Engaging the severely dysfunctional family in treatment: basic considerations.

The severely dysfunctional family is a clinical phenomenon that includes families with a wide range of serious symptoms. These families have been characteristically difficult to engage in treatment, and many do not respond well to traditional family therapy techniques. Some of these families do respond to innovative approaches such as paradox. However, many agencies do not have the capability to implement such highly specialized procedures, nor do all severely dysfunctional families respond well to these techniques. Thus, this paper presents a generic approach to the severely dysfunctional family; the emphasis is on facilitating engagement and maintaining sensitivity to the family's need for stability.