The Ladder to Family Communication

If there's one thing that is straightforward in psychology, it's treatment for phobias. If a child (or adult) is scared of a dog, we help them create a hierarchy of anxiety-provoking stimuli related to dogs: 1) picture of a dog, 2) looking at a dog in a cage, 3) petting a dog....etc. They can then climb the "bravery ladder" to conquering their fear of dogs. This process of exposure usually works because the individual gradually habituates to the feared stimuli such that they no longer need to worry about or to avoid the feared experience (or animal).

It's the subtle frightening tasks in life that are a bit more difficult to conquer - a shy adolescent boy asking someone out on a date, a people pleaser saying no when she's feeling overwhelmed. It's often the difficult aspects of communication that are most frightening in our relationships.

Exposure is one central intervention strategy in READY. We are attempting to guide participants to climb a "bravery ladder" towards more open, effective family communication about topics that are often avoided - finances, emotions, and sexuality (including issues related to HIV/AIDS). We begin with very brief family communication exercises that emphasize expressing positive thoughts and feelings about family relationships. We then progress to more difficult conversations throughout the intervention.

Jessica Pian, our research coordinator, taught our intervention team about exposure therapy and its relationship to the READY intervention.

 This week we had our first READY session that emphasizes the importance of family communication and begins discussion of financial issues in families. Here are some families beginning to climb the ladder.