Therapeutic dilemmas and crisis phonecalls in family therapy: Guidelines for positive practice

When clients believe that they have not got the personal resources to cope with the demands of either living with their problems or taking steps towards their resolution, stating their therapuetic dilemma may precipitate a therapeutic crisis. A therapeutic dilemma is a concise statement of the disadvantages and difficulties associated with leaving the presenting problem unresolved and the disadvantages and risks entailed by solving the problem. In this paper, a framework for conceptualizing therapeutic crises and guidelines for theri management are described. These guidelines allow the therapist to avoid becoming involved in problem maintenance and to retain a position from whcih to promote problem resolution. The framework and guidelines evolved within the context of a brief integrative approach to consultation with families who require help with child-focused psychosocial difficulties.