A key challenge that will arise throughout your work with families, is the tendency of young people and their caregivers to focus on the problems that have been plaguing their relationship. Despite your efforts to encourage a focus on the future and reassure the parties that positive change is possible, at least one of the parties may repeatedly point out problematic behaviours in the other person that never seem to change, or both parties will fall into interactions based on mutual blaming.

These techniques from Functional Family Therapy can be helpful as practitioners try to shape positive interactions. They can be used at any appropriate time throughout the first and any subsequent family meetings.

When meeting alone with the parent or caregiver, and before holding a 3-way meeting with a caregiver and young person, explain that part of your role in the work is to set positive expectations and to keep returning to the positive. Introduce a few of the following techniques and explain why you will be using them.

‘Relabel behaviour’ – If parents and/or adolescents are using pejorative labels to refer to an unwanted behaviour in the other person, change the meaning or value of the behaviour by pointing out its positive properties, or explaining that the adolescent / caregiver is not deliberately trying to make the other person miserable. For example if a parent says that the young person is ‘refusing to communicate’ when they leave an argument and go to their room, this behaviour might be relabeled as ‘taking time-out from conflict’ or ‘de-escalating anger’. If a young person says that their caregiver ‘wants to destroy my social life’, this might be re-labeled as ‘wants to set some limits’.

‘Curtail blaming’ – Communicate that blaming someone for previous problems does not serve any purpose. Emphasise the future, not what happened in the past.

‘Emphasise family strengths’ – Repeatedly reinforce discussions about aspects of family life that are working well such as pleasant events and activities.

‘Use exception statements’ – Ask the parent or caregiver to describe situations from the past where the problem behaviour was expected to occur but did not, then probe into what was different about this situation. For detailed information on the use of exception statements.

‘Facilitate new exceptions’ – Construct opportunities for positive interactions such as pleasant activities. Design activities that make it easy for the adolescent and family members to enact or practice behaviours that break away from the problem cycle.

The Adolescent Community Reinforcement Approach (A-CRA) offers several structured exercises/activities aimed at facilitating positive interactions.

3 Positive Things Exercise – It is best to introduce this exercise quite early in the first three-way or family session, and then re-visit it at the beginning of subsequent sessions. It is a good way to set the session off on a positive note. 

• Provide rationale for the exercise
• Emphasise that the young person and caregiver must speak directly to one another during the exercise (this is very important as it brings about an emotional shift)
• Ask each person to tell the other 3 positive things that the other person has done in recent days or weeks (e.g. I really liked the way that you …)
• Ask the recipient to repeat back the positive comments that they have heard (e.g. I heard you say that you liked …)
• Swap roles
• Provide encouragement and prompts if a person gets stuck (e.g. ask them to think back to the past when things were better)
• Praise their efforts and summarise what each person values in the other

Relationship Happiness Scale – This exercise involves the caregiver and the young person each spending 2-3 minutes completing a scale in which they rate their happiness or satisfaction with the other person in a number of different relationship domains. The Relationship Happiness Scale can be used to help identify areas of the relationship that are working relatively well, and spending some time discussing these can shift the interaction into a positive mode. The scale has 8 items that are each rated on a 10 point scale from 1=completely unhappy to 10=completely happy. There are slightly different versions for caregivers and young people. Items that are shared include communication, affection, emotional support, general home atmosphere, and general happiness.

• Provide rationale for the exercise
• Give the young person and the caregiver 2-3 minutes to complete the scales
• Collect the two forms and review several ratings for each person
• Start with the highest rating items in order to start off with a positive note. Ask why the particular rating was given and then what it would take to shift it to a higher rating

Daily Reminder to be Nice – This exercise is designed to be used by the young person and their caregiver on an ongoing basis as a strategy for improving their relationship, but it can also be introduced and practiced in a 3-way family meeting at times when the interaction is turning negative. The exercise simply involves asking the young person and caregiver to do at least ONE nice thing for the other each day. These are very simple things that should not take too much time, but may be quite challenging when relationships are strained. Examples include:

• Expressing appreciation for the other person
• Complimenting the other person on something
• Giving the other person a pleasant surprise
• Expressing affection
• Initiating a pleasant conversation
• Offering some help

Each person is encouraged to do one nice thing per day even if the other is not reciprocating. This exercise is ideally set as homework following the first 3-way meeting and revisited several times if possible. A-CRA has developed a record sheet for clients to record the nice things that they did for the other person on each day of the week.