Incorporating Family Work into Individual Counseling:
Establishing a Relationship with Families. ERIC Digest.
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
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.
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