Family Consulting: A New Role for Therapists

A new model for psychological practice entitled, "Family Consulting" is proposed. It is defined as a long-term, intermittent approach to working with families based on a developmental/non-pathological perspective. The specific format of intervention is described in detail. A brief review of the life-span perspective of development, the family life-cycle literature, and object relations family therapy, which serve as the building blocks of the model is provided. The role that family consulting can play in today's managed mental health care environment is discussed.     

Levels of Family Systems Thinking: Differences Between Chinese and German Therapists

This study compares levels of systemic thinking between Chinese and German systemic family therapists when conceptualizing a clinical case. Furthermore, it explores the relationships between levels of systemic thinking and several variables of clinical training and practice. Eighty-two Chinese and seventy-six German systemic family therapists participated in this study. Significant differences in levels of systemic thinking and significant predictors for these levels were found. Limitations of this study and implications for future research and clinical practice are discussed. This study is one of the first to compare the case conceptualizations between systemic family therapists in China and Germany.     

Rural Marriage and Family Therapists: A Pilot Study

Marriage and family therapists practice in more than a third of the rural counties in the United States. However, little is known about the practice patterns of marriage and family therapists who practice in rural settings. This pilot study examined the clinical practice and community involvement of a sample of licensed marriage and family therapists in rural Texas. The results contribute to a small but developing body of research about a relatively unknown group of practitioners.     

Searching for Family Therapy in the Rockies: Family Therapists Meet A Paleontologist

Family therapists use concepts germane to other academic disciplines. We recount four notions--context, explanatory metaphors, language conventions, and persistently refining knowledge--that family therapists and paleontologists each utilize. Revisiting family therapy's foundational concepts through the lens of another discipline reminds us of our theoretical beginnings, highlights those professional adaptations that we have made over the years, and offers us an opportunity to reinvigorate and expand our central organizing principles.     

Family Physicians and Family Therapists: Understanding the Interdependent Synergism

This article, written by a family physician and a family therapist, is designed to identify differences between these two cultures that may serve as stumbling blocks to successful meeting of occupants of these two worlds. With the differences identified and described, various notions and suggestions are offered in an effort to promote more successful bridging between these two groups. There is little question about the synergistic impact that can be engendered for recipients of their care should this bridging be successfully navigated. The present day realities in healthcare make this an idea whose time has not just come, but rather seems imperative.     

An Infertility Primer for Family Therapists:

A seemingly "self-evident truth" in most people's lives is that one day they will have children. This universal, biopsychosocial assumption goes unchallenged until a couple faces infertility. Although the effects of such a challenge are profound, infertility is often treated as a nonevent — both within our society as a whole, and within the field of family therapy in particular. To assist clinicians who work with this numerically increasing population, and the many others who have been affected by their encounter with infertility in the past, this article discusses the biological/medical, psychological, and social factors that shape the experience of infertility in our society.     

Training Family Therapists in a Multicultural Setting

Authors describe a multicultural training model for family therapists and psychologists at a traditionally conservative Afrikaans speaking university in South Africa. Black psychologists are now receiving high priority in a masters degree program that leads to professional registration licensure because of the needs of the population. The authors emphasize the importance of being able to think multidimensionally and creating a context in which students can do the same in such contexts.     

Family Resilience and the Management of Fibromyalgia: Implications for Family Therapists

Fibromyalgia Syndrome (FMS) is one of the most troubling rheumatic disorders for patients, significant others, and the health care providers who treat them. Responses from 150 participants provided valuable information on the relationship between family resilience and the management of fibromyalgia. Self reported family stressors, strains, and distress were significantly associated with an increase in health problems/functional disability, whereas family hardiness and family social support were associated with a decrease. Family stressors and family strains were also positively associated with the frequency of medication use. Medical family therapy interventions that consider the familial context are recommended for treatment. Additional implications for clinical practice and future research are discussed. J. Cameron Preece, PhD, Sage Health Care, PLLC, 339 Allumbaugh Street, Boise, ID 83704. Jonathan G. Sandberg, PhD, Department of Marriage and Family Therapy, Syracuse University, Syracuse, NY 13244. (jgandbe@syr.edu) Special thanks go to Linda Stone Fish, PhD, for her support and guidance throughout the study.     

Characteristics of E-therapy Websites Involving Marriage and Family Therapists

This study described some of the common ethical and legal issues that mental health professionals practicing over the Internet or phone may encounter. It also explored how 83 e-therapy websites involving marriage and family therapists characterize their services. Results indicated that a majority of the websites lack information regarding crisis resources, terms of service, procedures for treatment of minors, and procedures for provision of therapy across borders. Further findings indicated that practitioners may have not properly considered the global nature of the Internet and its risks. Therapists are urged to give attention to e-therapy limitations, as well as ethical and legal problems, before attempting distance treatment.     

Aging and Family Therapy: Exploring The Training and Knowledge of Family Therapists

The present study examined therapists' training in aging issues, and their knowledge and attitudes about aging. One hundred and ninety-one clinicians completed a web-based questionnaire. The majority of respondents reported to have some training in aging issues, although they did not believe it prepared them well to work with older clients. Clinicians reported feeling comfortable working with older adults, yet they also agreed that special training could benefit their work. Knowledge scores were significantly correlated with interest in aging issues, perceived importance of training, perceived competence, and perceived effectiveness in treating older adults. Research and clinical implications are discussed.     

Healthcare Policy in the United States: A Primer for Medical Family Therapists

As family therapists increasingly practice in healthcare settings, they need to be aware of forthcoming changes in healthcare policy and the impact of these changes on their clinical work and the lives of their clients. In this paper, we provide a primer on healthcare policy for family therapists, which describes current and proposed changes in healthcare that will potentially revolutionize healthcare delivery for families. We describe three key initiatives: (1) Triple Aim; (2) the Accountable Care Organization; and (3) the Patient Centered Medical Home. We conclude with a discussion about future directions and healthcare policies that include families.     

Challenges and Promises of Training Women as Family Systems Therapists

The structural/strategic family therapy model has drawn increasing numbers of women practitioners attracted not only by its effectiveness but by the opportunity to function in an active, orchestrative, flexible role. Traditional sex-role training, family and supervisor expectations, and patriarchal institutional structures pose particular challenges to the female family therapist and trainee. This paper explores several critical problem areas for women learning to function in this role, including the expression of authority, countertransference, sexual politics of supervision, and boundary issues. Particular content areas of focus for didactic training and common sex-role difficulties in the supervision process are delineated. The discussion underscores the need for assessment and intervention skills not only in small family systems but in larger institutional structures as well in order to enhance the professional development and effectiveness of women in the family therapy field at all levels.     

Global Mental Health: A Call for Increased Awareness and Action for Family Therapists

Global mental health (GMH) is an emerging field that focuses on the need for culturally sensitive mental health services in low‐ and middle‐income countries (LMICs). While many new initiatives have been established worldwide to understand GMH needs and to provide care in LMICs, family therapists have primarily worked with families in high‐income countries. The few existing family‐based initiatives in GMH focus on psychoeducation and are typically not based on general systems theory. However, emerging trends in family therapy may enable family therapists to impact mental health issues in LMICs. These trends, which are shared interests of both family therapy and GMH, include collaborative care, a growing emphasis on the importance of culture in understanding and treating mental health issues, recognition of the ability of families to support or impede recovery from mental illness, and the use of strength‐based and evidence‐based treatments. This paper describes ways for family therapists to become active in the GMH community.     

Informed Consent Documents of Marriage and Family Therapists in Private Practice: A Qualitative Analysis

This article describes a study involving informed consent documents (ICDs) of family therapists in private practice. Therapists' documents were obtained via email solicitation and analyzed using qualitative content analysis. Seven conceptual categories were developed and are summarized. Findings suggest that there were both substantial consistency in the major areas of the documents but variance in their more detailed aspects. The latter was viewed as indicative of the subjectivity involved in creating ICDs and suggests that developing a universal document could be nearly impossible. Stylistic differences were also examined in relation to how they may reflect personal aspects of the therapists.     

The Practice of Marriage and Family Therapists with Managed Care Clients

This study examined the practice patterns of Nebraska marriage and family therapists (MFTs) working with managed care cases. The participants' two most recently closed managed care cases were examined to determine the types of cases seen, the process of treatment, and treatment outcome. Results indicated that the therapists saw cases for a median number of six sessions. MFTs worked with a variety of presenting problems and diagnoses. Depression was the most common presenting problem, and the most common DSM-IV diagnosis was adjustment disorder. A comparison of pre- and post-treatment GAF scores indicated that clients' level of functioning improved significantly during the course of treatment.