Therapeutic Interventions

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1. Verbalize realistic expectations for marital harmony and effective family functioning. (1, 2, 3)

1. Assign the parents to describe and rate the current health of their marriage in various categories (e.g., parenting, shared responsibilities, intimacy or assign the "State of Our Marriage Report" activity from the Parenting Skills Homework Planner by Knapp).

2. Instruct the parents to set short-term goals for improving their relationship and family functioning that are specific and attainable (e.g., eat dinner together three times per week,

2. Negotiate and define spousal roles and responsibilities to one another and the family. (4, 5)

3. Identify and verbally affirm positive characteristics and behaviors in the marriage partner or co-parent. (6, 7)

reduce debt by 10 percent, engage in two family activities per week).

3. Assign the parents to read material to help them maintain a balanced perspective concerning marriage and family obligations (e.g., Don't Sweat the Small Stuff with Your Family by Carlson or The Seven Habits of Highly Effective Families by Covey).

4. Instruct the parents to list all the jobs and duties necessary for effective functioning of the family for the following week; negotiate which parent is responsible for each assignment.

5. Ask the parents to evaluate which marital and family roles (e.g., income provider, household manager, disciplinarian, activity planner) could be shared more equally or reassigned to more evenly distribute the marriage and family responsibilities.

6. Ask the parents to create a list of the strengths, assets, and positive behaviors they recognize in their spouse; assign each spouse to verbally acknowledge their appreciation of and admiration for one specific positive quality of their partner at least two times per day.

7. Assign each parent to support the co-parent by pointing out strengths during conversations with the children (e.g., "Your mom sure does love you; Your dad spends a lot of time supporting you.").

Identify and implement strategies to enhance a positive, supportive, and intimate relationship with the spouse. (8, 9, 10, 11)

Demonstrate techniques of effective communication that involve empathetic listening and clearly stated points of view. (12, 13, 14)

8. Ask the parents to make a commitment to strengthen their marriage and to follow through by attending counseling sessions, completing homework assignments, and implementing team-building strategies with the partner.

9. Assign the parents to read The Five Love Languages (Chapman) and identify their preferred methods of giving and receiving love (e.g., quality time, words of affirmation, gifts, acts of service, physical touch).

10. Instruct the parents to create intimacy by giving affection according to the love language most preferred by their partner at least once per day.

11. Recommend that the couple read The Gift of the Magi (Henry) as a preparation for creating ways to offer love and commitment to their spouse even though the effort may require some personal sacrifice.

12. Teach the parents to clearly state their point of view using "I" statements (e.g., "I feel . . . When . . . Because . . .") that express personal feelings and reactions to a situation rather than blaming personal feelings on another person (see Parent Effectiveness Training by Gordon). Assign the spouses to use this strategy at least five times during the subsequent week.

13. Role play with the parents how to use active listening (e.g.,

6. List and resolve to modify addictions, habits, and behaviors that are detrimental to the marriage and family. (15, 16, 17)

7. Participate in social activities that are family friendly and satisfying to both spouses. (18, 19, 20)

listening with empathy and understanding without giving advice or rushing to solve the problem) during spousal discussions.

14. Council the parents to establish a private and distraction-free time and place to meet for one hour two times per week to communicate about shared goals, interests, and concerns.

15. Brainstorm with the parents a list of their habits, addictions, and marriage-defeating behaviors that cause pain and/or friction in the relationship and family (e.g., infidelity, alcohol abuse, excessive spending, workaholic).

16. Assist the parents in prioritizing their negative habits and behaviors and in choosing one or two to eliminate and replace with more productive, family-friendly activities.

17. Refer the parent or parents to community programs or services dedicated to addressing serious addictions (e.g., Alcoholics or Gamblers Anonymous, psychiatric hospital).

18. Assist the parents in brainstorming a list of activities that are mutually enjoyable; assign them to engage in one activity as a couple each week.

19. Instruct the parents to eliminate television, videos, and computer access for everyone in the family for one hour per evening and to use the time to interact with one another (e.g., talking,

Define parenting roles and responsibilities so that both parents share the joys and responsibilities of raising the children. (21, 22, 23)

9. Agree to work together to eliminate resistance, manipulation, and triangulation by the children. (24, 25, 26)

listening to music, playing a game, working on a puzzle, participating in a hobby); invite the parents to increase the media-free time as they and the family adjust and discover the benefits of being together without media distraction.

20. Encourage the parents to plan a weekly family outing and to enlist the participation of each family member in the preparation.

21. Brainstorm with the parents a list of their parental responsibilities and assist them in assigning these obligations so that both parents engage equitably in providing for the children's physical, financial, and emotional needs.

22. Ask the parents to predict emerging future needs of the children and to commit to an ongoing relationship and personal involvement with them that includes nurturing and guidance.

23. Encourage the couple to predict how their spousal roles will change as the marriage and family evolves (or assign the "Our Evolving Marriage and Spousal Roles" activity from the Parenting Skills Homework Planner by Knapp).

24. Advise the parents to avoid power struggles with their children by setting limits with controlled choices (e.g., "Would you rather clean your room on Saturday or Sunday?") and

10. Back up the partner in issues of discipline and behavior management. (27, 28)

11. Negotiate and agree on strategies for positively relating to and disciplining the children. (29, 30)

using contingency management strategies (e.g., "You may watch television as soon as you homework is completed.").

25. Teach the parents the importance of administering discipline in a unified, even-handed, consistent, and logical manner to defuse manipulative efforts.

26. Direct the parents to avoid overprotective parenting by determining which problems belong to their child and then allowing the child to solve the problem alone or with guidance if necessary.

27. Advise the parents to form a cooperative alliance when addressing child management issues and to support each other on discipline decisions unless they are perceived as abusive.

28. Instruct the parents to discuss child management differences privately, come to an agreement that both can support, and then form a united front when presenting their decisions to the children.

29. Teach the parents to use consequences designed to teach their children a more appropriate behavior and to eliminate overly punitive reactions to negative behavior (e.g., broken curfew, return home one hour earlier next time, failure to clean room, no fun activities until room is clean).

30. Encourage the parents to refrain from interfering when a natural consequence is available to

12. Utilize techniques of positive discipline to address all child-behavior concerns. (31, 32, 33)

13. Reinforce and affirm all efforts given to positive relationships and appropriate activities among the siblings. (34)

14. Agree on and utilize a problem-solving process for resolving marital and family disputes. (35, 36, 37)

teach their children to be more responsible (e.g., forgetting gym shoes and sitting out during play, refusing to eat lunch and getting hungry before dinner).

31. Teach the parents to work together to offer frequent descriptive praise when recognizing positive behavior and to use constructive guidance when behavior requires redirection.

32. Encourage the parents to prioritize the discipline issues and to address them one by one rather than trying to solve all the behavior problems at once.

33. Advise the parents to remain involved in the lives and activities of their children; explain that careful monitoring of children's behavior is an essential responsibility of parents until the child is living independently.

34. Instruct the couple to promote positive interaction by initiating family games, reinforcing attempts at mutual activities, and encouraging discussions during meals and family gatherings.

35. Teach the parents a structured conflict-resolution process: (1) problem definition, (2) brainstorming for solutions, (3) listing the pros and cons of each potential solution, (4) agreeing on a strategy, (5) implementation of the plan, and (6) evaluation of the outcome); ask them to resolve two conflicts during the following week.

36. Teach the parents to work toward win-win solutions when resolving conflict by agreeing to negotiate and identify potential strategies until both spouses are satisfied with the plan.

37. Instruct the parents to eliminate hostile and passive-aggressive behaviors (e.g., arguing, pouting, appeasement, leaving) when resolving conflict by substituting more assertive, proactive negotiation strategies (e.g., "I" statements, active listening, brainstorming).

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