Simulation as a tool in family therapy research

The efficacy and validity of simulation for purposes of training and evaluation are well established. Simulation has proven valuable in human behaviour research as well. However, based on the belief that families and other small groups behave differently, many family theorists have concluded that simulation may not be valid for family research despite the fact that some empirical studies showed little difference between simulated and actual families, suggesting that the disparity may not be as great as commonly believed. Ongoing and future studies controlling for 'time together', a dimension presumed to be critical in comparing simulated with actual families, may demonstrate that differences are not sufficiently large to preclude the use of simulated families in family research. Methodological problems are addressed and directions for future research proposed.     

Family therapy outcome research: a trial for families, therapists, and researchers

This article describes the process of an evolving research project. Initially conceived as a study investigating outcome measures and their sensitivity to change after a course of family therapy, the project soon changed its focus. As unexpected results were recorded, the clinical research team became destabilized and the individual team members responded by making their own "sense" of the data, reflecting their respective clinical and scientific positions. As clinicians and researchers began to challenge each other's belief systems, the project entered a new stage. The interactions within the team became of increasing interest and themselves objects of research. The recursive nature of re-search was demonstrated, and the act of writing this report completed the circle, as the various authors tried to achieve a balance between reporting the content and the process of this project.     

Intensive family therapy: a way to change family functioning in multi-problem families

TA single group treatment outcome study of intensive family therapy (IFT) is presented. One hundred and nine families from five Swedish units participated and results on family measures for eighty-six of these families are reported. This multi-centre study is the largest so far of this treatment model. The units offered a full-day multi-impact treatment programme for families during an intensive period of approximately one month preceded by a period of extensive planning. Measures used were the self-rating 'Family Climate' and Family Relation Scale and observer-rated CRS-Turbo and the Beavers' System Scales. Significant changes in the direction towards a better family climate and a higher family functioning occurred. Given the very difficult circumstances of these multi-problem families the results are considered promising.     

Nontherapy family research and change in families: a brief clinical research communication.

This is the second interim report of an exploratory, prospective study of psychiatrically “nonlabeled” family interaction. The project focuses primarily on whole-family interaction as it progresses through time.     

Drawing a family map: an experiential tool for engaging children in family therapy

Inclusion of children in the treatment process is a central aspect of the discipline of family therapy. Young children's verbal skill and level of abstraction may not be suited to ‘talking therapy’, but they have an intuitive grasp of family life which is invaluable, and their views and needs should be considered when effecting change in the family system. A method is offered to engage young children, adolescents and adults of divergent verbal skills into a shared process. It requires no special set‐up or tools, only paper and markers. Distance and proximity are represented in a simple map of the family, adding symbols for affection and conflict. A spatial representation of the family system is created, and may be referred to in the course of the therapy.     

Teaching the family life cycle: A guide for a workshop using simulated families

Abstract

An experiential technique for teaching the Family Life Cycle is presented. Participants are asked to create simulated families and are assigned a series of structured exercises that focus the emotional, developmental, and systemic issues of each Family Cycle stage. Directions for each exercise, questions designed to develop observation skills, and discussion of specific workshop issues are also included.     

The EPPI family therapy outcome study

Information was evaluated from 1014 families seen in an eight-year period by therapists connected with the Department of Family Psychiatry at Eastern Pennsylvania Psychiatric Institute in Philadelphia. Statistical analysis revealed several factors that had some predictive value in relation to outcome of therapy; these were race, past psychiatric hospitalization, type of presenting family problem, and number of sessions held. There was a rather good chance of improvement being noted by the therapist if the family stayed in treatment for eight or more sessions. About 90% of the cases were seen for less than 20 interviews. Only about 3% were seen for longer than 35 interviews. The vast majority of EPPI cases were short-term. Black families tended to present different problems from white, and therapy was terminated with blacks sooner than for whites. About 35% of families terminated after one to two interviews, and another 30% after three to seven sessions. Since families tended to benefit most after eight or more sessions, the need for better methods or techniques to engage families is highlighted.The research was supported in part by a Career Development Award from the University of California, San Francisco, to the first author.     

The centrality of values in families and family therapy

Values are discussed in terms of development, nature, and implications for family therapy. Clinical examples are used to demonstrate concepts and a model is presented which depicts how the various leverages utilized in family therapy relate to family values. Individual development, cultural heritage (legacy), the nuclear family system, and the contemporary context are described as factors which interact to form values. A case is made for conceptualizing values as central to family therapy relative to engaging families, intervening in families, and evaluating therapeutic impact.     

Family therapy as a treatment for children: a critical review of outcome research.

The value of family therapy as a treatment for child psychopathology is considered by reviewing pertinent outcome research. Fourteen studies that met three criteria are included in the review: (a) a child or adolescent was the identified patient or referral; (b) therapy included at least one parent and the child; and (c) outcome was evaluated in terms of the child's symptoms. There are major shortcomings in most of the available data, with only two well-controlled studies. Some empirical evidence does exist that family therapy is an effective treatment for children; the data from studies of adolescents are especially encouraging. However, insufficient data are available for comparing the relative merits of conjoint family treatment and individual child therapy. If the value of family therapy as a treatment alternative or, ideally, as the "treatment of choice" for a referred individual child is to be established, more and better controlled comparative outcome studies will be necessary. Suggestions for future research are presented emphasizing the need for a developmental perspective by recommending, for example, the use of factorial designs in which the intervenaction of treatment and age can be analyzed.     

Videotaped interrogations and confessions: a simple change in camera perspective alters verdicts in simulated trials

Prior research has indicated that altering the perspective from which a videotaped confession is recorded influences assessments of the confession's voluntariness. The authors examined whether this camera perspective bias persists in more ecologically valid contexts. In Study 1, neither a realistic videotaped trial simulation nor potentially corrective judicial instruction was sufficient to mitigate the prejudicial effect of camera perspective on mock jurors' assessments of voluntariness or on their all-important final verdicts. Study 2 suggests that perhaps the best camera perspective to use is one that focuses trial fact finders' attention on the interrogator, as this particular vantage point may facilitate decision makers' capacity to detect coercive influences, which in turn could, in some cases, improve assessments of the confession's reliability.     

'Holding' as a therapeutic manoeuvre in family therapy

This paper describes the use of planned parental physical 'holding' as part of family therapy in a Child and Family Guidance Clinic. It is used when the child is overactive or out of parental control, or is not attached to its parents. Direct or indirect suggestions that parents hold their children are made by the therapist.     

Research as a family therapy intervention technique

The utilization of the research process as an intervention has recently been described in the family therapy literature. However, it is important to draw a distinction between research as intervention and research as a unique family therapy intervention technique. From a family systems perspective, research as an intervention technique may make therapy more palatable for some families. A case study is presented in which this technique created the context for change for a family involved in a chronic illness research project.The author would like to thank Dr. Wendy L. Watson for her participation as a member of the clinical team and Drs. Fabie Duhamel and Wendy L. Watson for their helpful critiques on earlier drafts of this paper.Supported by a grant from the Albert Foundation for Nursing Research.     

Women in families: feminist therapy and family systems*

Current family therapy has as its basis the concept of the family as a system. Systems theory has developed a set of explanations that are frequently functional in nature; they are often applied as though they assume that within a system a common goal is worked towards as in biological systems. For example, the concept of homeostasis is used in much the same way as Cannon (1929) used it to describe the mechanisms of stability within biological systems such as body temperature regulation. Here all the components of the system co-operate to maintain body temperature within certain limits. This functional assumption of a common aim amongst components of a system to achieve balance should be compared with a pluralist systems analysis which does not assume such commonality of goals. For example, a pluralist analysis could highlight the conflict inherent amongst different subsystems when one subsystem has more power than the other. At a theoretical level it can be seen that family systems theory has restricted itself to a limited set of assumptions about the explanatory concepts it uses. An analysis of women's psychology which has emerged through the developments of feminist therapy can enrich the theory and practice of family therapists.     

The person response function as a tool in person-fit research

Item responses that do not fit an item response theory (IRT) model may cause the latent trait value to be inaccurately estimated. In the past two decades several statistics have been proposed that can be used to identify nonfitting item score patterns. These statistics all yieldscalar values. Here, the use of the person response function (PRF) for identifying nonfitting item score patterns was investigated. The PRF is afunction and can be used for diagnostic purposes. First, the PRF is defined in a class of IRT models that imply an invariant item ordering. Second, a person-fit method proposed by Trabin & Weiss (1983) is reformulated in a nonparametric IRT context assuming invariant item ordering, and statistical theory proposed by Rosenbaum (1987a) is adapted to test locally whether a PRF is nonincreasing. Third, a simulation study was conducted to compare the use of the PRF with the person-fit statistic ZU3. It is concluded that the PRF can be used as a diagnostic tool in person-fit research.The authors are grateful to Coen A. Bernaards for preparing the figures used in this article, and to Wilco H.M. Emons for checking the calculations.     

Epistemological confusion in family therapy and research

Family therapy began as a movement sparked by a small group of behavioral scientists who challenged the orthodoxies of medical and psychodynamic therapies. This movement signalled the beginning of an epistemological shift, the roots of which can be found early in this century in the physical sciences. As the field has grown and become for many a means of livelihood rather than an experimental thrust, though exploration of epistemological issues has continued, a split has developed in the field that mirrors the epistemological split currently visible in Western society. The predominant reality system of the Western world remains rooted in Cartesian/Newtonian, nineteenth-century mechanistic and reductionistic "common sense," even though the basis for a new, nonmechanistic and nonreductionistic reality system has been emerging in the twentieth century. The juxtaposition of both reality systems in the field of family therapy has produced much confusion. This article attempts to clarify the basis for that confusion.     

Applying Delphi methodology in family therapy research

The Delphi technique, which is increasingly seen in family therapy publications, encourages the articulation of refinement in family therapy practice and theory. Combining both quantitative and qualitative methodology, this technique involves consideration of information that might otherwise have been overlooked. Due to lack of clarity on this approach, a dilemma exists in applying this research procedure in family therapy. To remedy this deterrent, this paper reviewed 11 studies and outlined use of the technique in regard to design, procedure, and sampling.