SPECIAL SECTION FILIAL Therapy I | ROBERT F. SCUKA, PHD, MSW, LCSW-C, AND LOUISE GUERNEY, PHD, RPT-S
developed as an extension of child-centered play therapy (CCPT;
Axline, 1947), FT essentially is a psychoeducational approach to therapy that teaches parents the principles and techniques of CCPT. Parents learn to conduct therapeutically oriented play sessions with their own children learning skills that enable them to better understand children’s feelings, motivations, thoughts, and needs and more effectively respond to them at home.
Basic Tenets FT represented a radical departure in therapeutic practice because it proposed involving parents directly in the therapy process with their children, an idea that many professionals regarded with profound conviction that the medical model’s emphasis on psychopathology, and in particular parental pathology as the purported source of the child’s problems, was seriously misguided. Instead, Guerney’s conviction was that (a) many parents simply lacked adequate parenting skills and (b) parents could be empowered to help their own children by teaching them CCPT skills, most importantly, the skills of following the child’s lead, showing understanding through empathy, and limit setting. By teaching parents these skills in FT, parents would become the primary agents to achieve therapeutic goals by helping their children work through emotional challenges and/or behavioral issues. In this way, Guerney reasoned, FT would simultaneously leverage the natural parent-child bond to further therapeutic goals while strengthening the attachment between parent and child.
Suitable Populations for Filial Therapy The most important factors regarding parent suitability for FT are the (1) level of motivation to participate in FT and strengthen the parent- child bond, (2) ability to regularly attend FT sessions and (3) willingness to carry out home sessions. Contraindications for parent inclusion in FT include: severe mental health and/or alcohol or drug dependency
20 | PLAYTHERAPY September 2019 |
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unsociable behaviors, child endangerment issues, parental dissention around participation in FT (Guerney & Ryan, 2013).
or anxiety; children on the mild end of the autism spectrum disorders; or fostered; children of divorce or remarriage; children with chronic or terminal illnesses; children who have experienced abuse or trauma, but currently are not in danger (Guerney & Ryan, 2013).
Contraindications for child inclusion in FT include: severe levels psychoses, profound autism, high levels of aggression, or very serious attachment disorders (Guerney & Ryan, 2013).
Treatment Description In its classic form, Guerney developed FT as a group therapy model in conjunction with his wife, Louise Guerney (Guerney & Ryan, 2013). Groups meet for 20 sessions for two hours, with a maximum of 10 parents and 10 children. (Adaptations of 10 to 12 sessions also exist.) Parents are brought together for the skills teaching component of the FT process. Then, each week, one or more parent-child dyads engage in a FT session while the therapist and other parents observe through a one-way mirror. Under the therapist’s guidance, the group processes that parent’s experience in the FT session and provides supportive feedback. All parents learn from observing each other’s individual FT sessions. Parents then are prepared to conduct play sessions at home. A video is available that illustrates the group FT model (L. Guerney, 1980).
Given the challenges of assembling groups of parents on a common schedule, FT has been adapted for implementation with individual families (e.g., VanFleet, 2013). Ortwein (1997) developed a manual that
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