How to work with families

The core elements of this module are the entire set of evidence-based practices from the Family Focused Interventions. Select any of the elements from the list below which may be useful, or work through them in order from here

F1. Engaging, orienting and negotiating ground rules
Engaging caregivers requires similar practices to engaging adolescents including outreach, active listening, demonstration of empathy, emphasising the positive, and reinforcement. It will be easier to engage parents and caregivers if they understand the scope of what is wanted from them as early as possible. It is vital to restrict family focused work to a highly practical set of achievable goals. Clarification of ground rules is necessary to establish a solid basis for a working relationship. 

F2. Information provision
The purpose of providing information is to enable family members to understand the nature of the service being provided for the young person in a manner that invites and encourages their involvement. Information is provided about the nature of the service, the range of service types on offer, and the reasons why family involvement is encouraged.

F3. Collaborating and building motivation
Based on the foundations of the initial orientation and engagement, the aim here is to build and maintain a strong collaborative alliance based on a shared goal, and to build motivation for pursuit of that goal. 

F4. Education for caregivers on young people, drugs and families
The goal of parenting education is to enhance understanding of adolescent development and the role of the family in this development. A key focus is how healthy family functioning enables the family to be a source of strength for its members.

F5. Holding a Family Meeting
Meeting face-to-face allows the practitioner to observe the young person and family member/s interacting, help them to set goals for behaviour change, model behaviours that can facilitate positive change, and provide timely reinforcement. It is vital to use the opportunity of the family meeting to impart some basic skills that family members can take away with them. Basic communication skills may be the most practical option <see Practice Element F6>.

F6. Family communication skills
A fundamental aim of family work is to build the capacity of family members to provide emotional and practical support for their adolescent. Relationships based on reciprocity are the ideal platform for achieving this. Basic family communications skills involve formulating and verbalizing requests for change in ways that facilitate listening, reciprocity and negotiation. 

F7. Family problem solving
Problem solving in the context of relationships is a process that helps people find out what they want, and how to get what is wanted, in a way that respects other people’s wants. Problem solving skills can be taught in the first family meeting as an alternative to learning communication skills <see Practice Element F6> or they can be the primary focus of a subsequent family meeting.

F8. Keeping the interaction positive
When relationships between young people and caregivers are strained, 3-way face to face meetings may become bogged down in negativity as the young person and caregiver play out communication patterns such as mutual blame and criticism. This practice element includes a range of techniques that can be used to break these cycles during meetings with the practitioner.

F9. Setting expectation and limits
Problems with limit setting and enforcement are frequently the main complaint presented by parents / caregivers about the behaviour of their adolescent. The role of the practitioner is to provide education and support that assists parents / caregivers to: define a set of limits; consult and negotiate with the adolescent; be clear and consistent in applying consequences, and be prepared to continually review limits.

Where does this module come from?

The practice elements in this module are drawn primarily from the Adolescent Community Reinforcement Approach (A-CRA), which in turn has drawn from various models of family therapy, and the skill development procedures of Cognitive Behaviour Therapy. A-CRA allocates considerable attention to the family system in which the young person is situated, whether this includes biological parents or other kinds of caregivers. Based on practice experience, and built up through a long term developmental process, the developers of A-CRA recommend a relatively formal and business-like approach to the sessions with caregivers, and a highly structured approach to the 3 way adolescent-caregiver meetings. The manual provides detailed description of the procedures.

This Working with Families module draws heavily on the caregiver and adolescent-caregiver procedures contained in A-CRA. We have supplemented these elements with additional material covering provision of information and parenting education. These elements are particularly important as alternatives to face-to-face meetings when parents or caregivers are unable or unwilling to engage in greater depth.

Finally, this module contains a practice element on Limit Setting. YSAS practitioners have found that problems with limit setting and enforcement are frequently the main complaint presented by parents / caregivers about the behaviour of their adolescent. Responding to the concerns prioritised by parents / caregivers is very helpful to the larger project of recruiting them as effective supporters of the young person.

Find out more about the Adolescent Community Reinforcement Approach (A-CRA)

Considerations for different practice contexts
Working with families is an area of practice that youth workers have historically been reluctant to embrace. This reluctance stems from philosophical ideas that have changed significantly in recent years, combined with a lack experience and confidence. Many youth workers feel unsure about what their role should be in relation to families, and are concerned about whether family members will accept their efforts as legitimate. For these reasons, this Module adopts a relatively structured approach to working with families. Having a clear structured agenda in family work puts clear boundaries around the scope of the work and affirms the workers’ sense of legitimacy in what they ask of family members.

It is recommended that relatively inexperienced youth workers adhere closely to the suggested structure. Supervision should also focus on helping practitioners to adhere to the recommended procedures. As practitioners gain more experience in working with families, more flexibility can be introduced with greater confidence.

Services embarking on family focused work need to have clear procedures documented for ensuring provision of:

  • Family assessment including risk assessment
  • Staff supervision
  • Office hours that are accessible for family members
  • Safety of staff during home visits to families by outreach staff