Intregrating family therapy into in-patient paediatric settings: a model

This paper describes the integration of structural family therapy and systemic consultation into an in-patient paediatric unit. Two case examples illustrate the approach used. It is concluded that six stages are involved in the successful integration of a systemic approach: planning and convening an initial staff meeting, developing a structural hypothesis, enlisting hierarchical support in the ward system, holding the family meeting, reconvening the professional team and disengaging the family and ward system.     

Process and strategy in network therapy

The following article presents a new methodology in network therapy. It describes the network therapy process from the referral and assessment of a client-system, through sessions held, to the concluding follow-up. The three stages of convening, connecting, and shifting the locus of control from the therapeutic team to the network are discussed. Various strategies and case material are described.     

Challenges of Urban Mental Health Disaster Planning

Summary

Establishing disaster preparedness is an urgent matter, particularly with regard to mental health. This article examines the challenges of mental health disaster planning in the context of an urban setting, which may differ from those pertaining to rural areas. The need to better integrate public health disaster planning and mental health disaster planning is critical. This document particularly focuses on the challenges involved in leading, coordinating, and convening an urban mental health disaster response. With time, dedication, resources, and creation of effective policy, successful mental health response capability will evolve and endure.     

A comparative review of total family functioning measures

Abstract

Three categories of instruments or methods have been used to assess family functioning: unstandardized measures of total family functioning; instruments which measure family subsystems or unitary processes; and standardized total family assessment procedures. Six methods, comprising the standardized total family functioning category, are reviewed and compared. It is concluded that methods of total family assessment are nearing the formation of a family systems paradigm, although the psychometric qualities of the instruments lag behind theoretical development. Recommendations are made for further development of procedures to assess family systems.     

Introduction to special section of the Journal of Family Psychology, advances in mixed methods in family psychology: integrative and applied solutions for family science

Mixed methods in family psychology refer to the systematic integration of qualitative and quantitative techniques to represent family processes and settings. Over the past decade, significant advances have been made in study design, analytic strategies, and technological support (such as software) that allow for the integration of quantitative and qualitative methods and for making appropriate inferences from mixed methods. This special section of the Journal of Family Psychology illustrates how mixed methods may be used to advance knowledge in family science through identifying important cultural differences in family structure, beliefs, and practices, and revealing patterns of family relationships to generate new measurement paradigms and inform clinical practice. Guidance is offered to advance mixed methods research in family psychology through sound principles of peer review.     

Reaping the benefits of research: Technology transfer

This paper presents the results of a technology transfer project designed to transfer knowledge about model behavioral intervention projects that significantly decreased HIV-related risk behaviors. The National AIDS Demonstration Research Program Technology Transfer (NADR TT) Project encompassed: (1) preparation of manuals based on successful intervention research; (2) convening of 7 Regional meetings on Behavior Change Strategies for Injection Drug Users (IDUs); and (3) conduct of twenty-three state implementation training events. An evaluation of the NADR TT project showed that it was successful in its efforts to transfer knowledge regarding model intervention programs. Participants expressed an increased level of confidence in their ability to implement the model and individual model elements were perceived to be useful to—and implemented by—participants. Results also pointed out that significant barriers to implementation of model elements of the behavioral interventions exist.     

Group Therapy Abroad

Abstract

Writing in a narrative tradition, the authors report on the 14th and final convening of the Boston-Threshold Group–sponsored annual Northern Ireland Group Psychotherapy Conference. “It Can Be Done: The Power of the Group to Bear the Unbearable.” They provide context and leadership perspectives on the history of the conference and the planning of its final meeting. Associations to the opening plenary presentation of the play Rounding Third, by Richard Dresser, as performed by the Red Well Theater Group, link themes of power sharing, trauma, containment, and hope to the here-and-now experience of the conference participants. Personal meanings attributed to the conference tradition and its ending are shared.     

Advancing a family perspective in health research: models and methods

In this essay we review and respond to four problems that have impeded the application of family theory to health research: the difficulty in translating family concepts to empirical health research; the confusion and uncertainty in measuring "wholes" and "parts" of a family in a single health project; the apparent conflict between circular-causal and linear perspectives in model building; and the putative, implicit "violation" of a family perspective by the employment of certain data management and design strategies. We argue that current, complex conceptualizations of the family have to be matched with equally complex research designs and methods, and that techniques are available to reach these goals. We distinguish between theoretical models and research methods, and review several strategies, design issues, and alternatives for data analysis. Throughout, we point to 1) the need to maintain consistency among theory, construct, and indicator, 2) the employment of multidimensional family assessment in health research, and 3) the use of readily available but infrequently used methods and procedures for appreciating the richness of multivariate family data.     

Toward a generative theory of the therapeutic field

In the various models of family therapy, family systems are described as being patterned and programmed in their operations and development. The regularities and patterns found in family life are believed to be the expression of a program that determines the behavior of the family system and each of its members. Therapists holding this view will use "programming methods" in order to map family phenomena, and therapeutic work will consist of disrupting the problematic sequences in a deterministic way. However, if we take into consideration the impossibility of always linking inputs and outputs and the inability to evaluate consistently the behaviors in a system, problems associated with indeterminancy appear. Under such conditions, it may be impossible for therapists to formulate programs of family functioning. Therefore, we have operationalized a set of methodological principles that can be applied in such conditions. In this article we present the theoretical and practical implications for the field of therapy of "nonprogramming methods." A videotaped session is analyzed in order to show the application of the nonprogramming methods in clinical practice.     

Spatial representation and assessment of family relationships

Abstract

In recent years, several attempts have been made to assess patterns of cohesion and power in order to analyze family functioning (e.g., Olson, 1986; Wood, 1985). In most studies, researchers use self-report methods or observation of family interactions. These methods often base the measurement of family structure on a total family score and therefore do not explicitly consider different system levels (dyads, etc.). This review presents Symbolic Figure Placement Techniques (SFPTs) and discusses their relevance for the investigation of family cohesion and power.     

焦虑障碍的系统式家庭治疗

焦虑障碍是最常见的心理障碍之一.其具有症状重、病程慢、复发率高、社会功能明显缺损等特点,给个人、家庭和社会造成了巨大的负担.家庭环境因素在焦虑障碍的发病、转归和预后方面都起到重要作用.本文介绍了国内外关于焦虑障碍患者家庭特点和家庭互动模式的研究结果.系统式家庭治疗作为一种家庭治疗模式,具有其独特的治疗理念和方法,国内外研究结果表明系统式家庭治疗用于焦虑障碍具有良好疗效.今后,还应该运用更加多元化的研究方法探讨中国焦虑症家庭动力学特点和家庭功能,并采用更加严格的随机对照设计,进一步证实系统式家庭治疗对焦虑障碍的治疗效果.     

Cancer Family History Reporting: Impact of Method and Psychosocial Factors

Family history is one the greatest risk factors for disease and one of the most important informational tools in medical genetics for the purpose of diagnosis, risk assessment, prevention and treatment. However, research is needed on the comparability of different methods of cancer family history assessment and the influence of psychosocial factors in family history reports. The purpose of this study was to determine if individuals had discrepancies between written and interview reports of cancer family history and the role of psychosocial factors in these discrepancies. Oncology patients (n=104) were administered a survey to assess psychosocial factors (i.e., information-seeking, worry, perceived risk, and health literacy) and were asked to provide family history in a written and an interview form. Randomization determined which form individuals received first. No differences in the amount of missing data or the amount of unspecified data were noted between the written and interview method. Psychosocial factors did not differentiate between those who had discrepancies in family history reports and those who did not have discrepancies in family history reports; although there was a trend for those with lower literacy and those who were blunters to be more discrepant on type of cancer diagnosis. In sum, this preliminary study indicates that written and interview methods of family history assessment for first degree relatives may be used interchangeably. The ability to use written methods will facilitate collection of basic family history information in the oncology clinic.     

Child custody disputes: A review of legal and clinical resolution methods

This paper reviews existing practices from the mental health, marriage and family therapy, and legal professions which offer alternatives to traditional adversarial custody resolution methods. Based upon suggestions from legal and mental health professionals, the authors advocate allocating state resources for interprofessional family courts which would provide custody counseling, mediation, evaluation, and consultation as alternatives to adversarial methods.     

Family routines and rituals in the context of chronic conditions: A review

This paper is a systematic review of 39 empirical studies on family routines and rituals in the context of a chronic condition of a family member. The search strategy encompassed a wide spectrum of chronic conditions affecting family members from childhood/adolescence to adulthood. Twenty quantitative, 13 qualitative, 3 mixed‐methods, and 3 intervention studies published between 1995 and 2012 were reviewed. A conceptual framework of routines and rituals as key elements of family health was adopted, resulting in three main findings. First, a chronic condition in a family member impacted the frequency and nature of family's routines and rituals. Second, these whole‐family interactions held important functions for individuals and families, constituting strategic resources in the condition's management and opportunities for emotional support exchanges, and providing the family with a sense of normalcy amid the challenges posed by chronic conditions. Third, family routines and rituals were linked to positive health and adaptation outcomes for both patients and family members. Implications for future research include the need for the distinction between routines and rituals against a conceptual background, use of validated assessment methods, and empirical examination of predictors of changes in routines and rituals throughout the course of the condition and of the mechanisms linking these family events to positive outcomes. Conclusions support the inclusion of routines and rituals in a family‐centered care approach to the understanding and treatment of chronic conditions.     

家庭文化资本对幼儿数学学习的影响

本研究对来自上海市的590个中、大班幼儿家庭进行问卷调查,旨在了解家庭文化资本对幼儿数学学习的影响。结果表明：作为家庭客体化文化资本的家庭文化环境和作为家庭身体化文化资本的幼儿家长数学教导信念对幼儿的家庭数学学习经验有直接的影响作用;作为家庭制度化文化资本的家庭教育背景则通过家庭文化环境和幼儿家长的数学教导信念对幼儿家庭数学学习经验有间接的影响作用。     

Enhancement of health-giving family support versus treatment of family pathology

Family assessment and therapy has emphasized the negative, pathogenic features of the family relationships of persons who have suffered episodes of schizophrenia. The role of the family as the major provider of supportive care for the disabled patient has received much less attention. A case is made for greater emphasis on the coping abilities of families and family therapy methods that specifically increase these functions through enhancing the problem-solving skills of the family unit.     

Alternative strategies for creating "relational" family data

A major problem facing family clinicians and researchers is creating data that will reflect the family as a unit. To address this problem, we present a framework for family assessment based on three measurement strategies: individual family member assessment, relational family assessment, and transactional family assessment. Within this context, we present several categories of methods for combining individual family member data into "relational" scores that reflect the couple or family as a unit. The problems and benefits of each method are presented, and it is suggested that the choice of method is dependent upon the content of the assessment, the theory underlying the content, and the statistical properties of the individual family member scores.     

The application of prospective strategies to family therapy

Among the most frequently used theoretical orientations for administering family therapy are the systems, interactional, structuralist, problem-centered, and attachment approaches. Each of these methods proposes a theory concerning the etiology and resolution of conflict, a protocol of assessment, and a view on the therapist's role in advocating intervention techniques. Despite the success of these methods, however, families often leave treatment lacking the interpersonal skills for predicting potential conflict and for overcoming episodes of transition. This paper explores how the prospective approach may rectify this problem by enhancing the family members' use of intuition for experiencing transition and predicting upcoming change. As such, the application of the prospective technique may be beneficial for strengthening family relationships.     

Convergence among multiple methods of measuring positivity and negativity in the family environment: relation to depression in mothers and their children

The present study addressed the following questions: (a) To what extent do different methods of measuring the family environment converge onto a single latent construct? (b) How are the constructs of positive and of negative family environment related? (c) Do the associations among various methods of measuring the family environment differ as a function of children's gender or of risk? and (d) How are the latent constructs of family environment related to depression in mothers and their children? Participants were 240 children (mean age = 11.86 years, SD = 0.57) and their mothers, who varied with regard to their history of depression. Family environment was measured with self-report questionnaires completed separately by mothers and by children, observations of mother-child interactions, and a 5-min speech sample of each mother talking about her child. Confirmatory factor analyses revealed that different methods for assessment of the family environment converged and that the constructs of positive and of negative family environments were significantly related to each other and to depression in both mothers and their children. These findings may help inform future intervention efforts by highlighting specific parenting dimensions that are strongly associated with maternal and with child depression.     

A Rawlsian Case for Economic Nationalism: Globalisation and Distributional Autonomy in the Law of Peoples

John Rawls’ resistance to any kind of global egalitarian principle has seemed strange and unconvincing to many commentators, including those generally supportive of Rawls’ project. His rejection of a global egalitarian principle seems to rely on an assumption that states are economically bounded and separate from one another, which is not an accurate portrayal of economic relations among states in our globalised world. In this article, I examine the implications of the domestic theory of justice as fairness to argue that Rawls has good reason to insist on economically bounded states. I argue that certain central features of the contemporary global economy, particularly the free movement of capital across borders, undermine the distributional autonomy required for states to realise Rawls’ principles of justice, and the domestic theory thus requires a certain degree of economic separation among states prior to the convening of the international original position. Given this, I defend Rawls’ reluctance to endorse a global egalitarian principle and defend a policy regime of international capital controls, to restore distributional autonomy and make the realisation of the principles of justice as fairness possible.