Abstract
The structure of home visit support for school refusals and socially withdrawn people was examined from the perspective of tripartite mutual relationships between the Identified Patient (IP), Visitor, and Parents. This was used in replacement of the older model that consisted of a dyadic relationship between the IP and Visitor. Interviews and a free response survey were conducted with case managers and visitors of home-visit-support facilities, and the different sets of data were analyzed. The results indicated that there was a tripartite relationship from the beginning to the later term of the visit, and it affected the process of support. In the beginning, the relationship tended to be suppressive and there was resistance to the visit, as well as a dependent attitude by IP. The visitor continuously adjusted the tripartite relationship by maintaining contact with IP and promoting feedback functions. Through this process, from the middle to the latter term of the visit, the tripartite relationship promoted support and the system of solving problems improved. A double support-control-structure that is different from interview-room type counseling relationships was suggested. The significance of understanding this structure using the tripartite relationship and interventions by communicating with IPs with low motivation is discussed.
