A family systems framework for intervention with individuals

This paper outlines a model for working contextually with individuals. Family work with individuals is contrasted with the prevailing psychological theories which inform individual counselling and therapy. A framework is provided which draws upon a number of approaches derived from family systems theory. Brief illustrative vignettes support the discussion.     

Intensive family intervention in a community consultation framework

This article describes a form of mental health consultation to community workers who have reached a state of crisis in their work with unmotivated, multi-problem families. The central part of the consultation is a therapeutic intervention that draws on principles of time extension and network intervention. The consultant sees the family together with its community workers in a one-time, intensive meeting of up to six hours duration. This meeting is divided into three phases, aimed at achieving respectively (1) structural, (2) emotional, and (3) cognitive imbalancing of the family system. This creates a new situation, which hopefully will enable the community workers and the family to move out of the crisis in which they had become stuck.     

Essay on feminist family therapy: A review ofWomen in families: A framework for family therapy andThe invisible web: Gender patterns in family relationships

Monica McGoldrick, Carol M. Anderson, and Froma Walsh (Eds.). (1989).Women in families: A framework for family therapy. New York: W. W. Norton.     

An evaluation of positive psychology intervention effectiveness trials using the re-aim framework: A practice-friendly review

Meta-analyses indicate the efficacy of positive psychology interventions in promoting well-being. But, despite accumulating empirical and anecdotal evidence of these interventions’ implementation in real-world settings, no review of effectiveness research exists. Accordingly, we identified 40 positive psychology intervention effectiveness trials targeting adults, and scored their reporting using the practice-friendly RE-AIM tool which assesses five dimensions of intervention utility: Reach, Efficacy, Adoption, Implementation and Maintenance. Reporting levels varied substantially: reporting on Reach scored 64%; Efficacy scored 73%; Adoption scored 84%; Implementation scored 58%; and Maintenance scored 16%. Within these five dimensions, reporting on participation rates, methods to select delivery agents, differences between participants and non-participants, programme maintenance and costs, was particularly sparse. The studies involved 10,664 participants, approximately half required specialist delivery, and 12 were researcher delivered. To maximize the potential of PPIs for population health promotion, expanded reporting on effectiveness trials is required. Recommendations to assist this process are offered.     

A family intervention in psychosis service integrating the systemic and family management approaches

A project to establish new family intervention services to support people with psychotic symptoms and their families is described. The new services are developed by training a whole team in each main population centre. The multidisciplinary training course and the family intervention service are described, and the way in which we integrate the 'family management' and 'family therapy' approaches is discussed.     

Reflective family play: A model for whole family intervention in the infant and preschool clinical population

This article proposes a new treatment model, Reflective Family Play, for clinical intervention in two‐parent families of children aged 0 to 5 years. It is play‐based and grounded in the evidence‐based treatment approach of Watch Wait and Wonder (WWW) as well as the assessment tool known as the Lausanne Family Play paradigm (LFP). WWW is a dyadic treatment for caregivers and their infants or preschoolers that has been shown to shift attachment in the very young (N.J. Cohen, E. Muir, & M. Lojkasek, 1999; N.J. Cohen, M. Lojkasek, E. Muir, R. Muir & C.J. Parker, 2002). The LFP is a more recent adaptation of the Lausanne Trilogue Play paradigm (LTP; E. Fivaz‐Depeursinge & A. Corboz‐Warnery, 1999). Together, the LTP/LFP have now been used for over 2 decades as reliable measures of the family alliance and interactions in two‐parent households. By combining concepts from WWW and the LTP/LFP, a novel approach is presented for treatment in two‐caregiver households. Clinical excerpts are used to illustrate.     

Telephone counseling and crisis intervention: A review

The empirical research pertaining to the effectiveness of telephone counseling and referral systems personnel was critically reviewed. The assessment was organized according to several evaluation strategies that researchers have utilized to evaluate effectiveness. These strategies included, for example, client self-reports, client "shows" versus "no-shows" following referral, data pertaining to suicide rates, counselor ratings of personal effectiveness, and phone workers' ability to offer empathy to clients. It was concluded that discussions of effectiveness should be constrained by a careful consideration of the specific index of efficacy chosen by investigators as well as methodological issues associated with current research in this area. There is reason to believe that the availability of telephone crisis services may be related to reduced suicide rates among young white females. Also, there is a significant need to empirically associate counseling technique and indices of effectiveness with substantive measures of client outcome in future research. Additional topics reviewed include the probable differential effectiveness of lay workers with various presenting problems of clients, and the role that training and maturity seem to play in successful interventions. Guidelines for the use of evaluation techniques which coincide with service goals are also offered.     

Sexually abusive clergymen: A conceptual framework for intervention and recovery

Effective intervention in cases of parishioner sexual exploitation by clergy can be better understood when placed in a meaningful conceptual framework. To improve our understanding, it is useful to compare clergy abuse to father/daughter incest. Within that context, it becomes more clear how this type of sexual exploitation originates and what intervention strategies are best suited to the situation. Borrowing from the field of sex offender treatment, clergy can also be helped most when a firm yet compassionate intervention is carefully planned and enacted. The experience of an intervention, while emotionally wrenching, can be a positive experience for all involved.Gerald Blanchard, M.A., A.C.P.S., is a clinical social worker in private practice residing in Sheridan, Wyoming. He is a faculty member with the Golden Valley Institute for Behavioral Medicine in Minneapolis and is the author of the recently published bookSex Offender Treatment: A Psychoeducational Model.     

Trauma and psychosis: A review and framework for psychoanalytic understanding

Empirical research substantiates Ferenczi's conception of the etiological importance of early neglect and abuse in the development of psychosis. Abuse can derail the development of language, identity, and social relationships that are intrinsic to schizophrenia, possibly through undermining secure attachment relationships. The Lacanian emphasis on language and early proto-dialogues with the Other can be useful in understanding this process. Some therapeutic implications for psychoanalytic approaches to the treatment of psychosis are proposed.     

The effects of Brazelton intervention: A review

This article reviews research that has used the Brazelton Neonatal Behavioral Assessment Scale (NBAS; Brazelton, 1984) as an intervention. It discusses separately the various effects NBAS intervention has been found to have in areas such as parent-infant interaction, infant development, temperament, and parental attitudes and satisfaction. Inconsistent findings are noted in each of these areas. This article then addresses issues that may play a role in the effectiveness of NBAS intervention, including the risk status of the population, the intensity of the intervention, and the receptivity of the parent. It concludes by suggesting that realistic goals be set concerning the expectations for early, short-term intervention such as the NBAS.     

Beyond home-based family intervention: A multi-family approach toward change

A growing specialty area in the mental health field involves working with emotionally disturbed youth and families-at-risk by providing services in the context of the home environment. A review of the literature provides documentation for family systems, social learning, and ecological interventions with at-risk families receiving home-based intervention but there is an absence of material on the use of multi-family groups with this population. The purpose of this article is to outline the implementation of a multi-family therapy (MFT) component for home-based programs serving at-risk families. Advantages and disadvantages when using MFT are also addressed.The authors are grateful to Linda Pannell for her helpful comments on drafts of this article.     

Psychopathy: A comprehensive review of its assessment and intervention

Psychopathy is one of the most studied personality disorders, in terms of the negative impact that the behaviors associated with this disorder — particularly, the criminal behavior — have in the community where the individual lives. The aim of this article is to present a comprehensive literature review on psychopathy, focusing some difficulties related to its concept, assessment, and intervention. Here, psychopathy is presented as a construct resulting from decades of clinical and empirical research, and whose dimensional nature justifies the possibility of assessing the general population. Studies indicate that psychopathy is manifested in a number of behaviors resulting from biological and personality factors related to a series of family history and environmental factors. We emphasize the need for more empirical research on psychopathy in the general population in Portugal, regarding the development and adaptation of measures of the construct.     

Preventing depression: A review of cognitive-behavioral and family interventions

Depression is one of the most common psychological disorders. It is associated with tremendous costs in terms of suffering, decrease in productivity, and loss of life. For many individuals, depression is a disorder that will recur throughout life. Recent findings suggest that the prevalence of depression is on the rise, particularly in young people. Clearly, depression prevention is an important goal. Can depression be prevented? In this article we review research on interventions designed to prevent episodes and symptoms of unipolar depression in adults and children. Our review focuses specifically on cognitive-behavioral and family interventions. We discuss what researchers have learned about the prevention of depression and conclude with recommendations for future investigations.     

Parental illness and disability: a family systems framework

Coping with the strains and uncertainties of parental illness and disability can be a monumental challenge. The Family Systems-Illness Model offers a psychosocial map to address this challenge and make the inevitable strains more manageable. Attending to the longitudinal psychosocial pattern of a condition within a multigenerational, life cycle and belief system context can provide the kind of structure – a common language that facilitates collaborative, creative problem solving and quality of life for families where a parent has a serious health problem. Some of the major challenges in families facing parental illness are addressed.     

The child's participation in family therapy: A review and a model

A major gap in family therapy, the treatment of children and adults together, is addressed. The literature on the children's participation is reviewed and a model which systematizes their involvement is presented. The full participation of the child necessitates the use of play. To create a context of play without alienating the rest of the family, action-promoting methods are used. These methods are implemented through family activities and role playing, which are followed by discussion. The advantages, the indications, and the contraindications to the use of action in family therapy are presented.