An Application of Brief Therapy to Family Medicine

The Solution-Focused Brief Therapy model has been applied to support families with various problems commonly met at the department of family medicine in a large, urban teaching hospital in Seoul. Korea. Many cases there show a different distribution of problems when compared with a tertiary family therapy center. The majority involve psychosomatic problems, family distress around a chronically-ill member, the loss of a family member, and severe illness, only a few involving drinking problems, family violence, or abuse. The SFBT model meets the seven requirements of Doherty and Baird (1983) for a family therapy model to be useful in a medicine setting.     

Scene-Based Psychodramatic Family Therapy With Troubled Adolescents and Parents: A Pilot Study

Scene-Based Psychodramatic Family Therapy (SB-PFT) is an innovative treatment used with troubled adolescents and their parents to improve family relationships and reduce adolescents’ problematic behavior. It integrates the principles of family therapy, psychodrama, and multiple-family group methodology. This research is a pilot study to obtain empirical evidence on the SB-PFT therapeutic process by gauging the perception of change of troubled adolescents and their parents, and assess the perceived helpfulness of its methodology and techniques. Ten multiple-family intervention groups were drawn up, with 110 participants (63 adolescents and 47 parents), and we adopted a qualitative methodology with focus groups, using an inductive analysis of 290 active constructions of participant narratives. Concerning perception of change, the adolescents reported mainly gaining in social support, prosocial attitudes, keys to problem solving, and expression of emotions due to the treatment. The parents perceived improvement in social support, keys for educational practices, emotional well-being, and expression of emotions due to the treatment. Regarding the perceived helpfulness of methodology and techniques, both adolescents and parents highlighted the usefulness of the group methodology for gaining social support, relativizing the problem, and expressing emotions. Additionally, participants referred to role-playing and mirror techniques as the most useful techniques. In conclusion, this first study on SB-PFT presents and describes its treatment for troubled adolescents and their parents. The participants’ positive perception of their personal and relational change after treatment should serve to promote further studies with quantitative methodology in order to verify the effectiveness of SB-PFT treatment.     

Family Therapy in the Forbidden City: A Review of Chinese Journals From 1978 to 2006

This article provides a glimpse into the development of family therapy in China, by reviewing family therapy articles written in Chinese and published in journals in China that are not, therefore, readily accessible to the international community. A content analysis of journals published between 1978 and 2006 revealed 199 family therapy articles in 109 Chinese journals. Most of the studies were conducted by psychiatry or medical professionals, and were based on general systems theory or a systemic family therapy model. The articles focused on the promotion of family therapy theories and interventions in China, but did not specify the application of theory to specific clientele or symptoms. After the year 2000, a threefold increase in the number of family therapy publications was noted. These papers included the introduction of additional theories, but did not include critical assessment of the applicability of Western family therapy models to Chinese families. The researchers noted an absence of articles that identified Chinese approaches to family therapy, and a paucity of papers on gender, professional reflection, and the therapy process. The article concludes that there is room for improvement in the quality of family therapy publications in China, and that gains may be made by interdisciplinary collaboration among academics and practitioners.     

Feedback in Couple and Family Therapy: A Randomized Clinical Trial

Routine Outcome Monitoring (ROM) is recommended as a psychotherapy procedure to serve as clinical feedback in order to improve client treatment outcomes. ROM can work as a warning signal to the therapist if the client shows signs of no change or deterioration. This study has investigated whether any difference in outcome could be detected between those clients in couple and family therapy who used the Systemic Therapy Inventory of Change (STIC) feedback system (ROM condition) versus those who were offered treatment without the use of STIC (“treatment as usual” or TAU condition). A sample of 328 adults seeking couple and family therapy in Norway was randomly assigned to ROM versus TAU conditions. Outcome measures were The Outcome Questionnaire–45 and The Revised Dyadic Adjustment Scale. The results demonstrated no significant differences in outcomes between the ROM and TAU. Possible explanations of this result related to design and implementation issues are discussed.     

Human‐Animal Bonds II: The Role of Pets in Family Systems and Family Therapy

The vast majority of pet owners regard their companion animals as family members, yet the role of pets in family systems and family therapy has received little attention in research, training, and practice. This article first notes the benefits of family pets and their importance for resilience. It then examines their role in couple and family processes and their involvement in relational dynamics and tensions. Next, it addresses bereavement in the loss of a cherished pet, influences complicating grief, and facilitation of mourning and adaptation. Finally, it explores the ways that clients' pets and the use of therapists' companion animals in animal‐assisted therapy can inform and enrich couple and family therapy as valuable resources in healing.     

Techniques of Structural Family Assessment: A Qualitative Analysis of How Experts Promote a Systemic Perspective

The trajectory of assessment in structural family therapy moves from a linear perspective, in which problems are located in the identified patient, to an interactional perspective, in which problems are seen as involving other members of the family. Minuchin, Nichols, & Lee (2007) developed a 4‐step model for assessing couples and families consisting of: (1) broadening the definition of the presenting complaint to include its context, (2) identifying problem‐maintaining interactions, (3) a structurally focused exploration of the past, and (4) developing a shared vision of pathways to change. To study how experts actually implement this model, judges coded video recordings of 10 initial consultations conducted by three widely recognized structural family therapists. Qualitative analyses identified 25 distinct techniques that these clinicians used to challenge linear thinking and move families toward a systemic understanding of their problems. We discuss and locate these techniques in the framework of the 4‐step model.     

Building an Expanded Therapeutic Alliance: A Task Analysis with Families Trapped in Parental-Adolescent Conflict

Parental-adolescent conflict is part of the normal developmental cycle of families, but when it occurs in a dysfunctional way, it is associated with the appearance of various harmful conditions for the family system and for the adolescent in particular. Family therapy is one of the main options for psychotherapeutic intervention in these cases and has ample evidence of its effectiveness. The success of this intervention is conditioned to the construction of an adequate therapeutic alliance with the family, but the process of this task has not been clarified yet. The present study is a task analysis, the purpose of which was to create a heuristic model of how an expanded alliance may be built in these kinds of cases. The model was revised and improved from the intensive analysis of six cases. The resulting model can be a useful guide for family therapists in that it describes the specific client and therapist behaviors involved in balancing the alliance, as well as the potential obstacles and suggested ways to resolve them.     

The Efficacy of Systemic Therapy for Childhood and Adolescent Externalizing Disorders: A Systematic Review of 47 RCT

Systemic (family) therapy is a widely used psychotherapy approach. However, most systematic efficacy reviews have focused solely on “family‐based treatment” rather than on the theoretic orientation “systemic therapy.” We systematically review trials on the efficacy of systemic therapy for the treatment of childhood and adolescent externalizing disorders. All randomized (or matched) controlled trials (RCT) evaluating systemic/systems‐oriented therapy in various forms (family, individual, group, multi‐family group therapy) with child or adolescent index patients (0–17 years) suffering from mental disorders were identified by data base searches and cross‐references. Inclusion criteria were as follows: index patient diagnosed with a DSM‐ or ICD‐listed mental disorder, and trial published in any language up to the end of 2011. The RCTs were analyzed for their research methodology, interventions applied, and results (postintervention; follow‐up). A total of 47 trials from the United States, Europe, and China, published in English, German, and Mandarin, were identified. A total of 42 of them showed systemic therapy to be efficacious for the treatment of attention deficit hyperactivity disorders, conduct disorders, and substance use disorders. Results were stable across follow‐up periods of up to 14 years. There is a sound evidence base for the efficacy of systemic therapy for children and adolescents (and their families) diagnosed with externalizing disorders.     

The Primacy of Discourse in the Study of Gender in Family Therapy

Family therapists and scholars increasingly adopt poststructural and postmodern conceptions of social reality, challenging the notion of stable, universal dynamics within family members and families and favoring a view of reality as produced through social interaction. In the study of gender and diversity, many envision differences as social constructed rather than as “residing” in people or groups. There is a growing interest in discourse or people's everyday use of language and how it may reflect and advance interests of dominant groups in a society. Despite this shift from structures to discourse, therapists struggle to locate the dynamics of power in concrete actions and interactions. By leaving undisturbed the social processes through which gendered and other subjectivities and relations of power are produced, therapists may inadvertently become complicit in the very dynamics of power they seek to undermine. In this article, we argue that discourse analysis can help family therapy scholars and practitioners clarify the link between language and power. We present published examples of discourse analytic studies of gender and sexism and examine the relevance of these ideas for family therapy practice and research.     

In search of cognitive equilibrium: Beauty,quality and harmony

The field of MCDM should become significantly concerned about problems that are also qualitative, ‘messy’, fuzzy or not well-defined—they abound in human systems. Dealing exclusively with quantitatively well-defined problematique (the proverbial ‘finding the shortest path’) is part of the unidimensional legacy of OR/MS: it programmatically neglects attributes of beauty, quality, harmony, aesthetics, safety and reliability. Yet these are the criteria which are ardently sought after by modern humans, while being mostly ignored or neglected by modern technocrats.     

Values in Family Therapy Practice and Research: An Invitation for Reflection

Values have been shown to be a pervasive part of both marriage and family therapy (MFT) clinical practice and research. Yet, many therapists and researchers remain unclear about how values affect their work. This article examines the influence of Western philosophical assumptions and therapy traditions in light of current understandings of values in therapy. The influence of values in MFT research processes is similarly examined. Implications for how family therapy professionals can be more reflective and sophisticated in their understanding of values in clinical practice and scientific inquiry are discussed. Suggestions for addressing values in MFT training also are given.     

The History of Family Therapy in South Africa

The history of family therapy in South Africa is presented from 1960 up to the present. The early days leading to the establishment of the South African Association of Marital and Family Therapy, national conferences, publications, national and international links are discussed.     

Development of Family Functions and Relationship in Families: A Mixed-Design Study

Abstract

This is a mixed-design study that examines the effects of a psychoeducation program on family functioning and the parent-adolescent relationship. The quantitative dimension of the study was quasi-experimental and included the pretest, post-test and follow-up model with control and experiment groups. The data were collected from both parents and adolescents. In the study, there were 32 adolescents in the experiment group (18 male, 14 female), while the control group consisted of 31 adolescents (15 male, 16 female). The results of the study show that the education program decreases the problem behaviors of adolescents while increasing family functions and promoting the adolescent-parent relationship     

Dropping Out of Marriage and Family Therapy: A Critical Review of Research

The lack of attention given to research on the premature termination by clients in marriage and family therapy is evident in research reviews of the dropout phenomenon in psychotherapy. This article is an attempt to fill that void. The research literature on dropping out of family therapy is reviewed and organized. Studies in this area tend to focus on four kinds of variables: client characteristics, therapist characteristics, therapy process variables, and interventions. Stable findings in each of these areas are pointed out. Both limitations and recommendations for future research are discussed.     

The Results of Family Therapy: A Critical Review of the Literature

A search was conducted in the family therapy literature for studied which reported on the outcome of family therapy. It was difficult to find any consensus on a definition of family therapy. Therefore an arbitrary definition, involving the predominant use of joint and family interviews, was stipulated. A total of eighteen studies met minimal standards for inclusion and were summarized and discussed in this paper. Only two of these studies could be considered adequate in their research design; the remainder of the studies were (with one borderline exception) considered inadequate. The clinical evaluations of family therapy were summarized and possible methods and goals for future research into the outcome of family therapy are discussed.     

Five Phases of Dyadic Analysis: Stretching the Boundaries of Understanding of Family Relationships

In the last decade, an increasing number of qualitative studies sought to investigate the dynamics of various dyads by conducting in-depth, multiple family member interviews. The emphasis in the methodological literature dealing with this type of research is primarily on the data collection process, and much less on the development of methods suitable for the analysis of the data thus derived, especially with regard to dyads consisting of family members belonging to different systems: families of origin or nuclear families. The purpose of this paper is to propose a model for dyadic analysis based on examining the dynamics of the evolving relationships between key caregivers of a family member with brain injury. The model includes inductive and abductive phases of analysis, and it is based on an ecological-systemic perspective. The benefits of this model are highlighted, and its potential contribution is further discussed.     

Family Therapy for Substance Use among Sexual Minority Youth: A Review of Treatment Options

Abstract

Substance use disorders are nearly twice as common among sexual minority youth (SMY) as among their heterosexual peers. Most applied literature about this population suggests interventions on either the individual or community level, and the benefits of family therapy for this population are often overlooked. The present literature review (a) outlines clinical knowledge related to sexual minority youth and substance use (e.g., prevalence rates, contributing factors), (b) discusses the importance of clinical self-awareness around these topics, and (c) outlines clinical behaviors and interventions from literature that may be employed when working with substance-using SMY and their families.