Nurturance: A Neglected Dimension in Family Therapy With Adolescents*

Abstract

This paper offers a model for integrating a nurturance framework into family therapy approaches with adolescents. This approach is seen as adding an important but neglected dimension to commonly used approaches, thus increasing both flexibility in treatment and the likelihood of a positive outcome. Steps to an effective treatment approach are outlined and guidelines offered for both in-session work and out-of-session tasks.Family therapy has become increasingly accepted as an important modality of treatment for adolescents. Family theory and research suggest that parental connection and its overt expression in the form of parental nurturance are positively correlated with health in both the adolescent and the family. However, the literature that addresses family therapy applications to adolescent treatment tends to neglect this dimension in favor of focus on issues of power/control and separatiodautonomy.This article will first. briefly review research supporting the importance of parental connection and nurturance in effective parenting of adolescents. Second, a review of the applications of family therapy to the treatment of adolescents will be organized into three prevalent frameworks: (a) the family life cycle/developmental task of individuatiodseparation; (b) the use of organizational concepts; and (c) behavioral focuses on conflict, power, and control issues. A discussion follows that suggests how parental connectiodnurturance can be incorporated into these frameworks. The article then addresses specifically how therapists can help parents develop greater connectedness with their adolescents within the context of therapy. Finally, the article offers guidelines for out-of-session tasks designed to increase parental nurturance. Therapists incorporating this framework and corresponding in-session and out-of-session tasks will enhance their flexibility in therapy with adolescents and their families and increase the overall effectiveness of treatment.I define nurturance as a subset of behavior within the more general category of interconnectedness or attachment behavior. Nurturant acts are behaviors directed toward another individual with the intent of providing physical or psychological nourishment. Like Wood (1989, I believe that an important dimension of a successful nurturant act is that the nurturer accurately assesses and responds to the emotions and needs of the other individual.This idea is also supported by attachment therapy, which suggests that secure attachment is characterized not only by the amount of contact between parent and child but also by how well the contact fits both the personal rhythms of the child and the child's developmental stage (Bowlby, 1982). This means that the parent needs to discriminate between the parent's own needs and emotions and those of the adolescent. Thus, an example of a successful nurturant act with an adolescent might be a parent who pats hisher adolescent on the arm instead of hugging himher in front of the adolescent's peers.

The Role of Hierachy in Parental Nurturance

“…Bowlby (1982) believed the development of secure attachment is not only dependent on the amount of contact between parent and child, but also on how well the contact matches the personal needs and the developmental stage of the child. Mackey (1996) suggested a successful nurturant act with an adolescent would be for the parents to pat the son on the arm instead of hugging him in front of his peers.…”

“…Mackey (1996) argued that most treatment approaches fail to give attention to parent-adolescent relationship issues. A majority of the treatment approaches are designed for conflict resolution in which connection-attachment or parental nurturance is not addressed.…”

“…This separation draws a boundary around the marital subsystem and encourages the adolescent's individuation (Mackey, 1996). This approach allows for cross-generational alliances (e.g., mother-daughter) to be altered in order to eliminate separation conflicts, sexual identity conflicts, and a wide range of other personality and behavior problems (Teyber, 1983).…”

“…Parental connection and overt expression of parental nurturance have been found to be an important dimension in healthy relationships within families (Mackey, 1996). Successful nurturant acts depend on the parents accurately assessing and responding to the needs of the children.…”

“…As developmental theory helps to explain the growth process in children through adulthood, much literature and research has been conducted on the importance of parental nurturance through this developmental process (Ahlberg & Sandnabba, 1998;Heilbrun, 1964;Mackey, 1996;Pawlak & Klein, 1997). Nurturance can be explained through behaviors that are directed toward another individual that involves interconnectedness or attachment behavior.…”