International Family Therapy: A View from Kyoto, Japan

"International family therapy" is an emergent field within (or overarching) the field of family therapy. At this stage, it can be described as the collecting and sharing of experiences by family therapists from different countries. Recent publications (7) gather information principally from Western cultures in which systemic family therapy has grown over the past thirty years. Japan is of particular interest to Western practitioners because it is a highly successful, post-industrial culture that differs markedly from the West. Familiar family therapy interventions often work for unfamiliar reasons, and different goals are often needed in order to respond to apparently similar family problems. An expanded sense of choice around strategies for family life and family therapy that such diversity implies is the primary contribution that this maturing, international family therapy movement can make to family therapy.     

Family therapy research: Comment on “research as a family therapy intervention technique”

Wright's emphasis on and illustration of the use of family therapy research as a unique intervention technique for therapy is an important contribution to the practice literature. Equally important, however, is the isomorphic shift in focus of the family therapy researcher. Rather than focusing only on process or outcome research, family therapists should become more interested in their clients as research subjects. Though rarely discussed in the family therapy literature, the competencies of family therapists as researchers and the utility of research in a family therapy context is critical to being a well-rounded professional. Examples are provided of how this emphasis is being introduced in a PhD family therapy program.     

箱庭疗法应用于家庭治疗的理论背景与临床实践

心理咨询与治疗领域出现了整合的趋势,将箱庭疗法应用于家庭治疗是这一趋势下的成功尝试。箱庭疗法应用于家庭治疗的理论背景是家庭治疗与游戏治疗的整合以及箱庭疗法在团体治疗中的应用。箱庭疗法应用于家庭治疗的临床实践包括家庭评估、家庭治疗、夫妻治疗、家庭治疗师督导,这些临床实践的开展为儿童青少年心理咨询与治疗方法的发展提供了有益的启示。     

Values and Ethics in Family Therapy

This article is an introduction to this special issue on values and ethical issues in family therapy. The author discusses the historical context for the rising interest in these issues in family therapy, describes the rationale for this special issue, and presents a framework for analyzing the core values of the prominent models of family therapy. The ethical debate over use of paradoxical techniques in family therapy is used as an illustration of a values clash between different models of family therapy.     

Costs of Treating Conduct Disordered Medicaid Youth with and without Family Therapy

This longitudinal, retrospective study investigated the healthcare costs of youth treated for conduct disorder in the Kansas Medicaid system. Along with a comprehensive range of services, youth received in-office individual therapy, in-office family therapy, or in-home family therapy. Data was available for 3753 youth. Overall, 3086 youth received care that included individual therapy (and no family therapy), 503 received in-home family therapy and 164 others received in-office family therapy. Healthcare costs for a period of two and one half years after therapy were available for analysis. The average cost of healthcare for youth receiving no family therapy was $16, 260. For those receiving in-office family therapy, the average cost was $11,116. Youth who received in-office family therapy received $5,144 (32%) less care on average than those receiving only individual therapy. Those who received in-home family therapy averaged $1,622 over the follow-up the period. Those who received in-home family therapy were least expensive of all, averaging at least 85% less than any form of in-office therapy. There does not appear to be an increase in the healthcare cost when family therapy is included in treatment.     

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.     

The Voices of Therapists and Children Regarding the Inclusion of Children in Family Therapy: A Systematic Research Synthesis

In 1970, Nathan Ackerman challenged the field of marriage and family therapy to actively involve young children in the family therapy process. How has the field of marriage and family therapy responded to his challenge? Using a systematic research synthesis to review and critique the non-empirical and empirical literature in the area of children in family therapy, the author discovered that the field of marriage and family therapy has not responded to Ackerman's challenge in the way he may have hoped for nearly three decades ago. A summary of the literature's findings is provided and recommendations for future research, as well as implications, for the field of marriage and family therapy are discussed.     

Intergenerational Relations and Family Therapy Research'' What We Can Learn from Other Disciplines

Although there are a number of theories regarding intergenerational relations within the family therapy field, few of these theories have been empirically examined. Indeed, intergenerational family research is in its infancy in the family therapy world. This article explores the literature on intergenerational relations within the sociological and psychosociological disciplines in order to understand what is known, and how this information could assist family therapy researchers interested in developing systematic studies of intergenerational relations for the family therapy field.     

Deterioration in Marital and Family Therapy: Empirical,Clinical, and Conceptual Issues

Recent empirical evidence of deterioration during both nonbehavioral and behavioral marital and family therapy is presented. While the frequency of patient worsening in marital-family therapy does not appear to exceed that previously found for individual psychotherapy, the acceptability of the evidence for negative effects in the treatment of systems may be greater than that which exists for individual treatment. After examining the empirical evidence of negative effects in family therapy and some of the factors that influence their occurrence, the authors discuss some conceptual issues relevant to a definition of worsening in marital and family therapy and present some methodological guidelines for the assessment of deterioration in therapy with family systems. It is concluded that the study of deterioration processes in family therapy may aid the understanding of family change processes more generally.     

Management of religious issues in family therapy

Social scientists have long emphasized the reciprocal relationship between family and religion in society. Yet the family therapy literature is virtually devoid of consideration of religious variables in family life and function. Four major psychosocial aspects of religion in family life are discussed: sacralization, coalitions with the supernatural, religious conflict as a projection of family conflict, and family conflict as a projection of religious conflict. Clinical issues presented include: family therapy in religious and secular contexts, family religious expectations and transference, therapist religious countertransferences, religious identification in family therapy, and family therapy in different degrees of congruence or difference in religious orientation between the family and the therapist. The family therapist must learn how to correctly interpret and appropriately respond to religious issues as they appear in family life and family therapy.     

Development of Family Therapy in Ireland

In Ireland family therapy is a small profession, with under 200 registered therapists. The Irish family therapy movement began in the mid-1970s. By 1980 the Family Therapy Network of Ireland in the Republic of Ireland and the Northern Ireland Branch of the UK Association Family therapy had been founded. At present there are three main family therapy training centers in Ireland: two in the south (the Mater University Hospital, affiliated to University College Dublin and Clanwilliam Institute) and one in the north (at Queen’s University Belfast). There is no statutory registration and licensing of family therapists in Ireland. Accredited professional family therapy programs in Ireland are 4-year part-time courses culminating in masters level qualifications. A primary degree in medicine, nursing, psychology, social science or education is a prerequisite for entry. Family therapists in Ireland work in both private practice and the public health service. Most family therapists in the public sector are employed as social workers, psychologists, psychiatrists or nurses, and conduct family therapy as part of their broader professional roles. Couple therapy in Ireland is provided by family therapists, and also by voluntary couple counselors based in networks of local centers, some of which were originally religiously affiliated, without a formal connection to national family therapy associations. The three major future challenges for Irish family therapy are creating a research infrastructure, developing a career structure in the public health service, and introducing statutory registration.     

Feminism and family therapy—a possible meeting point

This paper centres on the question ‘Is it possible to be a feminist and to practise family therapy?’ We explore the essence of feminism and family therapy and conclude that a style of feminist family therapy is possible. Feminist family therapy has a particular theoretical base and is characterized by a particular combination of practice principles. It also raises general issues for the training and practice of all family therapists.     

Family Therapy in the Forbidden City: A Review of Chinese Journals From 1978 to 2006

This article provides a glimpse into the development of family therapy in China, by reviewing family therapy articles written in Chinese and published in journals in China that are not, therefore, readily accessible to the international community. A content analysis of journals published between 1978 and 2006 revealed 199 family therapy articles in 109 Chinese journals. Most of the studies were conducted by psychiatry or medical professionals, and were based on general systems theory or a systemic family therapy model. The articles focused on the promotion of family therapy theories and interventions in China, but did not specify the application of theory to specific clientele or symptoms. After the year 2000, a threefold increase in the number of family therapy publications was noted. These papers included the introduction of additional theories, but did not include critical assessment of the applicability of Western family therapy models to Chinese families. The researchers noted an absence of articles that identified Chinese approaches to family therapy, and a paucity of papers on gender, professional reflection, and the therapy process. The article concludes that there is room for improvement in the quality of family therapy publications in China, and that gains may be made by interdisciplinary collaboration among academics and practitioners.     

The impact of structural family therapy training on conceptual and executive therapy skills

The importance of empirical evaluations of family therapy training is gaining increased recognition. This study reports the results of a controlled assessment of a training seminar in structural family therapy. Changes in the conceptual and executive skills of 44 therapy trainees (22 family trainees and 22 controls) were assessed over a 16-week period using repertory grid and videotaped therapy simulation techniques. Results indicated significant conceptual gains in family therapy trainees, but only among those with little previous exposure to family training. Differences in the overall number as well as the type of interventions were also noted. Results generally supported the predicted impact of therapy training, but left unanswered questions regarding the unique impact of family therapy training over individual training. These qualifications are discussed and directions for future work are highlighted.     

SOCIAL CONSTRUCTION THEORY AND THE SATIR MODEL: TOWARD A SYNTHESIS

Abstract

This article synthesizes social construction theory and the Satir approach to family therapy in terms of therapy as a process of cocreation of reality, the use of language and narrative, and the therapist's role as a participant-facilitator. Social constructionism has a tremendous impact on the present ideological shift in family therapy. The Satir model is a powerful approach to family therapy and has had a wide influence on generations of therapists. Although existing literature has well documented the influence of social construction theory on the postmodern school of thinking in family therapy, there is no literature exploring the compatibility of the Satir model with social construction theory. This research presents a theory-building process of the Satir approach to family therapy.     

A Re-Examination of the Current Status and Future of Family Therapy in India

Marital and family counseling has existed in India for many decades. However, the formalized discipline of marital and family counseling/therapy has its theoretical foundation in the West. The purpose of this paper is to present an overview of the need for and the current status of the practice of marriage and family therapy (MFT) in India. Based on our limited experiences we have attempted to prognosticate the future of the profession of family therapy in India by proposing a number of salient issues that we think would be useful discussion points as the development and advancement of family therapy in India is considered.     

Spatiality of the family's inner structure: choice of seat in family therapy

Many family therapists have observed that the family's choice of seat in the family therapy session provides information concerning the inner structure of the family. The purpose of this study was to study certain aspects of this observation. The selection of seats in family therapy sessions and the mutual distances between family members were investigated for 13 families. The inner structure of the family is described in terms of the existence of problematic relationships and the distribution and quality of power as assessed by the family therapists. The family members' selection of seats in the family therapy session was compared to the sitting order at meals, watching TV at home, and family drawings. It was found that the distance between the father and the patient (a son or daughter) and the location of the father and the mother in relation to each other in the family therapy are more related to the inner structure of the family than to situational factors.     

ABSTRACTS OF LITERATURE

This is a clinical controlled study comparing the effects of "behaviorally" orientated family therapy, "client-centered" family therapy, and no therapy at all for families with a delinquent member. Sample included 99 families randomly assigned to treatments. Results indicated the efficacy of the behavioral family therapy in reducing recidivism.     

The (HI)Stories We Live by: Power/Knowledge and Family Therapy in Africa

There is a need to Africanise family therapy so as to serve the interest of local communities. Western approaches to family therapy have been accused of being irrelevant to African contexts. They are seen as forming part of a dominant scientific knowledge which invalidates local folk and cultural psychologies and thereby continuing a historical tradition of oppressive colonial power relations. This paper aims at archaeologising and evaluating such criticism by situating family therapy within different fields of knowledge that have emerged historically and are currently co-existing in Africa. The advantages and disadvantages of dominant family therapy approaches in African contexts are explored by focussing on power relations between different knowledges in Africa. It is argued that many global narratives of family therapy offer congenial companionship to many local African narratives, but that family therapists should pay more attention to local spiritual and political narratives so as to attain more legitimacy and validation by local communities.     

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.