Family Interviews in Redefining a “Sick” Child's Role in the Family Problem
That the emotionally "sick" child is a spokesman of a family problem is increasingly recognized in child guidance. However much the child himself is now seriously impaired in his functioning, and however much he himself now contributes to perpetuating the roles that have evolved around him, the larger problem indicated by his disturbance is in the network of family relationships, as indeed are the larger resources for significant change. While the traditional child guidance model is intended to correlate helping efforts for the child and his parents, more ofcen than not even its successes involve a considerable undoing of the inherent communication in the treatment model: whereas the child is offered psychotherapy, the parents are seen in casework (the latter not always deemed "treaunenc" in the professional semantics of some instirutions) as if around understanding the chikfs problem. Nor is chis communication entirely undone by various clinical procedures intended to bridge the gap between the child and his helper and the parents and their helpers, e.g., joint interviews of parents by therapist and caseworker. The present preliminary report is intended to propose the usefulness of the newer treatment model of family therapy for leading the family more rapidly to a definition of its incegral problem which releases the child from his scapegoat role and dissolves parental defenses against involvement for themselves. In our experience, bringing the child and his parents (and occasionally siblings) together at che outset of treatrnenc iniciaces the following processes. 1. It is the family as a group that is accorded "patient" scams as child and parents together hear the treatment invitation for each of them to bring rheir suppressed needs in living with each other into the open. 2. The communicative meaning of the child's symptoms is invariably heightened and especially as the therapist shows regard for their intent as expressions of needs not being met in the family (e.g., Hal's "psychotic" talk about H-bombs is accepted as an expression of his anger at that time). 3. In their emergence as interactional responses to ongoing parental behaviors, the child's symptoms are also experienced as magnified replications of like parenral characceristics which signify the same fundamental dynamic