Facilitating children’s in-session involvement in child and family therapies: A dynamic framework of clinical practices.

Abstract

Children's in-session involvement in child and family therapies correlates with both positive and negative treatment outcomes. Thus, it is important to gain a better understanding of the clinical practices that facilitate children’s involvement in therapy sessions so that practitioners can employ them with greater precision. To address this need, we conducted a study to answer the following question: What clinical practices facilitate children’s in-session involvement in child and family therapies? The data consisted of 16 extant audiovisual recordings of child and family therapy sessions and 24 stimulated-recall interviews with the participants in the recordings. Following constructivist grounded theory and incorporating storyline as an additional analytical technique, we have constructed a framework consisting of four involvement-enhancing practices: managing time, staying relevant, adjusting intensity, and facilitating inclusion. Furthermore, by detailing some of the complex processes that practitioners navigate when they facilitate children’s involvement, our study adds a multi-layered and dynamic dimension to the list of already established involvement facilitators. It may be used to moderate an over-standardized work culture that continues to characterize services that address children’s needs. The results may be applied to other institutional encounters, providing resonance beyond the analyzed therapy sessions.