• By Kevin Mount
  • Posted on Monday 17th December, 2007

Before you take the therapy be sure to read the label

Usually the worst verdict evaluation will bring in on a human service is that it is ineffective – a waste of time and money. Rarely will researchers go as far as damning a treatment program for being downright harmful, especially if they are comparing it to one designed by their own Center. But work by Jose Szapocznik and Guillermo Prado, both of whom are well-known in the US for their preventive work with Hispanic families, is beginning to suggest that some mental health treatments can be counterproductive. They looked specifically at three studies conducted by The Center for Family Studies at the University of Miami School of Medicine, where Szapocznik serves as director. In each case, children and families participating in an intervention called Brief Strategic Family Therapy were compared to similar individuals receiving traditional, individual therapy (which does not involve other family members).Brief Strategic Family Therapy (BSFT) targets children and adolescents between the ages of eight and 17 who are displaying or are at risk for developing behavior problems, including substance abuse. The goal is to improve youth behavior by improving family relationships that are presumed to be directly related to youth behavior problems.“Totally unexpectedly,” according to the authors “the non-family treatment in each of the three trials demonstrated significant declines in family functioning.” Each of the studies had some significant limitations in terms of its methodology, so more research is needed to confirm that non-family treatments can have harmful side effects. These reservations apart, Szapocznik and Prado’s findings deserve attention because, as they point out, few studies even consider whether therapy for one family member might actually jeopardize the family as a whole.The authors speculate that an intervention that changes the behavior of one family member, but doesn’t help the rest of the family to adjust theirs accordingly, might make it more difficult for everyone to get along. But future research is needed to clarify why individual therapy can hurt the family system.Most people wouldn’t take a drug without reading the label about potential, harmful side effects. Szapocznik and Prado’s review suggests that policymakers and practitioners exercise the same caution when choosing programs to help children and families.For more discussion of the possible downside of programs, see: When togetherness can do more harm then goodBrief Strategic Family Therapy, developed by the Miami University Center for Family Studies is regarded as a Model Program in the field of Family Therapy by the US Substance Abuse and Mental Health Services Administration (SAMHSA)Summary of “Negative Effects on Family Functioning From Psychosocial Treatments: A Recommendation for Expanded Safety Monitoring” by Jose Szapocznik and Guillermo Prado in Journal of Family Psychology, Volume 21, Issue 3, September 2007, pp 468–47

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