Setting the Stage for Change: An Eco-Systemic Approach to In-Home Family-Based Treatment (2nd Edition)

In this second edition of Setting the Stage for Change, a detailed road map is presented for applying a strength-based, eco-systemic family therapy approach (ESFT) to helping children and adolescents with severe emotional problems (SED) and their multi-stressed, fragile families. ESFT has proven highly effective in helping children with SED break the cycle of repeated out-of-home placements. This easy-to-read book distills the clinical wisdom gleaned from ESFT's 35-year large-scale implementation in Pennsylvania's intensive in-home family-based programs.

The book addresses not only the nuts and bolts and "the how" of an eco-systemic approach to treatment, but also its theoretical foundations, or "the why" of treatment. One full unit is devoted to methods for engaging and keeping these children and their parents in treatment, a major challenge for this population given their histories of trauma, high levels of distrust, and frequent experience of failure in the behavioral health system. A second unit is devoted to the use of methods, such as systemic interviewing, enactments, relational timelines, and genograms for contextualizing and reframing problems as relational. A third unit describes four of the most common maladaptive family structures associated with SED. These include the enmeshed family, the under-organized family, the embattled family, and the authoritarian family. A fourth unit presents an integrative framework and tools for developing a systemic case conceptualization that is child-centered and family-focused which can be easily translated into a relational treatment plan.

The book is replete with case studies reflecting the realities of day-to-day clinical practice and includes reproducible clinical tools useful for both therapists and supervisors. These include a systemic case conceptualization worksheet, relational treatment plan and family safety plan templates, treatment fidelity measures, clinical skills assessments, and a glossary of concepts and terms used in family treatment.

C. Wayne Jones, Ph.D. , is the Founder and Director of the Center for Family-Based Training, an organization devoted to systems-oriented consultation and training of behavioral health professionals serving families and their children and adolescents who have severe emotional problems. Dr. Jones is Clinical Associate Professor of Psychology in the Department of Psychiatry at the University of Pennsylvania where he is on the training faculty of the Center for Couples and Families (CCAF). The center s mission is to provide education, clinical services, and research to advance the inclusion of family in psychiatry and medicine.

Dr. Jones has been closely involved with Pennsylvania s Family-based Mental Health Services program, a community-based initiative designed to prevent hospitalization and out-of-home placement of children with severe emotional disturbances, since it was launched 30 years ago. Dr. Jones leads a highly regarded three-year training curriculum in the application of Eco-Systemic Structural Family Therapy (ESFT) to intensive, in-home family-based treatment.