Social Work Practice with Families
A Resiliency-Ba sed Approach
THIRD EDITION
MARY PATRICIA VAN HOOK
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Library of Congress Cataloging-in-Publication Data
Names: Van Hook, Mary Patricia, author.
Title: Social work practice with families : a resiliency-based approach / Mary Patricia Van Hook.
Description: Third edition. | New York, NY : Oxford University Press, [2019]
| Includes bibliographical references and index.
Identifiers: LCCN 2018038039 | ISBN 9780190933555 (pbk. : alk. paper)
Subjects: LCSH: Family social work.
Classification: LCC HV697 .V36 2019 | DDC 362.82/53—dc23
LC record available at https://lccn.loc.gov/2018038039
Printed by Sheridan Books, Inc., United States of America
For my husband, Jay Martin Van Hook, and my children, Carie, Stephen, Suzanne, and John, and their families, who taught me important lessons about families and have given their ongoing support.
Preface ix
Acknowledgments xiii
About the Author xv Competencies xvii
CONTENTS
PART I INTRODUCTION TO RESILIENCY- BAS ED PRACTICE
1. The Nature and Sources of Resiliency 3
2. Setting the Stage for Work with Families: Development of the Therapeutic Alliance 50
3. Assessment of Families 64
4. Cultural Issues, Family Structure, and Resiliency 107
PART II APPROACHES TO SOCIAL WORK PRACTICE WITH FAMILIES: INTRODUCTION TO FAMILY THERAPY M ODELS
5. Social Learning/Cognitive Family Therapy Models 165
6. Psychoeducational Family Counseling 188
7. Structural Family Therapy 207
8. Solution-Focused Family Therapy 224
9. Narrative Family Therapy 248
PREFACE
The term resiliency has received increased attention, with widespread recognition that people have the ability to cope with a variety of difficult life events. The issue of Newsweek marking the 10-year anniversary of the tragic events of September 11 had RESILIENCE in bold letters on the cover. Communities seeking to restore life after deadly tornadoes or floods and experiences of interpersonal violence are described as resilient. The strengths- and assets-based approaches to micro and macro practice rely on concepts associated with the literature on resiliency. For me personally, the path to thinking about resiliency began early in my social career as part of an attempt to understand how people managed not only to overcome difficult early life experiences but also to emerge as contributing individuals.
As a beginning social worker, I was working at a major New York City teaching psychiatric hospital on the children’s services unit. In the course of arranging with a local foster care agency to place one of the children, we met the prospective foster father, a compassionate and responsible family man and father of two children. He and his wife were willing to open their home to a 5-year-old boy from our program. He told his own childhood story of going from foster home to foster home until he grew too old for the foster care system. During these years, he developed the goal of providing a stable foster home to protect other children from his own experience. The time had now come to fulfill this commitment, and he and his wife agreed to accept this little boy into their home. After meeting with this prospective foster father, the staff of the children’s services discussed our own limitations in understanding the emotional and interpersonal strength of this man. If he had been a patient in the hospital and we had been asked to explain why he was in the hospital and unable to function or relate effectively with other people, we would have had no difficulty explaining his illness. We would have talked about attachment problems, ego deficits, and other contributing factors. We recognized that our theoretical tools had no answers for why he was the caring, responsible man that he currently
was. We were humbled at the complex nature of human beings and the presence of strength despite great odds.
Several years ago, a colleague and friend of mine received a major award for his contributions to the field of mental health. He had been responsible for creating some important changes in mental health services and had developed and administered several important mental health programs. In his acceptance speech, he described the source of his commitment to making a difference in the services offered. When he was a child, his father, a volunteer fireman, had died rushing to respond to a fire. He and his brothers were then raised by their mother, a fragile woman with many serious mental health problems. She was in and out of hospitals, and the boys experienced the stigma of family mental illness in their small community with very limited resources to help the family. As a result, he grew up dedicated to ensuring that other families would receive the help they needed—help that had not been available to him and his family. He became a committed and effective leader in the field of mental health, especially to providing care to those in underserved areas. When I described my friend’s background to my students and asked for their description of his current situation, their stories were replete with pathology: inability to hold down a job, problems in relationships, perhaps substance abuse. They were surprised and rather skeptical when I described instead a caring husband and father, respected in the mental health field, and a good friend to those around him. Perhaps if we had met his two older brothers, both of whom grew up to be dedicated public servants and had learned more about the legacy left by his father, we would have had some clue regarding the source of his resiliency.
In the media, we hear and read of children caught up in crime and drugs within their troubled neighborhoods. Many of these children join the case rolls of social workers and other counselors. Their stories reveal the trauma and ongoing dysfunction in the lives of the people involved. But, receiving less attention are the children who somehow manage to forge productive and satisfying lives despite living in the same areas. We live in a world in which people must contend with the aftermath of accidents, violent actions, or severe illness that leaves families without a parent or partner. Other families face problems of poverty, political, or social oppression. Families experience the loss of children through illness or accidents. No family is immune to at least some of these adverse life events, and many of the families that we see in social work have experienced several of them.
Social workers and related professionals realize that while discovering and identifying why people develop problems and disabilities are important, this information is inadequate for the assessment and treatment process. It is essential to find answers to how people manage to endure, cope, and even sometimes thrive under the troubles that can be part of the human condition. It is further important to identify the specific aspects of a person’s life that make such coping possible (Blundo, 2002). The strengths perspective reminds us that such answers are critical in the design and implementation of prevention and treatment efforts and
can promote the healing process (Saleebey, 2000). McQuaide (2000), in writing about women’s resiliency at midlife, went even further. She described assessment and treatment that is vulnerability and pathology based as participating “in the process of subjugation—the subjugation of the resilient selves” (p. 74).
In recognition of the importance of identifying sources of strength, vitality, and effective coping in our work with families, this book draws on the theoretical framework and empirical literature regarding resiliency to examine the nature of the concept and the empirical basis of factors that promote resiliency in individuals and families. The book is organized to help the reader understand the concept of resiliency and the related concepts of risk and protection as well as individual, family, and community factors that promote resiliency. Subsequent chapters discuss resiliency from the perspective of families who are facing certain problem events and belong to different racial or ethnic and community groups and with diverse family structures. The book presents a model of assessing families using a resiliency framework. The book describes ways to join families using a resiliency approach. The understanding of what aspects of family life can either threaten or contribute to resiliency can guide the social worker in selecting intervention approaches that could be useful in strengthening a particular family with its unique set of current circumstances. Based on this discussion, the book links the concepts of resiliency with some of the family therapy approaches in terms of ways in which they can be used to promote the welfare of the family and its members.
Part I of the book introduces the reader to the concepts of resiliency and ways they can be incorporated into the basic social work practice with families. Chapter 1, The Nature and Sources of Resiliency, describes the meaning of the concept of resiliency and related concepts organized around risk and resiliency. It also presents findings regarding what contributes to resiliency for individuals and families and the process that influences how families are able to cope with potentially stressful life events. Recognizing the critical role that culture plays in how people experience and cope with life events, chapter. The next two chapters, chapter 2, Setting the Stage for Work with Families: Development of the Therapeutic Alliance, and chapter 3, Assessment of Families, discuss these two essential phases of social work with families from a resiliency-based perspective. Chapter 3 also begins to make the link between assessment and the section of intervention strategies. Resiliency theory thus becomes one of the tools that can be used by social workers in guiding their clinical judgments in working with families. This book is based on the premise that it is important to match the intervention approach to the family and its unique set of circumstances. In recognition of the importance of culture in influencing resiliency, chapter 4, Cultural Issues, Family Structure, and Resiliency, describes some of the risk and protective factors that have been identified for selected ethnic and racial groups, as well as military and gay and lesbian families. The updated section regarding ethnic/racial groups includes Latino, Africa American, Asian American, and First Nations and is organized in terms of risk and resiliency factors from the
community to the individual level. This edition also includes an expanded version on military families given the recent literature in this area and the increased need to understand what contributes to resiliency in these families.
Part II discusses several of the traditional family counseling approaches from a resiliency-based perspective. Resiliency-based practice can draw on various counseling strategies, with the joint goals of reducing the risks facing families and enhancing the protective aspects of families and their environment. This section opens with a chart of the major tenets of the models and a brief introductory history of important themes and developments in family therapy. The subsequent chapters discuss specific models of interventions with families and are generally organized in terms of the levels of family functioning described in chapter 3 with the exception of the chapter on multisystems family therapy because it draws on previously described models: chapter 5, Social Learning/ Cognitive Family Therapy Models; chapter 6, Psychoeducational Family Counseling; chapter 7, Structural Family Therapy; chapter 8, Solution-Focused Family Therapy; chapter 9, Narrative Family Therapy; chapter 10, Multisystems Family Therapy; and chapter 11, Bowen Family Systems Therapy (new to this edition); and chapter 12, Object Relations Family Therapy. The chapters regarding specific models include one or more case illustrations of the use of this approach, a discussion of the theoretical background, major tenets, goals of treatment, role of the social worker, and an evaluation of the theory. Several chapters include information about adaptations of the approach for specific cultural groups or problems facing families. This section ends with chapter 13, Spirituality. Unlike the preceding chapters that address specific models of practice, spirituality does not represent such a model but instead is an important aspect of life that can play a role in a variety of approaches.
Part III includes chapter 14, Families Coping with Difficult Life Circumstances, which discusses the literature in terms of risk and protective factors for families that are facing a variety of difficult life events. Recognizing that the families seeking social work help tend to be struggling with one or more difficult life events, this chapter reviews literature in terms of valuable supports for families facing selected problems. Some of the topics include illness (both physical and mental health related), sexual abuse, divorce, trauma, and childhood behavior problems. With the essential caveat that information related to the problems facing families must be paired with an assessment of individual families and their context, each of the sections also includes a discussion regarding implications for treatment approaches. Chapter 15, Conclusion, includes a brief summary of the elements of a resiliencybased approach to social work practice with families and a discussion of the important aspects of this approach in strengthening families.
ACKNOWLEDGMENTS
Many people have helped make this book possible. The families I have had the privilege to work with during my years of clinical practice have provided essential insights into the challenges facing families and the sources of resiliency. My own family also helped me more fully understand the reality of family life that underlies this book. This third edition builds on input that made earlier editions possible. A draft version of this manuscript was used with social work graduate students at the University of Central Florida. The feedback provided by these students and their faculty members, Drs. Michael Rothenberg and Mary Beth Harris, was invaluable. My husband’s editing skills were essential. I am also deeply indebted to my mentor, Dr. Sallie Churchill, professor emerita, of the University of Michigan School of Social Work, whose clinical wisdom has encouraged me to think in terms of resiliency. I would also like to thank Bruce Friedman, Mary Helen Hayden, Shelley Cohen Konrad, Marian Mattison, Fred McKenzie, Tom Meenaghan, Renee Pogue, William Powell, Pat Sickinger, Wendy Smith, Martha Wilson, and Olga Molina, whose reviews of earlier versions of the manuscript provided invaluable probing questions and insights for the second edition. Also, I would like to thank Timothy Myland for his insights regarding the Canadian social services situation. The University of Central Florida library helped make this book possible through access to current literature. I would like to thank David Follmer, whose ongoing encouragement and advice made this book a reality.
ABOUT THE AUTHOR
Mary Patricia Van Hook is professor emerita of the University of Central Florida School of Social Work. She was director of the University of Central Florida School of Social Work and taught research and practice social work courses at the University of Central Florida, the University of Michigan, Grand Valley State University, and Northwestern College. She was also a clinical social worker and administrator for mental health and family agencies in New York, Maryland, and Iowa. She has written extensively in the areas of families, rural mental health, spirituality, and women’s issues both domestically and internationally. She received the Howery Award for outstanding contributions to rural mental health and the Award for Distinguished Service to Christianity in Social Work by the North American Association for Christians in Social Work (NACSW). She was the Alan KeithLucas presenter for the NACSW in 2012. She received her PhD in social work from Rutgers University, her MS from Columbia University School of Social Work, and her BA from Calvin College.
COMPETENCIES
This book is designed to address important competencies required by the Council of Social Work Education in the 2015 EPASS standards. The material that follows identifies competencies and ways in which they are addressed.
Competency 1. Demonstrate Ethical and Professional Behavior
The competency to demonstrate ethical and professional behavior encompasses a wide range of expectations of ethical and professional behavior. The sentences “They understand how their personal experiences and affective reactions influence their professional judgment and behavior” and “use reflection and self-regulation to manage personal values and maintain professionalism in practice situations” are addressed in several ways throughout the book Chapter 2, Setting the Stage for Work with Families: Development of the Therapeutic Alliance, and chapter 3, Assessment of Families, discuss the need for social workers to be aware of their own responses and behavior in their work with families. While this issue is important in all models, it is especially so in models related to spirituality and object relations and is discussed so specifically.
Competency 2. Engage Diversity and Difference in Practice
Social workers understand how diversity and difference characterize and shape human experience and are critical to the formation of identity. The dimensions of diversity are understood as the intersectionality of multiple factors including. . . . Social workers understand that, as a consequence
of difference, a person’s life experiences may include oppression, poverty, marginalization, and alienation as well as privilege, power, and acclaim. Social workers also understand the forms and mechanisms of oppression and discrimination and recognize the extent to which a culture’s structure and values, including social, economic, political, and cultural exclusions, may oppress, marginalize, alienate or create privilege and power.
Social workers apply and communicate understanding of the importance of diversity and differences in shaping life experiences in practice at the micro, mezzo, and macro levels.
• A pply and communicate understanding of the importance of diversity
The issues identified in the competency to engage diversity and difference in practice are an important theme throughout the book and are addressed through case illustrations and other narratives, specific discussion of the risks and protective factors of many specific groups, and research findings from a range of different cultural and national groups as they pertain to treatment models and problems facing families. While evidence is presented in terms of the challenges of oppression, poverty, and so on, there is also an explicit effort to balance this with the sources of resiliency of these groups. Chapter 4, Cultural Issues, Family Structure, and Resiliency, is designed specifically to inform the reader about some major groups (e.g., Latinos, African Americans, Asian Americans, First Nations/Aboriginal people, Jamaicans, Military, gay and lesbian families, single parents, divorced families). Chapter 14 on coping with difficult life circumstances has an extensive discussion regarding refugees, child mistreatment, survivors of sexual abuse, persons with HIV/AIDS, and other forms of trauma. Throughout the book, there are case illustrations and narratives in which family members include, among others, Latinos, African Americans, refugees, Asians, Caucasians, Jewish individuals, Muslims, Christians, Hindus, single parents, gay/lesbian parents, and members of the military. While the primary emphasis is on issues in the United States and Canada, there is an explicit effort to include research findings regarding ways people cope and treatment models with people globally. The discussion regarding coping with life experiences includes research regarding how members of different cultural groups cope. Chapters regarding treatment approaches draw on case illustrations that reveal these risk and protective factors and include research regarding ways to adapt these models to members of different cultural groups.
• Present themselves as learning and engage clients and constituents as experts in their own experiences
The theme of presenting themselves as learners and engaging clients and constituents as experts in their own experiences is also important in the book. The
model used in this book is specifically a collaborative approach in which the client/ family members are respected as experts regarding their experiences. It is an essential theme in chapter 2, Setting the Stage for Work with Families, but emerges also as the approach in working with families using different treatment models. The following are examples: social learning/cognitive family Counseling, for which the assessment process is a joint family–counselor effort with an emphasis on helping family members identify the source of their family difficulties; solution-focused counseling, which has an emphasis on the family identifying their goals and ways to reach them; narrative therapy emphasizes the family’s story, with the counselor only a coeditor; multisystems therapy emphasizes the family selecting their key issue to address; psychoeducational counseling, in which family members are clearly identified as partners; and spirituality, which provides respect for what is important for the family members. Case examples and illustrations are used to demonstrate what this means in terms of practice. One, for example, draws from the counselor’s own practice in which it was important to ask the client herself what blood meant to her, with the revealing answer that the client gives that opens the door to a fuller understanding of her incredible history of trauma experiences and her strength.
• A pply self-awareness and self-regulation to manage the influence of personal biases and values in working with diverse clients and constituents
Again, the need to apply self-awareness and self-regulation to manage the influence of personal biases and values in working with diverse clients and constituents is emphasized in chapter 2, Setting the Stage for Work with Families. There is a lengthy discussion about the risk of counselor biases, the need to be aware of them, and the importance of self-awareness. It is also stressed in methods chapters; for example, in terms of spirituality (understand one’s own life views and separate them from our clients), recognize the importance of clients determining their goals and steps for solution-focused therapy. The relationship between the counselor and the family members is identified as critical and thus the social worker needs to be aware of how he or she uses one’s self in this process.
Competency 3. Advance Human Rights and Social, Economic, and Environmental Justice
While this is a book that focuses on counseling practices with families, there is recognition throughout the book on the need to identify and address macro issues that relate to poverty and discrimination. Some instances include the discussion of levels of intervention for multisystems treatment as well as the social and economic challenges facing families; information in the chapter on culture that identifies some
of the risk factors related to poverty, oppression, and other forms of injustice that create ongoing problems for family and members of at-risk groups; and the information in chapter 14 on coping with difficult life circumstances (especially relating to refugees, victims of various forms of trauma).
Competency 4. Engage in Practice-Informed Research and Research-Informed Practice
Use and translate research evidence to inform and improve practice, policy, and serv ice delivery. This book addresses research in the form of helping social workers draw on research to inform their practice with families. It does so by including findings from research throughout the book. The first chapter draws on research in the area of resiliency to help identify risk and protective factors that can influence needs and strengths of individuals and families. Research also informs the importance and practice of engagement with clients. Chapter 3, Cultural Issues, Family Structure, and Resiliency, is a research-based chapter to help identify risks and protective factors that can help inform practice needs and processes. The chapters on treatment models identify outcome results that are currently available as well as research regarding ways to adapt treatment to various cultural groups and needs. Chapter 14 on coping with difficult life circumstance draws on extensive research to help identify the issues of people facing these difficult life circumstances and practice implications.
Competency 5. Engage in Policy Practice
This book identifies policy issues that have an impact on families and ways in which policies influence the nature of accessible service. It is, however, not primarily designed to prepare social workers to address and become experts in policy practice.
Competency 6. Engage with Families, Groups, Organizations, and Communities
Social workers understand that engagement is an ongoing component of the dynamic and interactive process of social work practice with and behalf of diverse individuals, families, groups, organizations, and communities. Social Workers value the importance of human relationships. . . . Social workers understand how their personal experiences and affective reactions may impact their ability to effectively engage with diverse clients and
constituencies. Social workers value principles of relationship-building and inter-professional collaboration. . . .
• Social workers apply knowledge of human behavior and the social environment . . . to engage with clients.
The book addresses the value of knowledge of human behavior and the social environment in the process of engaging and working with clients through the book. It does so in several ways. First, the book uses a basic resiliency perspective to organize research and theoretical information about the risk and protective factors facing individuals and families and on various theories to form the basis for practice interventions. This information is drawn from research from some of the fields of human behavior and the social environment, for example, development, attachment theory, object relations, operant conditioning, social learning, ecological frameworks, family life cycle, family crisis and resiliency models, family processes and organization, culture, trauma, and life events. While it is the basis for chapter 1, The Nature and Sources of Resiliency, theories related to human behavior and the social environment and how these issues might impact family members are incorporated into all the following chapters: chapter 2, Setting the Stage for Work with Families; chapter 3, Assessment of Families; chapter 4, Cultural Issues; the chapters on specific treatment issues; and chapter 14, Families Coping with Difficult Life Circumstances. It also does this through case illustrations throughout the book (e.g., families facing economic crisis, families experiencing cultural transitions, families experiencing major family changes). The book also emphasizes self-understanding in terms of recognizing how the counselor can join the family dance in ways that perpetuate dysfunctional family patterns (joining process) and ways in which the counselor can use his or her own emotional response in the assessment process. The book recognizes that the counselor uses himself or herself as a tool and thus needs to be very self-aware of behavior and reactions.
• Use empathy, reflection, and interpersonal skills to effectively engage clients and constituencies
In addition to theoretical and research information that can help inform engagement, case illustrations are included to help develop empathy for families experiencing a variety of life circumstances. These help personalize the impact of these various life events (e.g., what steps a family might take if they fear deportation back to refugee camps; what it would mean when the pillar of the family becomes disabled, when a child becomes seriously ill, when a father and husband comes back from the war with post-traumatic stress disorder, for a family to fear eviction, for a child to think that he or she is responsible for the financial problems of a family, to have been sexually abused as a child; and many other examples throughout the book). These illustrations
can also be used tools for reflection to examine one’s own reactions and responses. The book also uses a shared vulnerability/strengths perspective by including several personal examples to further demonstrate how these life events can have an impact on people. While the focus is on direct work with families, there are also examples of incorporating other important people (e.g., pastors, other family members and support persons, teachers) in the lives of the family members into the process.
Competency 7. Assess Individuals, Families, Groups, Organizations, and Communities
This competency is addressed through the work in the following ways pertaining the subheadings.
• Collect and organize data and apply critical thinking to interpret information from clients and constituencies
Assessment is addressed in a variety of ways and places in this book. The book begins with a discussion of resiliency and risk and protective factors that can contribute to the understanding of information gained in the assessment process. Chapter 3 is devoted to the issue of assessment of families. This chapter describes in detail ways to engage the family in a joint assessment process of the family situation. In addition, the book describes and illustrates the use of two collaborative tools—the ecomap and the genogram. Subsequently, in the spirituality chapter (chapter 13), the book also describes a spiritual ecogram.
The book also identifies the assessment process from a resiliency perspective that enables the counselor to gain an understanding of the nature of the problem as viewed by the family, drawing on the verbal and nonverbal messages of the family. This assessment potentially includes discussion in terms of sources of information, the reaction of the social worker, the family’s coping process, current stressors and additive factors, relevant family belief systems, and family strengths and risks. This information is reinforced and supplemented in the chapters on treatment models by describing an assessment process with families through case illustrations and ways in which this information can form the basis for the intervention. The book also discusses the role of extended family members and others as sources of information.
• A pply knowledge of human behavior and the social environment, person-inenvironment, and other theoretical frameworks in the analysis of assessment data from clients and constituents
In addition to the general information identified previously, the application of knowledge takes place in several places. Each of the treatment model chapters is
based on theory, theoretical perspectives, or conceptual frameworks from the area of human behavior and person-in-environment knowledge. The theoretical basis is used in these chapters to understand family members and the family unit and thus is a basis for selecting an intervention model and intervention strategies. In this way, there is a direct link between theory, assessment, and the selection of an appropriate treatment intervention.
• Develop mutually agreed intervention goals and objectives based on the critical assessment of strengths, needs, and challenges of clients and constituencies
As described previously, the emphasis in this book is on a collaborative relationship between the counselor and family members in using the information obtained in the assessment process to identify the goals of the client and ways to reach these goals. In each of the chapters on treatment models, there is a discussion of the process of working with the family to understand their strengths, needs, and challenges to create a way to respond and work toward healing.
• Select appropriate intervention strategies based on the assessment, research knowledge, and values and preferences of the clients and constituencies
This statement on selecting appropriate intervention strategies speaks to the heart of the book. The entire focus of this book is on drawing on the research and practice literature to identify risk and protective factors and ways to use this assessment to help develop with clients an appropriate treatment strategy. All the treatment model chapters draw on research literature in terms of the theory and rationale for selecting this treatment approach and engagement with the family members in selecting and carrying out the intervention: “Begin where the client is.” In addition, chapter 14 regarding coping with difficult life situations also discusses implications for assessment and treatment approaches. Culture can play a critical role in influencing values and preferences; thus, this aspect is included throughout the book. The book was designed in this way because it helps link assessment with treatment models in a very explicit manner.
Competency 8. Intervene with Individuals, Families, Groups, Organizations, and Communities
Social workers understand that intervention is an ongoing component of the dynamic and interactive process of social work practice with, and on behalf of diverse individuals, families, groups, organizations, and communities. Social workers are knowledgeable about evidenced-informed intervention to achieve the goals of clients and constituencies. . . .
• Social workers critically choose and implement interventions to achieve practice goals and enhance capacities of clients and constituencies.
This statement is a theme of the entire book, which begins with a research-based discussion of resiliency as a basis for understanding ways to support a strengthbased perspective on working with and on behalf of people. It also posits that there are many different potential interventions, and it is the appropriate responsibility of the social worker to work cooperatively with the family to identify the intervention that is most likely to help them reach their goals and enhance their capacities. As described in chapter 3, Assessment of Families, people lose their homes for many reasons and with very different implications for intervention. As a result of the basic theme of the book, it is organized in such a way to link the selection of interventions with the assessment process, for example, using the following questions: Is this a family overwhelmed with basic needs to be met (multisystems approach)? Is this a family struggling with a sense of failure despite some important coping strategies (perhaps solution-focused or narrative approaches)? Is this a family going through transition and thus needing to learn new skills (social learning)? Is this a family having to deal with a person with a serious illness (psychoeducational)? Is this family situation an example of a community that has become demoralized (examples from First Nations in chapter 4 on culture)? Depending on the answer to some of these basic questions, the book uses the chapters on treatment models to begin to answer them. The chapters on ways in which families cope with difficult life circumstances (chapter 14) and cultural issues (chapter 4) also identify potential interventions depending on other related circumstances. These chapters also include information from the research literature in terms of outcome data generally and for specific cultural and other groups. This information is drawn from as many different cultures as the research literature permits.
• A pply knowledge of human behavior and the social environment, person-inenvironment, and other theories in intervention with clients and constituencies
The chapters regarding the treatment models discuss the research and theoretical frameworks that form the rationale for these models. These theoretical models are subsequently used to select the treatment model and also link specific behavioral and cognitive patterns with treatment interventions. The chapters then continue with a discussion of how this informs the treatment approach generally and specifically using examples. The discussion that follows represents some of the examples. Social learning/cognitive theory begins with a discussion of classical conditioning, social learning, and cognitive models and then identifies how this information can be used to counsel families. Multisystems treatment draws on an understanding of an ecological framework to assess families and develop intervention strategies. Structural family treatment bases its model on an understanding of family structure,
