Multi-problem families in intensive specialised multi-family therapy: theoretical description and case study report

Some families experience chronic, severe and intergenerational problems across multiple domains in their lives. These multi-problem families do not seem to benefit from standard treatment. For them, Intensive Specialized Multi-Family Therapy (ISMFT) was developed at the Department of Family Psychiatry (DFP) of a mental health organization in the Netherlands. ISMFT is an integrative treatment based on multiple family therapy with added elements of solution-focused therapy and a focus on the working alliance between families and therapists. This kind of intensive treatment for multi-problem families is rare across Europe, and is often seen as a ‘last resort’ before a decision on out-of-home placement of the children is made. This paper describes the theoretical principles used in ISMFT and uses a case study of an anonymized family to describe the course of treatment and illustrate treatment principles.

Practitioner points:
* Offering multi-family therapy helps families overcome feelings of isolation, maximises their own resources and provides opportunities for support and constructive criticism.
* Therapists have an important role in facilitating a safe group atmosphere, as well as challenging parents by voicing different perspectives and reflecting on parental behaviour.
* By making parents the expert on their own families, good treatment results can be achieved in therapy-resistant multi-problem families.