A study of in-home therapy




Smith, Joan

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Texas Woman's University


The purpose of this study was to explore therapists' perceptions of the influence of therapy location on aspects of therapy. Specific areas investigated were therapy style, family participation in therapy, and treatment outcomes for the family. It was found that therapy location does influence aspects of therapy. A qualitative, descriptive design was used to identify emerging themes from transcribed audiotaped interviews with 16 volunteer therapists. The subjects had master's level of education, or higher, and have provided therapy to families in their home in the last 5 years. The subjects were recruited through a purposive, snowball sampling method. Analysis of the data revealed three major themes relating to therapy style: (a) session agenda, (b) assessing needs, and (c) theoretical orientation. Therapists support individualized styles of practice that are flexible and accommodating to families in their home. Families are allowed to take the lead in setting the tone with in-home therapy. A preference is given to an office setting for initial contact and information gathering with families. The home environment is favored to get a better understanding of family dynamics. Therapists rely on at least one theory as their foundation for providing therapy. Major themes emerged from family participation: (a) therapy atmosphere, and (b) scheduling appointments. Higher family member attendance and therapeutic involvement is attributed to the ease of rapport building in in-home therapy. Appointments are scheduled in the home to accommodate a family's activities to ensure high attendance. The investigation of treatment outcomes for families yielded three major themes: (a) expectations, (b) monitoring progress, and (c) managed care. Therapists' expectations for treatment outcomes are similar in the office and home environments. The advantage to in-home therapy is that the professional can observe progress rather than rely on self-report by the client. Goals for treatment are specific and measurable to meet the guidelines of third-party payment sources. There was an emergent theme not directly related to the research areas, but considered important. Attention to therapist safety was identified as a concern. Most therapists provide in-home therapy after school and at night.



Family psychotherapy, Home-based mental health services, Family therapists