Ideas of the change process: family and therapist perspectives on systemic psychotherapy for children with conduct disorder

Abstract

This report is based on a small-scale qualitative study exploring therapist and client perspectives on the therapeutic change process in home-based family therapy for children with conduct disorder. The study consisted of focus group discussions with therapists, interviews with client families and audiotaped therapy sessions. The findings suggested that home-based therapy (home visits) was effective in improving hard-to-reach clients’ access to help, resources, and opportunities, as well as the therapists’ access to invaluable information about their clients. Home-based therapy also helped the therapists to develop professionally, making it possible for them and their clients to engage in different power relationships, which were seen by both parties as one of the principal motivating forces and important aspects of the change process. In addition, exploring clients’ perspectives appeared to be useful. Practitioner points: The process of engaging with hard-to-reach families starts in the context of specific therapist-client power relationships with the therapist encouraging the family to take charge Home-based therapy is useful for children with conduct disorder Home-based therapy provides children, family and therapists with information, resources, opportunities and good access, which are not always available in customary clinical settings.