The Center for Family Consultations seeks to resolve current problems in as brief a time as possible while still acknowledging that long-term developmental issues may at times need to be directly addressed. We assume that change is easiest when people are in crisis and that change is long lasting only when treatment includes all those involved in the present difficulty. The goal of therapy is quite simply behavioral change in which new positive actions replace self-defeating interactions. The program for at-risk youth, then, involves several components.
Since people are most open to change when they are under stress or in crisis, immediate response to their request for help is important. Phone contact is always established within 24 hours, and every attempt is made to schedule appointments within 72 hours.
Family Systems Approach
Effective change will require the participation of relevant family members. The focus of the program is on family and community interactions. This may not always require that all family members always be present, but every attempt is made to include family members in the treatment process. In order to make maximal use of brief therapy, the program also seeks to involve the efforts of as many other persons in the client’s system as necessary (e.g., teachers, pediatricians, counselors, friends, etc.). Often this will take the form of phone consultation, but in extremely difficult high-risk cases may involve a joint meeting with other professionals.
Most at-risk youth have experienced multiple failures in several areas of their life and are seriously disconnected to major social resources. The focus of treatment is on developing new successful routines to replace ineffective ones. This means identifying specific, workable goals and implementing them as quickly and as effectively as possible. The past may indeed have a bearing on current difficulties, but it is assumed that is a better use of client’s time and money to focus on current and future issues. Our experience is that most families can make positive gains in from 4 to 6 sessions, even though additional work may certainly be needed. If additional work is desired, they are encouraged to take as much ownership of the problem as possible and to plan for future. This may include identifying future problems, future resource people, and thinking about financial resources.
It has been our experience that at-risk adolescents need a mixture of warmth, sensitivity, support, and encouragement along with direct confrontation, limit-setting, and assertive feedback. The program attempts to provide both aspects as needed. For instance, therapy may emphasize decisive parenting skills some times and simple listening skills at other times; it may involve confronting an adolescent about their behaviors (e.g., substance abuse, burglary) or may involve offering daily phone contact to a depressed youngster. This may involve an extended discussion about cultural conflicts, ambivalent loyalties, or deceitful actions. The basic goal is to help youngsters begin to bond socially in places they previously had not (i.e., school bonding, peer bonding, family bonding).