How to Coach Yourself and Others Coaching Families | Page 65

counselor gains considerable rapport with families because he or she is willing to be of service at a time of
great need.
A Cautionary Note: Adolescents Attending Therapy Sessions on Drugs
Counselors usually refuse to work with a client who comes into the therapy session on drugs because the
client is viewed as "not being all there" to do the treatment work. However, in the case of a family therapy
such as BSFT, determining whether to conduct the session is a strategic decision the counselor must make.
One possibility in BSFT is to view the adolescent on drugs as an enactment of what the family confronts at
home all the time. Thus, when an adolescent comes to therapy on drugs, it can be viewed as an opportunity
for the counselor to teach the family how to respond to the adolescent when he or she takes drugs. The
BSFT counselor can see how each family member responds to this situation and look for the maladaptive
interactions that allow the adolescent to continue this behavior. The counselor can then work with the nondrug-using family members to change their usual way of responding to the adolescent on drugs. Hence, the
work in this session is not with the adolescent but with the other family members.
From Diagnosis to Planning
Once a therapeutic relationship has been established and a diagnosis has been formulated, the counselor is
ready to develop a treatment plan. The treatment plan lays out the interventions that will be necessary to
change those family maladaptive interactional patterns that have been identified as related to the presenting
symptom. Problematic patterns of family interaction are diagnosed using the six dimensions of family
interaction discussed in Chapter 3 (organization, resonance, developmental stages, life context, identified
patient, and conflict resolution). Often some dimensions are more problematic than others. The
interventions need to focus more on the most problematic interactions than on the others.
The six dimensions of the family's interactions operate in an interdependent fashion. For this reason, it may
not be necessary to plan a separate intervention to address each problem that has been diagnosed. For
example, addressing a family's tendency to blame its problems on the adolescent (i.e., the identified patient)
may bring the family's ineffective conflict resolution strategies to light. In a similar fashion, addressing a
son's role as his mother's confidant (i.e., inappropriate developmental stage) may bring out the rigid and
inflexible boundary between the parent figures.
Producing Change
As was stated earlier, the focus of BSFT is to shift the family from maladaptive patterns of interaction to
adaptive ones. Counselors can use a number of techniques to facilitate this shift. These techniques, all of
which are used to encourage family members to behave differently, fall under the heading of
"restructuring." In restructuring, the counselor orchestrates and directs change in the family's patterns of
interaction (i.e., structure). Some of the most frequently used restructuring techniques are described in this
chapter.
When the family's structure has been shifted from maladaptive toward adaptive, the family develops a
mastery of communication and management skills. In turn, this mastery will help them solve both present
and fu GW&R&