The field of family therapy is constantly evolving, with practitioners seeking innovative ways to improve therapeutic outcomes. A recent study titled "Assessing ad-hoc adaptations’ alignment with therapeutic goals: a qualitative study of lay counselor-delivered family therapy in Eldoret, Kenya" sheds light on the role of ad-hoc adaptations in therapy sessions. This research provides valuable insights for practitioners looking to enhance their skills and align interventions with therapeutic goals.
Understanding Ad-Hoc Adaptations
Ad-hoc adaptations are spontaneous changes made during the delivery of interventions. Unlike planned adaptations, which are premeditated and structured, ad-hoc adaptations occur naturally as therapists respond to the unique needs of each session. The study conducted in Eldoret, Kenya, aimed to identify these adaptations and assess their impact on intervention goals.
The research focused on Tuko Pamoja, an evidence-informed family therapy intervention designed to improve family dynamics and mental health in Kenya. Lay counselors were given flexibility in presenting content and practices during sessions, allowing for the emergence of ad-hoc adaptations.
The Role of Ad-Hoc Adaptations in Therapy
The study revealed that ad-hoc adaptations were prevalent and varied widely. They included the incorporation of religious content, use of exemplars or role models, engagement with community dynamics and resources, self-disclosure by counselors, and the use of metaphors or proverbs. These practices were largely found to be TP-promoting (49%) or neutral (39%), with only a small percentage (12%) interrupting intervention goals.
Religious Content
The integration of religious content was one of the most common ad-hoc adaptations observed. Counselors often used faith and prayer as strategies for coping with challenges faced by families. While these references generally aligned with intervention goals by affirming progress and encouraging active change, there were instances where they disrupted therapeutic objectives by promoting passive reliance on divine intervention.
Use of Metaphors and Proverbs
Counselors frequently employed metaphors and proverbs to explain intervention concepts and support counseling strategies. This approach was effective in promoting intervention goals by encouraging families to engage in problem-solving and affirming their efforts. However, lengthy or unclear metaphors sometimes hindered family participation.
Community Resources and Dynamics
Counselors also referenced community resources and cultural dynamics as potential supports or challenges for families. By encouraging families to seek out resources such as schools, churches, or elders for emotional or material support, counselors promoted active solution-making. However, over-promising solutions or becoming judgmental occasionally interrupted therapeutic goals.
Implications for Practitioners
This study highlights the importance of integrating ad-hoc adaptations into therapeutic practice while ensuring alignment with intervention goals. Practitioners can benefit from:
- Training and Supervision: Incorporating discussions about ad-hoc adaptations into training sessions can guide therapists on effectively integrating these practices during delivery.
- Cultural Sensitivity: Understanding the cultural context and incorporating culturally relevant content can enhance the acceptability and effectiveness of interventions.
- Continuous Evaluation: Regular evaluation of ad-hoc adaptations can help identify practices that promote or hinder therapeutic goals, allowing for adjustments to be made as needed.
The Path Forward: Encouraging Further Research
The findings from this study underscore the need for further research into the impact of ad-hoc adaptations on therapeutic outcomes. By systematically evaluating these practices in different settings, researchers can identify which adaptations are most beneficial and how they can be effectively integrated into various interventions.
This research opens up new avenues for exploring how therapists can balance flexibility with fidelity to intervention models while ensuring cultural sensitivity and contextual fit.
If you're interested in delving deeper into this topic, consider exploring the original research paper: Assessing ad-hoc adaptations’ alignment with therapeutic goals: a qualitative study of lay counselor-delivered family therapy in Eldoret, Kenya.
