Family resilience and ecological intervention involves strengthening families' ability to withstand challenges by drawing on their internal strengths and external social supports. Therapists employ several approaches, including multisystemic therapy, network therapy, multiple impact therapy, open dialogue, and family group conferencing, which mobilize family networks and communities to support families experiencing adversity. These ecological interventions aim to identify family strengths, build social support systems, and develop culturally appropriate plans to address challenges.

1. Family resilience and ecological
intervention
Presented By:
Surendra Prasad Bhattarai
MCP Third Semester
Samarpan Academy

2. Unit IV: Treatment Approaches
14. Some Other Therapeutic Approaches
• Family art therapy,
• Family music therapy,
• Family play therapy,
• Family resilience and ecological intervention,
• Mindfulness practices,
• Family therapy and mental illness

3. Family resilience and ecological
intervention
• The construct of family resilience (Becvar, 2013)
emerged some two decades ago.
• Family therapists have long been aware of how larger
systems influence family functioning (Imber-Black,
1988).
• Family resilience has been defined as the family’s
ability to “withstand and rebound from disruptive life
challenges, strengthened and more resourceful”
(Walsh, 2011, p 149).

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• More recently, practitioners and researchers
working with families who had experienced
adversity like physical and sexual abuse,
parental substance abuse, chronic or life-
threatening illness or natural disaster noticed
that some families managed adequately or
better, while others continued to live troubled
lives or spiral downwards.

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• Researchers began to ask what distinguishes
individuals and families who rise above their
adverse circumstances.
• It may be tempting to see these families as ‘super
families’, but in fact, they struggle, working hard
to communicate to express their care to one
another.
• Two recent reviews (Bhana & Bachoo, 2011;
Sheridan, Eagle, & Dowd, 2005) indicate that
resilient families exhibit:

6. • Cohesion, as expressed by family time and routines.
• Adequate problem-solving skills.
• Active and affective involvement with one another
that conveys empathy. In families with children,
parental involvement in school is positively
correlated with behavioral, emotional and academic
outcomes (Christenson & Sheridan, 2001).
• Social support, from within and outside the family.
• Shared beliefs and values, including spiritual beliefs
(Walsh, 1996).

7. • The opportunity of a child to contribute to the well-
being of the family. Ungar, Theron, and Didkowsky
(2011), interviewing youth in five countries, found
that they contributed to the well-being of families by
taking on a specific role to help their families. Rather
than seeing these children as ‘parentified’, they
argue that these children contribute significantly and
necessarily to the family’s well-being.

8. Dunst, Trivette, and Deal (1994) suggest
these principles for family centred service
delivery:
• basing intervention efforts on needs identified
by the family; utilizing existing strengths and
competencies;
• maximizing the use of the family’s social
network;
• and tailoring interventions with the family’s
motivation and readiness.

9. • Accordingly, a family therapists often help
families to gather social support outside of the
immediate or the extended family (Dutta &
Finlay-Musonda, 2007).
• Some examples of ecological interventions
are: (Multisystemic therapy, Network therapy
(Speck), Network therapy (Galanter), Multiple
impact therapy, The open dialogue approach,
Family group conferencing)

10. 1. Multisystemic therapy (MST)
• Multisystemic therapy (MST) targets families
of youth with serious problems (e.g. criminal
offenders [including violent and sexual
offenders], adolescent substance abusers,
youth experiencing serious emotional
problems).
• MST is based on several theoretical bases:

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• Bronfenbrenner’s (1979) theory of social ecology, which
considers the various social systems in which the young
person is located;
• Structural family therapy (Minuchin, 1974), which attends
to boundaries and recurring interactional patterns;
• Strategic therapy (Haley, 1976), which focuses on family
hierarchy;
• Social learning theory (Patterson, 1971), which focuses on
modeling and reinforcement of behavior; and
• Cognitive–behavioral therapy (Dattilio & Nichols, 2011),
which supports the development of problem-solving skills.

12. • MST is delivered intensively by a team of two to four
master’s level therapists, each of whom carries only
four to six families, for 3–5 months.
• Treatment is delivered outside of office hours, in the
family’s home or community.
• Family members, the caseworker and other
professionals are interviewed about the case, including
potential goals.
• The therapist assesses the strengths and needs of the
system from a social ecological perspective
(Bronfenbrenner, 1979).

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• Evidence-based interventions are custom designed,
with the specific goal of helping families develop a
sustainable local support system.
• MST has received wide acceptance. There are over
20 published outcome studies, including 18
randomized trials. It is delivered to more than 17 000
youth and families annually, at multiple sites.
Significant effort has gone into studying MST’s
portability across locations.

14. 2. Network therapy (Speck)
• Network therapy (Speck & Rueveni, 1969; Speck &
Attneave, 1971) gathers the kinship system, the
family’s friends and other significant people,
sometimes as many as 30 or 40 people, to work on
the problem.
• Network therapy began when conventional therapy
had not been effective.
• In addition to the family members, some of the
clients' friends came to the first session.
• Network meetings, without the therapist, continued
for 3 months after the last of the four sessions.

15. • The author believed that network sessions
facilitated ‘intensity of the involvement and
caring on the part of those network activists
who maintained a continuous support’.

16. 3. Network therapy (Galanter)
• Independently, and without reference to the
previous work by Speck, Galanter and Dermatis
(2011) developed a systemic approach by the same
name, for the treatment of substance abuse.
• It combines cognitive-behavioural relapse
prevention, involvement of the client’s support
system and ‘community reinforcement techniques’.
• The client’s support network is composed up of
people mutually agreed upon by the therapist and
the client.

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• Galanter found that the client’s social network
supports the client’s abstinence, undercuts
denial and supports the client’s treatment
plan.
• Outcome research found that the number of
network sessions in which the client
participated was positively correlated with
treatment outcome.

18. 4. Multiple impact therapy
• Multiple impact therapy was developed by MacGregor
(1962) at the University of Texas Medical Branch
Hospitals at Galveston.
• The Youth Development Project, a research project
treating adolescents referred from correctional services,
dealt with some families in crisis who lived a long
distance from the clinic.
• The team therefore developed a plan that treated entire
families for 2 or 2 and half days.
• A team of therapists of various disciplines would meet
with the family on their arrival, beginning with a team–
family conference.

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• Next steps varied from family to family, but typically
each family member was seen individually by a team
member, and then in various configuration with
other family members.
• At midday, the team would confer and further
interviews would be held in the afternoon, the day
ending with another team–family conference.
• The process would continue as required the next day,
extending to a third day if necessary.
• A follow-up visit was required; in one-quarter of the
cases, a further day’s treatment was arranged after
about 2 months.

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• Community resources such as local treatment agencies,
teachers and ministers were extensively involved in the
follow-up period.
• Multiple impact therapy has not been widely practiced,
likely because of the practical difficulties associated with
gathering whole families for two or more days.
• It may be particularly valuable when families live at great
distances from clinics, but as family therapists become
more numerous, and as technologies such as Skype are
available, this applies to fewer families.

21. 5. The open dialogue approach
• Developed in rural Lapland, Finland to meet the needs of
patients experiencing psychosis.
• The open dialogue approach is based on the principles that
‘the social network of the patient, including the family and the
professionals should always be invited to participate, from the
beginning and for as long as required’.
• The team aims to respond within 24 hr of the contact with the
patient.
• Treatment is flexible and collaborative.
• As the name implies, the generation of dialogue permits the
unspoken to be spoken.
• Treatment meetings are viewed as reflective dialogues, in
which decisions are not taken without consensus.

22. 6. Family group conferencing
• Family group conferencing (FGC) originated in New
Zealand. FGC was developed as a culturally responsive
way to involve the family, based on their kinship and
spiritual beliefs.
• The coordinator, interviews all stakeholders- parents,
extended family members, close friends and elders (if
appropriate) - before the conference, often spending
20–40 hr in preparation.
• The meeting is focused on identifying family strengths
and potential supports, as well as possible obstacles or
worries.

23. • The conference itself, held in a neutral
location, typically lasts 4 hr. If appropriate for
the family, the conference opens with
culturally relevant prayers or spiritual
practices, followed by introductions of
participants and their relationship with the
child in question.
• After all participants have expressed their
perspective, and the statutory body has
presented non-negotiable elements, the
family is left in private as long as required to
generate a plan for the child(ren).

24. • The entire group reconvenes when the family
states that they are finished meeting.
• According to Pennell and Burford (2000),
many of the plans generated by families are as
good as or better than would be generated
without their involvement.
• FGC has been applied in Australia, France,
South Africa, the United Kingdom, Sweden
and the United States.

25. Reference
• Basic Family Therapy, Sixth Edition. Philip
Barker and Jeff Chang.
© 2013 John Wiley & Sons, Ltd. Published
2013 by John Wiley & Sons, Ltd.