What is the question you need to answer? How consultation can prevent professional systems immobilizing families

Abstract

Consultation to an outside agency is an important part of the work of departments of child and adolescent psychiatry. This article describes and illustrates one particular approach to such consultations based on the principles of structural family therapy. It is premised on the belief that outside agencies have the capacity to arrive at a decision which is in the best interest of their clients. To do this the agency needs to define what is the question they need an answer in order to make a decision regarding their client. The consultants' role is to clarify what decision the consultee agency needs to make by following up the question, What is the question you need to answer? How this question is followed up is discussed.

Can Adolescent Court Reports be Used to Facilitate Therapeutic Change?

“…Structural family therapy provides a useful framework as it fits the court process, particularly the commissioning of the report questions, clarification of the roles of the professionals concerned and in the construction of the closing written statement (Dare, Goldberg, & Walinets, 1990;Jenkins, 1989;Minuchin, Montalvo, Guerney, Rosman, & Schumer, 1967;Reder, 1983). Surprisingly, adolescents often respond well to the imposition of authority if they understand that it may be in their longer term best interest (Bruggen & Pitt-Aikens, 1973).…”

“…As the question needs to be understandable to the young person, their family and supporters, it may need to be repeated, rephrased into everyday language, until one rephrasing is acceptable to all the parties involved. It may be important to ask why possible answers to the question may alter the court process or decision-making (Dare et al, 1990). Discussion of the likely consequences of foreseeable answers to the questions may provide information that will help the young person understand the forthcoming legal procedure and help him or her to consider their engagement with the process of collecting information and writing a court report.…”

Judgements of Solomon: the relevance of a systems approach to psychiatric court reports in child care cases

“…I t has proved a useful tool for thinking, and has lent itself to a variety of applications in working with both families and other systems. Increasingly, systemic approaches have also been applied in settings where consultation rather than therapy is offered (Wynne et al, 1987;Dare et al, 1990;Crowther et al, 1990;Cecchin, 1987). Perhaps a systems approach to consultation might provide a helpful paradigm (Lambie, 1991;Stratton, 1988;Minuchin, 1988) within which to consider the questions that concern the court.…”