The Heart of the Matter 2: Integration of Ecosystemic Family Therapy Practices with Systems of Care Mental Health Services for Children and Families

Abstract

Many children in this country do not receive the mental health care they need. At the same time, a nationwide movement known as systems of care is providing innovative services for families and children. This article links the ideas inherent in systems of care with ecosystemic family therapy principles and practices. Based on a study of nine innovative systems of care pilot projects in Massachusetts, it describes how these innovative programs, and others like them, have been most successful in increasing access to services and providing for coordinated services. They have been less successful in accomplishing positive clinical and functional outcomes. Change in these systems is often described in terms of how services are provided. Not enough attention is given to the conversations that take place between families and case coordinators and how these conversations lead to long-term change. This article contends that the ways in which services are delivered in these systems of care fit well with ecosystemic family therapy principles and practices. We, as family therapists, have an opportunity to link these two sets of ideas, which share common assumptions and values and increase the likelihood of positive clinical outcomes for children and families.

The Mental Health Recovery Movement and Family Therapy, Part II: A Collaborative, Appreciative Approach for Supporting Mental Health Recovery

“…In addition, their duties may involve accompanying consumers to medical appointments, shopping trips, or other tasks. Family therapists have several models for in-home and community-based services to draw from that can be used in alternative settings (Boyd-Franklin & Bry, 2001;Coffey, 2004;Rojano, 2004;Walton, Sandau-Beckler, & Mannes, 2001). Most recovery-oriented programs employ a team approach in which a multidisciplinary team works together in supporting a consumer in recovery (Davidson et al, 2009;Linhorst, 2006).…”

How can we reach reluctant parents in childcare programmes?

“…When outsiders are perceived as supportive and not judgemental, the family can maximise usage of the goods and services that will help them to re-connect with their core values and goals and re-establish new predictable patterns. As families are given support and responsibility for accessing their needed services, they will become more active in all areas of their lives (Coffey, 2004). Once families re-establish new predictable patterns or return to their old patterns, they return to Phase 1.…”

Family psychology and systemic approaches: Working effectively in a variety of contexts.

“…Although this approach has undoubtedly reduced service fragmentation and prevented out-of-home placement, the complexity of coordination among multiple systems often presents disagreement or misalliances among professional helpers, particularly for children in the child welfare system (Lewis, 2011). For example, there may be tension between the wraparound service team and the more traditional mental health service providers, as the two systems may not share the same language, philosophy of treatment, or expectations of the family (Coffey, 2004). Family psychologists are optimally trained to recognize and address these issues because (a) they value a strong alliance within the therapeutic system, which includes direct and indirect systems of which the family and the psychotherapist are a part (Pinsof, 1994); and (b) they are trained to understand the circular, complementary processes characterizing interactions between systems (e.g., school and family), and they are trained to intervene as needed to improve system collaboration.…”