Family Therapy For Adolescents Research Articles

ENGAGING ADOLESCENTS IN FAMILY THERAPY: THE ROLE OF ENGLISH SLANG AND DIGITAL COMMUNICATION NORMS IN THERAPEUTIC SETTINGS

ABSTRACT
 Adolescence is a critical stage marked by rapid cognitive, emotional, and social development, often presenting challenges within familial relationships. Family therapy serves as a vital intervention to address these challenges, yet engaging adolescents in the therapeutic process can be complex. This review explores the significance of English slang and digital communication norms in facilitating rapport and effective communication between therapists and adolescents in family therapy settings. In contemporary society, English slang and digital communication have become integral aspects of adolescent culture. Adolescents frequently employ slang terms and digital platforms to express themselves, communicate with peers, and navigate their identities. However, these informal modes of communication may pose barriers in traditional therapeutic settings where formal language is often prioritized. Recognizing the importance of meeting adolescents on their own communicative terms, therapists are increasingly integrating slang and digital communication norms into family therapy sessions. By incorporating familiar language and mediums, therapists can create a more inclusive and relatable environment, fostering trust and engagement with adolescent clients. Moreover, the utilization of slang and digital communication norms in family therapy promotes authenticity and enhances the therapeutic alliance between adolescents and therapists. Adolescents feel understood and validated when therapists demonstrate an awareness and acceptance of their linguistic and technological preferences, leading to increased participation and investment in the therapeutic process. However, the integration of slang and digital communication in family therapy requires careful consideration and ethical awareness. Therapists must balance the use of informal language with maintaining professional boundaries and respect for cultural diversity. Additionally, therapists should remain mindful of the potential implications of digital communication, including privacy concerns and the blurring of therapeutic boundaries. Understanding and incorporating English slang and digital communication norms are essential for effectively engaging adolescents in family therapy. By embracing adolescents' preferred modes of expression, therapists can foster meaningful connections, facilitate communication, and promote positive therapeutic outcomes within the familial context.
 Keywords: Adolescent, Family, Therapy, Slang, Digital, Communication, Norm, English.

Engaging adolescents in family therapy: The role of English slang and digital communication norms in therapeutic settings

Adolescence is a critical stage marked by rapid cognitive, emotional, and social development, often presenting challenges within familial relationships. Family therapy serves as a vital intervention to address these challenges, yet engaging adolescents in the therapeutic process can be complex. This review explores the significance of English slang and digital communication norms in facilitating rapport and effective communication between therapists and adolescents in family therapy settings. In contemporary society, English slang and digital communication have become integral aspects of adolescent culture. Adolescents frequently employ slang terms and digital platforms to express themselves, communicate with peers, and navigate their identities. However, these informal modes of communication may pose barriers in traditional therapeutic settings where formal language is often prioritized. Recognizing the importance of meeting adolescents on their own communicative terms, therapists are increasingly integrating slang and digital communication norms into family therapy sessions. By incorporating familiar language and mediums, therapists can create a more inclusive and relatable environment, fostering trust and engagement with adolescent clients. Moreover, the utilization of slang and digital communication norms in family therapy promotes authenticity and enhances the therapeutic alliance between adolescents and therapists. Adolescents feel understood and validated when therapists demonstrate an awareness and acceptance of their linguistic and technological preferences, leading to increased participation and investment in the therapeutic process. However, the integration of slang and digital communication in family therapy requires careful consideration and ethical awareness. Therapists must balance the use of informal language with maintaining professional boundaries and respect for cultural diversity. Additionally, therapists should remain mindful of the potential implications of digital communication, including privacy concerns and the blurring of therapeutic boundaries. Understanding and incorporating English slang and digital communication norms are essential for effectively engaging adolescents in family therapy. By embracing adolescents' preferred modes of expression, therapists can foster meaningful connections, facilitate communication, and promote positive therapeutic outcomes within the familial context.

Family therapy for adolescents with depression and suicidal ideation: A systematic review and meta-analysis.

To systematically review and meta-analyze the effectiveness of family therapy compared to other active treatments for adolescents with depressive disorders or suicidal ideation. We conducted a systematic search of The Cochrane Central Register of Controlled Trials, Medline, Embase, PsycINFO, AMED, CINAHL and Web of Science and performed two meta-analyses of outcomes for depressive symptoms and suicidal ideation. We screened 5,940 records and identified 10 randomized controlled studies of family therapy for depressive disorder or suicidal ideation in adolescents with an active treatment comparison group. Nine studies reported outcome measures of depressive symptoms and four reported outcome measures of suicidal ideation. The meta-analysis showed no significant difference between family therapy and active comparison treatments for end-of-treatment levels of depression. For suicidal ideation our meta-analysis showed a significant effect in favour of family therapy over comparison treatments for suicidal ideation. Based on the current body of research, we found that family therapy is not superior to other psychotherapies in the treatment of depressive disorder. However, family therapy leads to significantly improved outcomes for suicidal ideation, compared to other psychotherapies. The evidence for the treatment of depression is of low quality needs more research.

BRINGING FAMILIES TOGETHER IN CRISIS: FAMILY-BASED INTERVENTIONS ACROSS DIFFERENT SETTINGS OF CARE

There is considerable evidence for the clinical utility of family-based interventions (FI) in several domains of childhood psychopathology. Despite the known efficacy of FI, many child and adolescent psychiatry fellowship programs in the United States provide minimal FI training. The goals of this presentation are to highlight the feasibility and relevance of FI across acute care settings and crisis situations, and to provide practical tips on incorporating FI within the scope of daily practice of child and adolescent psychiatry. Presenters from different institutions across the country will discuss the role of FI in treating youth in crisis from inpatient, consultation-liaison, outpatient, and emergency department (ED) perspectives. Using a case-based approach, presenters will give real-life context for the following treatment approaches: brief family therapy for adolescents in the inpatient psychiatric unit, family CBT to treat psychological distress in children on a transplant unit, attachment-based family therapy (ABFT) for high-risk adolescents in the outpatient setting, and emotionally focused family therapy (EFFT) for suicidal adolescents in the ED. The presenters will engage the audience by incorporating a think/pair/share activity to practice problem solving in each treatment setting, and by providing clinical pearls for clinicians to apply FI skills in their practice. Family factors frequently play a significant role in childhood mental health crises. The presenters demonstrate how FI can be effective practical treatment tools for psychiatrists to apply across treatment settings. Family dynamics represent a critical underpinning in understanding both childhood mental distress and well-being. Therefore, it is critical for child and adolescent psychiatrists to understand how family dynamics affect patient distress and to be equipped with skills to intervene with families across treatment settings.

Assessing the effect of multidimensional family therapy in adolescents on police arrests against a background of falling crime rates. A randomised controlled trial with 7-year follow-up

BackgroundEarlier, we reported that multidimensional family therapy (MDFT) and cognitive behavioural therapy (CBT) decreased criminal offending in adolescents as measured with self-report in a randomised controlled trial with 1-year follow-up. The present study tested if this effect could be confirmed using police arrest data.MethodsStudy participants were 109 adolescents who were recruited for the Dutch part of a transnational treatment trial. National police arrest records were analysed for 3 years before the adolescents entered treatment with MDFT or CBT and for 7 years after treatment entry.ResultsPolice arrest rates rose in the 3 years preceding treatment and then dropped in both treatment groups to almost zero level during the follow-up period.ConclusionsThe results suggest that MDFT and CBT both strongly and durably decreased police arrest rates. However, this conclusion remains uncertain as crime rates concurrently decreased in the general population.Trial registrationISRCTN51014277

Multidimensional family therapy in adolescents with a cannabis use disorder: long-term effects on delinquency in a randomized controlled trial

BackgroundSubstance use and delinquency are considered to be mutual risk factors. Previous studies have shown that multidimensional family therapy (MDFT) is effective in tackling both conditions on the short term. The current study examines the long-term effects of MDFT on criminal offending.Methods109 adolescents with cannabis use disorder and comorbid problem behavior were randomly assigned to either MDFT or cognitive behavioral therapy (CBT). Police arrest data were collected for 6 years: 3 years prior to and 3 years after treatment entry. Using survival analysis and repeated measure General Linear Models (rmGLM), the two treatment groups were compared on number of arrests, type of offence, and severity of offence. Moderator analyses looking at age, disruptive behavior disorders, history of crimes, family functioning, and (severe) cannabis use were conducted (rmGLM).ResultsWhile police arrest rates increased in the 3 years before treatment, the rates decreased substantially after the start of both treatments. No differences were found between the treatment groups with respect to either time to first offence from the start of the treatment or changes in frequency or severity of offending over time. A treatment effect trend favoring MDFT was found for property offending in the subgroup of adolescents with high baseline-severity of cannabis use.ConclusionsAcross a follow-up period of 3 years, MDFT and CBT were similarly effective in reducing delinquency in adolescents with a cannabis use disorder.Trial registration ISRCTN51014277, Registered 17 March 2010—Retrospectively registered, http://www.isrctn.com/ISRCTN51014277

Family Therapy for Adolescents: A Research‐informed Perspective

Specific research‐informed models of family therapy have been developed for a range of adolescent problems. These include Brief Strategic Family Therapy (BSFT), Functional Family Therapy (FFT), Multisystemic Therapy (MST), Multidimensional Family Therapy (MDFT), and Multidimensional Treatment Foster care (MTFC) for conduct disorder and drug misuse; family‐focused cognitive behaviour therapy for anxiety disorders and depression; Attachment‐based Family Therapy (ABFT) for depression; family‐focused therapy as an adjunct to pharmacological therapy for bipolar disorder; ABFT, youth‐nominated support team, and Dialectical Behaviour Therapy (DBT) combined with Multifamily Therapy for self‐harm; the Maudsley model of family therapy for eating disorders; and psychoeducational family theory for psychosis. All of these approaches aim to reduce individual and familial risk factors which exacerbate adolescent problems, and enhance protective factors which promote resilience and recovery from psychological difficulties.

Using Dialogical Space to Create Therapy Enhancing Possibilities with Adolescents in Family Therapy

In the exchange between living persons in the therapy room there is a dialogical space, which, when attended to, may create therapy enhancing possibilities. This article explores three aspects of the dialogical space – context, the therapeutic relationship and the therapist's use of self – to consider how this space promotes trust, acceptance and dialogue when engaging and working with adolescents in family therapy. It proposes that the focus of the dialogical approach on the human experience of therapy offers an authenticity, which is refreshing when working with adolescents and their families.

Multiple Family Therapy for Adolescents with Anorexia Nervosa: a One-year Follow-up

Multiple Family Therapy (MFT) has gained increasing popularity in the treatment of eating disorders and many programs have been developed over the past decade. In this presentation, we examine the effects of a particular model of MFT on eating disorder symptoms, quality of life (OQ-45) and percentage of expected body weight (%EBW) in adolescents with anorexia nervosa. Eighty-two ED adolescents, aged between 11 and 19 years, were assessed pre-, post- treatment and at one-year follow-up using the EDI-2, the OQ-45 and %EBW. Results showed a significant increase in %EBW between the beginning of treatment and the end of treatment. At one-year follow- up, %EBW continue to improve significantly. Symptoms relative to all EDI dimensions (except for bulimia) significantly decreased during treatment. The three dimensions related to quality of life assessment also improved over the course of MFT. At the end of treatment, 70.7% of the patients had a total OQ-45 score below clinical significance. At one-year follow-up, no significant differences were found for the OQ measures and for the EDI measures, showing quality of life, ED symptoms and related psychological features stabilise after the end of treatment. This study suggests that Multiple Family Therapy may benefit adolescents with anorexia nervosa, with improvement on several outcome measures at the end of treatment, remaining stable at one-year follow-up. The improvement of %EBW at one-year follow-up indicate MFT continue to have effects after treatment is complete. However, the lack of a comparison group entails caution when drawing conclusions.

Anorexia nervosa: A fresh perspective

Anorexia nervosa is currently presented as a pathologised, psycho-medical feminine phenomenon through aetiological rationalisations and theories. Research results indicate that there have been no improvements in treatment outcomes for anorexia for over 50 years, except, possibly, with forms of family therapy for adolescents. This situation can be seen as critical and calls for alternative ways of understanding anorexia, and consequent different approaches to psychotherapy for persons in relationship with anorexia. This article critically explores these issues, and suggests that such circumstances offer opportunities for alternative post-structuralist approaches for informing different understandings of and working with anorexia in collaborative relational arrangements where the voices of persons in relationship with anorexia are honoured and heard.

A Grandparent in the room: multiple family therapy for adolescents

Objective To provide a descriptive clinical perspective on the introduction and development of Multiple Family Therapy Groups for Day Patients and Outpatients at Princess Margaret Hospital, Perth Western Australia. Challenges will be discussed including motivation, integration and application with view to sharing with the audience the pitfalls and possibilities of this dynamic approach combining family and group therapies.

Family therapy for adolescents with ADHD.

Adolescents with attention deficit hyperactivity disorder (ADHD) and their parents experience a great deal of conflict and coercion because the executive function deficits of ADHD interact with the parents' characteristics, family stress, and parenting practices. This article provides a step-by-step description of the defiant teen approach to family therapy, which is designed to help adolescents with ADHD and their parents reduce conflict and coercion. The article also summarizes 2 studies supporting the effectiveness of the defiant teen approach.

Engaging Fathers in Family Therapy with Violent Adolescents

Violent behavior in adolescents can often signal profound distress or pain arising from family conflicts, hostile marital separations, sudden losses and other family turmoil. By circumventing blame the therapist engages the family in a constructive process that allows adolescents to change and grow and parents to share pain and sorrow about their own issues and responsibilities for their children. This re-establishes healthy generational boundaries, produces a clearer co-parenting alliance (e.g. after divorce) and creates sibling support. This paper describes an experiential approach, for working with violent adolescents in family therapy influenced by the pioneer work of Satir and Whitaker. It integrates systemic and developmental theories linking the presenting problem to relevant family events. The therapist: (1) explores adolescent development in the family and social context; (2) establishes a therapeutic alliance through understanding the interpersonal context for violent behavior, and (3) re-directs negative actions into positive connections with family members. Segments of family therapy sessions with two adolescent boys and their families from different cultural backgrounds illustrate the impact of paternal absence for adolescent well-being and the need to actively engage fathers in family therapy. Mario, the father's ‘tumor’, and Juan with his despairing violence are two problematic adolescents brought to therapy because of their aggressive behavior at home and/or in the school. The paper describes how to give them a different voice and build a therapeutic alliance with the family.

Family Therapy for Adolescents with School Maladjustment Problems

Family Therapy for Adolescents with School Maladjustment Problems

How do therapists ally with adolescents in family therapy? An examination of relational control communication in early sessions.

Sequential analyses examined associations between the working alliance and therapist-adolescent communication patterns in 10 Spanish cases of brief conjoint family therapy. Early sessions with strong versus problematic alliances, rated by observers, were selected for coding of relational control communication patterns. No differences were found in the frequency of exchanges, but competitive responding by the therapists (reflecting an interpersonal struggle for control) was significantly more likely in problematic alliance sessions than in strong alliance sessions. Cases in which the adolescent's alliance with the therapist remained positive from Session 1 as compared with Session 3 showed a decrease in the likelihood of competitive symmetry. Notably, when the quality of the alliance deteriorated over time, the therapists were increasingly more likely to respond to the adolescents' domineering messages in a competitive manner. Results underscore the need to avoid competitive responding in order to ally with adolescents in conjoint family treatment.

Engaging reluctant adolescents in family therapy: an exploratory study of in‐session processes of change

Informed by a trans‐theoretical model of the therapeutic alliance in conjoint family therapy, this exploratory study was the initial stage in a task analysis of critical shifts in adolescent engagement. Specifically, we compared sessions in which a resistant adolescent either did or did not shift from negative to positive engagement during the session. Two successful and two unsuccessful change events were selected from an archival data set based on SOFTA ratings of the therapeutic alliance. The results suggested that one parent element (support) and five therapist elements (structuring therapeutic conversations, fostering autonomy, building systemic awareness, rolling with resistance and understanding the adolescent's subjective experience) seemed critical for successfully facilitating adolescent engagement. The qualitative results were informed by the adolescent's self‐reported target complaints pretreatment, which suggested varying reasons for the teenagers’ active or passive disengagement. Implications for practice and recommendations for future research are offered to continue this line of inquiry.

Attachment-Based Family Therapy for Adolescents with Suicidal Ideation: A Randomized Controlled Trial

Attachment-Based Family Therapy for Adolescents with Suicidal Ideation: A Randomized Controlled Trial

Experiential Activities in Family Therapy: Perceptions of Caregivers and Youth

Novel and creative therapeutic modalities have been developed in an effort to increase motivation in family therapy for adolescents and families. Many of these approaches incorporate experiential activities or “family play”, which provides a supplemental approach to traditional talk therapy. Incorporating experiential activities into family therapy sessions has been shown to increase engagement and enhance participation in therapy. Therefore, to understand how families view experiential activities within family therapy, we interviewed nineteen adolescents (age 12–17) and their parents/caregivers who were receiving family therapy augmented with experiential activities. We asked a series of open-ended questions to understand the families’ experiences concerning how they initially felt about participating in family therapy and their perceptions of the experiential activities. The activities involved experiential interactions and skill-building exercises that elicited active participation from all family members and encouraged further discussions. Topics of these activities focused on problem areas the family had identified, such as anger management, problem-solving, improving communication, substance use, expressing feelings, coping, etc. Results showed that most caregivers and youth found the experiential activities helpful in creating positive family interactions and developing communication skills. Caregivers and adolescents noted that the activities increased their desire to participate in family therapy sessions and they were more motivated to engage in the treatment process. Clinicians using the methods discussed in this intervention should be aware of the study’s limitations. Implications for clinical practice and research are discussed.

The Experiences of Parents of Adolescents in Family Therapy: A Qualitative Investigation

While understanding clients' experiences in family therapy is becoming increasingly important, we know very little about how the parents of adolescents in family therapy perceive and experience this process. The current study uses a multicase qualitative design and constructivist theoretical framework to describe the experiences of 15 parents of adolescents attending family therapy in private practices. Constant comparative analysis revealed four core categories that described parents' therapeutic experiences: (a) pretherapy presentation, (b) supportive therapeutic climate, (c) family therapy process, and (d) reflections on the therapy experience. The implications of study findings for clinicians and researchers are presented and discussed.

Family therapy for adolescents with poorly controlled diabetes: initial test of clinical significance.

We examined a structured family therapy approach in promoting clinically meaningful improvements in parent-adolescent conflict in adolescents with poorly controlled diabetes. Eighteen adolescents with poorly controlled diabetes and their parent(s) participated in 10 sessions of home-based Behavioral Family Systems Therapy (BFST). Outcome comparisons were made using a sample of adolescents with poorly controlled diabetes (n = 40) from a previous study. Clinically significant improvements were determined by calculating SD differences between treatment and comparison groups on measures of diabetes-related and general parent-adolescent conflict. Home-based BFST produced change in diabetes-related family conflict ranging from 1/3 to 1/2 SD and general family conflict ranging from 1/3 to 3/4 SD. BFST produced change in family conflict, a variable shown through previous research to relate to treatment adherence in adolescents with diabetes. The test of clinical significance represents an example of a method useful for pediatric research.