Multidimensional family therapy: what it is and how it works

Multidimensional family therapy is designed to address the most severe conflicts.

The social, economic, legal and emotional difficulties of a family can have a substantial impact on the development of each of the individuals who make up the family, especially adolescents, who are going through a time of special effervescence.

Since the family functions as a system, everything that affects one of the parts has its echo on the others, becoming a problem that alters the whole and requires an integrated and multidisciplinary treatment (psychologists, social workers, etc.).

The aim of multidimensional family therapy is to provide a set of therapeutic measures to address situations of extreme conflict.The following is a description of the main factors that can completely destroy the unit's ability to adapt to the environment.

Next we proceed to deepen in all the essential to know it better; emphasizing its definition, the dimensions susceptible of intervention and the measures that could be used for it.

Multidimensional family therapy

Multidimensional family therapy aims to provide an adequate coverage to the totality of the areas of operation that can be conditioned in the family bosom, especially when situations concur.This is especially true when there are situations of danger for its development (such as drug abuse or criminality). It is a procedure that has an obvious restorative purpose, and that sets in motion a whole myriad of social and human resources for this purpose.

The fundamental emphasis is on the care and monitoring of adolescents and their parents, so that the necessary mechanisms will be orchestrated to address any conflicts in the relationship between them.The fundamental emphasis is on the care and monitoring of adolescents and their parents, so that the necessary mechanisms will be orchestrated to address any conflicts in the relationship between them. This implies that mental health takes on special relevance, since it is not infrequent that substance abuse and/or criminality may be the cause or the consequence of some disorder in this domain.

In the following, we will focus on the areas that are of interest from this particular integrated form of intervention, which requires a multidisciplinary approach involving the educational and judicial system. It has been shown to have ample empirical evidence regarding its ability to address substance abuse and enhance the group's ability to adapt to the environment.

Objectives by areas

The following are all the objectives to be pursued with the application of multidimensional family therapy, which coincide with the individual elements of the family unit (the adolescent and his parents), the internal dynamics between them (the family) and their relations with the outside world (the community).

Adolescent

With regard to the adolescent, the basic objective of the intervention is to prevent or address the use of illegal substances, as well as to stimulate the adolescent's own abilities to regulate affect and communicate with people in the environment. In doing so all the areas of daily functioning are taken into consideration, among which we highlight the schoolAmong these we highlight the school/institute and/or the imminent access to the labor market (in case there is no interest in continuing academic training).

2. Parents

The parents of the adolescent are, without a doubt, one of the main links in the adolescent's well-being. The program is sensitive to their needs, mainly in terms of parenting styles and promoting constructive parenting styles and the promotion of constructive relationships with the adolescent.. The aim is to promote their mental health, as well as to explore any circumstance in this area that could be the object of intervention.

3. Family

The family is a system of relationships between parents and their children. It includes specific parenting styles and forms of interaction between all its members. The basic objective of this program is to to improve communication at all levels, as well as to increase the number of genuine exchanges of affection..

4. Community

The community refers to the different organizations, institutions and groups with which the family interacts; with the purpose of covering its social, human or other needs. In short, these are outward relations that contribute decisively to the dynamics of the interior. This dimension includes the school, the neighborhood and the courts, which must be used in a positive and balanced way.

Procedures

Once the areas of interest in multidimensional family therapy have been identified, let us look at the different procedures that can be deployed during its application and development. The educational and judicial systems are inextricably intertwined in the process..

Service and community collaboration

Multidimensional family therapy promotes the relationship between the family and all community services available to them in case of need. In this sense, the aim is to provide information on the assistance that the system can provide, especially in relation to access to housing, energy or basic foodstuffs to subsist in healthy and balanced conditions.

The aim is to to remedy, whenever possible, any difficulty in accessing the most basic living conditions.. It is a cardinal element of the process, in which all the necessary support system is deployed so that adequate control can be assumed over one's own life and over the options with which to be able to integrate adequately in the academic and work environment. The rationale is to preserve dignity and ensure the principle of equal opportunity.

In cases where criminal conduct has been committed and the different legal statuses are involvedIn addition, it is essential that the family receive counseling on how to relate to court officials and probation officers, whose role is to discourage those who have committed a crime from continuing to reoffend.

2. Training for home and school

Home and school are the two spaces in which the adolescent spends the most time, and therefore have a special importance in multidimensional family therapy. It is necessary to individual needs of the parents need to be identified and addressed appropriately, as the poor mental health of adolescents and adolescents is a major concern.It is necessary to identify the parents' individual needs and address them accordingly, as poor mental health is one of the main risk factors for the development of problems in the adolescent or child.

In addition to parenting styles and family dynamics, which are elementary in order to prevent forms of maltreatment or abuse, the following should be considered: problems in controlling impulses or emotions such as anger, deficits in social skills and lack of assertive contact. Often all this is reproduced in adults and children in the same family, so it may be necessary to organize an intervention aimed at training all of them, as these are circumstances that are often related to conflict within and outside the home.

The school should also be an object of interest for multidimensional family therapy, since it is where a large part of the family's work is carried out. school is where a very important part of adolescent life unfolds, especially at the level of peer relationships (for which a close relationship between peers is essential). (for which close supervision is essential). The objective is to minimize the risk of "bullying" (in the roles of victim or victimizer), to stimulate positive experiences as much as possible and to reinforce the desire to pursue an education in line with the child's interests.

Vocational guidance is a very important tool in this regard, and must be accompanied by the strengthening of the parents' willingness to participate in school life, which implies attending meetings and/or other events organized by the school management or the teaching staff. It is known that the involvement of parents in this type of activities is essential for the existence of a space conducive to the development of their child's academic potential.

3. Development of specific competencies

This part of the intervention makes use, above all, of psychoeducation.. The aim is to provide the most accurate information possible to parents and their children about some of the most dangerous circumstances that the latter face in the evolutionary period of adolescence: the use of drugs for recreational purposes, the possibility of contracting a sexually transmitted disease (HIV or others), accidents due to the irresponsible use of a vehicle, etc.

Anger control is also very important, and for this it is necessary to articulate strategies of various types, especially oriented to make it an affection that does not translate into acts of violence within or outside the family. Cognitive techniques aimed at exploring the mental contents underlying the emotion, in order to restructure them.The use of cognitive techniques aimed at exploring the mental contents underlying the emotion, in order to restructure them and give them a non-aversive meaning, are useful to reduce conflict in the family and to perceive reality in a way that is adjusted to its objective terms.

It is also important to provide parents with information on adolescence, since it is a stage that poses challenges both to the person going through it and to the immediate environment, including specific forms of communication that are useful to facilitate healthy exchanges between all the components of the family unit. In this sense, it is essential to provide knowledge on the application of reinforcements and punishments, as well as the management of privacy and the application of limits.

Along the same lines as the above, it is essential to provide knowledge about the most common risky practices at this time of life, such as unprotected sex or sexual intercourse.such as unprotected sex or the use of vehicles (motorcycles, for example) in an irresponsible manner. Sexually transmitted infections (not only HIV, but also the prevalent human papillomavirus, hepatitis, syphilis and even gonorrhea or chlamydia) and the consequences of a potential traffic accident will be discussed in depth. All this in order to seek prophylaxis of potentially extremely serious health problems.

Finally, it will be necessary to improve the training available to parents and adolescents in order to look for a job, including the use of professional social networks and strategies to look for a job or to face an interview with the employer. It is also interesting to provide information on courses and training complements implemented by different institutions, to the extent that they can provide knowledge/skills that facilitate access to the labor market.

4. Drug use

The specific approach to drug use is one of the basic objectives of multidimensional family therapy, especially when it involves the adolescent or child (since these are times when the nervous system is in full development and any use becomes a form of abuse). This step is necessary to build a life adapted to the environment, and should ensure that the history of consumption and its characteristics are defined both quantitatively and qualitatively, with emphasis on the consequences on personal and family life.

If there is no consumption, the necessary tools will be available to maintain abstinence over time.. If the adolescent is an active user, a treatment can be articulated aimed at stimulating motivation for change, reorganizing social networks, controlling stimuli associated with drug use and proposing pleasant or personally meaningful activities. Active listening is essential, as well as informing parents of the possible difficulties that may arise during cessation of the habit and of the processes that are inevitably related to the phenomenon of dependence (tolerance and withdrawal syndrome).

If there is substance use in the family, this should also be one of the objectives of treatment, as it is known to be associated with both the onset and maintenance of abuse and/or dependence among adolescents.

5. Judicial aspects

In those cases in which the adolescent has incurred in criminal or antisocial acts, it is possible that he or she may be immersed in an active judicial process, which which is an intensely stressful experience for the family.. In this case, all members of the family should be provided with the necessary skills for communication with the different agents that are part of the system (such as the judge, the clerks or the attorneys). All this so that they can collaborate in an appropriate way with the authorities during the resolution of their contentious situation.

It is intended that the parents become actively involved in the judicial process, accepting the imposition of the sanctioning measures in the civil or criminal field. The purpose of the whole effort is to prevent future illicit acts from occurring again, as these could definitely condition the future and the life of the adolescent or his family.

Bibliographic references:

• Danzer, G. (2014). Multidimensional Family Therapy in Theory and Practice. Child and Youth Services 35(1), 16-34.
• Rowe, C.L. (2011). Multidimensional Family Therapy: Addressing Co-Occurring Substance Abuse and Other Problems among Adolescents with Comprehensive Family-Based Treatment. Child and Adolescent Psychiatric Clinics of North America, 19(3), 563-576.