Structural Techniques for Engaging Reluctant Parents in Counseling

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Structural Techniques for Engaging Reluctant
Parents in Counseling

• www.wku.edu/csi-oku/

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Case Example

• Gerr Family
• Mary (age 41) and Norman (age 41) bring their
  daughter Charity (age 15) to counseling. Mary
  states that Charity is depressed and the school
  has threatened to report her to the authorities
  if Mary does not seek help for Charity. Mary
  indicates that Charity cries in school most days
  because shes heavy, and so she has low self
  esteem.
• During the session Charity and her mother
  describe a fight they had in the car the other
  day. Mary got angry at Charitys persistent
  depression and stated you dont know what
  depression is, you have never been raped like I
  was, youre just selfish, thats why youre
  depressed. Charity responded by stating that
  Mary is the selfish one. The fight escalated to
  the point where Charity tried to strangle herself
  with the seatbelt while her mother screamed for
  Charity to shut up!
• As counseling progresses, Norm confirms that
  this sort of interaction frequently occurs
  between Charity and Mary. He states that he just
  tries to stay clear of the trouble.
• Charity states that she was upset before the car
  ride because her mother had been in a bad mood
  all morning. She states that her mother was
  yelling about how they dont have any money and
  that she was too tired to put away the artificial
  Christmas tree, so she just threw it away,
  decorations and all. Charity states that she
  doesnt know how the family will continue
  financially. Mary agrees that she has been having
  a very hard time at work and a very hard time
  financially.
• As the counselor suggests that he is interested
  in talking with Mary and Norm about how they can
  de-escalate crises in the home Mary responds by
  crossing her arms sitting back and beginning to
  cry. She states I thought you were different, I
  thought you were nice, but you want to blame me
  for all of this just like everyone else. She
  then begins to sob uncontrollably. As her mother
  is sobbing, Charity crosses the room puts her
  arms around her mother and says thats alright
  mom, well be okay. As this is going on, Norms
  sits quietly and stares off into space.

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Why Engage Parents?

• Parents are often
• Contributors to the pathology of the identified
  client
• The best resource for promoting the mental health
  of the identified client.

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Thinking of the family as the client

• Subsystems
• Marital/adult
• Parental
• Child/sibling
• Boundaries
• The continuum between rigid and diffuse
• Hierarchies
• Developmentally appropriate
• Flexible

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Interventions

• Accommodation decisions
• when to accept family reality and when to
  challenge it
• the importance of the alliance
• like blowing up a balloon

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Focus Interventions

• Focus
• labeling interaction patterns
• the repetition of the counselors message
• implicit and explicit
• resisting family pull.

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Boundary/Hierarchy Interventions

• Boundary Management
• Use of space
• The forming of coalitions
• to change hierarchy or subsystem membership