Families need to be engaged, just as surely as does the young person who is the 'identified patient'. Without the support of the family the practitioner is severely limited (note one of the Core Features of AMBIT which is Scaffolding existing relationships

Major problems in engaging families can occur because of issues of Keeping secrets/different levels of disclosure within the family.

Alternatively, the family may already have a very strong idea/narrative about the nature of the problem and the required solution; "We want a hospital bed, not a home visit!" In this situation, any service offering something different from the family's agreed diagnosis and treatment will find itself struggling to engage them collaboratively.

An exercise

Work with family members either separately or apart:

1. Ask them to try to help you understand what different members of the family might hope for out of your intervention.
2. Acknowledge that different people may want different things out of the work - normalise this understanding: "because members of this family are clearly individuals!"
3. Once a family member has offered their own hopes, reflect this back - Check: have you understood this correctly?
4. Then ask that member to do their best to try to guess or use their intuition to estimate what they think other members of the family may be wanting - what is similar, what is different? If they are being seen alone, then you can use a "virtual client" technique:

"So if we can imagine your mother sitting here, what do you think she would say if I asked her [turning to the empty chair] what do you really hope for out of the work we are considering?"

The focus is on hopes for therapy - and it is important to steer family members quite actively away from the temptation of describing their fears about what will go wrong, who will fail to engage, etc.