Ideas of the change process: family and therapist perspectives on systemic psychotherapy for children with conduct disorder

Abstract

This report is based on a small‐scale qualitative study exploring therapist and client perspectives on the therapeutic change process in home‐based family therapy for children with conduct disorder. The study consisted of focus group discussions with therapists, interviews with client families and audiotaped therapy sessions. The findings suggested that home‐based therapy (home visits) was effective in improving hard‐to‐reach clients’ access to help, resources, and opportunities, as well as the therapists’ access to invaluable information about their clients. Home‐based therapy also helped the therapists to develop professionally, making it possible for them and their clients to engage in different power relationships, which were seen by both parties as one of the principal motivating forces and important aspects of the change process. In addition, exploring clients’ perspectives appeared to be useful. Practitioner points The process of engaging with hard‐to‐reach families starts in the context of specific therapist‐client power relationships with the therapist encouraging the family to take charge Home‐based therapy is useful for children with conduct disorder Home‐based therapy provides children, family and therapists with information, resources, opportunities and good access, which are not always available in customary clinical settings

Family Therapy for Conduct Disorder: Parent/Caregiver Perspectives on Active Ingredients

“…While Tighe at al. (2012) suggested a unidirectional relationship whereby parent change influences youth change, other research has suggested it is more reciprocal (Morino, 2019). Kaur, Pote, Fox, and Paradisopoulos (2017) described parents/caregivers’ perspectives on change in MST, while identifying parental change as an important factor.…”

“…Youth with CD and their families present with substantial treatment challenges and a remarkable unresponsiveness to treatment (Fairchild et al, 2019; Sexton & Datchi, 2014). Adverse cycles of missed appointments and recurrent non‐attendance to therapy sessions result in repeated referrals and worsening problems (Morino, 2019; Sexton & Datchi, 2014). Research shows the success of standard intervention programs (e.g., Triple P; Sanders, Kirby, Tellegen, & Day, 2014) is limited to younger children with less severe externalising behaviours (Sexton & Lebow, 2016).…”

“…A review of the literature shows only a few researchers have reported direct accounts from families (youth and parents) about their involvement in, and completion of, FT for CD (Morino, 2019; Paradisopoulos, Pote, Fox, & Kaur, 2015; Tighe et al, 2012). In the United Kingdom, Tighe et al (2012) interviewed 21 families who identified two conceptual domains as important to change: the therapeutic relationship and positive experiences of MST.…”

“…Emergent themes included the therapeutic alliance, growth in systemic understanding, acknowledging responsibility, and positive peer group connections. Most recently, Morino (2019) reported on the change process with his work in home‐based family therapy for CD in the United Kingdom. Findings from these studies begin to reveal the process of change from the family’s perspective and help researchers to further understand the active ingredients in FT for CD.…”