by Kaplan, David M. - Cole, Melody J.
As stated in the American Counseling Association Code of Ethics and Standards of Practice, "Counselors recognize that families are usually important in clients' lives and strive to enlist family understanding and involvement as a positive resource where appropriate" (1995). This digest will provide an overview of basic family counseling concepts for counselors whose specialty is in an area other than marriage and family counseling.
The counseling relationship accounts for fully thirty percent of client progress (Lambert, 1992). In Family Counseling for All Counselors, Kaplan (in press) posits that achieving a positive relationship with a client's family can be difficult. Family members often initially challenge the counselor's authority due to protectiveness and embarrassment. People tend to be much more protective of their families than they are of themselves, and they do not like to admit that a stranger is needed to handle family problems. It is the counselor's responsibility to establish a therapeutic relationship under these circumstances. When the counselor is able to successfully navigate this initial stage, the therapeutic nature of the counseling relationship is enhanced for both the presenting client and the familial unit. Conversely, a family that remains distrustful of the counselor will not allow progress to occur.
There are two pivotal areas the counselor and client must address upon deciding to involve a family in the client's counseling sessions: how to get the family to come into the office, and how to conduct the first session so as to increase the likelihood that subsequent sessions will occur when necessary. There are several practical steps a counselor should take to facilitate the establishment of a positive therapeutic relationship with families. These steps include: displaying professional credentials, dressing appropriately for the session, providing a comfortable seating arrangement, and obtaining informed consent. Establishing rapport and a relationship with clients is only the first step in counseling, but it is one that sets the tone for the therapeutic experience.
GETTING THE FAMILY INTO THE OFFICE
It may be stating the obvious, but a relationship cannot be established with a family that won't come for counseling in the first place (Kaplan, in press). Therefore, it is important to devise a plan to encourage a client's family members to come to the sessions. Critical to the plan's success is the identification of the family member who has the greatest power. The client and counselor can strategize on how best to enlist his or her aid in getting family members to come to the first session. Often, this pivotal family member will be the matriarch since families typically delegate responsibility for emotional issues to women (Kaplan, in press).
THE FIRST SESSION AND BEYOND
Family counseling work is qualitatively different from individual counseling. Due to both the number of individuals in the room and the nature of their relationship, it is important that the counselor be prepared for new and complex dynamics. The counselor should begin the first session by making an opening statement about why the family is there. This allows the counselor to set the tone for a positive, strength-based approach. It can be simply stated that everyone is gathered together because the counselor needs the family's help to deal with a problem. In addition, it can be stated that the gathered family members have valuable resources, background information, and ideas that will make the counseling much more efficient and effective than if the client were worked with individually. Family members may feel more relaxed when they begin to realize that the counselor is not out to blame the family for the presenting problem.
Kaplan (in press) presents several typical familial roles that a counselor can spot and utilize therapeutically. The family scapegoat, for example, might become obvious as soon as the family has arranged their seating. Families will sometimes choose a member to blame as the source of all or most family disturbances. A counselor can often tell when the client is the family scapegoat because other family members will cluster around each other and leave the client alone in a different part of the room. It is as if they are pointing and saying, "It is all his/her fault. This family would be fine if they wouldn't keep screwing up." This person is frequently the presenting client (Gladding, 1998). When visually noting that the family has isolated a family member it may be helpful to ask, "If we could wave a magic wand and everything was okay with [fill in client's name], would everything be all right with the family? Or would there still be problems?" This type of inquiry can help the family begin to address complex familial relationships, the ways in which current perceptions of one another are based in past experiences, and how families can build healthier relationships for the future.
A second role the counselor might identify in the first session is that of the gatekeeper (Napier & Whitaker, 1978). The gatekeeper guards the safety of the family in the counseling office. Gatekeepers can often be detected through seating arrangements as well as they will typically seat themselves between the counselor and the family. The gatekeeper will determine whether this is a safe environment for the family. The gatekeeper will control whether family members speak openly and will also be the one who decides if the family returns for future sessions. Ultimately, the gatekeeper can control the way in which the counselor can or cannot establish a relationship with the family.
The counselor's relationship with the family begins in the counselor's reception area. When a family is waiting for a session to begin, they should be able to view the counselor's graduate diploma(s), license and professional certifications. It is also useful to have a one-page waiting room resume that states the counselor's qualifications and strengths. This resume should include a listing of credentials, experience, professional affiliations, publications, and presentations (Kent, 1997). Providing this information in the waiting room allows the counselor to begin to establish credibility (and therefore trust) with a family even before they enter the office for the first time.
There are some topics that warrant revisiting no matter how long one has been a counselor. Appropriate attire for a family counseling session is such a topic. It is recommended that the counselor dress formally (e.g., a suit) when working with families. Formal attire serves two subtle purposes during the initial stages of family counseling: it is a sign of the counselor's respect for the family, and it gives the message that the counselor is an expert. Establishing expertise is a critical component in establishing a positive therapeutic relationship with a family (Kaplan, in press).
It is useful to have flexible seating in the office for conductingfamily work. Movable chairs mixed in with a loveseat, forexample, allow family members to adjust personal space to theircomfort. It also provides the counselor with insight into familydynamics, i.e., nonverbal messages, alliances, and roles. An officethat is comfortable for individual counseling yet can alsoaccommodate a family of five will take care of most seating needs.It is useful to have additional high-quality, padded folding chairsavailable for large family groups. Groups of larger than seven oreight relatives may be facilitated by seating arrangementsappropriate to a group counseling session and may require a biggerroom.
Informed consent refers to the provision of information about a counselor's practice to a family so that they can make a knowledgeable decision about whether to enter into a counseling relationship (Kaplan & Culkin, 1995). It covers issues such as confidentiality, the counselor's treatment approach and educational background, as well as information relating to fees and making appointments. Taking time during the first family counseling session to review a handout on informed consent helps establish a positive therapeutic relationship because it promotes trust. A family that understands the purpose and limits of the family counseling session is more likely to invest in a partnership with a counselor (Borden, 1975; Kaplan, in press).
SUMMARY AND CONCLUSION
Involving family members in counseling increases positive outcomes across a spectrum of presenting problems (Carlson, 1993; Baldwin & Huggins, 1998). The preceding paragraphs have offered a very brief overview of just some of the ways to establish and engage family members in the counseling relationship. This is by no means an exhaustive list for the how, what, or why of family counseling, but it should provide an entree to the benefits, dynamics, and challenges a counselor might encounter.
American Counseling Association (1995). ACA Code of Ethics and Standards of Practice, Section A.1, Paragraph d. Retrieved December 18, 2002 from http://www.counseling.org/resources/ethics.htm#ce
Baldwin, C., & Huggins, D. (1998). Marital and family therapy research: Outcomes and implications for practice. The Family Journal: Counseling and Therapy for Couples and Families, 6, 212-218.
Borden, E. S. (1975). The generalizability of the psychoanalytic concept of the working alliance. Psychotherapy: Theory, research & practice, 16, 252-260.
Carlson, J. (1993). Marriage and Family Counseling. Counselor efficacy: Assessing and using counseling outcomes research. ERIC Counseling and Personnel Services Clearinghouse: Michigan.
Gladding, S. T. (1998). Family therapy: History, theory, and practice (2nd ed.). Upper Saddle River, New Jersey: Prentice-Hall Inc.
Kaplan, D. M. & Associates (in press). Family Counseling for All Counselors. Greensboro, NC: ERIC/CASS.
Kaplan, D., & Culkin, M. (1995) Family ethics: Lessons learned. The Family Journal: Counseling and Therapy for Couples and Families, 3, 335-338.
Kent, D. (1997). Creating a waiting room resume: Six questions people ask when choosing a therapist. What's working in psychotherapy practice building, 15, 1, 7.
Lambert, M. (1992). Implications of outcome research for psychotherapy integration. In J. C. Norcross & M. R. Goldfind (Eds.), Handbook of psychotherapy integration (pp. 94-129). New York: Basic Books.
Napier, A., & Whitaker, C. (1978). The family crucible. New York:
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