Dynamics and dilemmas in working with families in Inpatient CAMH services

Working with the families of children and adolescents who are being treated in an Inpatient Child and Adolescent Mental Health facility can be both a vital part of the composite treatment package, and also a potential locus of tension, ambivalence and family-team rivalries. This article looks in detail at how collaborative principles put into practice in Inpatient CAMHS settings can benefit the children, adolescents, parents and siblings so that the family-plus-team system can be accessed as a working model for change in mutually desired directions. These principles include working in partnership with parents, being willing to learn from families and avoiding a culture of blame. The value of adopting a developmental perspective is also highlighted. Some thoughts on addressing stuck situations are shared and the importance of self-reflexivity in staff groups is emphasized. Case examples and clinical vignettes are included to illustrate both the difficulties and some experiences of their resolution on a particular children's inpatient unit.