Outpatient Multiple Family Therapy Groups
1992 By Lewis N. Foster
Outpatient multiple family therapy group (MFGT) sessions go for about 90 minutes and meet weekly. Open-ended groups seem to work best. When families are discharged (or quit) other families move into take their place.
Getting these groups off the ground can be coordinators' dream or horror. When it is determined (from the top administrator down) that multiple family therapy groups will be a part of the services offered, logistic and manpower questions will have been answered.
One suggestion for beginning MFGT is to build the first group from one therapist's caseload. This means that the families will be selected as a special group who has already joined with the MFGT leader. Chances of success are increased significantly. Set the group up to be successful by selecting families that seem able to commit to attending the group. Tell them about your plan and ask them to help.
Families who have common presenting problems often are placed in the same group. This allows each family to catch glimpses of themselves through the other families. They discover they are not alone and shame seems to give up its hold. Family members who have similar roles will identify with each other. This is, however, true for all multiple family therapy groups.
High stress families have many things in common. These families will do well in MFGT even if their presenting problems are different. The way that the family organizes itself around a high stress family member is similar in process. (See Dependency -- Codependency VS Interdependence Lecture) These families will do well in MFGT even if their presenting problems are different. The therapist's skills will be challenged to assist families in seeing their commonalities, but a little psycho-education with the group will help. A family who is living with a clinically depressed member will experience many of the same situations as a chemically dependent family. These families can grow in the same multiple family therapy group. The therapist's ability and attitude will determine whether this can take place.
As the success of the multi-family group builds, and other staff hears about it, there will be requests to make referrals to the group. At this point the need for more than one group may exist and more MFGT therapists required. This may take six months to 1 1/2 years, but it will happen, so begin planning early.
Some multiple family group therapists find it useful to employ the stages of a single-family session as described by Jay Haley in Strategic Family Therapy. The multi-family session would begin with a social stage where everyone shares something social about himself or herself. This is followed by the problem definition stage and everyone shares his or her perception of the presenting problem. Next comes the interaction stage where the families begin interacting intra and inter family. The final stage is the closing stage where contracting may take place and homework assigned and the session ended. Here at Bruce Hall Center here in Florence, SC, we use a Multiple Family Therapy Evaluation and Session Guide and Feedback Sheet for quality assurance and training and supervision. Download and make copies and tailor them to your needs.
These stages can be used during every session with some variations. The third session with the same group members would not require the same type of problem definition or social stage. Each family may be asked to share their perception of what happened in their family over the past week (that they would like to change). The idea is to relax, be creative, have fun, and if you are new at leading a multiple family therapy group, give yourself permission to do "screwed-up" therapy. We can't lead quality MFGT until we do "screwed-up" MFGT. You are not going to hurt the group members. Learn from your mistakes and take the direction of your supervisor and anyone behind the mirror. Having a co-leader in the room with you can be helpful as well. I am aware that sometimes staffing and other resources will not allow a co-leader or someone behind a mirror. Don't let that stop you.
Resource: A Meditation Exercise
Lewis Foster is the founder of the MFGT Resource Center and was the Coordinator of Family Counseling at Bruce Hall Center, Florence, SC, when this article was written. Today he is retired, but continues to maintain the MFGT website. www.multiplefamilygrouptheapy.com has been operational continuously from August 2005 to present. Former Director of Bruce Hall Center, Jim Holder, maintained the site for a few years.