The adolescent in family therapy : harnessing the power of relationships

Rich with clinical wisdom, this successful text and practitioner guide offers a comprehensive framework for treating adolescent problems in the family context. Even as teenagers become increasingly independent, Joseph Micucci shows, they still need parental guidance and nurturance. By strengthening family relationships, clinicians can alleviate symptoms and promote behavioral change. Vivid examples and session transcripts illustrate specific strategies for treating eating disorders, depression, anxiety, defiance, underachievement, and other frequently encountered challenges. Weaving together family therapy techniques with ideas from psychodynamic and cognitive-behavioral approaches, the book has a pragmatic focus on effective interventions for getting adolescent development back on track.

New to This Edition

*Thoroughly updated to reflect current research and reader feedback.

*Chapter on adolescent anxiety disorders.

*Expanded coverage of attachment issues; lesbian, gay, and bisexual youth; and racial and ethnic identity.

*New case material, one of the book's most popular features.

Author Notes

Joseph A. Micucci, PhD, ABPP, received his AB in Psychology from Cornell University and his PhD in Clinical Psychology from the University of Minnesota. In 1984, he joined the staff of the Philadelphia Child Guidance Center, where he served as Director of the Adolescent Unit from 1987 to 1993 and as Chief Psychologist from 1991 to 1993. Currently, Dr. Micucci is Professor of Psychology and Chair of the Division of Psychology at Chestnut Hill College in Philadelphia, Pennsylvania. He is Director of the PsyD Program in Clinical Psychology and has taught courses in Psychological assessment, adolescent development, and family therapy. Dr. Micucci is a member of the American Psychological Association and the American Family Therapy Academy, and is an Approved Supervisor for the American Association for Marriage and Family Therapy. He holds specialty board certification in Clinical Psychology from the American Board of Professional Psychology. Dr. Micucci has a private practice in Bryn Mawr, Pennsylvania.

1 Introduction	p. 1
My Orientation and Influences	p. 3
Diagnosis and Labeling	p. 4
Biology, Medications, and Systems	p. 5
The Paradox of Control	p. 6
Harnessing the Power of Relationships	p. 7
The ARCH	p. 8
Adolescents Need Nurturance	p. 9
The Plan of This Book	p. 11
2 Adolescent Development	p. 12
Developmental Issues of Adolescence: An Overview	p. 13
Early Adolescence	p. 16
Middle Adolescence	p. 29
Late Adolescence	p. 45
Summary	p. 56
3 Basic Concepts	p. 59
A Core Assumption	p. 59
Family Systems and Family Therapy	p. 60
The Symptomatic Cycle	p. 62
Consequences of the Symptomatic Cycle	p. 64
Common Patterns in Symptomatic Families	p. 68
The Pattern Is the Problem	p. 71
Summary and What's Next	p. 71
4 How to Assess and Treat Problems	p. 73
General Principles Guiding Effective Intervention	p. 74
How to Build an Alliance with the Family	p. 80
How to Identify Symptomatic Cycles	p. 82
Setting the Course for Treatment	p. 87
Techniques for Changing Patterns	p. 89
When to Conduct Individual Sessions	p. 101
Benefits and Risks of Consultations	p. 105
Summary	p. 106
5 Eating Disorders	p. 108
Perspectives on Eating Disorders	p. 110
Principles of Treatment	p. 115
Step 1 Negotiating a Treatment Contract	p. 121
Step 2 Encouraging Parental Collaboration	p. 125
Step 3 Addressing Unresolved Conflicts	p. 127
Step 4 Handling Relapses	p. 132
Step 5 Supporting Individual Development	p. 136
Step 6 Supporting the Transformation	p. 139
Pitfalls and Complications	p. 141
Summary	p. 145
6 Depression and Suicide	p. 146
The Role of Gender in Adolescent Depression	p. 147
Assessment of Adolescent Depression	p. 150
Treatments for Depression	p. 151
The Role of Family Dynamics in Adolescent Depression	p. 153
Common Family Patterns Associated with Adolescent Depression	p. 154
Helping Suicidal Adolescents	p. 162
Case Example: The Crying Father	p. 172
Summary	p. 183
7 Anxiety	p. 185
Anxiety and the Family	p. 186
Cognitive Factors in Adolescent Anxiety	p. 189
Anxiety and Abandonment	p. 191
Freeing the Family from the Grip of Anxiety: A Detailed Case Example	p. 198
Summary	p. 216
8 Defiant and Disruptive Behavior	p. 217
How Common Is Problem Behavior during Adolescence?	p. 220
Developmental Perspectives	p. 221
Factors Related to Adolescent Defiance	p. 222
Assessing the Severity of the Problem	p. 225
Interventions When the Problem Is Mild	p. 228
Interventions for Moderately Severe Defiance	p. 232
Interventions for Severe Defiance	p. 238
Summary	p. 253
9 Psychosis	p. 255
Theoretical Perspectives	p. 255
Psychosis and Isolation	p. 258
Reducing Isolation in Psychotic Systems	p. 261
Summary	p. 267
10 Underachievement and Other School-Related Problems	p. 269
Factors Contributing to Adolescent Underachievement	p. 271
Strategies for Intervention	p. 279
Identifying and Avoiding Triangulation	p. 291
Summary	p. 293
11 Leaving Home	p. 295
Perspectives on Leaving Home	p. 297
Assessment	p. 299
Intervention	p. 302
Summary	p. 304
12 Families with Multiple Problems	p. 306
Principles for Working with Overwhelmed, Low-Income Families	p. 310
Case Example: Two Tokens	p. 318
Summary	p. 321
Epilogue: The ARCH	p. 323
References	p. 329
Index	p. 359

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Table of Contents