It is generally best to attempt engaging parents / caregivers sooner rather than later, but this will vary depending on the needs and preferences of the young person. Engagement might begin with a brief telephone call to introduce yourself and provide a little information about the service being offered to the young person. Effective early engagement will harness resources that caregivers can offer to encourage the young person to connect with the service. Conversely, if caregivers have difficulties or are reluctant to engage, knowing this can alert you to potential barriers that the young person may face in their efforts to change.
Seek permission from the young person as early as possible, to contact their parents, caregivers or a significant adult in their life, to invite into partnership as a support person. Building on information collected during assessment so far, make sure to have a conversation with the young person about what kind of support they want from this person or persons. Explain that the work is still focused on them, and that it is up to them to decide how much involvement their family members would have.
After initial contact via telephone, subsequent engagement and orientation could be greatly facilitated by a face-to-face meeting with the caregiver, without the young person being present. Talking in the absense of the young person gives the caregiver an opportunity to tell their side of the story and to feel that they are being heard.
Orientation involves ensuring that parents / caregivers understand what is wanted from them, and what the roles of the worker are in exchange. This may require a considerable amount of explanation, encouragement, and negotiation in the early stages and beyond.
Family members should be oriented to the goals of family focused interventions which are to:
- engage families as partners in the service delivery process as far as possible,
- motivate family members as supporters of their young person, and
- build the capacity of family members to provide emotional and practical support that assists the young person along a positive developmental pathway.
Early in the process it is important to give parents/caregivers the opportunity to tell their side of the story and discuss their feelings about the family situation. Empathise with the caregiver’s concerns, but quickly direct attention to what needs to be done now.
Establishing a positive attitude and a focus on the future is critical.
Maintain an enthusiastic tone of voice when engaging with caregivers, communicate your belief that positive change is possible, and that the caregiver has a vital role to play.
Some caregivers will express the view that the problem is situated in the behaviour of the young person and expect that the service can provide treatment that will fix this problem. Explain that the caregiver and family situation are integral to the solution and that the role they play is perhaps more important than any ‘treatment’ that can be provided for the young person in isolation.
Important ground rules that will generally require explanation include:
- that the process is optional for the young person (as well as the family) and that it is unhelpful to coerce the young person in any way;
- that the young person has the right to confidentiality around information they do not want disclosed to parents/caregivers;
- that you will have to put boundaries around what you will tell parents;
- that based on ‘mature minor’ considerations, young people who are capable of giving informed consent have the legal right to seek services independently of parental consent, and
- that you are NOT there primarily as support for the parent.
Explain the range of options available for ongoing interaction between the family and the practitioner, with or without the adolescent being present (e.g. home visits, office-based appointments, telephone conversations etc) and negotiate options and times suitable to the needs of the participants.
If the caregiver is very reluctant to get actively involved, suggest that they ‘sample’ it or give it a try by attending at least one (or one more) face-to-face session. It will be helpful to adopt a Motivational Interviewing style of communication and demonstrate principles such as respect for parental autonomy, that the relationship is collaborative not directive, and that you are not an expert on what is best for the parent.
Some parents may express excessively high levels of concern about their child, demonstrate high levels of intrusiveness such as demands for full disclosure of the content of conversations that you have with their child, or make other demands of you. In these situations firmly:
- reiterate the ground rules and make sure that the parent / caregiver understands them;
- explain that the ground rules apply to the families of all clients, and
- explain that these ground rules are widely endorsed and found to be necessary by youth AOD services that work with families.
TAKE CARE: It is important to be realistic as well as optimistic. Don’t set expectations that are too high.
This element draws from and elaborates on the Caregiver Overview, Rapport Building and Motivation procedure of A-CRA as described by (Godley et al., 2001). For ideas on how to structure early face-to-face sessions with a caregiver see Procedure 9 in the A-CRA Manual.