Academic journal article Journal of Marital and Family Therapy

Influences on the Inclusion of Children in Family Therapy: Brief Report

Academic journal article Journal of Marital and Family Therapy

Influences on the Inclusion of Children in Family Therapy: Brief Report

Article excerpt

This study examined factors that influence family therapists to include children in or exclude them from therapy sessions. We hypothesized that therapist comfort child problem type (internalizing vs. externalizing), family composition (one- vs. two-parent families), and presenting problem (child-oriented problem vs. adultoriented problem) affect therapists' inclusion of children. A survey of clinical members of AAMFTfound that half of the therapists excluded children on the basis of their comfort and that those who felt more comfortable were more likely to include children in sessions. Therapists included children more frequently in cases of an internalizing vs. an externalizing child, more with single-parent than twoparent families, and more often when the presenting problem focused on a child than on an adult. Implications of the findings are discussed.

Inclusion of children is an important issue in family therapy, because there is little agreement in the field about how and when to involve children in sessions (Stith, Rosen, McCollum, & Herman, 1996). In fact, family therapy has been accused of "not seeing the children at all" (Diller, 1991, p. 23), ignoring their unique role in the family system. There is a paucity of empirical research that investigates the factors associated with inclusion of children in family therapy.

Therapists are continually faced with decisions about whether or not to involve children in sessions, about how many children to include and for how long, and about how to effectively involve them in therapy. Competent therapists often decide to exclude children, focusing on certain dyads and individuals on the basis of their own theoretical orientation and views about therapeutic change. The diversity of family problems and constellations creates many situations in which the physical inclusion of children in therapy sessions is neither necessary nor recommended.

However, some of the basic tenets of family therapy theory suggest that without the presence of all family members, at least in initial sessions, family therapists miss important information and opportunities for intervention (Ackerman, 1970; Baker, 1986; Chasin, 1981; Chasin & White, 1989; Diller, 1991; Gil, 1994; Guerney, 1964; Guerney & Guerney, 1987; Guttman, 1975; Kaye & Dichtera, 1986; Lax, 1989; Levant et al., 1985; Minuchin, 1989; Moss-Kagel, Abramovitz, & Sager, 1989; Nickerson, 1986; Safer, 1965; SavegeScharff, 1989; Taffel, 1991; Villeneuve, 1979; Villeneuve & LaRoche, 1993; Whitaker, 1967; Zilbach, 1986). When it comes to the inclusion of children in family therapy sessions, the family therapy field faces many unanswered questions. For example, have family therapists inadvertently excluded children in sometimes detrimental waysperhaps missing important factors such as abuse and neglect or children's reactions to other important events in the life of the family? What should children hear discussed in therapy sessions? What kind of child problems tend to be handled with the child in the room? Are adult-focused problems appropriate for children to hear, or is it more appropriate to exclude children in such cases? How comfortable do therapists feel about conducting a therapy session with children in the room? How do therapists make decisions about when to include children in sessions and when to exclude them? With the vast number of situations in which family therapists face these decisions, it is surprising that the field has produced few, if any, empirically based guidelines for therapists to follow (Korner, 1988; Korner & Brown, 1990).

The purpose of this study was to shed more light on the criteria family therapists use when they decide whether or not include children in therapy sessions. Specifically, the study examined the following questions: (1) Are family therapists who feel uncomfortable with children more likely to exclude children from sessions than therapists who feel more comfortable with children. …

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