Design as a Tool for Family Evolutionary Guidance

This article begins by describing the impact of systems science on the field of marriage and family therapy, discussing that systems concepts are broadly disseminated but have become diluted. The author describes the educational program at a marriage and family therapy graduate institute where students utilize social systems design in their research projects as well as their work with clients. The article outlines the specifications of the Idealized Systems Design (ISD) teaching system, its relationship with the larger institution, as well as its purposes and systemic functions. Application of ISD to the field of marriage and family therapy is emphasized, demonstrating its use in helping facilitate individual, family, and community health as a research tool as well as a set of intervention tools for the practicing therapist.     

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.     

A Review of Family Therapy in Residential Settings

This article provides an overview of the history of family involvement in residential treatment as well as a synthesis of the research showing family-centered interventions and outcomes for youth in residential settings. There are many methods for engaging families in residential treatment that are discussed in the literature; however, there is a significant gap as the field has not yet identified specific family therapy approaches that demonstrate efficacy in working with youth and their families in this particular setting. A review of the literature over the past 10 years will highlight the emerging family therapy models being utilized in this setting, which include multiple-family group intervention, family-directed structural therapy, and narrative family therapy. The article will also include a discussion of three major, well-established theoretical approaches that have been found to be effective in working with youth with conduct issues and show promise in treating youth and families in the complex setting of residential treatment: brief strategic family therapy, multi systemic therapy, and functional family therapy.     

Competences and occupational standards for systemic family and couples therapy

This article reports on the recent government initiative of 2007–2010 to delineate, for the major forms of psychological therapy, expected professional standards of practice and conduct in workplaces (the national occupational standards) and to specify expected levels of competent practice (the competences). The article focuses on the processes and outcomes of this initiative for systemic therapy and its clinical and political relevance. The rationale, research and consultation processes by which these formulations were achieved are described and the outcomes of the work are reported. We also discuss their wider implications, including the various ways in which these achievements might be used and their potential value for the field of systemic family and couples therapy.     

Commentary on “The Family Crucible”

InThe Family Crucible, a recent book that is highly popular and widely praised among mental health professionals, Napier and Whitaker (1978) describe their treatment of a family. The therapy is well done; their therapeutic approach is certainly one which many family therapists will approve; and the book is well-written and exciting to read. Nevertheless, it seems to us that the widespread approval which the book has received raises many questions about the field of family therapy itself, which it is the purpose of this article to examine.     

Centre and Periphery of Nano��A Norwegian Context

This work describes the nano field in Norway as currently emerging in the dynamics between two forms of nano research activities described along a centre-periphery axis. 1) There are strategic research initiatives committed to redeem the envisioned potential of the field by means of social and material reorganisation of existing research activities. This activity is seen as central as it is one of our premises that the standard circulating nano vision implies such a work of reorganisation. The fact that nano is often taken as a paradigmatic example of the shift from Mode-1 to Mode-2 research, supports this assumption. 2) In parallel to this activity, a wide variety of research projects pursuing nano strategies are being funded. We regard such research activity as peripheral in so far as the activity is not marked by being committed to the circulating nano vision, as may often be the case. In the process of reorganising, this article argues, the research activity at the periphery provides a crucial arena for discussing and validating what is to be achieved through the work of reorganisation that takes place at the centre. Our analysis is informed by two Norwegian cases. We examine a major nano research initiative at a Norwegian university as a centre and a research project utilising nanoparticles in fish vaccines as a periphery.     

Understanding alliances. How can research inform user‐friendly practice?

'User-friendliness' is described as a therapist stance which involves attentiveness to the quality of the 'therapeutic relationship', both between therapist and family and between service providers and their public. This article draws on research published in the last seven years from within and outside the family therapy field which can help improve this relationship. I will argue that the issues which challenge user-friendly practice need to be related to the theories which inform family therapy and to the traditional tension within the research field between focusing on measurable outcomes or on user satisfaction. The urgency for a clear analysis of what can make family therapy practice more sensitive to its public comes partly from the relative state of maturity which family therapy has now reached and its need actively to work alongside other approaches. Other crucial influences considered are a greater public demand for choice and improvements in public services, and social policy trends towards greater efficiency and accountability within the helping services.     

Pathways to adulthood and their precursors and outcomes

Norway has an extensive welfare system which may provide adolescents with many options and high levels of flexibility in terms of pathways to adulthood. This study aimed to describe Norwegian developmental pathways to adulthood, including changes in role statuses (such as living situations, education, work, marriage/cohabitation and parenthood) from 16 to 30 years of age, and their precursors and outcomes. Repeated measures latent class analysis of longitudinal data from 998 Norwegian individuals indicated three main pathways to adulthood among women and men. In both sexes, most individuals undertook a long period of education and postponed family formation. However, some individuals started working early, a group of women established families with partners and children early, and a group of men remained primarily single between 16 and 30 years of age. Furthermore, the results show that pathways to adulthood in Norway are surprisingly similar to pathways in other countries such as the US, UK and Finland. The results indicate that pathways to adulthood are influenced by social reproduction factors in a country with high levels of welfare benefits as well. In addition, the results suggest that pathways involving living with a partner and either higher education or work are associated with high life satisfaction at age 30.     

Family therapists as front line mental health providers in war-affected regions: using reflecting teams, scaling questions, and family members in a hospital in Central Africa

This paper will illustrate the utilization of systemic family therapy services inside a hospital in a war-affected region of the Central African Republic. Through an international non-governmental organization (NGO), the author, a family therapist, provided counselling supervision and services to hospital staff and patients in an area of open conflict in the northern region of the country. In circumstances of chronic insecurity fuelled by both government and rebel forces, families displaced in this region are vulnerable to numerous health conditions and social problems. Family therapy techniques and ideas were used to work with individuals, couples and families presenting with health and social problems resulting from HIV-TB, infections, chronic malnutrition, acute poisoning and beliefs about sorcery. Case examples illustrate the systems consultation model used with the mental health team in order to expand and promote the sustainability of patient mental healthcare in this underserved region.     

Human‐Animal Bonds I: The Relational Significance of Companion Animals

The importance of human‐animal bonds has been documented throughout history, across cultures, and in recent research. However, attachments with companion animals have been undervalued and even pathologized in the field of mental health. This article briefly surveys the evolution of human‐animal bonds, reviews research on their health and mental health benefits, and examines their profound relational significance across the life course. Finally, the emerging field of animal‐assisted interventions is described, noting applications in hospital and eldercare settings, and in innovative school, prison, farm, and community programs. The aim of this overview paper is to stimulate more attention to these vital bonds in systems‐oriented theory, practice, and research. A companion paper in this issue focuses on the role of pets and relational dynamics in family systems and family therapy ( Walsh, 2009a ).     

Systemic Family Therapy Competences in Child and Adolescent Mental Health Care

This article is based on a doctoral research project aiming to identify a comprehensive and detailed outline of the systemic therapist competences in child and adolescent mental health care in Norway. Because of the growing demands to offer specialized services within child and adolescent mental health care, I intended the identified competences to target the psychosocial difficulties that are categorized as associated abnormal psychosocial situations (axis 5) in the multiaxial diagnostic system (WHO, Multiaxial classification of child and adolescent psychiatric disorders. The ICD-10 classification of mental and behavioural disorders in children and adolescents. Cambridge University Press, Cambridge, 1996). The project is based on twelve qualitative in-depth interviews with six experienced systemic family therapists, and fieldwork observations of the therapists (participants) in practice. The qualitative methodology is based on Grounded Theory and five overarching categories were identified through the analysis: (1): the importance of ethical and contextual awareness in systemic therapy; (2) the systemic therapist’s stance; (3) therapeutic processes; (4) therapeutic practices; and (5) session-specific features. Challenges, such as limiting the systemic approach to five overarching competences, are discussed alongside this strengths and limitations of the study. The detailed outline of systemic therapist competences is intended to offer a framework for delivering flexible, yet specialized systemic therapy in the context of child and adolescent mental health care. This research may therefore facilitate a “bridge-building process” between mental health’s biomedical focus and postmodern systemic ideas.     

Family therapy and systemic practice with older people: where are we now?

Older people are becoming an increasingly significant group as demographic and cultural change impacts on their roles within the family and society. In this article we consider how family therapy and systemic practice with older people has developed over the past ten years from the early foundations identified by Richardson et al . in 1994. Although older people face particular challenges, themes such as social constructionism, attachment and narrative, familiar to therapists working with people earlier in the life cycle, have also been influential in work in this field. These developments have resulted in increasing recognition of the relevance of systemic practice in older people's services, but significant challenges remain.     

Tasteful Solutions: Solution-Focused Work with Groups of Immigrants

Solution-focused family therapy is well established as a method in the therapeutic field. Less is written regarding solution-focused thinking and practice in preventive work, providing health information. Informed by the work of Insoo Kim Berg and Steve de Shazer, a workshop of primary health care was established in an inner city area of Oslo, Norway in 1994 with a major task of developing methods for providing information about health issues for immigrants as well as the native population. Results from an evaluation of this work are presented and some issues are related to empowerment work and especially Paulo Freires' liberating dialogue.     

Family Therapy Training and Workforce Planning

There is a strong argument for further developing family therapy as a profession within the NHS, using the mechanisms for workforce planning at regional and national levels. Family therapy can be a full-time occupation, as a profession and a secondary activity, as systemic practice. There is ambivalence about professionalism within the field and at different levels of society. This article outlines areas of tension between family therapy and government policies which focus on evidence-based practice. Full integration into the NHS is possible through the career structure which links family therapy with clinical psychology, adult and child psychotherapy, and provides a model for linking workforce planning with education. There are risks of family therapy becoming marginalized in the future, as a profession or as systemic practice, unless it connects better with workforce planning.     

Mentalization‐based Therapeutic Interventions for Families

This article attempts to bridge two seemingly different and yet related worlds, the intra‐psychic and the interpersonal, by viewing systemic practice(s) through a mentalization‐based lens. It is argued that in therapy there needs to be a deliberate, conscious and consistent focus on mentalizing. The emerging mentalization‐based therapy for families is an innovative approach and a distinctive model which is systemic in essence, deriving its ideas and practices from a variety of diverse systemic approaches, yet enriching family work by adding mentalizing ingredients.     

Family Therapy in Chinese Culture and Context: Lessons from Supervising Therapists-in-Training in China

Systemic family therapy as an essential paradigm for treating couples and families has gone global since its initial rise to popularity. According to researchers, China has signaled a strong desire for training in systemic family therapy. Even though this mode of mental health service is a foreign import to China, the surge in interest for Western psychotherapy for individuals and families grows by leaps and bounds. However there has been evolving conversations about the transportability of systemic family therapy from the West to the East. Using a qualitative focus group format, this study explored the experiences of sixteen Chinese couple and family therapists on their perspectives in adapting systemic family therapy concepts to the local Chinese context. Results reveal the interplay between the systems of the changing Chinese family structure and of the application of family therapy models that originated from the West must work harmoniously in order to enhance the goodness of the familial system within the evolving Chinese society in the 21st century.     

The madman theory of war: a possible application in therapy

In therapeutic work a systemic approach has characteristically focused on the family or marital system. In this paper the author focuses on the patient/health care system in a particular case and argues that chronic disability can be seen as a systemic feature rather than a characteristic of the individual patient. A strategy is taken from the field of international conflict and its therapeutic value is explored.