Guiding Principles for Mobile, In-Home Family Therapy Services

Since 2014,CASES has provided Adolescent Portable Therapy (APT) [1], a flexible in-home family therapy model for justice-involved youth ages 12-24. Lasting four to six months, APT is designed to reinforce a family’s strengths and assets in order to foster new relational skills and begin to address such challenges as the young person’s problem behaviors (e.g., substance use, truancy, etc.). Because APT is primarily delivered in participants’ homes or somewhere where they feel comfortable in their community, CASES’ APT staff must remain flexible and attentive. Here are four quick principles APT therapists identify as foundational in their work with youth and families:

 

Empowerment

It’s important for us to understand that many of the families we serve have previous involvement with the juvenile justice and/or child welfare system(s), which often attempt to take away power from caregivers. This is one of the main reasons why families may be apprehensive about the potential positive changes we can help them obtain. We empower caregivers by reinforcing that they hold ultimate decision-making power in caring for and supporting their young person and by asking both the participant and their caregiver what they hope to get out of therapy.

 

Remaining Guests

Because many of our participating families have previous system-involvement, they may initially liken APT to a home visit intended to monitor their behavior and living arrangements. By demonstrating that we are guests (e.g., asking if and where we may sit, reassuring them we don’t have to check bedrooms, etc.), we are able to create a rapport that is more personal and participant-led. Approaching our sessions this way also gives participants opportunities to educate us about their community and their cultural norms from their perspective.

 

Attuned to Issues of Oppression and Privilege

This is about not just how the participant’s positionality impacts their view of the world, but how our own position as therapist, with the power inherent in that role, impacts how the participants view us and our involvement in their lives. In other words, we try our best to practice therapy that is informed by how our participants experience oppression socially, economically, and politically in their lives daily.

 

Transparency

We are honest with participants about what we think is happening right away, as opposed to the classic therapist who leaves a trail of bread crumbs for participants to get there on their own. This also means that we don’t talk about participants in a way that we wouldn’t want them to hear, in writing or in meetings.

These are four of the principles therapists use in their implementation of APT, which support the program’s success with youth and families. For example, since 2016, CASES has made APT available as a supplement to youth diverted to the Court Employment Project (CEP) [2], our longest-operating program, a proven ATI for youth otherwise facing jail or prison as the result of felony charges. Among youth enrolled in both CEP and APT, 82% of those who complete APT go on to successfully complete CEP, representing a 37% higher rate of CEP completion among youth co-enrolled in APT compared to the general CEP population. What drives this level of participant achievement is APT’s foundational understanding that improvements in a family’s everyday functioning starts with enforcing strengths and supporting a range of youth and family goals.