Working with families

In my interview last week for an internship at a youth-services agency, they asked me what I liked about teenagers, and what the challenges working with them were. I love teenagers because they're living through possibly the most formative time of life. They can still have the innocence of children (wellll, not so much the ones I work with), and some of the wisdom of adulthood (ditto). And I remember what a glorious yet angst-filled time that was for me. Plus, some of them respond really well to my sarcasm, and others to my sympathetic side, so we just really get along.

What I don't like about working with them is their parents. So many of the kids are in the hospital and diagnosed with bipolar disorder or intermittant explosive disorder because their families are just pretty fucked up. So rarely do I actually believe their mental health diagnosis is actually a chemical inbalance and not the response to a difficult, traumatic upbringing.

But today I led a family session that went so well. The mom was upset but still willing to support her son. First I asked her how she wanted to see his behavior change when he got home, and she listed a bunch of things. We talked about the supportive services he was already receiving. Then I brought him into the room and asked him to tell his mom what he had been working on while in the hospital. He said his anger issues and coping skills; and I asked him to elaborate and give examples about what skills he's learning. Then I gave both of them a copy of a poem called The Meanest Mother in the World. (It's pretty cheesy but it's a good way for kids to reflect on why their parents do things like impose curfews, make them do chores, etc.) I had him read it outloud and then explain what he thought it meant, and how it applied to his mom.

Then I brought out a art project the son had done during a therapy group about suicide. It was a funeral program. He read it to his mom and explained how he created it and why he included the things he did. It was a really amazing program. I said, "What do you think it would be like for your mom, if this were a real program for your funeral?" which generated good discussion.

I wasn't planning on the next part, but the conversation led up to it really well, so I asked the two of them to do a reverse role play of mom and son. The mother really got into it, acting like her son wanting to go out and hang with friends. I think the son was irritated by the exercise, but he responded as his mom would, and afterwards, was able to articulate some good thoughts about the activity.

Then we made up a contract of behaviors, what the son would work on when he went home, what the mom would do, and some things I'd be able to help them with. The son was able to come up with his own ideas of how his behavior should change that mirrored what his mom said, and she was agreeable to the things he asked her to do, like being there for him when he needed to talk and to not blame him for things before asking first if he caused them.

Finally, I gave each of them a saying about attitude and had the son read it. Then it was over, and the family hugged. One of the nurses asked me a little later what had happened, because evidently the kid came back to group with a really bad attitude. So maybe he didn't get as much out of it as it seemed, but I don't really care. The mom was pleased with how it went, and she's very supportive of him, and will allow him to come back into the home, so that's the important part. And it made me feel really good about my (slowly but surely) improving skills.