Therapy With Treatment Resistant Families

by McCown, William George, Ph.D.; Johnson, Judith

• ISBN13: 9781560242451
• ISBN10: 1560242450
• Format: Paperback
• Copyright: 1993-08-01
• Publisher: Routledge

Table of Contents

Contributors and Associates
Preface
The Treatment Resistant Family	p. 1
The Concept of Resistance	p. 1
Varieties of Family Treatment Resistance	p. 3
The Impact of Resistance	p. 10
Early Therapy Termination: The Most Extreme Process Resistance	p. 11
Treatment Resistance and Family Crises	p. 15
Systems Intervention with Highly Resistant Families	p. 18
Families and Family Therapy
A Brief History and Current Status	p. 23
Historical Concepts of the Family and Family Therapy	p. 23
Contemporary "Family Problems" and the Rise of Family Therapies	p. 27
The History of Family Therapy: The Developmental Analogy	p. 29
The Future of Family Therapy: Dynamical Systems Theory	p. 44
Family Resistance, Stress, and Crises	p. 49
Resistance and Crisis Intervention	p. 49
Crises and Stressors	p. 50
Family Stress	p. 53
Typologies of Family Stressors	p. 54
Responses to Normative and Catastrophic Stressors	p. 55
Perceptual and Instrumental Stresses: An Alternative Formulation	p. 57
Perceptual Crises	p. 62
Instrumental Stress	p. 64
Perceptual Crises and Treatment Resistance: An Empirical Study	p. 68
Familial Differences in Stress Coping	p. 71
Hill's ABC X Model of Family Resiliency	p. 72
The Hill/McCubbin Model and Treatment Resistance: An Empirical Study	p. 73
Family Stress and Opponent Processes	p. 76
The Perception of Stress as a Critical Variable in Crisis-Proneness and Treatment Resistance	p. 80
Family-Oriented Crisis Intervention	p. 85
An Overview to a New Method of Defeating Resistance	p. 85
Family-Oriented Crisis Intervention: A Brief History	p. 87
Theoretical Rationale for Family Crisis Intervention	p. 88
Crisis Intervention with Treatment Resistant Families	p. 98
The Goal of Crisis Intervention with Resistant Families	p. 101
Dysfunctional Coping and Treatment Resistance	p. 103
Models of Family Crisis Intervention	p. 106
Crisis Intervention and Consultation Roles	p. 108
The Stages of Therapeutic/Consultational Intervention	p. 110
Conclusion: Summarizing a New Strategy to Undercut Resistance	p. 111
Assembling the Family During Crisis: The First Session	p. 113
Family Crisis Intervention: Who Should Be Seen?	p. 113
Who Should See Resistant Families?	p. 117
Location of the Crisis Session	p. 121
Timing and Length of Sessions and Crisis Intervention	p. 122
Handling Anger of the Resistant Family	p. 124
Communication Principles During Crisis Intervention	p. 125
Payment of Fees	p. 128
Hospitalization	p. 130
Crisis Defusion and Evaluation	p. 135
Crisis Defusion (D): Making the Crisis "Workable"	p. 135
Family Crisis Evaluation (E): The Framework for Empowerment	p. 149
Family Problem Solving: A Crisis Intervention/Consultation Approach	p. 167
Developing and Communicating Tentative Crisis Formulations: The First Step Toward Family Problem Solving	p. 167
Decision Avoidance: The Principal Obstacle to Family Problem Solving	p. 174
Problem-Focused Coping: The Family Generates Its Own Answers	p. 178
Ego-Lending: Making Decisions for the Family	p. 187
When the Family Decides Poorly: The Consultant Stance	p. 191
Translating Problem Solving into Specific Actions: Empowerment of the Resistant Family	p. 201
The Behavioral Contract	p. 202
Integrating Family Assessment into the Behavioral Contract	p. 205
Specifics of the Behavioral Contract: Interventions to Change Dysfunctional Coping	p. 209
Identification of Potential Compliance Problems	p. 219
Subsystems Therapy: Link Therapists and the Behavioral Contract	p. 225
The Decision for Future Therapy	p. 230
Terminating the Crisis Interview	p. 231
When All Else Fails: Reiterating Reality to the Resistant Family	p. 233
Beyond the Crisis Session: What to Do with the Resistant Family After ADEPT	p. 237
When the Resistant Family Is Incestuous	p. 243
General Principles	p. 244
Initial Intervention	p. 246
Family System Factors	p. 251
Individual Factors	p. 253
Family of Origin Factors	p. 255
Socio-Environmental Factors	p. 255
Precipitating Events	p. 256
Coping Mechanisms
Dimensions of Intervention	p. 257
Conclusion	p. 264
Delinquency and the Resistant Family	p. 267
The Efficacy of Family Therapy with Delinquents	p. 267
Family Factors and Delinquency	p. 270
Treating the Resistant Delinquent Family	p. 275
Conclusion	p. 281
Families of Brain-Compromised Individuals	p. 283
The Brain-Compromised: A Growing Population	p. 283
Traumatic Brain Injury	p. 285
Degenerative Dementia	p. 295
Final Words on Treatment Resistance	p. 303
References	p. 305
Index	p. 315
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