CONCEPTUAL AND CLINICAL DIMENSIONS OF A MULTIDIMENSIONAL, MULTISYSTEMS ENGAGEMENT STRATEGY IN FAMILY-BASED ADOLESCENT TREATMENT

Therapy with adolescents challenges even the most skilled clinicians. Teenagers are difficult to engage in treatment, and the systems in which they are involved (schools, juvenile justice) frequently do not understand or support therapy's goals. Adolescents with behavior and drug problems live in families characterized by emotional estrangement or turmoil, sometimes both. Adolescents showing problems are involved with peer systems that are difficult for therapists to understand because of their secretive nature. Parents of these adolescents have generally not found previous attempts at seeking help useful or effective. In the face of these formidable challenges, therapists work in settings in which they must carry large caseloads, too often with inadequate supervision. Prior to clinical experience with adolescents and their families, therapists typically have not received adequate preparation to work with this specialized population. This article addresses these problems by outlining key aspects of the engagement and beginning treatment process within an empirically based family focused intervention for adolescents-Multidimensional Family Therapy. The foundation of the article is an expanded vision of engagement-one that follows from an ecological and developmental perspective on adolescent problem formation and intervention. Key therapist techniques and their conceptual underpinnings are presented.