26.3 “WE'RE ALL WALKING ON EGGSHELLS!” FAMILY THERAPY INTERVENTIONS TO RESOLVE MEDIA-RELATED CONFLICTS

Abstract

Objectives: Child and adolescent psychiatrists often hear parents lament that their child is on a screen too much. This can be disruptive to the family and can displace other important activities for the child, such as schoolwork, sleep, or exercise. The lines are blurred now more than ever, in the context of COVID-19, when screens are necessary for remote learning and for peer socialization. For some families, navigating screen limits becomes an ongoing and recurrent conflict leading to everyone feeling like they are “walking on eggshells.” This presentation will focus on the application of family therapy concepts to working with families around negotiating media rules. Methods: Key concepts, largely from narrative and attachment-focused family therapy theories, will be described. These will include the importance of joining with each member of the family and defining the problem in systemic terms such that all members recognize their contribution to sustaining and maintaining the problem and their role in improving it. Ensuring that all parties, including the child, have buy-in to work on the problem is important. Recognizing problematic patterns in families (such as the parent nagging/child withdrawing, parent overfunctioning/child underfunctioning) will be described. Language to externalize the problem, or to look at the problem as located within the system and not within the child, will be offered. Focusing on improving attachment relationships within the family, which are often frayed in the context of these recurrent conflicts around media, will be reviewed. Results: Concepts from the family therapy literature and practice will be highlighted. These concepts can be easily incorporated into the practice of child and adolescent psychiatrists. Conclusions: Child and adolescent psychiatrists are well poised to help families navigate conflicts and negotiate limits around screen use. Collaborative ways to engage the child and family in shifting problematic patterns can improve family relationships and communications. FT, FAM, MED