ABSTRACT

Some writers (e.g., McGlothin, 2006) have recommended that therapists evaluate which family members will be positive, helpful resources and which will not, and engage in treatment only those likely to have a positive influence on the person at risk. I go at this a little bit differently. While I do not issue blanket invitations to any family member that I come across, it would have to be an extreme situation for me to deliberately exclude a concerned relative from some role on a helping team, or from a place at the table in a family therapy session. (A separate issue is that a client may choose to be connected with some family members and not with others, and I would of course respect that.) I have worked with family members whose major contribution-and it was in fact a major contribution-was as a negative example. (Remember Ashley, in Chapter 6, not wanting to end up a lush like her mother?) I have also worked with more family members than I can count whose history with the person at risk included lessthan-positive, or in some cases, downright negative aspects-and who made critical contributions to that person’s chances for recovery,

sometimes at considerable personal cost or sacrifice, sometimes just with a steady determination to do what they could. I have seen brothers who voluntarily went for addiction treatment, and uncles and grandmothers who sent a postcard every week or an e-mail every day, and estranged mothers who worked two jobs to pay for a child’s treatment. I believe in the possibility of change, but I do not fool myself that it is easy or even common. The desire to do something to help a beloved person who is at risk of death by suicide can be a powerful change motivator. Witnessing such change in people and relationships, or just noticing that someone is trying to help, can make a difference for clients who have been caught in feelings of hopelessness and perceptions of isolation and helplessness.