Keeping Families Engaged: The Effects of Home-Based Family Therapy Enhanced with Experiential Activities

By Thompson, Sanna J.; Bender, Kimberly et al. | Social Work Research, June 2009 | Go to article overview

Keeping Families Engaged: The Effects of Home-Based Family Therapy Enhanced with Experiential Activities


Thompson, Sanna J., Bender, Kimberly, Windsor, Liliane C., Flynn, Patrick M., Social Work Research


Engagement and retention of high-risk adolescents and their families is a serious challenge for providers in community social service agencies. Research on rates of engagement has shown that 40% to 60% of families who begin services terminate prematurely (Coatsworth, Santisteban, McBride, & Szapocznik, 2001), and only 22% of families seeking treatment for a youth behavior problem actually complete initial assessments (Szapocznik et al., 1988). Because clients who inconsistently participate in the therapeutic process and prematurely terminate treatment are less likely to successfully attain treatment goals (Dakof, Tejeda, & Liddle, 2001), providers need therapeutic tools to improve engagement and retention strategies.

Despite the need to understand the critical components of successful treatment outcomes, little is known about the mechanisms involved in the process of treatment engagement and retention (Kazdin & Nock, 2003). In an effort to address this gap, this study reports on a test of an innovative method to improve engagement and retention in family therapy sessions in comparison with family therapy treatment as usual. Experiential activities were incorporated in family therapy sessions delivered in a family's home environment. These activities were developed as creative techniques designed to increase youths' and families' participation in treatment sessions, improve their capacity for relationship building, and increase the likelihood of treatment completion.

ENGAGEMENT AND RETENTION

Engagement is a complex and crucial component of effective treatment that increases retention in services--a requirement for successful outcomes and behavior change (Simpson, Joe, Rowan-Szal, & Greener, 1995). Engagement is typically defined across general dimensions of therapeutic involvement and participation during treatment. Clients who are engaged in the treatment process are more likely to bond with therapists and endorse treatment goals, and they participate to a greater degree during treatment (Broome, Joe, & Simpson, 2001). Providers who actively work to increase client engagement are likely to build stronger alliances with their clients and elicit greater client investment in the treatment process (Dearing, Barrick, Dermen, & Walitzer, 2005).

Retention refers to the duration of treatment and represents a global indicator of the dose of treatment (Joe, Simpson, & Broome, 1998).With clients who initiate treatment, retention has been shown to be a challenging clinical task (Coatsworth et al., 2001), but it has also been shown to be the single best predictor of positive outcomes (Joe et al., 1998). Clients who leave services prematurely are less likely to show the clinical gains found among service completers (Stanton & Shadish, 1997), and 40% to 60% of adolescents who begin treatment terminate prematurely (Kazdin & Wassell, 1999). Thus, retention is an important area of clinical focus.

IN-HOME FAMILY THERAPY

Considerable empirical support confirms the effectiveness of including family members in therapy with adolescents (Liddle et al., 2001; Stanton & Shadish, 1997). In addition, delivery of family therapy in the homes of clients has also been shown to significantly increase attendance and participation of adolescents and their families in therapeutic sessions in comparison with office-based therapy (Slesnick & Prestopnick, 2004). Home-based family therapy has been found to be more effective than peer groups (Liddle et al., 2001), parent education (joanning, Quinn, & Mullen, 1992), multifamily interventions (Liddle, 1995), and individual counseling (Henggeler et al., 1991).

Researchers and practitioners have noted that barriers to families seeking and engaging in traditional office-based family therapy include the lack of reliable transportation, inconsistent or late work schedules, limited financial resources, and child care difficulties (Kazdin & Wassell, 1999). …

The rest of this article is only available to active members of Questia

Sign up now for a free, 1-day trial and receive full access to:

  • Questia's entire collection
  • Automatic bibliography creation
  • More helpful research tools like notes, citations, and highlights
  • A full archive of books and articles related to this one
  • Ad-free environment

Already a member? Log in now.

Notes for this article

Add a new note
If you are trying to select text to create highlights or citations, remember that you must now click or tap on the first word, and then click or tap on the last word.
One moment ...
Default project is now your active project.
Project items

Items saved from this article

This article has been saved
Highlights (0)
Some of your highlights are legacy items.

Highlights saved before July 30, 2012 will not be displayed on their respective source pages.

You can easily re-create the highlights by opening the book page or article, selecting the text, and clicking “Highlight.”

Citations (0)
Some of your citations are legacy items.

Any citation created before July 30, 2012 will labeled as a “Cited page.” New citations will be saved as cited passages, pages or articles.

We also added the ability to view new citations from your projects or the book or article where you created them.

Notes (0)
Bookmarks (0)

You have no saved items from this article

Project items include:
  • Saved book/article
  • Highlights
  • Quotes/citations
  • Notes
  • Bookmarks
Notes
Cite this article

Cited article

Style
Citations are available only to our active members.
Sign up now to cite pages or passages in MLA, APA and Chicago citation styles.

(Einhorn, 1992, p. 25)

(Einhorn 25)

1

1. Lois J. Einhorn, Abraham Lincoln, the Orator: Penetrating the Lincoln Legend (Westport, CT: Greenwood Press, 1992), 25, http://www.questia.com/read/27419298.

Cited article

Keeping Families Engaged: The Effects of Home-Based Family Therapy Enhanced with Experiential Activities
Settings

Settings

Typeface
Text size Smaller Larger Reset View mode
Search within

Search within this article

Look up

Look up a word

  • Dictionary
  • Thesaurus
Please submit a word or phrase above.
Print this page

Print this page

Why can't I print more than one page at a time?

Help
Full screen

matching results for page

    Questia reader help

    How to highlight and cite specific passages

    1. Click or tap the first word you want to select.
    2. Click or tap the last word you want to select, and you’ll see everything in between get selected.
    3. You’ll then get a menu of options like creating a highlight or a citation from that passage of text.

    OK, got it!

    Cited passage

    Style
    Citations are available only to our active members.
    Sign up now to cite pages or passages in MLA, APA and Chicago citation styles.

    "Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences." (Einhorn, 1992, p. 25).

    "Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences." (Einhorn 25)

    "Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences."1

    1. Lois J. Einhorn, Abraham Lincoln, the Orator: Penetrating the Lincoln Legend (Westport, CT: Greenwood Press, 1992), 25, http://www.questia.com/read/27419298.

    Cited passage

    Thanks for trying Questia!

    Please continue trying out our research tools, but please note, full functionality is available only to our active members.

    Your work will be lost once you leave this Web page.

    For full access in an ad-free environment, sign up now for a FREE, 1-day trial.

    Already a member? Log in now.