Collaborative Therapy with Multi-Stressed Families: From Old Problems to New Futures

by William C. Madsen

Resistant, difficult, dysfunctional--these and other labels are often applied to families who have not been well served by traditional mental health, social service, and medical systems. This volume sets forth an alternative approach to thinking about and working with multi-stressed families. Working from the conviction that clients are more than the difficulties in their lives, seasoned practitioner William Madsen invites therapists to move away from trying to identify and correct old problems. Instead, he outlines a detailed framework for collaborating with family members to envision desired futures and develop new lives. Anyone working with families in crisis, especially in settings where time and resources are scarce, will gain valuable insights and tools from this book.

Highlighting the importance of the therapist's relational stance, the book discusses how helpers can position themselves as appreciative allies in clients' lives. Guidelines are provided for conducting nonpathologizing assessments that promote attention to families' resources and abilities as well as their challenges. Ways to engage reluctant clients in treatment are demonstrated, with special attention to those families who may minimize difficulties or insist that one particular family member needs to be "fixed." Illustated with numerous case examples and client-therapist dialogues, chapters show how to implement interventions that elicit themes of competence, connection, hope, and vision. Therapists learn concepts and strategies to help clients shift their relationship to the problems in their lives; take apart the old stories that have organized family life; and build alternative narratives that open new possibilities for growth and change. Other topics covered include helping clients develop communities of support; successfully collaborating with other helping professionals; and revisioning agency structures, procedures, and paperwork.

Offering concrete guidance for therapists facing challenging clinical situations, the book facilitates a strengths-based focus without romanticizing families or minimizing their difficulties. It is an invaluable resource for therapists, counselors, and supervisors, particularly those working in outpatient clinics, community agencies, and home-based family preservation programs. In addition, graduate-level students of family therapy, social work, and clinical and counseling psychology will find it a clear and informative text.

Genres: Psychology, Social Work, Counselling, School, Nonfiction

358 pages, Paperback

First published October 6, 1999

Reviews

[Christian · Rating 4 out of 5]

This is a textbook 🤪 But I really enjoyed it. I’m really into Narrative therapy lately.

[Adam Jarvis · Rating 4 out of 5]

Very helpful, very much a textbook

[Kony · Rating 3 out of 5]

Required for therapy school. Decently well written, and includes useful concrete examples rather than hovering in the theoretical realm.

However... while this book does readers a service by acknowledging racism, classism, and saviorism as ongoing problems within the profession, it is unfortunately not completely free of white savioristic assumptions. Madsen repeatedly uses the paternalistic term "helpers" to describe people working in community mental health and similar fields. And while he briefly discusses the oppressive impacts of bureaucratic requirements in the field, he essentially says "good luck working within those requirements." He stops short of urging us to use our privilege to disavow and dismantle the capitalistic framework that justifies those requirements. Had he gone there and actually offered practical pointers in this vein, I might've liked the book more.

Overall, this is one of the better books in the therapy school curriculum, but it doesn't go far enough in addressing the harmful systems that constrain healing work within community mental health care settings, and therefore it still needs to be read with a critical eye.

[Harry Remer · Rating 4 out of 5]

It took me a while to penetrate Madsen's academic style of prose, very theoretical and dense. Interestingly, in person, he's much more down-to-earth and a great teacher. However, there is an incredibly useful framework hidden amongst the philosophy if you stick to it.

The framework here was of tremendous use to me while working during years of working with multi-stressed families in a community mental health center. It continues to inform my longer-term, private work with both individuals and families today. If you want to be relieved of the burden of responsibility for your clients' woes, want to empower them more than yourself, want to penetrate quickly to what's wrong and to their pre-existing (if unconscious) resources, this book will help tremendously.

[Katie · Rating 2 out of 5]

This was another assigned book for my studies. It was a book that I hated reading while I read it but was glad that I did in the end. Madsen spends the first two chapters on a rant about how therapists need to look at clients. I agree with his advice whole heartedly but the way in which he wrote it turns the reader off. He is very repetative which is good on one hand because he is wordy and the book is long but it would probably be shorter if he didn't reapeat himself so much. That asside Madsen gives great examples on how to help families that have more than one stressor in their lives. He promotes a collaborative view that works with the client as the expert on their own lives.

[Lucy · Rating 5 out of 5]

This is a brilliant and very useful book. I appreciate the author's transparency and his dedication to collaborative, empowerment-supporting practices. The "intake form" that he outlines, along with ideas for more in-depth questions, is extremely useful.