I knocked on a family’s door. The mother answered, simultaneously shoving the dog aside with her foot and pushing a stack of papers into my hands. Her hair looked rumpled and she wore the same blue t-shirt from the day before.
“Miss Longo, the system is broken!” she shouted up at me. I looked at the papers and noted her welfare case had been closed again. The family’s entitlements would be suspended until she endured another full-day battle just to begin the process of reapplication. I could feel her looking at me expectantly. My eyes met hers and I raised one side of my mouth in shared disappointment. “Frustrating,” I said. “I wish you didn’t have to go through the whole process again.”
Her face relaxed and she straightened herself up to her full five feet. “Thank you. I think it’s frustrating too.”
I agree with my client’s lament and have come to realize I am operating within an imperfect system. In the beginning, I thought my job was to deliver quick fixes and neat solutions to these service gaps faced by families. Now, I realize that my families are not just looking to me for immediate answers but also for unwavering support and validation.
MST expects “continuous effort” from family members in order to shape the most effective interventions and to anticipate barriers early on. As a therapist, I can feel caregivers holding me to the same expectation. I am rarely the first service provider who has entered the homes of my families. Most feel unfairly judged from the beginning. Engagement becomes the bedrock of treatment and for good reason. Kazdin, Whitley, and Marciano (2006) “found that the parent–therapist alliance was related to the extent to which the parents improved in their interactions in the home and overall parenting” (p. 443). Many families presume that I will be one more extension of the system and assume I have nothing of value to offer. Gaining trust requires continuous effort on my part. It is a difficult process to bring caregivers the awareness that changes must be made within them in order to affect change in their children.
It has become easier to meet my families where they are, both in their mental and physical states. MST provides flexibility that allows the therapist to move around the community and conduct therapy sessions in unconventional places. I remember meeting a mother at the laundromat. We talked while she balled up socks and shook the wrinkles out of sweatshirts. She struggled while trying to fold a bedsheet. “Can I help?” I asked.
She raised her eyebrows and muttered, “Ok, sure…” I grabbed one end of the sheet and we matched our motions until it became a small green square. “You know, growing up my mother always told me, ‘Don’t trust the Worker, Workers always want to take your kids away.’ How come you do this job?”
I smile and am grateful for the opening, “I think families are the most amazing things in the world. No family is perfect and we can all use a little help. I want to give you that help because I can’t help but notice how important this family is to you.”
Alessandra Longo is a Licensed Master Social Worker who also holds a Master's in Child Development. She is currently practicing as an MST-SA Therapist at University Behavioral Associates at Montefiore Medical Center located in the South Bronx. Alessandra currently resides in West Harlem.
Learn more about the nine principles of MST.
