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News & Views - Mar, 2000 Issue #67

A Valuable Resource
By Alan K. Springer, Ph.D.
Provo Canyon School

Each year thousands of adolescents are placed in residential treatment centers that are geographically distant from their homes and families. Although attempts are made to provide face-to-face family therapy, the logistics often make that impossible or permit only infrequent sessions. Studies at Provo Canyon School (PCS) in Provo, Utah have demonstrated that adolescents and their families can engage in productive family therapy using telephones (Springer & Stahmann, 1998, Springer, 1991).

Hines (1994) found that non-sighted (blind) therapists effectively compensated for the loss of nonverbal cues in family therapy. It was his conclusion that therapists, whether sighted or non-sighted, can conduct good family therapy using telephones if they will pay attention to nonverbal cues. Albert Ellis (1989), who conducted thousands of telephone therapy sessions over a period of 40 years, indicated that telephone sessions are remarkably similar to face-to-face therapy sessions in terms of the skill required and benefits obtained.

Janice (not her real name) was 16 when enrolled at PCS as a result of persistent truancy, defiance, alcohol abuse, and suicidal ideation. Her mother, living in the Midwest, was the custodial parent. However, Janice had been placed in the Utah treatment center by her father living on the west coast. There was bitter conflict between the divorced parents regarding appropriate parenting.

Mother was protective and lenient, father was structured and controlling. Intimidated by her former husband, the mother was in a coalition with Janice against the father. Former therapists believed that Janice’s symptoms would persist until the family dynamics were dramatically shifted.

Telephone family therapy was initiated with the father on the west coast, the mother in the midwest, and the therapist in Utah. Janice was not included in those early sessions. The mother indicated that in past face-to-face confrontations with her former husband, she had felt inadequate and powerless. On the telephone, however, she was more comfortable. She could talk to Janice’s father with ease, she noted, because she was safe in her own home and lacked the visual triggers which had intimidated her in the past. Within four sessions, the imbalance of power between the parents was neutralized. Janice was initially pleased to learn of the shifting balance of power between her parents. However, she soon realized that parental unity would destroy some off her control. Splitting was no longer an option. She would be accountable for her actions. Predictably, she rebelled.

The structure of the program easily managed Janice’s rebellious behavior; the internal rebellion was fodder for more telephone family therapy, including Janice and both parents. Janice soon learned to accept, then utilize, the changed family dynamics. Five months after admission she successfully returned to live with her mother. Major changes had occurred within the family using four telephones in three distant states.

Telephone family therapy is beneficial in bridging geographical distances. It provides a way for non-custodial parents and extended family members to participate in family therapy. It is often less threatening than face-to-face family therapy.

Telephone family therapy, as compared with traditional family treatment, (1) is more likely to encourage equal sharing of power between clients and their therapists, (2) can be a time-management tool for therapists, and (3) can provide a transitional bridge for individuals leaving residential care and returning to their homes.

1) Equity between therapists and families in treatment: Families in traditional therapy are at a social disadvantage because they meet in the therapist’s domain. Telephone family therapy may have an equalizing effect on the relationship between the therapist and family members since the parties can participate from familiar environments, that is, their homes or places of business.

2) Time management: Traditional family therapy is frequently scheduled for times other than usual business hours, since that is when clients are available. Telephone therapy is more likely than traditional therapy to occur during regular working hours since preparation and travel times are reduced. Family members may be able to leave daytime responsibilities long enough to participate in telephone family therapy.

3) A transition: Family therapy is often essential for individuals leaving residential care. When circumstances prevent family members from traveling to the treatment center on a regular basis to participate in traditional family therapy, telephone therapy can provide a relatively inexpensive alternative.

A study that explored the value of telephone family therapy was conducted at Provo Canyon School, an adolescent treatment facility. The subjects were 47 parents whose adolescent children were residents at the school. Telephone conversations that included parents, therapists, and adolescent residents were compared with telephone conversations when either residents or therapists were excluded. Telephone family therapy was defined as interactions in which therapist and adolescent residents were together in therapy offices, and the parent(s) of the adolescents were involved in the conversations via speaker telephone.

The parent survey was administered by telephone to one parent for each adolescent resident. The main results were as follows:

The more frequently parents participated in Telephone Family Therapy, the more likely they:

* perceived that phone calls helped their families be functional;

* perceived that phone calls helped their families communicate;

* were to be satisfied with their decision to place their adolescents in residential treatment.

The findings of this study suggest that parents of adolescents in residential treatment viewed Telephone Family Therapy as effective in helping family communication and functioning. These findings provide some evidence that Telephone Family Therapy can be a productive alternative or adjunct to face-to-face family therapy.

Traditional family therapy with family members in the treatment room is generally more productive than telephone therapy; however, in some circumstances, telephone family therapy is the method of choice. When clinicians overlook the therapeutic value of the telephone, they limit treatment to those family members who can, and will, attend traditional sessions. By using the telephone, family members who can not attend traditional sessions can still participate in the treatment.

Ellis, A. (1989, May). Telephone counseling [Letter to the editor]. APA Monitor, p. 5. Hines, M.H. (1994). Using the telephone in family therapy. Journal of Marital and Family Therapy, 20, 175-184. Springer, A.K. (1991). Telephone Family Therapy: An Untapped Resource. Family Therapy, 18, 123-128. Springer, A.K., & Stahmann, R.F. (1998). Parent Perception of the Value of Telephone Family Therapy when Adolescents are in Residential Treatment. The American Journal of Family Therapy, 26, 169-176.

Copyright © 2000, Woodbury Reports, Inc. (This article may be reproduced without prior approval if the copyright notice and proper publication and author attribution accompanies the copy.)

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