Frequently Asked Questions
1. The Multi-Day Family Intervention (MDFI) includes both parents and the children. Step-parents/new partners are usually included for at least part of the intervention. It is appropriate for families when the Court has made an order for the MDFI (including the pre-intervention intake process necessary to determine suitability and to set therapeutic goals. After the MDFI and the immediate monitoring phase offered by the FMF clinicians, we will make recommendations for aftercare services with the expectation that these will be implemented by FMF clinician(s) or other service providers in the parents’ jurisdiction. The order for the MDFI should include reference to these anticipated services and the cost-sharing stipulations.
2. The Blended Sequential Intervention (BSI) is appropriate for families when the Court has made an interim or permanent order for custody (major decision-making) and an extended period of restorative parenting time for the resisted parent with the children without the involvement of the favoured parent. The initial multi-day intervention therefore includes the resisted parent and children. A subsequent intervention for the favoured parent is made available, to occur at an appropriate time in the future. Next and where appropriate, interventions may involve the the family members in various combinations working towards the child(ren) having normalized contact with both parents.
For more information about the MDFI and the BSI interventions (including the required Clinical Intake Consultation phase) you are encouraged to review the informed consent agreements for the particular multi-day intervention you may be considering. All of the service agreements have blanks for family-specific information to be inserted. In some cases, with the approval of FMF, some changes may be made to the agreements in line with the family circumstances.
Phase 1 is the referral and intake phase. For the MDFI, each parent is required to complete the Parent Referral Form and return it for our review. For the BSI, each parent is invited to complete the Parent Referral Form and return it for our review, however the ‘resisted parent’ must do so regardless if the favoured parent declines to participate at that stage. Once received and reviewed, the assigned FMF clinician will determine whether to take the next step, which is to request a referral call with counsel. This referral call is necessary to determine whether the requirements are in place (for example, a court order with the required components) to proceed to a Clinical Intake Consultation (CIC).
You will be required to provide your informed consent to proceed by executing the Clinical Intake Consultation Agreement following review of it with your FMF clinician. Presently you are encouraged to review both the CIC Agreement and the Intervention Informed Consent Agreement for the particular multi-day intervention you may be considering (the Multi-Day Family Intervention or the Blended Sequential Intervention). During the CIC process, the lead clinician will meet with members of the family in various combinations as needed, and review all relevant documents including but not limited to court orders, parenting plan documents, s.30 assessment reports, and Voice of the Child reports. Once the CIC is completed, the lead clinician will confirm the suitability of the FMF multi-day intervention for your family with a recommended treatment plan including therapeutic goals and objectives.
On our website, you will note under the Documents section, a document entitled “Terms to Consider” where you will find some sample terms to consider for inclusion in a court order. The court order does not need to be worded specifically as these sample terms; however certain components must be determined before the therapists can proceed. In addition, other required components include for example: specifically naming Families Moving Forward as the service provider for the family; direction as to how the fees for service and the associated costs are to be paid: a provision for parenting time with the resisted parent immediately following the multi-day intervention: the subsequent parenting time schedule for the child(ren) with both parents; and, the requirement for aftercare services such as out-patient multi-faceted family therapy or other therapy or dispute resolution services as recommended. Case law provides examples of these orders.
Please note, notwithstanding the court order, the informed consent of each parent will also be expected upon review of the appropriate service agreement early in each phase.
At the commencement of the referral, parents indicate on the Parent Referral Form which multi-day intensive intervention they are seeking. Each option has different requirements to proceed to the required intake phase (CIC), in terms of post-intervention contact with each parent, as well as a plan to normalize parent-child contact with each parent. The lead therapist who completes the CIC will offer a statement with regard to the suitability of the family for the requested service, and if suitable will include goals and objectives. Note that the CIC clinician cannot recommend how the parenting schedule ought to progress as this is a matter for the parents and counsel to resolve, or sometimes the judge to order.
If the CIC process deems your situation suitable for the requested multi-day family intervention, the planning for it will begin. Phase 2 is all about the Multi-Day Intervention (whether MDFI or BSI), described above, which will include pre-intervention sessions with the parents when appropriate and time permitting.
Phase 3 is the required period of aftercare, described below. The lead aftercare therapist may be a family therapist in your community identified during the CIC, or one of the therapists who participated in the MDFI with you in his or her private practice when appropriate and agreed upon.
The multi-day family interventions typically occur outside of the city of Toronto, ideally in nature (in a setting with access to the necessary technology and amenities to conduct the psychoeducational components), or at a resort. Sometimes parents offer suggestions of alternative settings that are affordable and also meet the needs of the process. FMF clinicians are open to all appropriate suggestions.
As these family problems are complex and have typically taken time to evolve, the multi-day intensive interventions cannot reasonably be expected to fully resolve the fractured parent-child relationship and the associated parenting and coparenting challenges. The intensive interventions serve as a “jump-start” to break an impasse in parent-child contact and launch a process of repair and healing which, depending upon the unique family dynamic, must include appropriate aftercare services.
Many factors contribute to successful outcomes and the attainment of the goals listed in the informed consent agreements and court orders. These factors include, for example, attributes unique to each parent and child, the history of coparental conflict (pre and post separation), and factors related to the nature of the court orders accompanying the interventions. Anecdotal reports range from positive gains, the family situation remaining the same, and in some cases the situation worsening.
The area of “reintegration therapy” (also referred to as “reunification therapy”) is still relatively new and considerable social science literature is available. Some case and empirical studies are available, however, the research has not yet been able to catch up to the clinical issues which professionals face on a daily basis, and the need of families to find appropriate services. Research on intervention outcomes is in its infancy stage, with some studies reporting positive outcomes while noting the limitations and other important considerations to understanding the status of the research to date (Saini, Johnston, Fidler, & Bala, 2016, Saini, 2019; Saini & Deutsch, 2016; Warshak, 2018). At this time, there is no outcome data available that evaluates “success” of the FMF program. There are some data on other family systems intervention programs, and some preliminary evidence that points to the family systems intervention on which the FMF services are based, as appropriate for these cases (Fidler & Bala, 2013; Polak & Moran, 2016).
There are many variations of interventions making the study of outcome challenging. All of the research in this area (like that of much intervention research) has limitations. Existing research on specific interventions combined with research on related topics inform multi-faceted family therapy, which is currently considered a best practice approach to intervention. These researched topics include child development, parenting, risk and resiliency factors and impact of separation/divorce, short and long term impacts of parent-child contact problems, high conflict personality functioning and coparenting; and, therapies for depression and anxiety disorders (e.g., CBT, systematic desensitization), therapy more generally, and the social science literature reflecting the hundreds of years of combined experience of mental health professionals working with this challenging problem of parent-child contact problems.
Firmly entrenched family dynamics cannot be entirely reversed and resolved in four days. Please note, after Phase 2 (the multi-day intervention) is completed, the acceptance and timely delivery of aftercare services — Phase 3 — are essential to the consolidation of any gains achieved during the multi-day interventions. Aftercare in the form of multi-faceted family therapy (as described previously), or sometimes other services such as another type of therapy or parenting coordination, must begin promptly after the multi-day process. These services involve all family members in various combinations in regular sessions as needed to continue to work on, e.g., the parent-child relationships, the individual adjustment of the child(ren) and parents, each parent’s parenting, and their coparenting.
The multi-day intervention provides the intensive jump-start, and the aftercare services aim to build on any gains achieved during the intervention to stabilize more normalized parent-child relationships — often in step with monitoring by the court. The importance of aftercare services continuing on an out-patient basis cannot be over-stated. It is emphasized with parents and counsel in advance of the multi-day intervention; and, must be a component of the court order, which governs the intervention and the aftercare services to the extent that it requires the parents to accept the recommendations.
FMF therapists are not engaged as assessors (per s.30, CLRA), and given the distinction between the two roles (therapist or assessor) we cannot make recommendations about parent decision-making (custody) or parenting time (access) at any time, during any phase of our involvement. A therapist who offers recommendations about these matters is assuming a dual role not supported by our standards of practice, and further doing so compromises the efficacy of the therapy. Any recommendations made throughout the process are therapeutic or educational in nature.
Accordingly, the parents with the assistance of counsel and often with Court’s oversight must determine the parenting time schedule. The therapists will assist the family to implement this schedule. Often the court-ordered or agreed upon parenting schedule is interim in nature or provides for an interim or ‘step up’ plan; and other times a permanent parenting schedule is (or has already been) ordered or agreed upon in advance of the multi-day intervention.
As stated above, the therapists cannot determine parenting time in any way. It must be determined some other way. For example, in some cases, parenting time is set out in advance of the intervention with the Court’s assistance. There may be a ‘step-up’ parenting time schedule agreed upon with the assistance of counsel or the Court. In other cases, the parenting time is understood to revert to a previous order or executed agreement. Clarity regarding post intervention contact is one of the important components that must be sorted out before FMF involvement can begin.
The FMF interventions are based on a family-systems approach (see MFFT information for parents and lawyers document available on our website), which attempts to involve both parents from the outset regardless of which multi-day intervention being sought (MDFI or BSI). The mandate and objectives outlined in the informed consent agreements speak to the importance of both parents not only cooperating but being invited to fully participate in and support the therapy and its purpose. This is a requirement for the MDFI intervention, during which the interventions are delivered to the family including both parents and the children (and the parents’ new partners as determined by the lead therapist), and with different combinations of family members meeting in caucus and as a whole family group.
For the BSI intervention however, the involvement of the favoured parent will be different than with the MDFI. The delivery of BSI interventions will be implemented sequentially as directed by the FMF therapists per the BSI Agreement and court order. While efforts are made to involve both parents where possible and to the extent appropriate, sometimes the opportunity is not embraced at the outset. The ultimate objective is for the child(ren) to have good and normalized relationships and parenting time with both parents, as well as positive child adjustment, improved family functioning, and more effective parenting and coparental communication.
In addressing this question, as noted above, FMF is not in a position to make recommendations about parenting time (access) or parent decision making responsibility (custody) at any time in the process. Keeping that in mind, the BSI does require a court order for a period of restorative contact. Current best practices and combined experience of clinicians across North America and other locations inform the policy of requiring a period of at least 60-90 days of restorative contact for the child(ren) with the resisted parent immediately following the multi-day intervention. This restorative period and the BSI interventions in combination provide the foundation to support the possibility of achieving the objectives detailed in the BSI Agreement.
The current requirement for restorative contact with between the child(ren) and the resisted parent immediately following the MDFI is an extended vacation period not less than one-week.
This is an important consideration during the CIC for both the MDI and BSI. The assessment for suitability of our service includes consideration to any risk factors associated with bringing the children to the intervention, and to appropriately plan and coach the favoured parent when this is determined to be an issue. Parents often pose this concern and there are options for how to resolve it. When identified as an issue there may be discussion with both parents and their lawyers to develop a coordinated plan. Often, for both the MDFI or BSI, it will fall to the favoured parent to exert his or her parental authority and moral persuasion to bring the child(ren) to the intervention, and with support on site from members of our therapeutic team once the parent and child(ren) arrive. In some cases involving the BSI, decisions about transportation of the children from the care of one parent to the other and to the intervention will be the full responsibility of the court and/or the resisted parent and not the responsibility of FMF.