Ideas of the change process: family and therapist perspectives on systemic psychotherapy for children with conduct disorder

This report is based on a small‐scale qualitative study exploring therapist and client perspectives on the therapeutic change process in home‐based family therapy for children with conduct disorder. The study consisted of focus group discussions with therapists, interviews with client families and audiotaped therapy sessions. The findings suggested that home‐based therapy (home visits) was effective in improving hard‐to‐reach clients’ access to help, resources, and opportunities, as well as the therapists’ access to invaluable information about their clients. Home‐based therapy also helped the therapists to develop professionally, making it possible for them and their clients to engage in different power relationships, which were seen by both parties as one of the principal motivating forces and important aspects of the change process. In addition, exploring clients’ perspectives appeared to be useful. Practitioner points The process of engaging with hard‐to‐reach families starts in the context of specific therapist‐client power relationships with the therapist encouraging the family to take charge Home‐based therapy is useful for children with conduct disorder Home‐based therapy provides children, family and therapists with information, resources, opportunities and good access, which are not always available in customary clinical settings 抽象 关于改变过程的想法：家庭和治疗师对于行为障碍儿童的系统心理治疗的看法 本报告基于一项小规模定性研究, 探讨治疗师和来访者对儿童行为障碍的驻家家庭治疗的改变过程的看法。研究数据来自与治疗师进行焦点小组讨论, 与来访者家庭进行访谈, 和治疗过程中的录音。研究结果表明, 驻家治疗（家访）有效地改善了平时很难接触到的来访者获得帮助、资源和机会的条件, 也有利于治疗师获得有关其客户的宝贵信息。以家庭为基础的治疗也帮助治疗师在专业上有所发展, 使他们和来访者能够体验不同的权力关系, 而这是双方所认为的变化过程中的主要激励力量和重要方面之一。此外, 探索来访者的看法看来也是有用的。 对实务工作者的启示 与难以接触的家庭进行接触的过程始于治疗师与来访者在具体情境下的权力关系, 即治疗师鼓励家庭主动担起责任。 家庭为基础的治疗对于有品行障碍的儿童是有用的。 以家庭为基础的治疗为儿童、家庭和治疗师提供信息、资源、机会和良好条件, 而这些在传统的临床环境中并不总是具备的。 o Ideas del proceso de cambio: perspectivas de la familia y el terapeuta sobre la psicoterapia sistémica para niños con trastorno de la conducta Yuriko Morino Este artículo presenta un estudio cualitativo a pequeña escala que explora las perspectivas del terapeuta y del cliente sobre el proceso de cambio terapéutico en la terapia familiar domiciliaria para niños con trastorno de la conducta. El estudio consistió en discusiones grupales con terapeutas, entrevistas con familias de clientes y sesiones de terapia grabadas. Los hallazgos sugieren que la terapia domiciliaria (visitas domiciliarias) fue efectiva para mejorar el acceso de los clientes con dificultades para acceder a la ayuda, a los rec