Therapeutic Response to Families in Crisis

Instructor: Clio Stearns

Clio has taught education courses at the college level and has a Ph.D. in curriculum and instruction.

If you are a mental health professional who works with families, chances are you will occasionally see a family in crisis. This lesson discusses how you can respond therapeutically in these situations.

Understanding Family Crisis

As a psychotherapist, Olivia knows that it is her job to listen and respond to the situation in front of her. Right now, she works for an agency that provides mental healthcare and emotional support to families.

Olivia works with many different kinds of families, and often, she meets them in times of crisis. In this case, crisis refers to a set of severe emotional stressors that are really impeding a family's capacity to function.

For example, Olivia is currently working with a family in which the grandmother has recently died. The mother, who was very close to her own mother, has been depressed and unable to cope. The children are acting out behaviorally, and meanwhile, the father is having a lot of financial stress.

Olivia knows that there are a few different approaches she can take when she responds to a family in crisis.

Behavioral Interventions

First, Olivia sometimes uses behavioral interventions, or a therapeutic response that targets specific behavioral patterns within the family. Many families in crisis fall into patterns that are problematic and harmful to the well-being of everyone in the family, and behavioral interventions can help untangle these patterns.

For example, Olivia has learned that the children in the family she is working with stay up really late. This frustrates the parents and gives them less time for themselves. Olivia helps them develop a behavior chart that rewards the children for early and efficient bedtimes. This simple change in their family behavioral patterns helps reduce the level of chronic stress they are experiencing. The children are also less tired and have more energy to direct toward their schoolwork and daily interactions with others.

Olivia has also used behavioral interventions to target frequent fighting in a family, disordered eating, and smoking.

Relational and Psychodynamic Interventions

However, Olivia knows that families in crisis also require interventions and support that go deeper than the surface behavioral level. Sometimes, it is important to get to the root of what is happening in families. In these cases, Olivia works psychodynamically, meaning she tries to uncover the early experiences that might have led the family to this crisis point.

After showing the mother in the family that she is trustworthy and caring, Olivia is able to encourage the mother to express her tremendous sadness at the loss of her mother and how it brings up other losses she has experienced.

Olivia is also able to work relationally, meaning she takes what she learns from this psychodynamic work and uses it to help her address problematic patterns in the relationships in the family.

In this case, Olivia sees that the mother is unconsciously projecting her sadness onto her kids and asking a lot from them emotionally. In turn, she also helps the father see that his wife could use more emotional support and encouragement from him while she works through her loss.

Psychodynamic and relational interventions can take time and require the therapist to build trust in the therapeutic relationship. However, they can be incredibly helpful when it comes to precipitating long-term change.

Other Services

Finally, Olivia believes that sometimes she has an obligation to connect the families to ancillary services and resources that they might need in order to get themselves out of a crisis mode.

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