Family Therapy Training in Clinical Psychology Programs

In a national questionnaire survey of graduate programs offering the Ph.D. or Psy.D. in clinical psychology, the status of family therapy training was examined. With a 79 per cent response rate (102 programs), the study found that 10 per cent of the nationwide faculty identified themselves as primarily family therapy oriented, 32 per cent of the programs had no family-oriented faculty members, 18 per cent of all psychotherapy courses were family therapy courses, and 21 per cent of the schools had no family therapy course. The ratings of the importance of providing students with family therapy training were found to be unrelated to the number of family therapy courses available but positively correlated with the percentage of family therapy courses within the total curriculum.     

Let’s Play: Using Systemic and Experiential Techniques in the Play Therapy Instruction of MFT Masters’ Students

Marriage and family therapists are uniquely poised to work with entire families, including children. It is surprising then, that so few MFTs affiliate with play therapy. Many COAMFTE accredited masters’ programs offer some form of play therapy training, but therapists often report feeling uncomfortable with play therapy (Gil, 2015). In this paper, we offer a condensed refresher course on play therapy for MFTs, including suggested readings, materials, and instructions to expand training from a 2-day seminar to a 14-week course. We discuss the strengths and weaknesses of offering play therapy instruction as a semester long required course for masters’ students.     

The WebQuest: An Illustration of Instructional Technology Implementation in MFT Training

This teaching case illustrates the innovative application of an instructional technology modality, the WebQuest, in family therapy training. It describes what a WebQuest involves, and how it can be used as a tool for developing critical thinking and application of contemporary marriage and family therapy (MFT) theory to social and global issues. The authors discuss the results of the survey and focus groups conducted to assess the value of this assignment from the students’ perspectives. Results indicate that its application in a family therapy theories course fostered students’ awareness of global issues impacting family life, integration of family therapy theories to serve children and families, creativity in developing their own intervention models, and ability to discuss and integrate knowledge from different knowledge bases and perspectives.     

Stages in the Family Therapy of Adolescents

Family therapy is considered from the systems point of view as a process with a series of stages including definitive beginning and end points. The stages are identified as crisis points in family therapy - i.e., moments in the therapy process when the equilibrium of the family is upset and when stress reactions among family members are most likely to be intense. Since times of crisis also provide special opportunities for growth and change, they can be utilized therapeutically provided the therapist is knowledgeable about the kinds of upheavals that a family may experience and the time sequence in which they may occur. Eight such crisis points and their relation to therapeutic intervention are presented. The purpose of this paper is to outline the role of the crisis as therapeutic opportunity in the course of family therapy.     

Assigning Homework to Couples and Families

Homework assignments, or “out-of-session assignments,” have gained popularity among couple and family therapists due to their potential to solidify the work achieved during the course of therapy and to help clients take responsibility for their own change. Homework assignments also serve as a testing ground in therapy to determine what works and what does not. This article provides an update on some of the empirical literature on homework assignments and its reported effectiveness in the domain of couples and family therapy. It also highlights the need for and the effectiveness of out-of-session assignments during the course of treatment.     

Sharing a multicultural course design for a marriage and family therapy programme: one perspective

The marriage and family therapy (MFT) field has made tremendous progress in acknowledging the importance of multicultural training. Nevertheless, multiculturally committed MFT trainers still struggle with issues of multicultural course design and delivery. In a subject so controversial and which requires a great deal of experience and skills to teach, little has been done in terms of sharing different multicultural course designs and working towards their implementation in MFT programmes. This paper presents a prototype curriculum of an introductory course in multiculturism in counselling for marriage and family therapy students with the overall goal of making trainees more multiculturally aware. It includes a few examples of strategies designed to aid the continuing infusion of multiculturalism into MFT programmes.     

A Case of the Blind Leading the “Blind”: Reframing a Physical Handicap as Competence

Structural and strategic family therapy inform the course of treatment of a family with a blind member. Alteration of the family's view of the problem through reframing the blindness as competence is reported.     

Family criticism and self-starvation: a study of expressed emotion

The measure Expressed Emotion (EE) has been established as an exceptionally useful indicator of relapse in people with schizophrenia and depression. EE is now also being applied more broadly for the investigation of other disorders. EE is usually rated by conducting the Camberwell Family Interview, i.e. in the course of separate individual interviews with the relatives of the symptomatic individuals. This paper reports the rating of EE in adolescents with eating disorders within a semi-structured family schedule - the Standardized Clinical Family Interview. Consecutive referrals for eating disorders were assessed prior to family therapy and again at regular intervals during therapy. EE ratings for this sample, the prognostic value of EE, and the changes in EE that took place during the course of therapy are presented and their clinical implications discussed. The findings suggest that even low levels of Critical Comments from the parents to the anorexic adolescent are associated with continuing symptoms.     

The influence of therapist experience upon evaluative perceptions of family members

Abstract

This study investigated the influence of experience in family therapy on therapists' evaluative perceptions of family members. Beginning students in family therapy, advanced students, and experienced staff rated members of 100 families according to the Semantic Differential technique. Contrary to expectations, beginning students did not evaluate identified patients more favorably than parents. Staff and advanced students, however, rated parents more favorably than identified patients. Beginning students were also found to evaluate all family members more favorably than staff and advanced students. These results were discussed in terms of experienced therapists initially taking the side of the parents and the effects this potential source of bias may have on the course of family therapy.     

Textbooks in Accredited Marriage and Family Therapy Programs

Although choices of required textbooks are important decisions in developing a course curriculum, faculty in marriage and family therapy training programs have few convenient resources to guide curriculum development. This article presents results of a survey of textbook selections of accredited marriage and family therapy programs within a regional affiliate of AAMFT. The five programs surveyed listed 108 different titles used in their curriculum. Only 12 texts were used by two programs, and only one text was used by more than two programs. This article presents the textbook selections by the six curricular areas of COAMFTE accreditation standards. The wide variety of textbooks used by programs leads us to conclude that no consensus exists about what textbooks best represent the core knowledge of marriage and family therapy. The body of knowledge taught in accredited marriage and family training programs reflects a distinct and autonomous body of knowledge.     

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.     

Families-at-risk and home-based intervention: A therapist training model

Home-based family therapy programs are designed to provide intensive family intervention for at-risk children and adolescents. However, examination of the literature reveals limited publications about training therapists for this difficult task. The purpose of this paper is to describe a therapist training model based upon a family-as-context approach to crisis intervention. Specific units covered during the course include: family-as-a-system, structural family therapy, family crisis intervention, family assessment and simulation. It is concluded that the effective prevention of placement for at-risk children and adolescents requires both a home-based family treatment program and a specific therapist training model for family intervention.John J. Zarski, PhD, is a professor in the marriage and family therapy training program at the University of Akron. Carol A. Pastore is program coordinator for the T.I.E.S. program in Canton, OH. A. Lynette Way and Richard N. Shepler are home-based therapists with T.I.E.S. The authors would like to express their appreciation to Professor John West for his helpful comments on drafts of this article.     

焦虑障碍的系统式家庭治疗

焦虑障碍是最常见的心理障碍之一.其具有症状重、病程慢、复发率高、社会功能明显缺损等特点,给个人、家庭和社会造成了巨大的负担.家庭环境因素在焦虑障碍的发病、转归和预后方面都起到重要作用.本文介绍了国内外关于焦虑障碍患者家庭特点和家庭互动模式的研究结果.系统式家庭治疗作为一种家庭治疗模式,具有其独特的治疗理念和方法,国内外研究结果表明系统式家庭治疗用于焦虑障碍具有良好疗效.今后,还应该运用更加多元化的研究方法探讨中国焦虑症家庭动力学特点和家庭功能,并采用更加严格的随机对照设计,进一步证实系统式家庭治疗对焦虑障碍的治疗效果.     

‘Tell us what we need to know to do this!’ Preparing a path to safe uncertainty in assignment writing on a family therapy foundation course

This article describes a single session aimed at helping participants on a family therapy foundation course to move from a position of anxiety and discomfort about completing a written assignment to a position of safe uncertainty. Evaluation from the perspectives of course participants, course facilitators and assignment markers has shown participants engaging more enthusiastically with the writing of the assignment and expressing less anxiety about the process.     

Childhood asthma: family therapy as an adjunct to routine management

A controlled trial of the effectiveness of family therapy for asthmatic children has been completed, and the results indicate that family therapy may have a part to play in the management of asthma. Our observations have shown that an interaction of psychosocial factors can have a significant effect on the course of the asthma by setting up a circular system which may ultimately lead to clinically intractable asthma, as well as intense emotional distress. Treatment is based on an understanding of the interactional model with the aim of interrupting the progressive sequence of events. A family approach is indicated when (1) emotional factors seem to be playing a significant part; (2) the asthmatic child is manifesting behaviour problems; (3) there is evidence of family psychopathology or (4) the asthma is not being reasonably well controlled with conventional methods of management.     

Family therapy vs. parent groups: Effects on adolescent drug abusers

Abstract

The families of adolescent drug abuse clients who were admitted to six outpatient drug-free (OPDF) treatment programs were randomly assigned to either a family therapy method or a parent group method. It was later found that in 93% of the family therapy families, one or both parents participated (N=85); but that in only 67% of the families assigned to a parent group did one or both parents participate (N=50). This is considered to be an important practical advantage for family therapy. At follow-up evaluation 15 months later (after a 6-month course of treatment and a 9-month follow-up period), the clients and their mothers in both groups reported significant improvement on numerous outcome criteria, including reduction in substance use. There was no significant difference between the two groups in degree of improvement.     

From the institute to the ivory tower: The live supervision stage approach for teaching supervision in academic settings

Abstract

In this paper, we describe an experimental academic course on marriage and family therapy supervision. The course, an adapted version of an institute program, was taught in four stages, combined a seminar and a practicum, and culminated with live supervision of live supervision.     

Culturally sensitive therapy? Examining the practice of cross‐cultural family therapy

This article is drawn from a research project that examines cross‐cultural family therapy sessions in order to consider what constitutes culturally sensitive practice. A discourse analytic approach was adopted in the analysis of three sessions from two families where the family and the therapists originated from different ethnic backgrounds. This article is based around part of the research findings connected to one of the families, and focuses upon the ways in which ‘culture’ is talked about in therapy (the term ‘culture’ will be referred to in inverted commas in order to acknowledge its complexity as is emphasized in this article). This allows for an examination of the cultural assumptions that we hold as therapists, which are enacted in therapy with effects on all participants and upon the course of the therapy. The value of qualitative research methods in examining the cultural assumptions we bring to therapy is highlighted as one way of improving culturally sensitive therapeutic practice, especially with regard to therapist reflexivity.     

Early interactional change and its relationship to family therapy outcome

In the present study, a tailoring methodology was employed to investigate the detection of early interactional change in the course of family therapy and the possible prognostic value of such change for therapy outcome. The predicted relationship received partial support and suggested a model of change in families, with early interactional change as a mediating factor.     

The Divorce of Marriage and Parenthood

Marriage is a template for domestic life and the problems that arise in it. The patterned assumptions that traditionally defined marriage gave substance to the family. These assumptions have become less compelling over the course of a century. In this paper, I suggest how and why this has happened. I focus on the meaning of parenthood and its relationship to marriage. In the course of a century, parenthood has been redefined as a rational choice governed by calculation. As a result, childbearing, pregnancy, marriage and parenthood have been redefined. Their relationships to one another have, to varying degrees, been altered. Marriage is an institutionalized way to care for the babies that once came, inevitably, as a result of sexual intercourse. What becomes of marriage when sex no longer produces babies? The answer is that everything about marriage and the family changes. Such changes help explain the rise of professional family therapy and related fields.