Multisystemic Therapy Blends Three ‘Parents’ Into One Team

Posted by Aime Bennett

Jul 14, 2016 11:00:35 AM

Three parents can sometimes be better than one

Jane was a 13-year-old middle-schooler who lived with her grandparents, having little to no contact with her biological parents. By the time she came into MST, she was using drugs, getting in trouble, failing in school, leaving home without permission, and being defiant and aggressive with her grandparents. 

 

Early in treatment, Jane’s behaviors intensified as she began to self-harm. To complicate things further, Randy, her father, returned to live in the home. The father tried to take on some of the parenting duties by forcing Jane to live up to expectations. True to form, Jane dug in her heels, trying to put him back in his place—classically yelling, “You never acted like my dad before. Why are you trying to now?” When Randy endeavored to make sure she didn’t leave without permission, Jane became aggressive with him, quickly trapping him by making him feel guilty  about  past and hopeless to impact the present. 

Meanwhile, Jane’s grandparents, Nanny and Pop-Pop, were raising Jane, her sister Tracy, and adjusting to their adult son living with them. While Jane was rebellious, Tracy struggled with anxiety which manifested itself in Tracy refusing to eat, refusing to sleep in her own bed, and in verbal aggression.  Boundaries in the home were very blurred and in need of clarification. 

Looking at Jane’s referral problems, we identified contributing factors in her peers, school, community and family systems, and quickly realized how crucial it was for Randy, Nanny and Pop-Pop to work together to clarify the parental roles and responsibilities.

As we examined their parenting patterns, we saw it was very important for Nanny and Pop-Pop to be “fun grandparents” with loads of warm fuzzies. This need often led them to being permissive—wavering on their expectations. To take advantage of their strengths, we immediately increased daily fun family time and activities, and added incentives to their current repertoire of discipline techniques. This way when Jane left the home without permission or misbehaved in school, there was a clear rule with a reward and consequence in place for her. These interventions helped the adults see the value of an authoritative parenting approach that encompassed both control and warmth. 

Adults learn to divide parenting roles

As part of this process, the family worked to clarify Randy’s role. Due to his current life circumstances, he chose to be more of a support to Nanny and Pop-Pop rather than an enforcer. Randy learned to uphold the expectations for Jane without undermining the grandparents’ authority. He learned how to handle small behavioral issues with the same skills they used—exit strategies and a matched warmth and control discipline approach. This allowed Randy to support his parents in raising his children while he established a closer relationship with Jane. Randy and Jane began spending time together, engaging in activities that were important to each of them, such as being outdoors together and sharing Randy’s passion for volunteering at the local fire department. The warmth between them grew as Jane was able to share her pain regarding Randy not being present in her life. On hearing this, he gave his daughter more support and love. 

Nanny and Pop-Pop also learned to listen to Jane and help her with her emotional needs. Jane’s demeanor improved, and her self-harm behaviors decreased. Nanny, in particular, became Jane’s main confidante and support. This utilized grandmother’s existing strength of connecting and communicating emotionally with her family members and friends.

Overall, the entire family learned how to decrease aggressive communication and find ways to really “hear” what Jane’s needs were in her communication. They were able to share their concerns without being critical and could focus the outcome of the conversation on problem-solving rather than it resulting in an argument where feelings were hurt and warmth was compromised. Additionally, humor was re-introduced into the home. This served to bring them closer, making the overall atmosphere one of comfort and approachability. 

Loving attention goes a long way

Ultimately, Jane found a renewed sense of being loved and taken care of, while simultaneously knowing that because she was loved, she would be held accountable to certain standards of behavior. At the close of treatment, Jane was most proud of her ability to demonstrate self-control, successfully meeting each of her overarching goals.

What is most touching in this story for me as the therapist is Nanny and Pop-Pop’s willingness to practice sacrificial love, putting aside their own desires and investing in their grandchildren’s futures. It was this drive that motivated them through tough times and made even the smallest successes a source of hope to propel them toward reaching their goals.

Aime Bennett is an MST Therapist at Adelphoi Village. 

To learn more about how MST can impact entire families, read the results of this 25-year follow-up study of siblings.

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Topics: Child Welfare