Abstract
Children’s engagement and disengagement, adherence and non-adherence, compliance and non-compliance in healthcare have important implications for services. In family therapy mere attendance to the appointments is no guarantee of engaging in the treatment process and as children are not the main initiators of attendance engaging them through the process can be a complex activity for professionals. Through a conversation analysis of naturally occurring family therapy sessions we explore the main discursive strategies that children employ in this context to passively and actively disengage from the therapeutic process and investigate how the therapists manage and attend to this. We note that children competently remove themselves from therapy through passive resistance, active disengagement, and by expressing their autonomy. Analysis reveals that siblings of the constructed ‘problem’ child are given greater liberty in involvement. We conclude by demonstrating how therapists manage the delicate endeavour of including all family members in the process and how engagement and re-engagement are essential for meeting goals and discuss broader implications for healthcare and other settings where children may disengage.
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Notes
Note that prior to the sequence displayed here the parents were reporting a story about the children’s uncle Joe being arrested for child sex offences some years ago and that social services have recently raised this as an issue.
Here they are referring to the fact that Adam was victim of sexual abuse from his biological father and the father was arrested, charged and sentenced for child abuse. Adam then went on to be an abuser of Daniel, who is now engaging in inappropriate sexual behaviour with his younger sibling Stuart. This suggests a cycle of behaviour and thus Adam’s attendance and engagement could be potentially beneficial.
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The authors would like to thank Claire Bone for her comments on drafts of this article and the ESRC for funding the project.
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O’Reilly, M., Parker, N. You Can Take a Horse to Water But You Can’t Make it Drink’: Exploring Children’s Engagement and Resistance in Family Therapy. Contemp Fam Ther 35, 491–507 (2013). https://doi.org/10.1007/s10591-012-9220-8
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DOI: https://doi.org/10.1007/s10591-012-9220-8