From ‘joining’ to ‘social


distancing’ John Cavanagh


Over the time we authors have been pulling together this issue on ‘joining’, we have suddenly found ourselves in a society needing urgently to become ‘socially distant’ or ‘isolate’ within a context of families still needing to be seen and supported. We have had to quickly develop ways of engaging young people and families without face-to-face contact. Here are my thoughts and refl ections, three weeks into functioning within these social distancing measures due to COVID-19.


My agency context is within a functional


family therapy team, which is “a short term structured, intensive family intervention model for delinquent and substance-using adolescents” (Alexander et al., 2013). T e team is part of the wider adolescent service in Brighton and Hove, working with young people and families where there is a risk of becoming a looked aſt er child or going into custody due to many referral behaviours, including child sexual exploitation, criminal child exploitation, mental health, substance abuse, child-to-parent violence and domestic violence. Due to the uncertainty regarding


the length of time social distancing may need to occur, we needed to fi nd a way of continuing to off er functional family therapy as a systemic family intervention. To do this, we needed to very quickly become aware of the process of off ering sessions ‘virtually’ and become ‘comfortable’, and able to use the many virtual platforms, including Whatsapp video, Skype and Zoom.


Checking in: pre-session T e fi ve phases of our approach are


engagement, motivation, relational assessment, behaviour change and generalisation. T ere is some overlap between the phases (Alexander et al., 2013). For the purpose of this article and the link to working virtually, I will focus on engagement, motivation and the behaviour change phase. As with all principles of systemic psychotherapy, the focus on engagement is key and is evident throughout our whole therapy process. Specifi c techniques and goals in the phases act to ensure this is being adhered to. In the engagement, then the motivation


phase, the checking-in about the process of working virtually seems to be key.


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This includes questions such as do the family want a telephone conversation before a video call? How would we ensure all family members could listen and/ or be involved in this process? Would completing the SCORE-15 hinder or aid building the relationship(s)? Due to the relational aspect of the questions on the SCORE-15, the task of completing this may embed ideas of the importance of the relational impact on each other. We could start the relationship


building by talking about the family’s relationship to screens and or virtual video-calling platforms. The exploration of any negative connotations attached to being on a video call for any member of the family feels tricky in the engagement phase; however, this discussion about being video-called may be important for young people and families, especially if anyone has experienced a private sexual photograph or film sent to another person without consent, causing distress – so called ‘revenge porn’. It is an interesting shift from talking


to friends and family members to now talking to professionals on screens. I wonder if this feeling of familiarity aids or constrains the therapeutic relationship. My initial response was surprise from some families that I’d met face-to-face who had started the ‘engagement phase’ then didn’t feel comfortable with seeing me virtually. T e talk about ‘safety’ feels like this


should take place in writing and/or verbally on the telephone, reiterating that, if the conversation becomes hostile and the call is ended, and they don’t answer again, if I am concerned enough, I will need to contact the police. I would reiterate that I hope this wouldn’t need to happen, and that we would explore how the family would all


look aſt er each other if the content and tone became heated. Working virtually, the discussion about


practicalities feels longer; however, this provides a lot of information. If there is only one telephone number, whom should I call? What does this tell me about the family? How will they decide who will hold it and where the phone will be located? I have had to express the need for the phone to stay in one location, where possible (to visually see the whole family) and to avoid the screen being moved to minimise the rollercoaster eff ect! I have found that the families I had seen face-to-face before going virtual, keeping their session at the same day and time has potentially added to their, and to my, feelings of some certainty in an uncertain and anxious world.


The session


Engagement, then motivation phase Discussing before and during the


session the need to have a few virtual sessions to test technology, to allow the discussion about the process of working virtually and navigating the therapeutic relationship via a screen feels like it has been very benefi cial. I have found the need to have at least two of these sessions to allow the virtual therapeutic relationship to grow, even if I have been in the next phase (behaviour change) when we were having face-to-face sessions. T is demonstrates me virtually privileging the therapeutic relationship, and for some coordination of this process to evolve. As stated above, there are specifi c


techniques in this phase including the “pointing process”. T is includes the therapist commenting on the process of how family members relate to each other, thereby making explicit the


Context 169, June 2020


From ‘joining’ to ‘social distancing’


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