Behavioral Family therapy



Behavioral Family therapy

Introduction

Family Therapy has emerged as a preferred treatment approach for adolescent behavior problems (Sexton & Alexander, 2002). Despite positive treatment outcomes, there is still a gap between research and practice and an incomplete understanding of how to successfully disseminate evidence-based family programs into every day clinical practice. Many researchers have attributed adolescent problem behaviors to a number of risk factors including individual, family, peer, school, and neighborhood factors (e.g., Gerard & Buehler, 2004); therefore treatment approaches should be broadened to include the important relational contexts and salient subsystems in which adolescents' problematic behaviors tend to develop and are expressed (Kazdin & Weisz, 2003).

A major limitation, however, of current family and evidence-based programs is the ability to successfully transport them into community-based practice settings, creating a significant gap between evidence-based researches developed in the lab and the current applied practice settings within our communities (Mendel, Meredith, Schoenbaum, Sherbourne, & Wells, 2008). Translational research involves the time it takes to disseminate findings derived from basic science and adapting it for an applied practice setting, for example, how specific components of a treatment intervention affect changes in symptoms, the number of times a specific therapy component should be used in therapy, how to guard against implementation of harmful treatment, and attention to specific samples that represent the population being studied (Tashiro & Mortensen, 2006). For the purpose of this mixed-method study, translational research was used to elucidate specific strategies for translating research into practice.

Diagnosing the need for Behavioral Family therapy

The first visit starts with a standard diagnostic interview. The primary goal is to acquire medical and lifestyle data in order to solicit information of importance for treatment. Our secondary goal of this interview is to observe how the family reacts and cooperates when answering questions. It reveals important information about family function for our analysis on how to best help the family. Our third purpose is to start the process of change among family members. Every question is constructed to address the goals of the interview.

“If you compare yourself with your mother, do you eat less, as much, or more?” a dietician asks the child when addressing the topic of appropriate portion size. The form of this question is guided by an assumption that a child should not consume more than an average sedentary-working middle-age female. The question is formulated in a circular way that requires comparison with other family members and involves other parts of the family (Selvini et al., 1980). Richard answers with pride: “I eat more than my father”. This information reveals that the child eats too much. A mother adds: “But I eat very little. I'm the kind of person who really needs to think about portion size, otherwise I gain too much weight”. Such information also indicates a strong genetic component.

The topics in the initial diagnostic interview include questions about the child's family and school situation, medical history, food and physical activity patterns, genetic background for obesity and obesity-related ...