Sustaining engagement: A change event in family therapy.

Abstract

It comes as no surprise to experienced family therapists when family members, feeling desperate about their situation, are nevertheless reluctant to work through their interpersonal difficulties with each other. In the session, family members may resist engaging with one another when they do not recognize the potential benefits of doing so or the potential costs of not doing so. Even when the therapeutic alliance is strong, not all family members may be ready or willing to take the risks necessary for change. Indeed, for many reasons, resistance to the therapeutic process is likely to be more problematic in conjoint family therapy than it is in individual treatment. Despite an abundant literature on reducing clients' resistance and enhancing their active involvement in individual psychotherapy, surprisingly little has been written about engagement in family therapy. In the clinical literature, we found that only structural theorists have provided extended discussions on the topic (e.g., Aponte & VanDusen, 1981; Colapinto, 1991; Minuchin & Fishman, 1981; Szapocznik & Kurtines, 1989). In these discussions, however, engagement tended to be defined either as entering treatment or complying with the therapist, rather than as a productive collaboration between and among family members in the session. Szapocznik and Kurtines (1989), for example, detailed strategies (e.g., phone calls, home visits, or homework