Play therapy is a non-directive and child centred therapeutic intervention that assists children of all ages to process any difficulties they may be experiencing. Read More>
Cognitive therapy is directive goal-oriented therapy suitable for children, adolescents, and adults whose negative thought patterns may be having a negative impact on their lives Read More>
Family therapy is a systematic therapy for the family as a whole and for each individual family member, to assist with the functionality of the family unit. Read More>
“Play permits the child to resolve in symbolic form unsolved problems of the past and to cope directly or symbolically with present concerns. It is also his most significant tool for preparing himself for the future and its tasks.”
— Bruno Bettelheim, Child Psychologist
At SUGRU, an individualized session plan will be designed for your child by Arlene, a qualified Therapeutic Play Practitioner, on a needs basis. Child-centred therapy helps the child process his/her emotions by communicating through play, which is the language and occupation of children. During this process, children are not directed but are encouraged to engage in their own process at their own pace. A wide range of tools are available to allow children represent their world and pursue their personal interests in a private secure environment. At SUGRU, therapeutic play always includes the facilitation of a child’s play in order to accept and empathise with his/her inner world and experiences, with Arlene focusing both on verbal and non-verbal interaction, utilizing the tools of the playroom and being aware of how she physically places herself in relation to the child in the room. Arlene develops a warm and friendly relationship with the child by working with the child in a non-judgemental capacity and accepting the child as s/he presents him/herself. The child’s inner world is more easily revealed through a range of expressive methods of communication, which are best supported by Arlene engaging with the child in the play space. The child has the freedom to express whatever it is that s/he wishes to express through whatever medium they choose. The session is entirely non-directive with the child leading and therapist following and non-interpretive with the child being supported with active listening skills. This establishment of permissiveness maintains a deep respect for the child’s ability to problem-solve and make his/her own choices. Boundaries are established by the therapist to not permit the child to behave in a way that may be dangerous to him/herself or to others. Therapeutic play sessions are confidential in nature, with the exception of child protection concerns that may arise as Arlene’s practices are fully compliant with the Criminal Justice (Withholding of Information on Offences against Children and Vulnerable Persons) Act 2012 and with the Children First Bill 2014.
Who is it for?
SUGRU’s Therapeutic Play is a beneficial process for all children who may be experiencing any type of social, emotional, cognitive, physical, psychological or educational difficulty. Therapeutic play is recommended for an array of difficulties including social/academic underachievement; elective mutism; bereavement issues; disturbed sleep; aggression; addiction disorders; problem attachment styles; any type of abuse; difficulties adjusting to separation or divorce; and inappropriate emotional responses, to name but a few.
What to expect?
At the Sugru centre, the therapeutic practitioner employs a selection of evidence-based techniques from her toolkit to work with children, including meditation, creative visualization, therapeutic stories, music and movement, sand play, drawing and painting, clay/play-dough, puppetry, role play, dressing up, and a wide variety of games. For further information and evidence for these tools, for further information and evidence for these tools please see the relevant sections below.
When is it on?
Therapeutic Play sessions take place in the SUGRU centre and sessions will continue for as long as recommended by the therapist as decided in consultation with the child and the parent. Sessions typically last for one hour. Although younger children may not be in therapy for one full hour, please allow that amount of time in order for the child to settle in and for a wind-down time afterwards. Please contact us with any questions or to arrange a consultation for your child.
“Perhaps it is easier to understand that even though we do not have the wisdom to enumerate the reasons for the behaviour of another person, we can grant that every individual have his private world of meaning, conceived out of the integrity and dignity of his personality.”
— Virginia Mae Axline, Psychologist and Author.
The foundations of Play Therapy, also known as Therapeutic Play, were laid by Carl Rogers, an extremely influential and widely recognised American psychologist, and one of the forbearers of the humanistic approach, later coined the child-/person-centred approach. His lifetime contribution to psychological research earned him an Award for Distinguished Scientific Contributions by the American Psychological Association (APA) in 1956. Therapeutic Play applies person-centred principles to counselling with children and it is now one of the most widely used approaches among play therapists that adhere to a primary theoretical approach (Lambert et al., 2007). Virginia Axline (1947) pioneered this method of counselling children and coined the approach “non-directive” play therapy, now commonly referred to as CCPT (or “Child-Centred Play Therapy”). The basic principles of Therapeutic Play, as outlined by Axline, recommend that the therapist:
- Develop a welcoming and companionable relationship with the child.
- Accept the child as s/he is.
- Encourages a sense of permissiveness within the relationship such that the child feels free to express his/her feelings fully.
- Is alert to identify the emotions the child is revealing and reflects these same emotions back so that the child gains awareness of his/her own behaviour.
- Remains respectful of the child’s capacity to solve his/her problems and allows the child the opportunity to do so. The duty to make choices and to instigate change is the child’s.
- Does not attempt to direct the child’s actions or talk in any way. The child leads, the therapist follows.
- Does not rush the therapy, which is regarded as a gradual.
- Only establishes any limitations to attach the therapeutic process to the “real world” and to make the child aware of his/her responsibility in the relationship.
Play Therapy Ireland (2008)
The strength of Play Therapy is linked directly to its dedicated belief in every child’s innate inclination to grow and mature along with its corresponding belief in children’s ability to heal in a self-directed manner (Axline, 1947; Landreth, 2012). These philosophical foundations provide children in Therapeutic Play the freedom to direct their own play and fully express their inner world within the limits of a safe and predictable therapeutic relationship characterized by empathy, genuineness, and unconditional positive regard (Axline, 1947; Guerney, 1983; Landreth, 2012).
A wide body of research spanning over seven decades supports the effectiveness of Therapeutic Play as a developmentally responsive intervention for children exhibiting a range of mental health concerns (Bratton, Ray, Rhine, & Jones, 2005; Ray & Bratton, 2010). In addition to this, a wide range of evidence supports each individual tool used in Therapeutic Play as outlined below.
Music and Movement
Oftentimes, children do not have the language or the cognitive capacity to make sense of and convey their experiences, so they spontaneously enhance these abilities with other more symbolic forms of expression and communication (Nizamie & Tikka, 2014). As a result, childcare professionals need to aid verbal methods of therapy with more symbolic forms of engagement, especially while working with younger children. Research on different neuronal responses to pleasant and unpleasant music has found that both pleasant and unpleasant types of music have been shown to have an effect on emotional regulation (ventral striatum and amygdala) (Koelsch, Fritz, Cramon, Müller & Friederici, 2006). The relationship between the perceived happiness/sadness of a song is interesting as sadness can actually be a source of pleasure, which is recognized and explored in Therapeutic Play, and most other forms of creative art do not make this association (Peretz, 2001). The effects music has on brain activity have been well documented in the literature, especially via electroencephalography (EEG) (Trainor, 2012). Laban (1879-1958) was a movement theorist who developed a technique of observing, analyzing, and notating all forms of movement (Preston-Dunlop, 1998). Much neurophysiological research on the relationships between sensorimotor, affective and cognitive aspects of movement supports Laban’s work (Bartenieff, 1974). The four major components of Laban Movement Analysis (LMA) are the body and its internal pathways of coordination; the shape that the body and its parts form during motion; the space in which the movement occurs; and the dynamics of movement (Hamburg & Clair, 2003). From here it was discovered that a person’s individual pattern of movement is a reliable blueprint of their personal, practical, and social abilities (Hodgson, 2001). The application of Laban’s theories in therapy has been remarkable and hugely significant. Therapeutic use of dance and movement has been consistently shown to result in the integration of one’s self with one’s body, in self-confidence, in better awareness of boundaries, and in greater emotional security (Capello, 2007). Engaging in free movement, as in therapeutic play, allows the child to experience bodily-centred movements, as in meditation, which can result in stress reduction and increased interactive communication (Edwards, 2008). Movement in therapy can be of particular benefit to children with emotional regulation difficulties, with a diagnosis of Dyspraxia, and a diagnosis of ADHD. Deep breathing, movement, and singing can regulate the autonomic nervous system via the vagus nerve and which results in reduced aggression, greater confidence and greater ability to manage difficulty feelings which in turn results in greater concentration and greater social skills (Nehrig, 2014). By having their exhibited sensory expressions validated and mirrored in the safe therapeutic space allows for the release of anxious feelings which slowly builds coping skills thus allowing for the emergence of more appropriate styles of managing feelings (Meekums, 2002).
Storytelling is a developmentally sensitive tool that can be used to elicit children’s thoughts, identify their distortions, and help them to more accurately make sense of their world (Carlson and Arthur, 1999). The use of stories in therapeutic play is a productive means for communicating with children; it provides a medium through which a real message can be presented to children in a manner accessible to them. Story telling in the context of therapeutic play provides an opportunity for the therapist and the child to form an interactive bond as story teller and listener, thus assisting with the forming of a relationship between the therapist and the child, which is one of the fundamental principles of play therapy as outlined by Axline (1947). The presentation of a therapeutic story is also an opportunity for the child to form a relationship with the characters of the story or to identify with a character in the story. Therapeutic story telling needs to assume a responsibility and accountability to the child and it must communicate the therapist’s responsibility to help a child achieve what they want or need. An effective therapeutic story will have the child’s therapeutic outcome in mind in its formation and delivery (Burns, 2005).
Sand Play Therapy
Dale and Wagner (2003) defined sand play as a psychotherapeutic technique that enables clients to arrange miniature figures in a sand tray to create a sand world corresponding to various dimensions of his/her social reality. The technique originated from British paediatrician and child psychiatrist Margaret Lowenfeld (1939; 1979) who utilised the medium of sand and water combined with small toys in a method of play known as the world technique. This technique was further developed and refined by Dora Kalff (1980) to form the method of sandplay therapy used to date. The process of sandplay therapy involves the use of a sandtray with an array of small objects or figures from categories consistency of people, animals, vehicles, buildings, vegetation, natural objects and symbolic objects (Allan & Berry, 1987) Applying the Axline principles to a sand tray are what define the difference between playing with sand and therapeutic sand play. The process of a therapeutic sand tray provides the child with an opportunity to work through an array of difficulties that a child may be experiencing. Children do this by creating their world in the sand tray and safely being able to express their emotions about situations. The purpose and benefit of working in accordance with the Axline principles gives the child the space, the permissiveness, and the alert support to be who they need to be in the world they create in the sand. The sand provides a stage for the child to communicate visibly his/her life situation and to change the scene as their thoughts and feelings about the situation develop over the weeks of therapy. Research has shown that a school sand play programme had positive effects on the emotional symptoms of anxiety and depression among preschoolers. Furthermore, their teachers relayed reports of sand play being related to prevention in the increase in emotional and behavioural symptoms that had previously been reported.
Research shows that the practice of meditation reduces stress, promotes relaxation and well-being while developing the skills of concentration and self-control, while enhancing emotional intelligence and self-esteem (Erricker & Erricker, 2001). Teachers report that it helps create a happier, healthier and more focused learning environment (Fisher, 2005). The most practical reason to engage in meditation is that it contributes to human well-being (Fisher, 2006). For many children childhood is not a carefree time. Often children are subject to the same stresses and strains as adults, in addition to this they absorb others frustrations and angers and can experience negative emotions more intensely than adults. Children can also find it difficult to articulate their problems and so they manifest themselves into difficult and impulsive behaviours. Much research has highlighted the positive practical effects of meditation (Murphy & Donovan, 1999). Since 1970, the Transcendental Meditation Program (TM) has undertaken circa 500 studies at universities and research institutions in more than 20 countries, and the positive results are published in over 100 scientific journals (see http://www.tm.org). The main findings show that meditation can improve mental abilities (including increases in intelligence, creativity, learning ability, memory and academic achievement), health (including reductions in stress, anxiety, incidences of ill-health, improved cardiovascular health and increased longevity), and social behaviour (including improved self-confidence and relationships with others) (Fisher, 2006). Furthermore, meditation can help expand aspects of metacognitive awareness. This refers to what I know and think about myself in the private theatre of my thoughts (Fisher, 2006). Meditative experience provides useful groundwork for discussing with children body/mind concepts such as consciousness, thinking and imagination. Guided relaxation has been found to be an ideal preparation for philosophical discussion (Haynes, 2002). The most common and basic object of ‘mindful’ meditation is to focus on the naturally calming physical process of breathing. In the ’mindfulness of breathing’, one stills the mind through attending to the sensations of breathing. If you focus your attention on an object in stillness and silence, your mind gradually becomes calmer and more receptive. This is known as receptive meditation, meaning having a point of focus, such as a picture, object, sound, word or image, and being receptive to whatever experience is arising. The aim of this practice is to become more open and receptive, to achieve a heightened consciousness of experience.Generative meditation is where the attention is consciously focused and guided. A guided visualisation is an example of a ‘generative’ practice, where the mind is invited on an imaginative journey and guided towards a personal creative response. A particular meditation practice usually includes elements of all these approaches but with the emphasis on one particular aspect.
Drawing and painting
Different types of art mediums, such as drawing and painting, are increasingly being used to help with an array of problem areas such as emotional and behavioural problems and risk of school exclusion, as well as aiding children during times of trauma, bereavement or crisis (Karkou & Glasman, 2004). The therapeutic benefit of such an approach is often attached to the fact that it needs no verbal communication, and can deal with issues that are often too stressful for children to vocalize. This allows artistic therapeutic play to help the child in a holistic and creative manner, which is being led by the child at all times, such that the pace and content are comfortable for them. As with all types of therapeutic play, work with art supplies is completely non-directive and aims to enhance the overall wellbeing of the child.
Drama, puppetry, role play and dressing up
Butler, Guterman & Rudes (2009) suggest that puppets are an effective tool for externalizing problems children may be dealing with for a number of reasons. These include using puppets to objectify and distance themselves from their problems, such that they can work through them more effectively. The application begins to create distance between the problem and the child, which is a first step in the process of externalizing the problem (White & Epston, 1990). The benefit of drama, role play and dressing up in the therapeutic context involves the child creating their own stories with the help of a non-directive therapist, which reinforces a deeper comprehension on their story as well the ability to communicate expressively (Butler, Bakker & Viljoen, 2013). Cecchin (1992) details that the therapeutic story in the drama is a process of co-construction for the child, where the therapist allows an environment of many possibilities and endings.
“You mainly feel the way you think.”
— Albert Ellis (The second most influential psychologist of all time, as voted by the American Psychological Association)
Cognitive Behaviour Therapy @ Sugru
Arlene utilizes the principles of CBT, a form of psychological therapy, for an array of emotion, behavioural and cognitive difficulties and disorders. The tenets of CBT are applicable to many forms of therapy and there is a vast range of evidence for the benefits of this approach, details of which can be found at Cognitive Therapies Rationale, details of which can be found below. Within a cognitive behaviour therapy session, the private events within the mind (thoughts, perceptions, attitudes, inner talk, and underlying assumptions) of an individual are attended to and these are used to understand the behavioural problems the individual may be exhibiting in the family environment. This enables the therapist at Sugru to conduct cognitive restructuring, which involves modifying the pattern of thought which is causing the behavioural or emotional problems. Both client and practitioner are encouraged to be present, focused, and active during sessions to facilitate a joint identification of negative patterns of behaviour. This allows for the cultivation of more healthy ways of thinking which, in turn, will lead to more functional and beneficial behaviours.
Mindfulness Based Cognitive Therapy @ Sugru
The human mind is genetically programmed with a negative bias that leads our minds to attend more acutely to negative experiences than to positive experiences; the reason for the natural development of this bias finds its source in the evolution of our brains at a time where physical survival required human’s to be continuously alert to the threat of predators. However, in modern society the greatest predator can be our own minds. Often people are living their lives in ‘thinking traps’ which involves being overly pre-occupied with thinking about the future (what ifs), the past (if only), or introspection and the analysing emotions in a negative way. The more one focuses on these negatives in their private mind the more it results in real positive experiences being perceived as negative as they are tainted by the negativity of the private mind. At Sugru Arlene incorporates Mindfulness Based Cognitive Therapy into her work with children to enhance their innate ability to be mindful and to be happy. In her work with adolescents Mindfulness Based Cognitive Therapy can help teenagers spend less time in a state of fixed thinking and more time in active thinking and flowing thinking. An important part of this work with adolescents is assisting them to monitor their media diet and instead spent more time living in the moment and using all of their senses to do so – visual, auditory, kinaesthetic, gustatory, olfactory. Sugru flies the flag for happy families, and a happy family is a mindful family. Arlene coaches parents to be present in their own reality and to be able to derive happiness from their family lives. Arlene instils this practice by helping parents build an understanding of what is going on in their own minds and in the minds of their children and guides them through specific steps to be able to take control of their thoughts to be able to embrace their family life.
“A person who is depressed may have the belief, ‘I am worthless,’ and a person with panic disorder may have the belief, ‘I am in danger.’ While the person in distress likely believes these to be ultimate truths, with a therapist’s help, the individual is encouraged to challenge these irrational beliefs.”
— National Alliance on Mental Illness (NAMI)
Cognitive Behavioural Therapy
Cognitive Behavioural Therapy (CBT) was primarily developed through an integration of behavior therapy (often referred to as “behavior modification”) with cognitive psychology research, from which the label of cognitive behavior modification emerged. This tradition thereafter merged with the earlier approaches of Cognitive Therapy (Beck, 1963) and Rational Emotive Therapy (Ellis & Dryden, 1997). These two traditions, while rooted in rather different theories, have been characterised by a constant reference to experimental research, conducted at both a clinical and a basic level. Common features of CBT include a focus on the “here and now”, a more therapist-guided approach, a structuring of the therapy session, and an alleviation of clients’ symptoms and vulnerability (Rachman, 1997). This problem-focused psychotherapeutic approach is employed to deal mainly with problematic emotional, behavioral and cognitive processes utilizing a goal-/action-oriented systematic method. As the name suggests, a blend of principles are used, informed by both behavioural and cognitive theory and research. CBT is used with clients who may be experiencing any difficulty and a range of evidence-based strategies are chosen by the therapist to alleviate difficulties and improve the wellbeing of clients (Schacter, Gilbert, & Wegner, 2010). CBT is an effective approach for everyday difficulties and can contribute to the elimination of a number of negative emotional, cognitive and behavioural processes including problematic attachments, disabling fears and stressors, and anger issues. This type of therapy is considered extremely effective for the treatment of a variety of conditions, including Depression, Anxiety Disorders, Panic Attacks, Eating Disorders, Insomnia, Substance Abuse, and Phobias. Many CBT treatment programs for specific disorders have been evaluated for efficacy and CBT has been recommended over other psychological approaches (Lambert, Bergin, & Garfield, 2004).
Mindfulness Based Cognitive Therapy
Jon Kabat-Zinn, the founder of Mindfulnessbased Stress Reduction (MBSR) and Mindfulness Based Cognitive Therapy (MBCT), defines mindfulness as “paying attention in a particular way; on purpose, in the present moment, and non-judgementally.” It is not surprising to learn that the pressures of modern living are taking their toll on people all over the world. When not dealt with appropriately, stressful situations can result in negative psychological (anxiety, depression, low self-esteem) and physical (problematic digestion, elevated cardiovascular markers, migraines) consequences. One hundred years ago, the biggest cause of death worldwide was infectious disease; however, today it is poor lifestyle choices, with 75% of all ill-health thought to be directly related to stress. The practice of mindfulness is one which promotes paying direct attention to the present moment, utilizing techniques such as attentive breathing, relaxation meditation and yoga. The tenet of philosophy behind being mindful is that it allows us an opportunity to become aware of our thoughts such that we feel empowered to cope with what is going on, rather than feeling overwhelmed. Attending to the present state of our body and mind affords us an opportunity to scrutinize our emotions more thoroughly, enhance our ability to attend to and concentrate on events, and improve communication and clarity within relationships in our lives. Being mindful generally means to pay attention to our thought and emotions, but it also involves attending to auditory, gustatory, tactile and visual stimulation (Napoli, Krech, and Holley, 2005). Mindfulness Based Cognitive Therapy is generally considered to be a “wellness intervention”, which focuses specifically on an array of social, emotional, physical, spiritual and cognitive outcomes (Willard, 2010). Research has shown that mindfulness improves anxiety by 58%, depression by 57%, and stress levels by 40% (Krusche, Cyhlarova, & Williams, 2013). Mindfulness and meditation-based treatments have been successful for the treatment of many physical conditions: specifically, chronic lower back pain (Morone, Greco, & Weiner, 2008), fibromyalgia (Grossman, Tiefenthaler-Gilmer, Raysz, & Kesper, 2007), rheumatoid arthritis (Pradhan, Baumgarten, Langenberg, et al., 2007), psoriasis (Kabat-Zinn, Wheeler, Light, et al., 1998), and Type II diabetes mellitus (Rozenzweig , Reibel, Greeson, et al., 2007). In conclusion, evidence-based psychological research has shown how beneficial mindfulness skills are in the life of a child, as this simple practice is vital for the encouragement of the promotion of positive psychological well-being and the prevention of unhealthy behaviours (e.g. Schonert-Reichel and Lawlor, 2010). Education settings such as schools are largely regarded as the primary location within which health-promotion interventions should occur, as they are accessible and familiar to all school-going aged children (Albrecht, 2014).
Family Therapy @ Sugru
In the simplest of terms, the aim of a family intervention is the deliberate modification of a person or family’s behaviour, feelings, or thoughts. Family interventions are characterized by a group of individuals that typically attend this type of event, including the intervention professional and members of the family unit. The overall goal of any type of intervention is to confront the problem behaviour in a way that is non-threatening and enables any individual to view how their behaviour is hurtful, both to themselves and to the other family members. Family interventions strive to help the family member/s accept the fact that they do exhibit problem behaviour, for which they need to seek help sooner rather than later. The route of treatment that Arlene will employ will vary from one family to the next. An individually-tailored support plan will be designed based on an initial assessment with the family, and will typically consist of a combination of cognitive therapy and play therapy, depending on the needs of the family member. Typically, there are three stages involved in a successful family intervention.
The Assessment Stage – this is where Arlene will sit down with the family in a warm, relaxed and supportive environment at the SUGRU centre and discuss issues that each member may be dealing with. There are a number of questions that need to be answered such as:
- Who is attending the intervention and how do they fit in with the rest of the family unit?
- What type of difficulties do the family unit feel they have to deal with?
- What type of difficulties does each member feel as though they are dealing with?
- Which type of therapy will facilitate the family’s needs most suitably?
Arlene will then meet with each family member separately and discuss more private concerns or issues that may be pertinent to the situation. These may involve personal struggles; problems that may cause embarrassment, shame or conflict if shared with the whole family unit present; or negative feelings pertaining to another member of the family.
The Orchestration Stage – this involves the specifically-designed intervention wherein each family member becomes involved in identifying and treating problem thoughts, feeling and/or behaviours. During the process, each member will engage in a therapeutic plan designed for their own individual needs and also in therapy designed to promote communication and encouragement between family members in a shared environment, conducive to open personal expression and active listening.
Successful Completion of the Intervention – the real measure of success with any family intervention strategy is how effective the process was at getting the family unit and the family members to look at how their problems are manifested and what tools can be used to diffuse tensions, communicate openly and honestly, and be accepted unconditionally.
Who is Family Therapy @ Sugru for?
SUGRU’s Family Interventions are for any family who may be dealing with any type of issue.
What to expect?
During SUGRU’s Family Interventions, families will experience an environment that will help develop positive interactions and foster effective communication techniques. Families will initially engage in a consultation with Arlene as a unit, and then individually to create a more robust assessment of how all members are feeling. The intervention itself will consist of one-to-one therapy with each member, as well as group sessions, where all members are involved in a tailored approach designed to meet the needs of the family unit. A variety of therapeutic play activities are also available to use for any member, which may be beneficial for younger children.
When is it on?
Family Interventions take place at the SUGRU Centre. Sessions differ in their length but normally last about one hour. After an initial consultation, Arlene will clearly explain what each type of recommended therapy will consist of, how long it will take and how much it will cost. A detailed assessment and evaluation will be provided by Arlene upon completion of the intervention. Please contact us to register your interest in our family interventions or to ask any questions you might have.
Family Therapy Rationale
The most basic function and purpose for hosting a family intervention is to gently and effectively change a member’s or members’ behaviour, feelings, or thoughts in a supportive environment.Traditionally, individual interventions assumed the willingness and ability of the troubled family member to recognize problems, seek out services, and engage with treatment until completion (Armbruster & Kazdin, 1994). Oftentimes, the National Health Service is contacted but the affected family member is unwilling or unable to engage, and there is no alternative program offered (Lewis et al., 2013). Family-based interventions offer a route by which family members who are initially reluctant can be gradually encouraged by other members who are also attending. Main advantages of the family-based model include:
- promotion of child/adolescent/parent engagement by allowing one’s voice to be heard;
- encouragement of interaction between specific family members in order to help resolve conflict;
- enhancement of familial support, compatibility and attachment;
- reduction of vulnerability and poor communication within the family; and
- incorporation of cognitive behavioural (CBT) techniques during sessions.
Considering the significant influence of the family, psychological researchers advocate early interventions which target family support factors such as assisting parents to build and maintain a supportive family environment, appropriate parental monitoring and the use of effective parenting approaches, particularly in adolescence (Jacka et al., 2013). There is an increasing body of research suggesting that risk factors for depression and anxiety are related to poorer parent-child relationships, insecure family attachment, high familial conflict, and a lack of involvement in family activities(Letcher et al., 2009; Fletcher,2009). Family interventions have been shown in a number of studies outlined below to assist with a wide variety of problems that can take place within the family unit.
Al, Stams, Asscher, & Laan (2014) found improvements in parent-child interaction, parenting stress, parental competence and child behaviour problems after completion of family interventions with 183 families. Crisis change, safety change and improved family functioning were associated with programme characteristics, especially the therapeutic relationship, analysis of the crisis situation, duration of the intervention and the solution-focused approach.
McManus, Belton, Barnard, Cotmore, & Taylor (2013) conducted a 10-week family intervention programme that supported families who had experienced domestic abuse. This was conducted to strengthen the mother-child relationship and deal with other aspects of their recovery from the experience of abuse. Mothers and children were positive about the intervention and felt it had helped their recovery and relationship with one another. Identified as most effective were the activities which helped participants to deal with difficult feelings related to the abuse, sessions where mothers and children worked together (relationship improvement), and the support from staff who enabled participants to feel less alone.
Rather than directly attempting to interfere with the addictive behaviour itself, Zhong, Zu, Sha, Tao, Zhao, Yang, Li, & Sha (2011) conducted a study focused on how to enhance family functioning via family therapy for young people and their parents. Youths participated in a 14-session family-based intervention and results found significant improvement of communication, roles and interpersonal trust within the family, general functioning of the family, affective responsiveness, and comprehension of social support. This study also found that loneliness/depression and distraction were significantly reduced, while social comfort and control over impulses improved significantly. Therefore, this study found that internet addiction was reduced as a result of improvement in the functioning of the family unit.
Youth Substance Misuse
Two studies examined the long-term outcomes of family interventions designed for young adolescents dealing with substance use (Bröning, Sack, Thomsen, Stolle, Wendell, Stappenbeck, & Thomasius, 2014; Spoth, Redmond, & Shin, 2001). Youths who had participated in these family interventions showed lower use of alcohol, tobacco, cannabis, self-reported observer-rated aggressive behaviour and hostile behaviour within adolescent-parent interactions. On average the differences between family within and without interventions became more distinct over time. Parents who had participated in an intervention exhibited better parenting skills (e.g. setting limits) and more effective communication (e.g. expressing affection), as well as better parental monitoring. It was concluded that even generally-designed family interventions, short in duration, have the potential to reduce adolescent substance use.
Parental Substance Misuse
Templeton (2014) investigated the findings from thirteen family interventions for sixty-four families made up of seventy-five adults and eighty-two children, affected by parental substance misuse across England. One of the most important features of these family interventions was how it brought groups of families together and facilitated them sharing their common experiences and using this mutual support to consider individual and familial change. The majority of families benefited by gaining a greater understanding of addiction and its impact on children, and improved communication within the family. At Sugru, these added benefits could also be attained by participating in one of the parenting workshops that provide the opportunity to meet with families in a similar situation to your own. As a result of participation in the family interventions, resilience was strengthened in children, as evidenced by feeling more confident and understood, being able to express emotions and feelings, learning how to cope and stay safe at home, getting on better at school and making friends. In many families, following from the family intervention, there was more openness and honesty, stronger relationships and more time spent as a family unit, and a reduction in arguments and conflict.
Sanders and McFarland (2000) compared the effects of two forms of family intervention in treating difficulties in families with a clinically depressed parent and a child with significant conduct problems. Parents participated in either a Behavioural Family Intervention (BFI) or a Cognitive Behavioural Family Intervention (CBFI). Initially, both treatments were equally effective in reducing mothers’ depression and children’s disruptive behaviour. However, six months later, more families engaging in the Cognitive Behavioural Family Intervention compared to those in the Behavioural Family Intervention, experienced clinically significant reductions in maternal depression and child disruptive behaviour. These findings support the value of Cognitive Behavioural Family Intervention in reducing depression in mothers of children with conduct problems and the children’s disruptive behaviours. The approach to family interventions taken by Sugru is that of a Cognitive Behavioural origin.
Step Family Difficulties
Nicholson and Sanders (1999) examined the effectiveness of a family intervention for the treatment of child oppositional- and conduct-behavioural problems in stepfamilies. Forty-two stepfamilies took part and those involved in the family interventions reported significantly greater reductions in child behavioural problems and couple conflict over parenting, and were more likely to show clinically convincing improvements in child anxiety and self-esteem.
Capps (2012) explored the application of filial (parent-child) therapy as a means of strengthening relationships between foster parents and adolescent foster children. Adolescents in foster care may experience a number of disruptions and while a number of therapeutic interventions are implemented to assist adolescents in foster care, very few are aimed at strengthening the foster parent-foster child bond. Studies have repeatedly shown filial therapy as an effective method for strengthening parent-child relationships. Through the use of family intervention, adolescent foster children’s stability in foster homes has the potential to be greatly impacted by facilitating an increase in the attachment bond.