Children’s participation in family therapy: Towards a dialogical partnership

Abstract

Children, or more specifically their symptoms, often bring their families to therapy. Children can be seen as “doors” through which to enter the family as a multigenerational and multifaceted chain of relations and its systemic conscious or unconscious core beliefs, rules and habits. Given that a child’s symptoms reflect some uneasiness in family relations that might have increased over the years, or even generations, frees the child from being positioned as the problem or as a scapegoat. Seeing one family member’s symptoms as an issue or difficulty shared by the whole family enables family therapists to treat the whole family and view its problems as well as possibilities and resources from relational perspectives in accordance with systemic principles. Children’s participation in family therapy has not, however, always been self-evident, despite the original idea of family. Children’s engagement in a meaningful way in family therapy practice has commonly been noted as presenting both therapists and families with a challenge. The number of studies in which the voices of children as family therapy participants are heard continues to be limited. This doctoral research contributes to filling this gap by presenting three case studies on children’s perspectives. The first investigated how a child diagnosed with an oppositional defiant disorder participated in family therapeutic discussions when the family’s difficulties were discussed. The second studied how sensitive and multigenerational family secrets were dealt with when children were present. The third examined how children participated in collaborative post-therapy research interviews and talked about their perceived difficulties and experiences. The three studies applied qualitative methods. The research data were drawn from data gathered for a larger family therapy research project titled “Family-centred Treatment and Systemic Feedback in the Prevention of the Social Exclusion of Children Diagnosed with Oppositional Defiant or Conduct Disorder and their Families”. The research project is a collaborative effort by the University of Jyväskylä, Kuopio University Hospital, and the University of Eastern Finland. The data consist of video-taped family therapy sessions with 14 families of children aged 6-12. The results presented in this dissertation are primarily intended for those who are working with families and promoting children’s participation and agency in family therapy. The most central result of this thesis underlines the importance of seeing children in family therapy as subjects, i.e., as active and meaningful dialogical partners whose presence and contributions need to be supported and approached in a respectful way. The challenging responsibility of the family therapist is to construct a positive and balanced alliance with each family member. By focusing on a family’s strengths, family therapy can mobilise the family’s hidden resources and thus activate an intrinsic healing process within the family. Keywords: children, family therapy, dialogical approach, qualitative research