Family Therapy in Romania

The article outlines the development of family therapy in Romania. Family therapy has a relatively brief history in this country, only beginning with the first training programs in the early to mid 1990s. However, as far as the number of professional associations is concerned, it is well represented on the map of psychotherapy approaches. There are several opportunities for training in family therapy. The accreditation of the training programs and the certification of the graduates of these programs is clearly regulated by law. From the legal point of view psychotherapy is considered a specialization of psychologists rather than an independent profession. The authors offer a brief overview of the history of family therapy in Romania, its present position in the health and social care system, the context of training, accreditation standards, the network of professional organizations and some of the possible future directions for family therapy. Finally, recently produced Romanian films are suggested as a medium for getting acquainted with the complex dilemmas faced by contemporary Romanian families.     

Family therapy training—give the customers what they want

Family therapy training is an area of current interest and debate within the Association for Family Therapy. At a local level regional groups and branches have been promoting family therapy through a variety of sources and events (Bott, 1979; Haldane, 1980). The development of training has therefore been of a haphazard and ad hoc nature. More recently the Sub-Committee on Training for Family Therapy has addressed itself to establishing and co-ordinating formalized training programmes and to the attendant issues of course structure, content and accreditation.
The Workshop at Bangor looked at the rationale behind and organization involved in setting up introductory training in family therapy. Several introductory training schemes already in operation throughout the U.K. were described and the results of a recent consumer survey conducted in Northern Ireland were presented.     

Couple and Family Therapy Within the Current Pan-Canadian Context

Canadians take numerous approaches to couple and family therapy due in part to Canada’s diversity of people and geography, as well as the influence of the health care context, a central facet of our national identity. Tracing back to Nathan Epstein, the founder of family therapy in Canada, there continues to be a strong tradition of couple and family therapy within Canada which has international reach. Formal training in family therapy, as well as couple/marital therapy occurs largely outside of the scope of degree granting programs and university settings. The American Association for Marriage and Family Therapy has a strong presence in Canada, with six divisions across the country. Popular models of practice for Canada’s couple and family therapists include cognitive-behavioral therapy, solution-focused therapy, narrative therapy, emotionally-focused therapy, and Bowenian/intergenerational therapy. A growing number of training opportunities are becoming available across Canada, and the practice of couple and family therapy is becoming institutionalized as one of the core competencies for professions such as psychiatry. In this article, we examine the context of family therapy in Canada by examining its history, the unique accreditation standards, qualifications and organizations associated with family therapy, the relationship between couple and family therapy, and future directions for this field of practice.     

Development and Practice of the Systems Paradigm in Argentina, Chile and Peru

The systems paradigm has been developing in the southern region of South America for more than three decades, albeit at different paces and with a variety of achievements as can be expected when describing the process of countries as diverse as Argentina, Chile and Peru. This article describes the circumstances and actions that have enabled the systemic approach to gain a legitimate place in the local psychotherapy field permeating family, marital/couple, and individual therapy. Moreover, the family/contextual perspective has attained a valued respectability in the family legal system as well as in community interventions. Overall, the community is aware of and at ease with this efficacious contextual approach. As in other parts of the world, the universities have joined the private entities in the training endeavor and the accreditation process is a complex goal with obstacles that have not yet been surmounted.     

Co-constructing a cross-cultural course: resisting and replicating colonizing practices

This article examines the cross-cultural complexities of teaching and learning processes at different levels in a family therapy training program delivered in a different country. It presents two interlinked narratives of an advanced family therapy training program delivered in Slovenia by a U.K-based family therapy training institute. The context in which the training was negotiated and planned is discussed, highlighting issues at the macrosystemic level. Dilemmas that arose in relation to differing beliefs about teaching and learning are elaborated. We examine power relationships, ways that we positioned ourselves and each other, and how we tried and sometimes failed to take these into account. We question how the issue of spoken language and its meanings creates its own constraints and power structures, and how we respond to the impossibilities of translation. We argue that it is through the examination of uncomfortable processes that we develop self-reflexivity and work toward more equitable relationships.     

It’s not Easy Becoming Green: Student-Therapist Perceptions of Family Therapy in an Eco-sustainable age

Recent attention given to environmental concerns has been vaulted to the forefront of American society and the world. This has resulted in an increase in ecologically minded practices known as the ‘go green’ movement. Despite the overlap between environmental sustainability and systemic thought, marriage/couple and family therapists (M/CFTs) have remained relatively silent regarding ecologically friendly practices within training and clinical practice. In this qualitative study (the first one of its kind), we asked 25 M/CFT trainees to describe their perceptions of ecological and family sustainability in general, as well as in the context of applying eco-informed language and practice into their therapy. In general, M/CFT trainees reported that although they believe that ecological practices are important for families, they struggle with what the inclusion of such practices might look like practically. Implications for clinical practice and training are presented as well as suggestions for future research.     

The Negotiation of Values in Therapy

Values are integral to all social systemic operations and therefore to the heart of the therapeutic process. For the therapist, values are an essential component in defining and assessing a problem, determining goals, and selecting therapeutic strategy. Therapists do not have a choice about whether they need to deal with values in therapy, only about how well. The training of therapists about their values needs to be integrated with the training about their own emotional and family issues. This training should be carried out in the context of treating families and have as its primary focus the relationship of the therapists' personal issues to the conduct of their therapy with families. Personal insight and mastery over handling their own values and family issues will maximize therapeutic effectiveness.     

Establishing the Validity of the Spirituality in Clinical Training Scale: Measuring the Level of Integration of Spirituality and Religion in Family Therapy Training

The existing literature suggests that family therapy training programs are not adequately preparing students to address spiritual and/or religious beliefs as a resource for change in therapy. Therefore, this study sought to validate the Spirituality in Clinical Training Scale (SCTS) as a measure of the level of integration of spirituality and/or religion in family therapy training. Additionally, this study examined the latent associations among the subscales of the SCTS and measures of personal importance of spirituality, spiritual clinical competence, and spiritual self-exploration. Finally, given that the type of educational institution (i.e., religious compared to non-religious schools) may influence the extent to which spirituality is addressed in training, this study examined whether attending a religious or non-religious institution moderated the associations among the SCTS and constructs used to assess validity. A sample of 341 master’s and doctoral family therapy students completed an on-line survey for this study. The results suggest that the SCTS is a reliable and valid measure for assessing integration of spirituality into family therapy training. The establishment of this measure is important given that no previous scale measuring the integration of spirituality into therapy training exists. The results also suggest that spiritual self-exploration is associated with increased use of interventions that integrate spirituality into therapy. Implications for clinical training are discussed.     

Chaplain–Physician Consultancy: When Chaplains and Doctors Meet in the Clinical Context

This paper summarizes the perspectives of 327 Australian health care chaplains concerning their interaction with physicians within the clinical context. In general terms the findings indicated that nearly 90% of chaplains believed that it was part of their professional role to consult with physicians regarding patient/family issues. Differences of involvement between volunteer and staff chaplains, Catholic and Protestant, male and female chaplains and the type of chaplaincy training are noted, as are the perspectives of chaplaincy informants regarding their role in relation to physicians. Some implications of this study with respect to chaplaincy utility and training are noted.     

The formalization of family therapy training—issues and implications

This paper highlights the emerging debate, particularly evident in the U.K. and Australasia, regarding the desirability of more formalized training programmes for family therapy. The professionalization of family therapy is under way. The implications of this process for training structures, the role of the family therapist, the nature of family therapy associations and thus the ultimate goals of family therapy are summarized. Alternative models of training structures, their ideological bases and the implications of these alternatives for the nature of an association and the family therapy process are then briefly discussed. In summary, some priorities for a desired model of family therapy training are listed for discussion.     

The growing pains of family therapy in Singapore

Family therapy in Singapore is both short on history and overdue for development. Through in‐depth interviews with six experienced local family therapists and trainers, this article explores the challenges of family therapy development in Singapore, giving particular attention to practice, supervision, training, and research. Over time, family therapy practitioners in Singapore have gained insights in applying systemic ideas in this pluralistic society where there is a rich mix of race and ethnicity. This article highlights the contribution Singapore's experience of family therapy can make to a more global picture, in view of its rich multicultural context despite significant challenges.     

Systemic Reflecting Team Training: Perceptions and Experiences of South African Educational Psychologists

Abstract

There is limited research on the application of systemic family therapy in developing countries. This qualitative study explored the perceptions and experiences of 12 educational psychologists and a family therapy trainer, who have worked within a systemic reflecting team using Tom Andersen’s method of training and supervision. The semi-structured interview findings suggested positive perceptions of systemic intervention, despite various challenges experienced in its implementation within the South African context. The educational psychologists identified their reflecting team experiences as being beneficial for both their professional development and current practices. Future research which investigates the reflecting team process in action is recommended.     

The family-of-origin framework: A model for clinical training

Family-of-origin work is defined as a person's attempt to examine and/or change the patterns of interaction that occur in the family in which s/he was raised. This article outlines a model of family-of-origin work that is used in the clinical psychology training program at St. Louis University. The family therapy literature, particularly the work of Bowen, provides its theoretical underpinnings. An integral part of family-of-origin presentations is the genogram, or visual depiction of a family tree. Many ethical issues arise from the use of family-of-origin work within the context of clinical training, including confidentiality, responsibility, informed consent, values, and the boundaries of the supervisory relationship.     

Family and Systems Therapy and Training in Portugal

The history of systemic family therapy in Portugal since its appearance until the present is discussed. Some data on systemic family therapists’ training is provided in the context of the Portuguese Society of Family Therapy and Academic Institutions. In Portugal, family therapy has been extended to various contexts, including medical and community services. Finally, future directions for family and systems therapy practice and training in Portugal are provided emphasizing the importance of family interventions as an important resource to empower families living with health chronic conditions. The Portuguese Family Therapy Society, every 2 years, organizes a scientific Iberian conference with Portuguese and Spanish speakers. This allows the exchange of clinical experience and research about family and systems theory.     

Integrating Family Therapy Training into Psychiatry Residency Programs: Policy Issues and Alternatives

This article explicates policy issues and alternatives in the integration of family therapy training within general psychiatry residency programs. These issues include controversies about the definition of the field; elective versus required teaching; curriculum content; and when, where, and who should teach family therapy in this context. The article concludes with recommendation for further clarification of this training area.     

What we say we do: results of the 1997 UK Association of Family Therapy Members Survey

This study represents the first UK national survey of family therapists and systemic practitioners. The aim was to provide demographic information of systemic practitioners/family therapists and also to describe their clinical practice. The sampling frame used was the UK Association of Family Therapy membership list and all members were sent a postal questionnaire. The response rate was 33% with 495 out of 1500 questionnaires returned. Among the major findings were: systemic practitioners/family therapists are most likely to work for an NHS trust, to use family therapy techniques/systemic ideas predominantly, and to treat a broad range of client issues. They are also most likely to work with families, and therapy is relatively short term (five to eight sessions) regardless of whether they treat families, couples or individuals. Most family therapists/systemic practitioners use some measure of outcome, although frequently this will be feedback from clients. Supervision is sought by the majority of AFT members. In spite of some methodological limitations, the study provides interesting insights into the training and practice of UK family therapists and systemic practitioners which appears to differ in some respects from our American colleagues. It also provides a baseline for future surveys, making it possible to describe the developments of family therapy and systemic practice in this country.     

The Development of Family Therapy and Systemic Practice in Europe: Some Reflections and Concerns

This paper outlines the development of pan European systemic thinking and practice. This development has been enabled and supported with the establishment of the European Family Therapy Association (EFTA). EFTA has evolved over the last decade from an organisation of individual members to an organisation of organisations—representing also national associations of family therapy and family therapy training institutes across 28 European countries. There are three sections to this paper: (1) a brief summary of the development of family therapy practice in Europe; (2) a brief summary of the work of the national associations of family therapy in EFTA; and (3) a brief summary of current concerns of some senior family therapists and family therapy trainers within the EFTA organisation.     

Art therapy in transcultural family therapy

The increased existence of foreign culture patterns in the child population calls for transcultural comprehension in child psychiatry. This case report describes transcultural aspects in the therapy of an 11 year-old Moslem girl admitted to a child psychiatric department. Her symptoms were abdominal pain, headache, anxiety, and pretended fever. A family therapeutic approach was used together with elements of art therapy and individual therapy in a successful treatment. The family therapeutic approach was based on art therapy as a part of the communication where cultural symbols were an important part. An interpreter was not used. The cultural context where it is acceptable to overstep the borderline between reality and fantasy is seen as an important healing capacity.I would like to acknowledge my debt and my appreciation to Ebba Ernst, psychologist of the department and supervisor in the therapy of the S. family. I would also like to thank professor Kai Tolstrup and child psychiatrist Torben Marner for stimulating support in the process of writing the article. A grant from Enkefrue Hermansens Mindelegat made the participation in the Krakow Congress possible.