Where challenge is needed
• Any argument engaged in can be considered lost
• Make an inquiry to make people think
• Embody confrontation

As the family feel the respect for them that you hold, you can address almost anything. Confronting and arguing are high risk strategies; one might consider any argument engaged in as lost. Finding aspects of the family’s processes, ideas, intentions, etc, to validate and acknowledge is likely to be more helpful. For instance:

"I understand you described some reluctance to come in. Does that reluctance indicate the care you take about what outside influences your Family is exposed to?"
" I am wondering if the strength of the anger you experienced when you 'lost it' is an indication of the strength of love you have for Mandy?"
" I notice you are answering a number of the questions I put to Mandy. Is that because you want to be sure we have the fullest information in order to help her?"

Challenge is an effective stimulus for movement when felt by the family as respectful inquiry. It can stimulate the family’s thinking. For example:

"Is this working for you/Johnny/Mandy?"
"What are you hoping Mandy will take from that?"
"What do you think the effect is of …?"
"Is this the sort of parenting you are wanting to be doing?"
"Has this worked in the past?"
" Do you want things to keep going the same or do you want some movement?"

When a parent is lecturing a child or young person, it can be very clear to a clinician that this is not a helpful strategy and there is a strong temptation to tell the parent this. But the process of telling is a high risk strategy as it has an implicit agenda that the therapist knows and the parent doesn’t. There is a range of inquiries which can enable the parent to reflect on the conversation style they are using, bring forward intention and their own assessment of its usefulness.

"What are you hoping Mandy will take from this?"
" Is this something you have tried before?"
"How well has it worked?"
"Should we ask Mandy what her thoughts are about it?"
"Do you feel this sort of talking is an important part of being a parent?"
"Do you have concerns about what might happen if you did not keep letting Mandy know how you think she should behave?"

In the extreme situation where confrontation or coercion is needed, it is important to own it in the context of the power relation and the authority we hold.

“I have a concern”.

If this is taking a different view from the family make this explicit.

“The understanding of this that I have is different from the understanding that you hold.”

Clarify the role and authority on which the overriding of the family’s choice is based. It is not that we have a hotline to truth, but that we take up responsibility in the role or position we hold.

“In my position as … I need to …”

Acknowledge fallibility.

“I am aware that I could be wrong, but on the basis of a, b, c, I estimate the risk at a level where I feel a requirement to act.”

It may be helpful to identify external authorities such as professional bodies or the coroner’s court to which we may be answerable if we do not act within certain parameters. It is also important to clarify avenues the family can take to oppose our stance or have it re-evaluated.