Youth Interventions: Theory, Research, and Practice – Article overview (UNIVERSITY OF AMSTERDAM)
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Van der Pol et al. (2019). Common elements of evidence-based systemic treatments for adolescents with disruptive behaviour problems.” – Article summary
Identifying common elements between treatments could render them more effective. Many treatments have common elements yet a unique focus. This could help personalize the treatments. Knowing common elements of treatments allows therapists to implement these techniques in treatment more easily. Knowledge of treatment mechanisms and identification of potent treatment techniques can support enhanced precision in matching systemic treatments to the needs of adolescents and their families.
There are several common elements across individual systemic treatment protocols:
- Engagement
This refers to motivating and involving all the key agents to start the process of change. This includes matching (1), facilitating (2) and availability (3). - Alliance
This refers to creating an atmosphere of positive bonds between the therapist, client and family members. This allows for consensual goal setting and establishing a foundation for positive change. - Interactional focus
This refers to viewing family-parent interactions as stable patterns that need to change and the family members are viewed as a resource for change. - Developmental process
This refers to individualizing the interventions and fostering developmental process. The therapeutic process is considered as phasic and continuity is stressed. - Relational assessments/evaluations
This refers to assessing and evaluating the situation to be able to act swiftly and to choose the most effective interventions and techniques. - Here-and-now focus
This refers to an emphasis on the here-and-now in the communication of and with the family. It is also used for resolving problems and crises.
The treatments typically had one to three sessions a week and lasted between three and 12 months. Conflict management and communication skills were techniques that are used in all systemic treatments. There are several common techniques in most systemic treatments:
- Conflict management
This refers to identifying and handling conflict in a sensible, fair and efficient manner. - Communication skills
This refers to improving the way family members communicate. - Reinforcement
This refers to making use of reinforcement. - Assigning and reviewing homework
This refers to assigning and reviewing tasks to be completed between sessions. - Problem-solving
This refers to generating alternative solutions, evaluating options, considering the consequences of each option and providing self-rewards. - Psychoeducation
This refers to teaching through didactic instruction or explanation. - Anticipating and training for setbacks
This refers to predicting future setbacks and relapse prevention. - Divert and interrupt
This refers to interrupting a negative of blaming interaction between family members by diverting the negative speech-act to a more positive one. - Reframing
This refers to changing the conceptual setting or viewpoint in relation to which the situation is experienced (i.e. change the meaning of the situation). - Reviewing goals and progress
This refers to reviewing previous work and themes and progress toward meeting established goals. - Special time
This refers to creating special quality time with the adolescents. - Limit-setting
This refers to setting limits (e.g. time-out). - Enactment
This refers to the therapist directing family members to talk or interact together about feelings and emotions to observe and modify problematic transactions. - Working with boundaries
This refers to shift the alliances in a family. - Monitoring
This refers to improving parental awareness of the adolescent’s activities and communication to the adolescent about concerns. - Reconnecting
This refers to reconnecting positive feelings and emotions by talking about how the relationship was in the past. This is done in difficult and negative situations.
All techniques were applicable for the family, parents and adolescent with some exceptions. The divert and interrupt (1), limit-setting (2), enactment (3), monitoring (4) and enactment (5) were not applicable to adolescents. Limit-setting was not applicable to the family.
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Youth Interventions: Theory, Research, and Practice – Article overview (UNIVERSITY OF AMSTERDAM)
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