place, especially if the understanding and acceptance is emanating from a trusted and beloved parent, a child is then liberated to grow and change, confident that whatever path they choose, they can always draw solace from the anchorage that unconditional positive regard perpetuates.