11/1/14: FFT Ch 5 Engagement Phase

Engagement Phase

Engaging External Systems

• FFT therapists try to establish positive links with every referral source and respond immediately to each referral.  
• They provide as much info about themselves as possible to referral sources to foster a relationship of openness, collaboration, and willingness to help.
• As appropriate, they provide the referral systems with info about tx attendance, progress, need for ancillary care, or other info the systems might need for their own accountability.  
• Most FFT clients come after working with lots of different systems (medical, mental health, private groups, juvy, etc.) and those relationships have to be based on respectfulness, matching, and perspective taking.

Assessment: Pretreatment and During Engagement

• Referral info ("James--runaway", "James--Drug Dealer", etc.) can help to gain as much understanding as possible about the context therapy is about to occur in.
• Formal assessment is only used when specific questions can't be answered in direct clinical contact.  
• FFT emphasizes the identification of the interpersonal impact of the behavior on each family member

Engaging the Family System

• The goal of Engagement is to maximize family members' initial expectations of positive change.  This is accomplished through
• High availability
• Effective management of the intake process
• presentation of tx enhancing the therapist's credibility.
• Engage people who are the major players in the youth's referral and problem behaviors.  This might include people the referral source has left out (live-in boyfriends of mom, etc.)
• It helps to frame it like, "Would you be willing to attend one session so I can get a broader picture of what is going on?  I think your perspective will be very valuable."
• Whatever we can do to get parents and kids in their together from the outset is worth the effort for the increased retention rates and ability to move through the FFT stages more quickly. 
• See them anywhere--Jail, RTC, community shelter, school, etc.
• The first call requires some skills:
• matching
• nonjudgmental attitude
• strength-based focus
• respect
• persistence
• Schedule 1st session ASAP and offer to go to the home if necessary

"Engagement is not therapy--the only goal is to get them into the session so therapy can begin. "