Disadvantaged, Multi-Stressed Families Adrift in a Sea of Professional Helpers

  • Valentín Escudero
  • Myrna L. Friedlander
Part of the Focused Issues in Family Therapy book series (FIFT)


Multi-stressed families (those who are experiencing moderate to severe difficulties in social, personal, and financial areas) tend to find it difficult to engage in the therapeutic process, despite a pressing need for help. These families often come to therapy at the insistence of social services (especially child protective services) or family court. These institutions often offer economic help under the condition that the family participates in conjoint treatment. In this chapter we discuss ways to reduce resistance and facilitate engagement through “joining with” and by demonstrating concern, interest, and empathy, including at times visiting the family’s home in order to forge alliances and strengthen motivation. Reframing is essential when the family and therapist have opposing views on the presenting problems, on how the problems should be approached, on the nature of the therapeutic relationship, and on the family’s relation to the agency in which the therapist is working. Next, we describe alliance empowerment strategies geared toward repairing the family’s lack of safety and integrating common ingredients of different collaborative, strength-focused therapy approaches. Specific alliance-fostering strategies include creating an “affected community,” clarifying who is the “real client,” serving as bridge to specialized treatments, and conveying optimism. An extended case example describes varying the format to hold some sessions with the whole family and some with the parents and siblings separately. The case involved a low-income, Haitian immigrant family that was mandated to treatment by social services after a series of serious signs of neglect in two of the family’s four children.


Multi-stressed family Multiproblem family Acculturation Affected community Professional network Collaborative therapy Strength-focused interventions Involuntary clients Mandated clients Home-based therapy 


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Copyright information

© Springer International Publishing AG 2017

Authors and Affiliations

  • Valentín Escudero
    • 1
  • Myrna L. Friedlander
    • 2
  1. 1.University of A CoruñaA CoruñaSpain
  2. 2.University at Albany/SUNYAlbanyUSA

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