Development of Family Therapy and Systemic Therapy in Germany

The roots of systemic therapy in Germany date back to the sixties. Systemic therapy is one of the most widely applied forms of psychotherapy and counseling in Germany. The majority of therapists and counselors in child guidance centers, couples therapy counseling centers and youth protective services have been trained in systemic therapy. A high number of clinical psychologists, social workers and medical doctors have received training in this model of therapy. In the beginning, multigenerational, experiential, as well as structural-strategic and Milan systemic approaches were popular. Today, the post-modern systems concepts, solution-oriented and narrative approaches and self-organization theory appear to be predominant. Some centers provide research and training in behavioral and psychodynamic family and couples therapy. However, systemic approaches are clearly leading the field with over 10,000 people who have received systemic training and about 150 training institutes across the country. The critical attitude shared by many leading figures towards empirical research has limited its success in university programs. In addition, training is usually provided in the form of post-graduate courses rather than at academic institutions. Currently, three journals and one online-journal publish articles on various systemic topics. Many publishing houses have a series of books on systemic therapy and one publishing house specializes exclusively on systems oriented books. In 2008, systemic therapy gained recognition as an evidence-based treatment. Four years later, the appropriate authorities have not initiated the process of assessing it as a treatment paid for by public health insurances. In consequence, systemic therapy is not available on a large scale in the public outpatient psychotherapy system. Some additional remarks are provided on the history and current situation of systemic therapy in Austria and Switzerland.     

Emotionally Focused Family Therapy and Play Therapy Techniques

Emotionally Focused Family Therapy provides a framework for understanding children's behaviors in terms of attachment needs of comfort and support. However, when working with young children, play therapy is often developmentally preferred over “talk therapy.” By integrating play therapy techniques within an Emotionally Focused Family Therapy theoretical framework, therapists can help parents understand and meet their child's needs for affection and comfort. This article will discuss how play therapy techniques can be integrated with an Emotionally Focused Family Therapy theoretical framework for work with young children and their families.     

Couples Therapy

The authors propose a more comprehensive definition of couples therapy since parenting and individual issues can impact so forcefully on spousal relationships. Couples therapy, is redefined as a therapy with both spouses concerning their individual, parenting, and marital functioning which is conducted in conjoint marital/family sessions and individual meetings with each spouse. A case example illustrates this approach which is called Comprehensive Family Therapy.     

Family Therapy With Irish-Americans

This paper presents a paradigm for understanding the cultural values and family patterns of Irish-American families and offers suggestions for clinical intervention. Families' correspondence to the model described will depend upon their level of acculturation, socioeconomic status, and other contextual factors. The paradigm suggests a number of issues that may create difficulties for the therapist and for the family in therapy. In general, behavioral techniques, Bowen systems therapy, and strategic interventions may be more useful than techniques emphasizing expression of emotions in therapy or direct attempts to alter communication or family behavior in therapy sessions, as used in structural therapy.     

Pragmatic Existential Therapy

A pragmatic model of existential therapy is offered to support the thesis that brief, solution focused therapy is a clinical application of existential psychology. Superseding pioneering existential therapies more concerned with insight than with clinical technique, pragmatic existential therapy is a dynamic clinical intervention facilitating in patients, decision, choice, self-commitment, and concrete action, the goal of which is movement toward the future and fulfillment of patients' latent potentials. In addition to clarifying the model's theoretical focus on (a) lived experience, (b) self-creation, and (c) existential anxiety, practical guides to brief existential treatment are offered. Sources from existential philosophy and psychology, as well as brief solution focused treatment, are used to evidence core elements of an existential therapy that is not contemplative and insight-focused, but pragmatic and action-based.     

Structural Family Therapy

Research studies show that Chinese communities in the United States are in need of mental health services. Structural family therapy offers an effective model for treating families in need of therapy. This article describes why and how the model can be applied.     

Narrative Sexual Identity Therapy

Sexual identity therapy is an alternative to the two polarized positions of sexual reorientation therapy and gay-integrative therapy for clients who present with sexual identity concerns. This alternative model focuses on sexual identity—the private and public acts of identifying and communicating one's sexual preferences—and how the decision to do so is informed by dominant stories about what sexual attractions mean to a client. As one expression of sexual identity therapy, this paper presents narrative sexual identity therapy, an approach that utilizes a narrative therapeutic approach and techniques to facilitate exploration of dominant narratives and counter-narratives that speak to sexual identity with the goal of achieving a synthesis that reflects felt congruence of clients' beliefs/values and behavior/identity.     

Wilderness Therapy

Wilderness therapy is neither a newcomer nor a fringe therapy-it originates from wilderness challenge programs that were established in 1945, and it has been applied to clinical populations in the United States since the 1960s. Its efficacy, particularly in work with adolescent populations, is supported by a solid body of research. Its therapeutic application to survivors of incest, rape, and battering is, however, very recent (early 1980s), as is its specific application to empowerment of women (mid 1980s). After a brief review of the general wilderness therapy model, this paper turns to a consideration of wilderness therapy in work with survivors of abuse and empowerment for women. The author draws on the voices of women who have experienced wilderness as healing and empowering, and includes her own voice, to explore two distinct components of wilderness therapy-the healing effects of specific therapeutic activities and challenges in a novel environment, and the more elusive spiritual healing effects of a newly found or renewed sense of connectedness with the power of the earth.     

The Efficacy of Behavioral Couples Therapy and Emotionally Focused Therapy for Couple Distress

Twenty treatment outcome studies, 13 of which evaluated behavioral couples therapy (BCT) and seven of which evaluated emotionally focused therapy (EFT) were reviewed, leading to the following conclusions. BCT leads to short and long-term gains for moderate to severe couple distress. In the long term BCT probably leads to no better outcomes than its constituent components—behavioral exchange training and communication and problem solving skills training. Addition of a cognitive therapy component to BCT or the use of a variety of treatment formats does not improve the efficacy of BCT. Integrative couples therapy and insight-oriented marital therapy may be more effective than BCT, but studies supporting this conclusion require replication. EFT leads to short and long-term gains for mild to moderate couple distress. Addition of a cognitive therapy component to EFT does not enhance its efficacy. EFT may be more effective than problem solving therapy and less effective than integrated systemic therapy, but the two studies supporting this conclusion require replication.Michael Byrne, PhD, is a Clinical Psychologist, Midland Health Board, Ireland; Alan Carr, PhD, is Director of the Clinical Psychology Training Programme, Department of Psychology, Arts Building, University College Dublin, Belfield, Dublin 4, Ireland (alan.carr@ucd.ie). Marie Clark, PhD, is Lecturer, Department of Psychology, University of Surrey, United Kingdom.     

Time Perspective Therapy: A New Time-Based Metaphor Therapy for PTSD

Time perspective therapy (TPT) is a new time-based therapy that focuses on clients' perceptions of their past, present, and future. Based on Zimbardo's temporal theory and the utilization of the Zimbardo Time Perspective Inventory, the authors have developed this new narrative therapy approach for the purpose of treating clients diagnosed with posttraumatic stress disorder. The goal of TPT is to identify clients' six time perspective factors and then work with and balance these perspectives to promote a more positive future orientation, replace their traumatic past negativity, and thereby create a more responsive and healthier individual.     

Feminist Issues in Couple Therapy

Abstract

The authors reviewed the feminist couple therapy literature from 1995 to 2006. They summarized this large body of work into several key themes. The first revealed that feminist couples therapists are continuing to discuss and deconstruct gender issues in couple therapy. The second showed that feminists believe that therapists should be educated both academically and personally about culture and diversity so as to support couples in their therapy around their own issues of diversity as well as learning to deal with issues of social justice as a couple. In the third theme, the authors introduced readers to feminists' emphasis on connection and empathy within couple and sex therapy. And, in the fourth, the authors explored feminists' work with power in couple therapy as they applied to couple therapy in general as well as around the specific topics of: balancing family and work and therapy for familial violence.     

Family Therapy in China

This paper aims to provide an overview of the family therapy in mainland China, by analyzing its development, current situation and future directions. The authors argue that the history of family therapy can be understood as three stages: introductory stage from 1985 to 1994, “blossoming” stage from 1995 to 2004, and “fast growing” stage from 2005 to present. In every stage, we can see clear differences in each of the following fields: training (including training programs in universities and workshops held by companies or institutes), academics (including research articles, professional books and conferences), and general public environment (including media and policies). We also outline the development of China’s first university system family therapy training program as an example and evidence of family therapy’s significant present and future development in mainland China. Based on this, we highlight some points for future improvement in family therapy in mainland China, including developing indigenous theories and practice models, reinforcing training and research programs in university systems, and improving accreditation standard for all family therapists.     

Family Therapy in Romania

The article outlines the development of family therapy in Romania. Family therapy has a relatively brief history in this country, only beginning with the first training programs in the early to mid 1990s. However, as far as the number of professional associations is concerned, it is well represented on the map of psychotherapy approaches. There are several opportunities for training in family therapy. The accreditation of the training programs and the certification of the graduates of these programs is clearly regulated by law. From the legal point of view psychotherapy is considered a specialization of psychologists rather than an independent profession. The authors offer a brief overview of the history of family therapy in Romania, its present position in the health and social care system, the context of training, accreditation standards, the network of professional organizations and some of the possible future directions for family therapy. Finally, recently produced Romanian films are suggested as a medium for getting acquainted with the complex dilemmas faced by contemporary Romanian families.     

失眠症治疗的最新进展

失眠是睡眠障碍之一,主要表现为睡眠时间减少、入睡困难、入睡后易惊醒、醒后不易再入睡等。本文主要探讨了失眠的非药物治疗,包括睡眠约束,光疗法,认知治疗,松弛疗法和行为治疗。     

降压治疗的决策思考

尽管降压药物有了很大发展,高血压的控制率仍很低下。降压治疗中还存在包括医生和患者两方面的许多误区。目前已取得的共识是:降压治疗的益处主要来自血压控制。因此,非常重要的是要达到血压的有效和长期稳定的降低。根据患者的年龄、基线血压、伴随的临床状况等,因人而异地选择副作用小、降压效果好的药物,提高顺应性是改善高血压控制率的关键。     

产褥期抑郁症的高危因素及防治措施的分析

产褥期抑郁症是指产妇在产褥期内出现抑郁症状,是产褥期精神综合征中最常见的一种类型.国外报道发生率达30%,国内资料较少,防治措施亦少.通常在产后6周内发病,产后2周出现症状,表现为易激惹、恐怖、焦虑、沮丧等,有时还会陷入错乱或嗜睡状态.既往无精神病史,包括抑郁症在内的抑郁症史.现对我院2004年6月～2005年6月分娩产妇中随机抽取有随访条件的1824例产妇进行调查,有产后抑郁症状者达289例,发生率15.84%.     

Expectations About Couple Therapy Over Time

One common factor of therapy, expectations, has been demonstrated to be a significant contributor to outcome in individual therapy. Despite this, little is known about expectations about couple therapy. This paper presents the qualitative results of a study exploring clients’ expectations before beginning couple therapy and after six sessions. Results indicate that clients form pre-therapy expectations about their therapist, the process of therapy, and their partner. Results also showed that after six sessions, clients’ expectations about therapy were often met or modified in ways that were positive. Implications for therapists and researchers are included.