Treating Families with Adolescents: An Ecological Approach

Abstract

Over the past fifteen years, there have been recommendations in the field of psychotherapy and specifically in the field of family therapy to develop an ecological approach to the delivery of mental health services. Auerswald (1968) and Hoffman and Long (1969) graphically anecdoted the problems encountered by families “being helped” by several different agencies, each of which was working at cross purposes to the other. To avoid such splintering of services, an integrated approach has been advocated but as yet there exist few models of how to actually achieve this integration in a system which is already splintered. Such a system may exist when adolescents live outside their families and receive therapy from multiple sources. For example, if a teenager is in residential care it is not unusual to find representatives from the probation, school and social services systems all involved in delivering treatment. This is in addition to the services provided by the residential care staff. With so many helpers involved, there is a high potential for therapy to be fragmented. The focus of this paper, therefore, is to discuss an ecological approach to treating families who have a teenager living in residential care. The assumption is made that adolescents can best be treated in a family systems context. Initially, the ecological approach will be presented and attention will be given to the potential problems involved in working with multiple helpers. How specific family and individual developmental issues influence treatment planning will be discussed. Therapeutic issues to consider when implementing the ecological approach will be raised and practical suggestions will be given to facilitate effective work with multiple helpers.