Parallel short forms of the family of origin scale: Evidence of their reliability and validity

Two parallel short forms of the Family of Origin Scale were developed from data provided by 69 women and 63 men who completed the full Family of Origin Scale along with a variety of measures of family-of-origin characteristics. Data on the reliability and validity of the short forms are provided and discussed. The results indicate that both short forms are strongly and significantly correlated with each other and with the full-scale version of the FOS and that they share its reliability and validity characteristics to a very high degree.     

Experiential Exercises in MFT Training: Gender, Power, and Diversity

An experiential exercise that is used to empower Marriage and Family Therapy students and systematically introduce students to feminist themes is described. Faculty in the university's theatre department recruit their students to serve as client families. Role-play exercises with theatre students based on vignettes developed by clinical faculty increases realism and includes other training benefits. This approach is consistent with a feminist model of training and supervision.     

Examining the potential impact of a family session in therapeutic assessment: a single-case experiment

Most clinicians concede the benefits of conceptualizing children in systemic terms. Yet, many child assessments involve parents only on a limited basis. The Therapeutic Assessment model for children and families (TA-C) emphasizes parental involvement and family-driven collaboration throughout the intervention. Child TA has shown promise as an effective brief intervention (e.g., Smith, Handler, & Nash, 2010; Tharinger et al., 2009). Family intervention sessions (Finn, 2007; Tharinger, Finn, Austin, et al., 2008) are an integral component of the child TA model in facilitating familial changes. However, TA-C research has yet to empirically examine the potential impact of a family session on treatment trajectory. This case study includes an extended presentation of the development and execution of a family session. The authors use a daily measures time-series experiment to empirically examine the clinical effectiveness of the TA-C and the hypothesis that the family session was a tipping point in the trajectory of improvement.     

Adaptability of Family Therapy Modalities in the Treatment of Lesbian and Gay Clients with Bulimia Nervosa

Bulimia nervosa (BN) has becoming an increasingly common form of eating disorder, particularly with gay and lesbian populations. The lack of current literature on this particular topic, as well as the limited resources for recommendations of treatment adaptations for this population is evident by the disproportionate number of sexual minorities that present for treatment. This paper discusses the possible reasons for the lack of literature and resources, and provides clinicians with the adaptations of Emotion Focused Therapy, Cognitive Behavioral Therapy, Structural Family Therapy, and Internal Family Systems when working with lesbian and gay populations who are suffering from BN. This paper aims to contribute more to the limited research in the area of sexual minorities in hopes to broaden the understanding of the treatment of individuals, as well as family functioning. We attempt to adapt these therapy modalities to be more inclusive of these nuanced presenting concerns, and to provide clinicians from all scopes of practice a thorough look into the treatment of a sexual minority population.     

Nathan w. ackerman as a therapist and individual: An interview with donald bloch and kitty la perriere

Abstract

In June 1984 the Eastern Virginia Family Therapy Institute sponsored a two-day conference with Paul Watzlawick which is reviewed in this issue by Robert Smith with an absorbing depth of focus, and a uniquely stimulating viewpoint. The puzzle of the persistence of behavior as well as the change of behavior has long intrigued philosophers and therapists, as well as other tacticians and strategists. The work from Palo Alto which was begun by Bateson, Jackson, Haley and Weakland has been carried on by Watzlawick and Fisch and others. This excellent review gives both theoreticians and clinicians a current perspective and challenge. -I. A.     

Clinical Guidelines for Working With Stepfamilies: What Family,Couple, Individual,and Child Therapists Need to Know

This article draws on four decades of research and clinical practice to delineate guidelines for evidence‐informed, clinically sound work with stepfamilies for couple, family, individual adult, and child therapists. Few clinicians receive adequate training in working with the intense and often complex dynamics created by stepfamily structure and history. This is despite the fact that stepfamilies are a fundamentally different family form that occurs world‐wide. As a result many clinicians rely on their training in first‐time family models. This is not only often unhelpful, but all too often inadvertently destructive. The article integrates a large body of increasingly sophisticated research about stepfamilies with the author's four decades of clinical practice with stepfamily relationships. It describes the ways in which stepfamilies are different from first‐time families. It delineates the dynamics of five major challenges stepfamily structure creates: (1) Insider/outsider positions are intense and they are fixed. (2) Children struggle with losses, loyalty binds, and change. (3) Issues of parenting, stepparenting, and discipline often divide the couple. (4) Stepcouples must build a new family culture while navigating previously established family cultures. (5) Ex‐spouses (other parents outside the household) are part of the family. Some available data are shared on the impact of cultural and legal differences on these challenges. A three‐level model of clinical intervention is presented: Psychoeducational, Interpersonal, and Intrapsychic/Intergenerational Family‐of‐Origin. The article describes some “easy wrong turns” for well‐meaning therapists and lists some general clinical guidelines for working with stepfamily relationships.     

The Family Cycle: An Activity to Enhance Parents’ Mentalization in Children’s Mental Health Treatment

This article introduces the Family Cycle, a therapeutic activity informed by attachment theory, family systems theory, and current literature on reflective functioning. The Family Cycle helps clinicians and families create a narrative about a child’s psychopathology that considers complex trauma and/or adverse childhood experiences. It reframes observable dysfunctional phenomena as behavioral sequelae of more deeply rooted emotional loss. After the theoretical underpinnings of the Family Cycle are laid out, we describe the implementation of the Family Cycle within the context of an intensive home-based, family-focused intervention created at the Yale Child Study Center, the Intensive In-Home Child and Adolescent Psychiatric Service (IICAPS). The Family Cycle provides a teachable clinical framework to facilitate the treatment of families with complex, multigenerational trauma.     

Clinical Supervision Dilemmas Related to Child Abuse in Wraparound Treatment

We conducted two separate, exploratory studies to evaluate the differences between the supervision of wraparound (in-home) and outpatient (office) child treatment interventions. Study one (n = 96) examined the structure and norms of supervision between groups as well as rates of general disclosure to direct supervisors. Study two (n = 116) specifically examined the frequency of child abuse and neglect encountered in each intervention setting, and the level of disclosure in supervision of these mandatory reporting events. Findings from the first study suggest that wraparound clinicians received significantly less individual supervision and colleague consultation than their office-based counterparts. Additionally, wraparound clinicians were significantly more likely to withhold information about client cases from their direct supervisors. In the second study, wraparound clinicians endorsed significant increases for observed child abuse, observed child neglect, and verbally reported child neglect compared to their office-based counterparts. In regards to mandatory reporting issues with children, wraparound clinicians were found to be significantly less likely to disclose issues pertaining to child neglect to their direct supervisors than office-based clinicians. Our studies show preliminary evidence for a needed increase of individual supervision in wraparound practice, in addition to a greater focus on clinician disclosures related to incidents of child abuse and neglect.     

Deconstructing Agnes – externalization in systemic supervision

Externalization is seen in this paper as a valid and useful part of the process of clinical supervision in systemic family therapy training. We offer a discussion on the use of externalization based on an example from a supervision group on a London M.Sc. in Family Therapy. Externalizing practices are located in the context of a postmodern perspective and narrative ideas within systemic family therapy. We explore the use of narrative ideas and the recursive relationship between theory, practice and the subjective experience of the trainee, within the practice of systemic supervision.     

The supervisory alliance: Comparison of measures and implications for a supervision toolkit

Background Clinical supervision lies at the core of the professional development of clinicians providing services within a range of service settings. The supervisory alliance is regarded as the most important construct in effective supervision which underlies the importance of metrics to assess this construct. Aims materials and Method A cross‐sectional self‐report questionnaire design was used to examine clinical supervision constructs. The study used two scales measuring the supervisory alliance (SRQ and SWAI‐T), a scale measuring supervision satisfaction (SSQ) and a scale measuring disclosure (TDS). The questionnaires were administered to 127 clinical psychology trainees who were undertaking a practicum placement. Results Both scales measuring the alliance were positively correlated with satisfaction with supervision and disclosure, with similar sizes of correlation for each alliance scale. There was also a large, positive correlation between the two scales of measuring the alliance. Discussion Both scales were designed for use in supervision and are related to supervision outcome measures in the expected directions. Conclusion The SRQ has some distinct advantages over the SWAI‐T that lend the SRQ to be potentially more useful in clinical and research settings.     

Family Photographs: in Treatment and Training

The universal appeal of nostalgia and reminiscence makes photographs a natural instrument for studying the impact of the past upon the present. This paper explores photography as a medium for facilitating reminiscence to discover individual roles, interpersonal relationships, and family dynamics. A method is described for using family photographs in treatment and training of clinicians at a Family Therapy Clinic.     

Academic Guidance in Medical Student Research: How Well Do Supervisors and Students Understand the Ethics of Human Research?

Research is increasingly recognised as a key component of medical curricula, offering a range of benefits including development of skills in evidence-based medicine. The literature indicates that experienced academic supervision or mentoring is important in any research activity and positively influences research output. The aim of this project was to investigate the human research ethics experiences and knowledge of three groups: medical students, and university academic staff and clinicians eligible to supervise medical student research projects; at two Australian universities. Training in research ethics was low amongst academic staff and clinicians eligible to supervise medical student research. Only two-thirds of academic staff (67.9 %) and students (65.7 %) and less than half of clinicians surveyed (47.1 %; p?=?0.014) indicated that specific patient consent was required for a doctor to include patient medical records within a research publication. There was limited awareness of requirements for participant information and consent forms amongst all groups. In the case of clinical trials, fewer clinicians (88.4 %) and students (83.3 %) than academics (100 %) indicated there was a requirement to obtain consent (p?=?0.009). Awareness of the ethics committee focus on respect was low across all groups. This project has identified significant gaps in human research ethics understanding among medical students, and university academic staff and clinicians. The incorporation of research within medical curricula provides the impetus for medical schools and their institutions to ensure that academic staff and clinicians who are eligible and qualified to supervise students’ research projects are appropriately trained in human research ethics.     

Training Public Sector Clinicians in Competency-Based Clinical Supervision: Methods,Curriculum, and Lessons Learned

This article describes an initiative to train public sector clinicians in competency-based clinical supervision. It was delivered as an 18-session course taught online to clinicians employed in departments of behavioral health in nine Southern California counties. The curriculum was co-constructed by a team of clinical supervision scholars and leaders who then served as instructors. Each two-hour meeting addressed a specific topic for which a training video had been prepared, usually featuring a member of the training team who had expertise in that topic. The second part of each meeting focused on a class member’s supervision case presentation. Those presentations revealed 35 themes; the four most frequently occurring were: developing supervisees’ clinical competencies, addressing countertransference and parallel process, balancing clinical and administrative supervisory roles, and addressing record keeping/paperwork. Participants’ pre-to-post supervisory self-efficacy changes demonstrated a moderate effect size (Cohen’s d?=?.46) for the training, with the greatest pre- to post-training changes being in the use of technology, multicultural competencies (awareness of oppression, bias, and stereotyping in clinical work and in clinical supervision), and contracting. They reported that the strengths of the course included an inclusive learning environment and opportunities to reflect on and apply new knowledge and skills, though they also reported struggling with the assignments and the course platform software. Lessons learned reflected the use of technology in this online program, the importance of obtaining buy-in from agency decision makers and being prepared to address challenges related to the use of direct observation in supervision, gatekeeping, and enacting the simultaneous roles of administrative and clinical supervisor.

     

Reflections on Family Therapy in Australia

Family therapy in Australia has been influenced by ideas mostly from North America and Europe. However Australian family therapists have also made their own significant contributions to theory and practice. The vastness of the continent combined with a relatively small population has presented challenges with respect to the formation of a national association and for many years, the Australian Journal of Family Therapy (later the Australian and New Zealand Journal of Family Therapy Board acted as de facto national voice for the discipline. The Australian Association of Family Therapy was formed as recently as 2011. It has a total of over 1,000 members and is the sole organisation representing family therapy and family therapists in Australia. Clinical membership is achieved via successful completion of a 2-year sequence of study in family therapy followed by 50 hours of supervision (or its equivalent). Family Therapy training is mostly delivered in the four most populated states in Australia at both University level and through private organisations registered to provide training at government approved levels. La Trobe University (through the Bouverie Centre), Swinburne University (through the Williams Road Family Therapy Centre) and the University of New South Wales currently provide training leading to specialist qualification in family therapy. A number of other private institutions also provide recognised family therapy training. To date, family therapists and couple therapists in Australia have not in the main shared common platforms such as conferences, training and professional journals. Narrative therapy has also remained somewhat detached from “mainstream” family therapy. Family therapy qualifications are often valued by prospective employers even when duty statements are focused on the more traditional skills of professionals such as psychologists or social workers. Researching family therapy outcomes remains challenging. But although there is increasing practiced-based evidence of the efficacy of family therapy, Australian family therapists as a group are yet to concentrate their efforts on convincing funding bodies of its usefulness. At the same time, via the teaching and promotion of family sensitive practices, systemic ideas are being increasingly incorporated within areas of mental health, disability, alcohol and drug dependency, and within a range of health and welfare areas that impact not just on the individuals but on those close to them.     

Abstracts

McDaniel, S. H. (1990) Marital therapy and the resolution of gender role conflict. Journal of Family Psychotherapy
Storm, C. L. and Heath, A. W. (1991) Problem-focused supervision: rationale, exemplification, and limitations. Journal of Family Psychotherapy
Burkett, L. P. (1991) Parenting behaviours of women who were sexually abused as children in their families of origin. Family Process
Palmer, R. L., Chaloner, D. A. and Oppenheimer, R. (1992) Childhood sexual experiences with adults reported by female psychiatric patients. Journal of Psychiatry
Brewin, C. R., MacCarthy, B., Duda, K. and Vaughn, C. E. (1991) Attribution and expressed emotion in the relatives of patients with schizophrenia. Journal of Abnormal Psychology     

The family of origin scale: A construct validation study

Data from 69 women and 63 men along with ratings from a panel of expert judges were used to assess the construct validity of the Family Of Origin Scale as a measure of family health. Loevinger's conception of construct validity, focusing on the substantive, structural, and external components of validity, was employed to organize the research procedures followed and the data analytic techniques used. Results showed that the instrument appears to be a useful measure of a warmth-coldness affect dimension in the family of origin, but the multi-dimensional structure of the test, as a measure of family-of-origin health, could not be validated. Suggestions for use, score interpretation, and further development are discussed.     

Parent and Primary Care Provider Priorities for Wellness in Early Childhood: A Discrete Choice Experiment

Journal of Child and Family Studies - Guidelines recommend that primary care clinicians address a broad range of wellness topics, but time constraints limit clinicians’ ability to address...     

Direct‐Supervision and Remote‐Supervision Jails: A Comparative Study of Psychosocial Factors1

The direct‐supervision style correctional facility has been offered as a design that provides a better atmosphere for staff and inmates. Prior research has shown minor support in favor of the general environment created by direct‐supervision facilities. However, the claims of benefits associated with direct supervision far outweigh the number of empirical research studies on the design. This research examined corrections officers' and inmates' feelings of boredom, perceived control, aggression, attitudes toward each other, and stress in a direct‐supervision style facility and a remote‐supervision style facility. Results from 164 inmates and 82 correctional officers showed that staff in the direct‐supervision facility reported elevated levels of perceived control, less anger and hostility, and less boredom.     

The medium is the message?—how agency setting influences our effectiveness as family therapists*

This paper formed the basis of a workshop at the Fourth Conference of the Association for Family Therapy. Three different agency settings are examined for their impact on family therapy: a social services department, a child psychiatric clinic and a hospital paediatric setting. Seven categories of influence are considered: physical setting, family motivation, the identified patient, expectations and resources, the extent of limits, supervision and recording and, finally, support networks. Case material is used and an attempt is made to assess the overall importance of the setting to family therapy. A chart summarizing the subject matter is included as an appendix.