ABSTRACT
Calling a family a ‘multiproblem family’ is, of course, not a clinical diagnosis or category, but a convenient label to describe multiply disadvantaged and marginalized families that present with severe relationship problems. Poverty, unemployment, social isolation, educational failure, alcohol and substance misuse and intra-family violence, including child abuse and neglect, as well as severe psychiatric or behavioural disorders, are often all present at the same time. These families have a particular susceptibility to psychological, physical and psychosomatic symptoms and illnesses that is significantly higher than in the normal population. It is often their children who come to the notice of social services, the education authorities, and child and adolescent mental health services. Multiproblem families are frequently also ‘multi-agency families’, as they have a tendency to attract multiple helpers who provide different and at times contradictory inputs, causing problems in their own right. There is a distinct pattern, in that the family’s seeming helplessness paralyzes the professional network, with chronically entrenched relationships developing. With a large number of helpers present, there is usually also a large number of opinions and inputs, which may further contribute to the seeming helplessness and confusion that the families and their individual members experience. They can feel inhibited by the helpers’ continued availability and this can create problems in their own right. Increased dependence on expert advice can lead to further helplessness.
