Family therapy and clinical psychology

The results of a survey of 111 clinical psychologists in the Republic of Ireland along with some comparable data from US and UK surveys were used to address a series of questions about the link between family therapy and clinical psychology. Family therapy was not a clearly identifiable sub-specialty within clinical psychology in Ireland. Family therapy theoretical models were used by more than a quarter of the Irish sample to conceptualize their work but by less than a tenth of US and UK respondents. In all three countries about a tenth of treatment time was devoted to the practice of family therapy. In Ireland, the use of family systems models, family assessment interviews and family therapy was more common within the child and family specialty than within the mental handicap or adult mental health clinical psychology specialties. The experience of live supervision and participation in family or couples therapy were important formative factors in the development of some clinical psychologists. Further training in systemic consultation, particularly in situations where an abuse of power has occurred, was identified in the survey as a priority area for continuing professional development. The evolving relationship between family therapy and clinical psychology is discussed in the light of these findings.     

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.     

RAE WEINER

Rae Weiner, a pioneer of the concept of family therapy with the Philadelphia Child Guidance Clinic and the Family Institute of Philadelphia, died Monday, August 13th at the age of 46. Mrs. Weiner received a bachelor's degree from the University of Pennsylvania and a master of social studies from Bryn Mawr College. Mrs. Weiner joined the Philadelphia Child Guidance Clinic in 1968 where she was instrumental in creating and overseeing family counseling programs. She was also closely affiliated with the Family Institute of Philadelphia, an organization of family therapists and social workers. Mrs. Weiner was president-elect of the Family Institute and served on its executive council. She is survived by her husband, Oscar R. Weiner, M.D., two sons and a daughter.     

Marriage and Family Therapy with Low-Income Clients: Professional,Ethical, and Clinical Issues

Economic stress greatly increases the likelihood of mental health issues occurring within a family. Although this is widely known within the mental health profession, there is a lack of literature that assists therapists in working effectively with low-income clients. As a result, marriage and family therapists may be ill equipped to meet the needs of those in poverty, and may even be conducting therapy that is ethically unsound. The authors of this article discuss several ethical and professional issues regarding therapy with families in poverty. A number of suggestions are presented for improving the effectiveness of therapy with low-income clients. Michele E. Grimes and Alyssa D. McElwain are masters students in Marriage and Family Therapy at Purdue University Calumet, Hammond, IN. Michele E. Grimes and Alyssa D. McElwain contributed equally to this article.     

Family therapy for continuing professional education

This is a report on a program of family therapy instruction intended as a continuing professional education service to mental health personnel. The rapid expansion of the program since its inception in late 1971 is due to increasing demand from human service agencies in and around the Greater Philadelphia area. By the end of 1978 more than 550 had participated. Approximately 15% went on to higher levels of family therapy training available at the Department of Family Psychiatry of Eastern Pennsylvania Psychiatric Institute. Some characteristics of participants are described: most are master's level personnel representing a wide variety of human service agencies within a 100-mile radius of Philadelphia; most had a positive response to the training; most did not intend to become family therapists but wanted an exposure to theory and methods. Comments are included by selected category of how participants use what they learn.     

Media Coverage of Child Sexual Abuse: An Opportunity for Family Therapists to Help Families and Communities

The recent media coverage of child sexual abuse charges involving priests is likely to trigger various needs among the public for professional services. Family therapists should prepare to respond effectively to the high anxiety that these media stories trigger. Family therapists with expertise in human sexuality should use such reports to promote a fuller understanding of all aspects of sexuality for individuals and families. Professionals can integrate much needed aspects of sexuality education in dealing with the mass media, in crisis intervention for persons at risk, and in therapy that centers on child or adult experiences of sexual abuse.     

The Credentialing of Professional Psychologists and Its Implication for the Other Mental Health Disciplines

Professional psychology was the first mental health profession to challenge the preeminence of psychiatry and in so doing blazed the trail for clinical social workers, mental health counselors, marriage and family therapists, and addiction counselors. Social work has followed one decade behind psychology's footsteps, and the other rapidly emerging mental health professions are not too far behind social work. This article reviews the lessons learned by professional psychology when it adopted the strategy of statutory regulation, freedom of choice, control of its own training and of its national organization, and future strategies for Medicare and eventually for the enactment of universal health care. These lessons are important to the professions following psychology.     

Cause and responsibility: towards an interactional understanding of blaming and 'neutrality' in family therapy

This paper aims to shed light on the ways in which 'neutrality' is both produced and resisted by socially competent actors in family therapy sessions. It draws upon recent and previous papers in this journal ( Stancombe and White, 1997; Stratton, 2003a, 2003b ), which highlight the importance of blame in therapeutic encounters. When families come to therapy, individual members frequently deliver competing accounts about the family troubles and who is to blame for them. This produces particular challenges for the therapist. We examine the practices of therapists in managing accountability in the session and in their own discussions. Family therapists operate with a professional ethic of neutrality, or multi-partiality. This paper is concerned with the linguistic strategies used by therapists to deal with overtly blaming accounts, how these strategies are responded to by family members in talk-in-interaction and how therapists go about crafting accountability-neutral versions. We show that the social and moral context of family work makes the therapist's job of communicating multi-partiality precarious. In producing accountability-neutral versions of families' troubles, therapists are forced to make practical-moral evaluations of competing versions of events. We conclude by arguing for a more explicit engagement with the moral nature of therapeutic practice.     

The Profession of Family Therapy in South Korea: Current Status and Future Directions

The authors present a brief overview of the family therapy field in South Korea. Since its introduction in the late 1970s, family therapy has been developing into a professional field with education and training institutions, practice settings, credentials, and practitioners holding memberships in various professional organizations. While such issues as family values and types, filial piety, violence, interethnic marriage, and social polarization have resulted in an increased demand for family therapy, such services are not readily accessible to Korean families in need. Efforts should be made in increasing number of competent family therapists by strengthening both academic and clinical requirements for credentialing. Efforts are also needed in increasing accessibility of family therapy services by making them more available within a variety of human service contexts.     

Family Awareness for Nonclinicians: Participation in a Simulated Family as a Teaching Technique

This paper describes a course in family theory geared to "well" family members that combines didactic and experiential teaching techniques. A key feature of the course is that students participate in a simulated family for twelve weeks. Family therapists are skilled at using techniques that powerfully dramatize family process; they can provide a needed and useful service to the community by teaching the dynamics of families functioning to people who have a personal or professional interest in learning more about families.     

What the family brings: gathering evidence for strengths-based work

Families attending child and adolescent mental health (CAMH) services are often assumed to have problems in key areas such as communication, belonging/acceptance and problem-solving. Family therapy is often directed towards addressing these difficulties. With increasing emphasis in family therapy and human services fields over the last decade on identifying and building from strengths, a different starting point has been advocated. This paper describes a large survey of the self-reported pre-therapy functioning of children and families using a public CAMH service (n=416). Before commencing family therapy parents identified family strengths across a range of key areas, despite the burden of caring for children with moderate to severe mental health problems. This evidence supports theoretical and clinical work that advocates a strengths perspective, and highlights how resilience framed in family (and social) rather than individual terms enables a greater appreciation of how strengths may be harnessed in therapeutic work.     

Family therapy with black families

Family therapy in Britain must develop to encompass the external reality of family life. Living in a racist society dominates the lives of all black families. Family therapists need to acknowledge and address this before intervening in the family system. This paper offers personal and professional experiences, confrontaion, structured exercises and general and specific principles for work with black families. Minimal and positive goals are advocated so that practitioners do not feel paralysed by the enormity of the task.     

Relationships,Environment, and the Brain: How Emerging Research is Changing What We Know about the Impact of Families on Human Development

Recent research is providing family therapists with new information about the complex interaction between an individual's biological makeup and his/her social and physical environment. Family and social relationships, particularly during sensitive periods early in life, can affect a child's biological foundation. Additionally, stress during the early years can have a lasting effect on an individual's physical and mental health and contribute to the onset of severe mental illness. Community programs have been developed to intervene early with families who have an at‐risk child to prevent or minimize the onset of mental illness including providing partnerships with at‐risk mothers of infants to shape attachment relationships. Programs are also developing individual and family interventions to prevent the onset of psychosis. Practicing family therapists can incorporate emerging neuroscience and early intervention research and leverage the growing base of community programs to enhance the effectiveness and sustainability of mental health outcomes for clients. Additionally, family therapy education programs should broaden student training to incorporate the growing body of information about how family relationships affect individual mental health development.     

Confidentiality: an ethical and legal conundrum for family therapists

There are several important issues influencing the holding of confidences in family therapy, among them are privacy, family secrets, confidentiality, and privileged communication. Clinicians need to be aware that breach of confidentiality is considered a high-risk area in clinical practice, which could be brought within a "low profile" malpractice configuration by adopting certain risk management techniques. Family therapists have an obligation to maintain their practice under the guidance of professional ethics, agency policies/procedures, and within emerging judicial parameters. The questions of confidentiality that confront family therapists have no clear and easy answers and the legal dilemma is ever present.     

Systemic training for healthcare professionals: the Chicago Center For Family Health approach

There has been increasing interest in family-centered, collaborative, biopsychosocial models of care by health and mental health professionals and consumers. This trend has led to growing demand and development of specialized training in family systems approaches to health care. This article describes the Families, Illness, and Collaborative Healthcare programs developed at the University of Chicago affiliate, the Chicago Center for Family Health. The program philosophy is guided by the following principles: a systems orientation focused on the family, a Family Systems Illness Model, a family resilience framework, a family-centered collaborative model of health care, and a social justice and advocacy orientation. Specific training components that implement these principles are described, including intensive certificate and fellowships; workshops, conferences, and institutes; and consultation and training services for community-based organizations. Discussion includes professional networking opportunities, funding challenges, and policy recommendations.     

‘Why should we talk to you? You'll only tell the Court!’ On being an informer and a family therapist

The family therapy literature recognizes the constraints imposed on a therapist's freedom and impartiality in a statutory agency. This paper shows that clinical settings that are apparently independent are not free of such constraints. The wider professional welfare system has confused expectations of a clinical agency that it should provide simultaneously both therapy and a measure of social control. An account is given of one hospital-based family therapy team's struggles to find manoeuvrability in child-focused statutory cases, so as to be helpful both to families and referrers. One method of working is illustrated with a case example.     

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.     

The Development of Family Therapy Practice and Training in Taiwan: A Review and Prospects for the Future

This thesis reviews the development of family therapy in Taiwan since its commence in 1969 to today, with two focuses on the status quo in practice and in training. The practice of family therapy in local hospitals, social welfare agencies and community counseling institutes are reviewed respectively, with a discussion of the challenges local family therapists encounter. The status quo of local family therapy trainings is also examined in terms of trainers, programs, professional organizations and licensure. The limitations and possible hindrances to the current professional training system are explored, and finally suggestions for the advance of local family therapy professional development in Taiwan are proposed.     

Engagement and recruitment for family therapy research in community settings

Based on the recruitment experience in a family therapy research project with heroin addicts, this paper explores the difficulties of researcher networking with other social service agencies. Concepts from contextual family therapy are used to explore four general areas that contribute to successful intra-agency relationships: 1) Evaluating the nature of larger system relationships; 2) identifying the resources and needs of a clinic; 3) joining with the counseling staff; and 4) addressing the impact of public policy and ideology on clinic life. A case of engaging one clinic is presented and nine guidelines for engaging large community settings for participation in family therapy research are offered. These areas are considered in light of the relational dynamics that arise when working with multiple social service systems.An earlier version of this paper was presented at the American Family Therapy Association conference in Washington, DC, June 1986. The authors are grateful to the recruitment staff of the Intergenerational Family Therapy Project: Guillermo Lopez, Bart Rubin, Sharara Godfry, and Armando Chenyek. This research was supported in part by a grant to Guillermo Bernal from the National Institute on Drug Abuse (DA03543).     

The practice of community family therapy

This paper presents a summary of the basic theories and methods of Community Family Therapy (CFT), a relatively new therapeutic approach developed in response to the need for effective intervention in treating low-income, urban families. CFT operates outside of the traditional therapeutic box, successfully combining family therapy techniques with developmental and motivational theories, community mental health, social work, economic development, and community mobilization strategies. CFT utilizes a dualistic approach in which both client and therapist become involved with the same three levels of engagement. Specifically, the client strives for: (a) personal and family change and growth-level 1, (b) accessing community resources-level 2, and (c) leadership development and civic action-level 3. Also, CFT calls upon therapists to strive for: (a) personal growth and maturation-level 1, (b) collaboration with community resources for professional support-level 2, and (c) operation as a "citizen therapist," through civic action and volunteer services-level 3.