More families, more possibilities, more solutions A day care treatment for families Bruno Hillewaere

1
More families, more possibilities, more
solutionsA day care treatment for families
Bruno Hillewaere Ann Vancoppenolle
Change is happening all the time.Our role is to
identify useful change and amplify it. Gregory
Bateson By nature we have no weakness that
cannot become a strength J.W. Goethe
Figure 1 part of a solution-focused genogram

• Introduction
• This presentation describes the methodology of a
  day care treatment for (3 to 4) families with
  adolescents in The Viersprong Insitute,
  Halsteren, Netherlands. It offers a specialised
  treatment program of nine days (spread over ten
  weeks) for families with a variety of problems,
  such as blocked interaction processes between
  parents and teenagers.

Method The applied method is a combination
of different models, with a strong emphasis on
Multi Family Therapy (Asen, 2002),
Solution-Focused Therapy (de Schazer, 1991, 1994
Berg De Jong, 1998) and a reflecting team.
A) Multi Family Therapy For the treatment of
a group of different families we found
inspiration in the ideas about multiple family
therapy (Laquer, in Asen, 2002) and made some
applications for the method and the setting.
Families and adolescents are experimenting with
distance and proximity. Adolescents have often a
ambivalent desire leaving home and being able to
come home for support. Therefore, a healthy
balance in sessions with the whole group, within
one family and in the peer group is recommended
Figure 1 Families are invited to draw
their own genogram. Leisure activities, resources
and qualities are added to the genogram.
Figure 2 examples of goalsetting in the initial
phase

• To talk more open in the family
• To develop a better atmosphere
• Taking our time to have dinner together
• To react more directly and open in case of
  conflicts

• Segment of solution-focused MFT
• This fragment is about a (single) mother (J)
  with an (only) seventeen years old son. The
  mother is in search of how she can set reasonable
  and realistic goals. More specific, she is
  looking for a way that can be good enough.
  Other families, especially the other mothers are
  trying to help.
• Mother J I dont really know what to do
  especially when he doesnt do anything at all
  that is so completely again my own feelings
• Mother K But you can do it I have learnt how
  to do it..
• Mother J But nothing at all you see, I mean,
  between everything and nothing is a way in
  between, that is what I would like.
• Th1 You would like to involve him, You would
  like to be able to still ask him some things
• Mother K Yes, this must be possible ( has to
  be), I must (should) be able to ask him
• Mother S You say must quite a lot
• Mother J really?
• Mother S Yes, that little sentence. For me
  that is like
• Th2 Well, that could be a very nice goal. For
  instance only in two sentences one must,
  instead of every sentence
• Mother S You know, you say must really very
  often, do you realise that?
• Mother J No, I dont hear it myself when I
  say it
• Mother S Try to listen to yourself, how often
  you use this word must
• Mother S You should count yourself, how often
  you say must
• Mother K I can see myself
• Th2 How are you going to write it down?
• Mother J I must (laughs), I thought to say,
  I must (corrects herself)
• I want to think twice before I say or do
  something

Goals are at the initial stage formulated by the
family in their own words. Afterwards they are
formulated in a more concrete way (SMART
specific, measurable, attractive, concrete and
time-related)

C) Reflecting Team and Reflecting processes
Lastly, an application of a Reflecting Team and
ideas about Reflecting Processes (Andersen, 1987)
were added to the program, taking in
consideration de Schazers reflections on team
work and his ideas about polyocular viewpoints
(de Schazer, 1991). Adolescents and families are
progressively invited to share their reflections
in a respectful way. e.g. a 17 year old girl
chooses the metaphor of a turtle to express to
her parents that she sometimes walks more slowly
then her parents, but that she is confident to
arrive where she wants to arrive.

• Conclusion and further recommendations
• This presentation describes the methodology of a
  day care treatment for families with adolescents.
  Three different models are combined into one
  programme. Case examples offer a more concrete
  idea about the programme and its content. The
  presented approach is not a miracle, but a useful
  way to empower families and realise very concrete
  progress. Further research is recommended, and
  will start in 2008.

References Andersen, T. (1987). The
Reflecting Team Dialogue and metadialogue in
clinical work. Family Process, 26, 415-428.
Asen, E. (2002). Multiple Family Therapy an
overview. Journal of Family Therapy,
243-16. Berg, I.K., De Jong, P. (1998).
Interviewing for solutions. New York Brooks/
Cole. De Shazer, S. (1991). Putting difference
to work. New York Norton. De Shazer, S. (1994).
Word were originally magic. New York
Norton. Hillewaere, B. (2006). Werken met de
mogelijkheden van cliënten en families door
middel van kernkwadranten en genogrammen.Tijdschri
ft voor Psychotherapie, 32, 3, pp. 161
177. (English Hillewaere, B., Bertolino, B.,
Loots, G., Strengthening families using genograms
and core qualities, subm.) Hillewaere, B.,
Lefevere de Ten Hove, M. (2006). Narratieve en
oplossingsgerichte toepassingen bij genogrammes
samen hoopvolle perspectieven creëren.
Tijdschrift voor systeemtherapie, 18, 2, pp.
69-87. (English Hillewaere, B., Jordan, K.,
Narrative and solution-focused genograms to
therapeutic ends creating hopeful perspectives,
subm.) Hillewaere, B., Van Gerwen, J., Deuss, I.,
Sluyter, L., Bakker, H. (2007). Meer gezinnen,
meer mogelijkheden, meer oplossingen. Tijdschrift
voor systeemtherapie in press, dec. 2007 ).
B) Solution focused Therapy Inspired by the
solution-focused therapy (Berg De Jong, 1998
de Sahzer, 1991, 1994), we invite families to
mobilise their strengths and resources to realise
very concrete changes towards their own chosen
goals. We developed several different
solution-focused techniques, e.g.
solution-focused genograms (Hillewaere Lefevere
de Ten Hove, 2006), goalsetting, family
drawings, a family dictionary and the corequality
model for families (Hillewaere, 2006), that were
added to the programme.
More information Bruno.Hillewaere_at_deviersprong.nl
of www.deviersprong.nl