The Admitted Family Model: A Relational Framework for Adolescent Inpatient Care

Area of Science:

• Psychiatry
• Family Systems Therapy
• Clinical Psychology

Background:

• Adolescent psychiatric hospitalisation often isolates patients from families, potentially worsening relational ruptures and dependency.
• Current models may stabilize acute symptoms but neglect family dynamics and parental roles.

Purpose of the Study:

• To introduce the Admitted Family Model (AFM) as a clinical-conceptual framework for adolescent inpatient care.
• To propose a model that integrates families into the admission process.

Main Methods:

• The AFM was developed through sustained clinical observation and multidisciplinary reflection.
• It integrates concepts from family systems, mentalisation, psychoanalytic, and child- and family-centred approaches.
• Clinical vignettes were used to illustrate the model's application.

Main Results:

• The AFM framework includes five key functions: family in the admission field, parental function restoration, 'calmamiento' (slowing relational tempo), team vitality, and sustainable discharge.
• 'Calmamiento' aims to reduce urgency, shame, and overpressure, fostering reflective capacities.
• Discharge planning emphasizes sustainable reorganization with auxiliary family support.

Conclusions:

• Adolescent psychiatric admission can be viewed as a relational intervention, not just symptom stabilization.
• The AFM can reduce institutional dependency, blame, and shame for adolescents, families, and clinical teams.
• It creates conditions for safer thinking and relating among all involved parties.