Summary of research and learning from academic articles

¶ … teenagers, especially those who are identified as "at-risk." Engagement is described by the authors as "a complex and crucial component of effective treatment that increases retention in services," which is "a requirement for successful outcomes and behavior change," (Thompson, Bender, Windsor & Flynn, 2009, p. 121). Engagement will manifest differently for each client but generally it refers to bonding with the therapist, participation in treatment options, and caring about treatment goals. Basically, engagement is what keeps the client interested. Thus, the therapist has an active role in creating motivation for and means of engagement. At-risk youth are identified as those exhibiting behavioral problems, and who are therefore at risk for developing more severe problems if left untreated. Delinquency, truancy, running away, and other family conflicts are considered "at risk" behaviors (Thompson, et al., 2009).

The authors examine the role of in-home family therapy in encouraging or promoting engagement of adolescent clients. In-home family therapy has been shown to "significantly increase attendance and participation of adolescents and their families in therapeutic sessions in comparison with office-based therapy," (Thompson, et al., 2009, p. 121). The reason for the success of at-home family therapy is that it occurs on the family's time, eliminating problems related to schedule conflicts or general discomfort in showing up for office appointments. Transportation barriers, and financial constraints also delimit the level of engagement of the client and the family. At-home family therapy has also been shown to "be more effective than peer groups" in treating at-risk adolescents, probably because in-home therapy can highlight family dynamic issues that would not emerge in the context of peer therapy (Thompson, et al., 2009, p. 121). At-home family therapy has also been shown to be more effective than individual therapy, according to the authors. "Creative approaches" to in-home family therapy increases engagement among all members, "ultimately improving family-child interactions," (Thompson, et al., 2009, p. 122).

One technique used in creative in-home family therapy is "family play." Family play is an experiential intervention strategy that reduces the amount of time spent talking about problems, instead encouraging all parties to engage in ways that are stimulating and fun. Furthermore, social workers and therapists are able to observe the family's dynamic in a naturalistic way, or at least more naturalistic than in an office setting. This research design focuses on the success of family play as an in-home therapy intervention. The study included 83 families in Texas, 42 of which received the experiential treatment/play intervention. The majority of the participants were Latino. The dependent variables in the research included retention in treatment, measured by the number of sessions each family completed. A questionnaire was also used as a quantitative measure of engagement. A test called the Client Evaluation of Self and Treatment (CEST) was used. It was found that the clients who received at-home family-based therapy with experiential activities did remain in treatment longer than the control group, as hypothesized. The authors call the effect "dramatic," (p. 123). However, the self-report questionnaires did not reveal as strong a relationship between the experiential at-home treatment with perceived engagement. Some variables like "rapport" were rated higher among parents who participated in the at-home treatment but generally there were no significant differences between the two groups, either for parents or teens. However, greater overall satisfaction with treatment was indicated. From these findings, the reader learns that fun, creative, and personalized solutions are helpful for at-risk youth and their families.