Adult Treatment Planner
16: Family Conflict
SNOMED Terms
- Antisocial personality disorder
- Borderline personality disorder
- Dependent personality disorder
- Intermittent explosive disorder
Goals
- Resolve fear of rejection, low self-esteem, and/or oppositional defiance by resolving conflicts developed in
the family or origin and understanding their connection to current life.
- Begin the process of emancipating from parents in a healthy way by making arrangements for independent
living.
- Decrease the level of present conflict with parents while beginning to let go of or resolving past conflicts
with them.
- Achieve a reasonable level of family connectedness and harmony where members support, help, and are
concerned for each other.
- Become a reconstituted/blended family unit that is functional and whose members are bonded to each other.
Behavioral Definitions
- Constant or frequent conflict with parents and/or siblings.
- A family that is not a stable source of positive influence or support, since family members have little or
no contact with each other.
- Ongoing conflict with parents, which is characterized by parents fostering dependence leading to feelings
that the parents are overly involved.
- Maintains a residence with parents and has been unable to live independently for more than a brief period.
- Long period of noncommunication with parents, and description of self as the "black sheep."
- Remarriage of two parties, both of whom bring children into the marriage from previous relationships.
Diagnoses
- Dysthymic Disorder
- Anxiety Disorder NOS
- Intermittent Explosive Disorder
- Alcohol Dependence
- Cocaine Dependence
- Polysubstance Dependence
- Antisocial Personality Disorder
- Dependent Personality Disorder
- Borderline Personality Disorder
- Personality Disorder NOS
Objectives and Interventions
- Describe the conflicts and the causes of conflicts between self and parents.
- Give verbal permission for the client to have and express own feelings, thoughts, and perspectives
in order to foster a sense of autonomy from family.
- Explore the nature of the client's family conflicts and their perceived causes.
- Attend and participate in family therapy sessions where the focus is on controlled, reciprocal, respectful
communication of thoughts and feelings.
- Conduct family therapy sessions with the client and his/her parents to facilitate healthy
communication, conflict resolution, and emancipation process.
- Educate family members that resistance to change in styles of relating to one another is usually
high and that change takes concerted effort by all members.
- Identify own as well as others' role in the family conflicts.
- Confront the client when he/she is not taking responsibility for his/her role in the family conflict
and reinforce the client for owning responsibility for his/her contribution to the conflict.
- Ask the client to read material on resolving family conflict (e.g., Making Peace with Your Parents
by Bloomfield and Felder); encourage and monitor the selection of concepts to begin using in
conflict resolution.
- Family members demonstrate increased openness by sharing thoughts and feelings about family dynamics, roles,
and expectations.
- Conduct a family session in which a process genogram is formed that is complete with members,
patterns of interaction, rules, and secrets.
- Facilitate each family member in expressing his/her concerns and expectations regarding becoming a
more functional family unit.
- Identify the role that chemical dependence behavior plays in triggering family conflict.
- Assess for the presence of chemical dependence in the client or family members; emphasize the need
for chemical dependence treatment, if indicated, and arrange for such a focus (see Chemical
Dependence and Chemical Dependence - Relapse chapters in this Planner).
- Verbally describe an understanding of the role played by family relationship stress in triggering substance
abuse or relapse.
- Help the client to see the triggers for chemical dependence relapse in the family conflicts.
- Ask the client to read material on the family aspects of chemical dependence (e.g., It Will Never
Happen to Me by Black; On the Family by Bradshaw); process key family issues from the reading that
are triggers for him/her.
- Increase the number of positive family interactions by planning activities.
- Refer the family for an experiential weekend at a center for family education to build skills and
confidence in working together. (Consider a physical confidence class with low or high ropes
courses, etc.).
- Ask the parents to read material on positive parenting methods (e.g., Raising Self-Reliant Children
by Glenn and Nelsen; Between Parent and Child by Ginott; Between Parent and Teenager by Ginott);
process key concepts gathered from their reading.
- Assist the client in developing a list of positive family activities that promote harmony (e.g.,
bowling, fishing, playing table games, doing work projects). Schedule such activities into the
family calendar.
- Parents report how both are involved in the home and parenting process.
- Elicit from the parents the role each takes in the parental team and his/her perspective on
parenting.
- Read and process in a family therapy session the fable "Raising Cain" or "Cinderella" (see
Friedman's Fables by Friedman).
- Identify ways in which the parental team can be strengthened.
- Assist the parents in identifying areas that need strengthening in their "parental team," then work
with them to strengthen these areas.
- Refer the parents to a parenting group to help expand their understanding of children and to build
discipline skills.
- Direct the parents to attend a tough-love group for support and feedback on their situation.
- Train the parents in the Barkley Method (see Defiant Children by Barkley) of understanding and
managing defiant and oppositional behavior.
- Parents report a decrease in the frequency of conflictual interactions with the child and between children.
- Ask the parents to read material on positive parenting methods (e.g., Raising Self-Reliant Children
by Glenn and Nelsen; Between Parent and Child by Ginott; Between Parent and Teenager by Ginott);
process key concepts gathered from their reading.
- Assign the parents to read material on reducing sibling conflict (e.g., Siblings Without Rivalry by
Faber and Mazlish); process key concepts and encourage implementation of interventions with their
children.
- Train the parents in a structured approach to discipline for young children (e.g., 1-2-3 Magic by
Phelan; Parenting with Love and Logic by Cline and Fay); monitor and readjust their implementation
as necessary.
- Report an increase in resolving conflicts with parent by talking calmly and assertively rather than
aggressively and defensively.
- Use role-playing, role reversal, modeling, and behavioral rehearsal to help the client develop
assertive ways to resolve conflict with parents.
- Parents increase structure within the family.
- Assist parents in developing rituals (e.g., dinner times, bedtime readings, weekly family activity
times) that will provide structure and promote bonding.
- Assist the parents in increasing structure within the family by setting times for eating meals
together, limiting number of visitors, setting a lights-out time, establishing a phone call cutoff
time, curfew time, "family meeting" time, and so on.
- Each family member represents pictorially and then describes his/her role in the family.
- Conduct a family session in which all members bring self-produced drawings of themselves in
relationship to the family; ask each to describe what they've brought and then have the picture
placed in an album.
- Ask the family to make a collage of pictures cut out from magazines depicting "family" through their
eyes and/or ask them to design a coat of arms that will signify the blended unit.
- Family members report a desire for and vision of a new sense of connectedness.
- In a family session, assign the family the task of planning and going on an outing or activity; in
the following session, process the experience with the family, giving positive reinforcement where
appropriate.
- Conduct a session with all new family members in which a genogram is constructed, gathering the
history of both families and that visually shows how the new family connection will be.
- Assign the parents to read the book Changing Families (Fassler, Lash, and Ives) at home with the
family and report their impressions in family therapy sessions.
- Identify factors that reinforce dependence on the family and discover how to overcome them.
- For each factor that promotes the client's dependence on parents, develop a constructive plan to
reduce that dependence.
- Ask the client to make a list of ways he/she is dependent on parents.
- Increase the level of independent functioning - that is, finding and keeping a job, saving money,
socializing with friends, finding own housing, and so on.
- Confront the client's emotional dependence and avoidance of economic responsibility that promotes
continuing pattern of living with parents.
- Probe the client's fears surrounding emancipation.
- Assist the client in developing a plan for healthy and responsible emancipation from parents that
is, if possible, complete with their blessing.
Index