Adolescents at Risk: Home-Based Family Therapy and School-Based Intervention - Hardcover

Boyd-Franklin, Nancy; Bry, Brenna Hafer

Hardcover

ISBN 10: 1462536549 ISBN 13: 9781462536542

Publisher: Guilford Press, 2019

Synopsis

Rich with illustrative case material, this book guides mental health professionals to break the cycle of at-risk behavior by engaging adolescents and their families in home, school, and community contexts. The authors explore the multigenerational patterns that shape the lives of poor and ethnic minority adolescents and present innovative strategies for intervening beyond the walls of the agency or clinic. Grounded in research, the book shows how to implement both home-based family therapy and school-based achievement mentoring to provide a comprehensive web of support. Building on the earlier Reaching Out in Family Therapy, this book reflects the ongoing development of the authors' multisystems approach and many other important changes in the field; the majority of the content is completely new. It is an indispensable resource for beginning and experienced professionals or text for courses on adolescent intervention or adolescent mental health.

About this title

About the Author

Nancy Boyd-Franklin, PhD, is an African American clinical psychologist and family therapist and is a Distinguished Professor in the Graduate School of Applied and Professional Psychology at Rutgers, The State University of New Jersey. Her outstanding contributions have been recognized with awards from many professional organizations, including the American Family Therapy Academy, the Association of Black Psychologists, the American Psychological Association (Divisions 45 and 43), the Association of Black Social Workers, and the American Psychiatric Association, and she has received an honorary doctorate from the Phillips Graduate Institute. Dr. Boyd-Franklin is the author or coauthor of numerous articles and books, including Adolescents at Risk: Home-Based Family Therapy and School-Based Intervention; Black Families in Therapy, Second Edition: Understanding the African American Experience; and Therapy in the Real World: Effective Treatments for Challenging Problems.

Brenna Hafer Bry, PhD, is Professor Emerita in the Graduate School of Applied and Professional Psychology at Rutgers, The State University of New Jersey, where she served as Department Chair and Director of Clinical Training. Her research has focused on risk factors that predict adolescent conduct problems. She discovered that the probability of youths’ future problems increases as their number of risk factors increases, and that their probability of future problems can be reduced by reducing their number of risk factors. She subsequently developed and evaluated the Achievement Mentoring Program, a school-based intervention that reduces numbers of risk factors, which she is currently disseminating. Dr. Bry is a recipient of the Prevention Science Award from the Prevention Research Society.

Excerpt. © Reprinted by permission. All rights reserved.

Adolescents at Risk

Home-Based Family Therapy and School-Based Intervention

By Nancy Boyd-Franklin, Brenna Hafer Bry

The Guilford Press

Copyright © 2019 The Guilford Press
All rights reserved.

ISBN: 978-1-4625-3654-2

Contents

Chapter 1 Introduction and Overview of the Book, 1, 
PART I. AT-RISK ADOLESCENTS AND THEIR FAMILIES, 
Chapter 2 At-Risk Adolescents and Their Families: Behaviors, Risk, and Protective Factors, 15, 
Chapter 3 Cultural, Racial, and Socioeconomic Issues, 33, 
Chapter 4 Working with Kinship Care Families, 63, 
Chapter 5 Multigenerational Patterns in Families of At-Risk Adolescents, 87, 
PART II. THE MULTISYSTEMS MODEL AND HOME-BASED FAMILY THERAPY, 
Chapter 6 An Overview of the Multisystems Model and Home-Based Family Therapy, 121, 
Chapter 7 Multisystemic Therapy, 148, 
Chapter 8 Multisystems Model Case Example, 164, 
Chapter 9 Supervision and Training of Home-Based Family Therapists, 189, 
PART III. ACHIEVEMENT MENTORING: AN EVIDENCE-BASED, SCHOOL-BASED INTERVENTION, 
Chapter 10 School Engagement, Disengagement, Dropout, and a Learning Theory Approach with Patricia Simon, 207, 
Chapter 11 The Achievement Mentoring Program, 226, 
Chapter 12 Communication Skills for Achievement Mentoring, 253, 
Chapter 13 Achievement Mentoring: A Case Example, 267, 
Chapter 14 Achievement Mentoring Implementation in Schools with Mina Yadegar, 285, 
PART IV. RESEARCH, 
Chapter 15 Relevant Research for Home-Based Family Therapists and Achievement Mentors, 303, 
References, 341, 
Author Index, 361, 
Subject Index, 368, 

CHAPTER 1

Introduction and Overview of the Book

This book draws upon our collective experience of more than 40 years each of clinical work, supervision, and the development of programs that reach out to at-risk adolescents and their families in their homes, schools, and communities. Throughout our careers, we have witnessed many professionals such as therapists, counselors, clinical program directors, and school personnel (i.e., teachers, counselors, mentors, principals, and other administrators), who have been well trained to work with adolescents and families, become demoralized as they discover that their clients, students, and families often do not choose to participate in available programs. Many of these at-risk adolescents and their families are not self-referred and may not trust or believe in therapy or in school-based interventions. This response to participation in these programs is unfortunate because the trajectory for too many at-risk youth starts with school failure and all too often ends with involvement in the juvenile justice system. As a result, many of these adolescents are not well served by the very systems that are in place to help them. This book is dedicated to mental health and school-based professionals who are committed to reversing this process by reaching out to these adolescents and ensuring that they can overcome challenges, achieve their potential, and realize their life goals.

The number of at-risk youth in this country, particularly among ethnic minority groups and those from poor families, has continued to rise. These adolescents are at risk for school disengagement, academic failure, dropping out of school, behavior and conduct problems, school and community violence, involvement with delinquent peers, juvenile delinquency, gang involvement, drug and alcohol abuse, incarceration, family conflict, child abuse and neglect, removal from their families, teenage pregnancy, and other serious issues.

With these risks in mind, we have developed effective strategies for reaching out to engage these adolescents through their families and their schools. This new book builds on the ideas we first introduced in Reaching Out in Family Therapy: Home-based, School and Community Interventions (Boyd-Franklin & Bry, 2000). In order to address the needs of at-risk adolescents in different settings, this book presents the evolution of our reaching-out model in two different approaches: home-based family therapy and the implementation of the school-based Achievement Mentoring Program for at-risk students. The reaching-out approach is essential for programs serving a population that is often facing complex, multiple, and overwhelming life challenges, such as poverty, racism, discrimination, unsafe communities, violence, homelessness, and struggling schools. With these complex issues in mind, we have incorporated the Multisystems Model as a core principle in our work to empower these adolescents and their families, and to assist service providers in coordinating care and avoiding redundancy in interventions.

THE MULTISYSTEMS MODEL

The Multisystems Model is a problem-solving approach that helps adolescents and families with multiple problems to focus and prioritize their issues, and that allows clinicians to maximize the effectiveness of their interventions (Boyd-Franklin, 1989, 2003; Boyd-Franklin & Bry, 2000; Boyd-Franklin, Cleek, Wofsy, & Mundy, 2013). This model was introduced by Boyd-Franklin (1989) in her book, Black Families in Therapy: A Multisystems Approach, which was the first to combine a Multisystems Model with a multicultural approach to the treatment of African American families. It represents a combination of structural family therapy (Minuchin, 1974; Nichols, 2011), strategic (Haley, 1976), and behavioral/family systems (Robin & Foster, 2002) approaches.

Our Multisystems Model incorporates multiple systemic levels, including the individual, family, extended family, "nonblood kin" and other close friends, peers of the adolescents, church and community resources, and other outside systems (see Chapter 6). This outside systems level deserves particular emphasis here because therapists and school personnel often discover that many of the adolescents and families with whom they work are dealing with multiple complex problems and have a preexisting involvement with an array of agencies, systems, and institutions, including schools, medical or health care providers, mental health agencies, child welfare or protective services, welfare programs, housing authorities, courts, and the juvenile justice system. To further complicate matters, individual family members may have separate relationships with such agencies, institutions, and systems, many of which may be negative and most of which will have a considerable impact on the therapeutic relationship, the outcome of therapy, and the adolescent's performance in school. The Multisystems Model covers these various systems and also includes a final level that addresses societal forces that impact these youth and their families on a systemic level: poverty, racism, discrimination, immigration policies, homophobia, ageism, and sexism, among others.

A number of researchers and clinical scholars (Aponte, 1995; Boyd-Franklin, 1989, 2003; Boyd-Franklin & Bry, 2000; Boyd-Franklin et al., 2013; Bronfenbrenner, 1977; Henggeler et al., 2009) have developed different pragmatic approaches to understanding complex ecosystems and have encouraged therapists to intervene at multiple systemic levels. It is extremely helpful in work with poor families, including those who are White, who may simultaneously confront a staggering number of problems. In addition, because the Multisystems Model recognizes the impact of the dual sociopolitical stressors of poverty and racism or prejudice, it is particularly useful in work with African American, Latino, and other ethnic minority families and communities (Boyd-Franklin, 1989, 2003; Boyd-Franklin & Bry, 2000; McGoldrick & Hardy, 2008) (see Chapter 3).

In addition to our Multisystems Model, this book also discusses multisystemic therapy (MST) (Henggeler et al., 2009; Henggeler & Sheidow, 2012), an evidence-based, home-based family therapy that also incorporates multisystemic levels in its treatment approach (see Chapter 7).

REACHING OUT

The Multisystems Model is a useful theoretical framework for schools and clinical programs that recognize that at-risk adolescents and their families may need a different level of reaching out in order to engage them in their services. In schools, these at-risk youth who are disengaged from the school culture and who may be experiencing academic failure and behavior problems may require special efforts to engage them in their school work and reverse the trajectory that may be leading them toward dropping out of school. The Achievement Mentoring Program is a proven form of such special efforts to reach out (see Chapters 11–15). For clinicians who do home- or office-based clinical work, the Multisystems Model allows them to conceptualize the realities of their clients' lives in a more complete and complex way. By incorporating the process of reaching out (i.e., outside the office), this approach can allow the clinician to observe and intervene directly in the various systems that either support or hinder their clients' progress toward achieving therapeutic change (Boyd-Franklin, 1989, 2003; Boyd-Franklin & Bry, 2000; Boyd-Franklin et al., 2013; Henggeler et al., 2009).

In office-based family therapy, we frequently work with only an isolated subsystem of a complex family household and extended family network, not engaging with individuals who often have a great deal of power either to produce or to sabotage change (Boyd-Franklin, 1989, 2003; Boyd-Franklin & Bry, 2000; Haley, 1976; Minuchin, 1974; Nichols, 2011). By reaching out to the family's environment and significant others in home-based work, however, we have the opportunity to engage and form a therapeutic alliance with fathers, boyfriends, and other key extended family members, such as grandparents, who often do not come in for office-based sessions.

Reaching out also has a broader meaning that extends beyond the family and extended family. Too often a clinician or family therapist "joins" only with those present in treatment. This may be a serious error, particularly with poor African American and Latino clients and families. Our approach encourages therapists to actively intervene in the multiple settings that are significant in their clients' lives (Boyd-Franklin, 1989, 2003; Boyd-Franklin & Bry, 2000; Boyd-Franklin et al., 2013). This outreach may take place in a client's home; school; or, if it is convenient or useful to the intervention, at a local facility or institution, such as a church, community center, or another common meeting place.

Strategies for Clinicians in Office-Based Work

Many office-based clinicians may be motivated to make home- and community-outreach efforts, but feel constrained by workplace practices that often restrict treatment to agency premises and by insurance plans that do not cover home- or community-based services. For therapists in these situations, the benefit from even one well-timed home-based family session can increase the impact of ongoing office-based work. For example, a key family member resistant to attending an office session may be amenable to a home-based session, and such participation can facilitate his or her "buy-in" and support of the therapeutic process (Boyd-Franklin, 1989, 2003; Boyd-Franklin & Bry, 2000). Targeted reaching out can also be useful in crises or major therapeutic efforts that require the participation of a large number of family and extended family members.

Clinicians have often told us that paying a brief lunch-hour visit to a child's school avoided hours of wasted time engaged in "telephone tag." Although a large caseload may prevent such visits on a regular basis, one carefully planned meeting may allow a clinician to connect with a principal, teacher, or counselor who has the power to make major decisions in a youth's life (see Chapter 8).

KEY CONCEPTS

The key concepts described in this section represent the guiding themes and values in our work that are incorporated in chapters throughout this book:

• The multisystems or ecological approach to service delivery (Boyd-Franklin, 1989, 2003; Boyd-Franklin & Bry, 2000; Boyd-Franklin et al., 2013). The Multisystems Model allows us to view clients and families in their full ecological and systemic context, including the many different institutions, agencies, and systems that have an impact on them (see Chapter 6). In addition, see Chapter 7 for a description of multisystemic therapy (MST) (Henggeler et al., 2009).

• Cultural sensitivity and competence (Boyd-Franklin, 2003; Falicov, 2005, 2014; McGoldrick, Giordano, & Garcia-Preto, 2005). Each intervention must be tailored to and sensitive to the cultural realities of the family.

• Emphasis on strengths (Boyd-Franklin, 2003; Boyd-Franklin & Bry, 2000; Henggeler et al., 2009). The emphasis is on identifying the strengths in the adolescent, parent, caregiver, family, school, and community that can be utilized to produce change.

• Empowerment of families, particularly parents or caregivers (Berg, 1994; Boyd-Franklin, 2003; Boyd-Franklin & Bry, 2000; Henggeler et al., 2009). This approach emphasizes empowering families to take charge of their own lives. The clinician should not take over the job of the parents or caregivers.

• The importance of reaching out to schools and to at-risk adolescents in schools. The importance of contacting schools as a part of the Multisystems Model (Boyd-Franklin & Bry, 2000) is addressed from the perspective of family therapists and other clinicians (see Chapters 6 and 8). Part III of this book provides an in-depth discussion of the Achievement Mentoring Program, a school-based program that reaches out to adolescents who present with school disengagement and academic failure and who are at risk for dropping out (see Chapters 10 through 14).

• Proactive and active interventions (Boyd-Franklin & Bry, 2000; Bry, 1994). Rather than accepting the situation and waiting for change to occur, the role of the clinician or the achievement mentor in this model is active and proactive. The therapist reaches out to family members and initiates contact and changes within systems, such as schools, child protective services, the juvenile justice system, the police, and the courts; the achievement mentor reaches out to the adolescents in the school and to their teachers and parents.

• Value of support (Boyd-Franklin & Bry, 2000; Henggeler et al., 2009). Throughout this book, we emphasize the importance of support and support networks in the lives of adolescents, parents, and families.

• Community involvement (Boyd-Franklin & Bry, 2000; Swenson, Henggeler, Taylor, & Addison, 2005). As key community members and organizations can be helpful to the process of change, reaching out extends to the communities in which the families live. For example, a church might provide a location for a family support group, a school might provide an after-school tutoring program, and a community center in a low-income housing project might provide general equivalency diploma (GED) courses or job training.

• Prevention (Boyd-Franklin & Bry, 2000; Bry, 1994). One of the most useful applications of the Multisystems Model and the process of reaching out involves interventions with adolescents who are at risk for conduct disorder, dropping out of school, drug or alcohol abuse, school or community violence and/or gang involvement or other criminal activity. These negative outcomes can be prevented if targeted interventions begin at an early stage.

OVERVIEW OF THE BOOK

When we embarked on this project, our goal was to create a comprehensive resource that could serve as a guide for both beginning and experienced therapists in many different types of agencies and clinics, as well as for school personnel interested in implementing the Achievement Mentoring Program in their schools. With this objective in mind, we have divided this book into four parts: (I) an in-depth description of at-risk adolescents and their families; (II) discussions of the Multisystems Model and home-based family therapy; (III) an analysis of the risk factors for adolescents in the schools and an exploration of the Achievement Mentoring Program, including the process of mentoring and the competencies of mentors; and (IV) a research chapter documenting the evidence base for home-based family therapy interventions and Achievement Mentoring programs.

Part I: At-Risk Adolescents and Their Families

Chapter 2 discusses risk and protective factors at all multisystems levels including the individual, the family, peers, the school, and the community, and provides a comprehensive discussion of the types of issues presented by at-risk adolescents that may result in school dropout, such as school disengagement, academic failure, truancy, and behavioral and conduct problems in the school. (School-related risk factors are discussed in more detail in Part III, Chapter 10.) Also discussed are presenting problems related to conduct disorder and antisocial behaviors, including violence, involvement with delinquent peers, juvenile delinquency, drug and alcohol abuse, and gang involvement.

In Chapter 3, we discuss the importance of understanding the cultural, racial, and socioeconomic factors present in the lives of at-risk adolescents and their families. This chapter focuses primarily on the cultural strengths of African American and Latino families and on our interventions with poor and working poor families from many cultures, including White families. Case examples are included in order to illustrate culturally competent clinical work and school interventions.

(Continues...)

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Edition details

• Publisher: Guilford Press
• Publication date: 2019
• Language: English
• ISBN 10: 1462536549
• ISBN 13: 9781462536542
• Binding: Hardcover
• Edition number: 1
• Number of pages: 380