Therapy with Multi-Stressed Families: From Old Problems to New Futures. - Review - book review

Adolescence, Winter, 2000

MADSEN, William C. Collaborative Therapy with Multi-Stressed Families: From Old Problems to New Futures. New York: The Guilford Press, 1999. 358pp. $35.00 (h).

Resistant, difficult, dysfunctional--these and other labels are often applied to families who have not been well served by traditional mental health, social service, and medical systems. This volume sets forth an alternative approach to thinking about and working with multi-stressed families. Working from the conviction that clients are more than the difficulties in their lives, Madsen invites therapists to move away from trying to identify and correct old problems. Instead, he outlines a detailed framework for collaborating with family members to envision desired futures and develop new lives. Highlighting the importance of the therapist's relational stance, the book discusses how helpers can position themselves as appreciative allies in clients' lives. Guidelines are provided for conducting nonpathologizing assessments that promote attention to families resources and abilities as well as their challenges. Ways to engage reluctant clients in treatment are demonstrated, with special attention to those familie s who may minimize difficulties or insist that one particular family member needs to be "fixed." Illustrated with numerous case examples and client-therapist dialogues, chapters show how to implement interventions that elicit themes of competence, connection, hope, and vision. Therapists learn concepts and strategies to help clients shift their relationship to the problems in their lives; take apart the old stories that have organized family life; and build alternative narratives that open new possibilities for growth and change. Other topics covered include helping clients develop communities of support; successfully collaborating with other helping professionals; and revisioning agency structures, procedures, and paperwork. Offering concrete guidance for therapists facing challenging clinical situations, the book facilitates a strengths-based focus without romanticizing families or minimizing their difficulties.