People in groups: Dynamic and therapeutic aspects

The author differentiates between a sociological-interactional (horizontal) axis and a psychological-motivational (vertical) axis in the group, and discusses the socio- and psychodynamics both of and in the group from each of these points of view. In group therapy, five phases are described: 1) exploratory contact; 2) regression; 3) catharsis; 4) insight; and 5) social learning. Group psychotherapy with large diagnostically heterogeneous groups in a hospital setting, small diagnostically homogeneous groups, and group discussions with patients' relatives are all described. In addition, attention is paid to experiential psychodynamic group process groups (analytic self-experience groups), which provide young psychotherapists with the opportunity to gain insight into both groups and the psychodynamics stimulated within this framework. The training of group therapists should include, after academic studies, clinical experience, individual psychotherapeutic training, an experiential group, cotherapy, group therapeutic work under expert supervision, and theoretical training.     

Using Art-Based Strategies in Group-Based Counselor Supervision

In addition to course work and experiential learning experiences, a vital aspect to counselor training is clinical supervision. Supervision acts as a mediator bridging the gap between theory and practice. Using creative interventions has been increasing in clinical work and may be beneficial to be used more in training counseling students. One way to incorporate creative and expressive techniques into a counseling program is to use art-based strategies in clinical group supervision. Research and clinical experiences are discussed.     

Values in Family Therapy Practice and Research: An Invitation for Reflection

Values have been shown to be a pervasive part of both marriage and family therapy (MFT) clinical practice and research. Yet, many therapists and researchers remain unclear about how values affect their work. This article examines the influence of Western philosophical assumptions and therapy traditions in light of current understandings of values in therapy. The influence of values in MFT research processes is similarly examined. Implications for how family therapy professionals can be more reflective and sophisticated in their understanding of values in clinical practice and scientific inquiry are discussed. Suggestions for addressing values in MFT training also are given.     

Multiple theoretical approaches to supervision: choices in family therapy training

The supervision techniques used in structural, strategic, family-of-origin, and experiential family therapy training are discussed and compared, with emphasis on the isomorphism between supervision and therapy in each school. The usefulness of each supervisory model is related to supervisees' needs at different levels of training. Recommendations are made about the sequence of family therapy training, including the utility of eclectic versus purist family therapy training programs for trainees at different levels of experience.     

Deconstructing Agnes – externalization in systemic supervision

Externalization is seen in this paper as a valid and useful part of the process of clinical supervision in systemic family therapy training. We offer a discussion on the use of externalization based on an example from a supervision group on a London M.Sc. in Family Therapy. Externalizing practices are located in the context of a postmodern perspective and narrative ideas within systemic family therapy. We explore the use of narrative ideas and the recursive relationship between theory, practice and the subjective experience of the trainee, within the practice of systemic supervision.     

Beyond a single standard: levels of evidence approach for evaluating marriage and family therapy research and practice

Randomized clinical trial (RCT) research has come to dominate the research landscape of marriage and family therapy (MFT). Despite becoming the ‘gold standard’ for evaluating clinical research and clinical practices, there is a growing debate regarding the reliance on RCTs as the primary basis for evaluating clinical intervention in MFT. Given the natural diversity of clients, settings and clinical problems faced by practitioners and the relational and recursive interactional process of MFT, one of the major challenges for the field of MFT will be to come to grips with the research–practice gap by moving beyond a single methodological standard through adopting a ‘levels of evidence’ approach as a framework that promotes diverse research methods, different methodological criteria (depending on the method), and evaluation based on the accumulated type of evidence needed to answer a specific policy, clinical practice choice, or within a model clinical decision.     

Spirituality and religion in training, practice and personal development

In the midst of a revitalized interest in spirituality and religion in Western societies, there has been reported a resurgence of activity regarding spirituality and religion in the mental health professions, including marriage and family therapy (MFT). Little is known, however, about the beliefs, behaviours, and training experiences of MFT graduate students. Therefore it is important to examine the training (education and supervision) needs in this area. For this initial study, a sample of US MFT graduate students were surveyed regarding their spiritual and religious attitudes and practices in their personal and professional lives. In most areas, graduate students were found to be similar to the previously published reports of practising professionals. In other areas, they report even more investment in spirituality and religion. The results of the survey suggest a need to include systematic attention to these areas in graduate training curricula and in the professional supervision process.     

Adventures in Supervision: Implications for Supervision of Adventure Based Counseling

Supervision is a key component of counselor education. Although a variety of models guide the supervision process, few address the needs of counselors engaging in Adventure Based Counseling (ABC), a mode of treatment that uses experiential activities in a group setting. To address the experiential nature of ABC, the authors propose an integrative supervision approach comprised of the discrimination model of counseling supervision and the ENHANCES model for ABC. The authors also address training needs of ABC supervisors as well as supervision best practices. Finally, the article includes a case-study demonstrating the implementation of an integrative model of ABC supervision, addressing both the technical and clinical skills.     

Electronic Communication in Supervisory Relationships: A Mixed Data Survey

Much has been written about online communication between therapists and clients, particularly regarding the feasibility, ethics, and frequency of such practices. Little, however, has been published with regard to electronic communication patterns between therapists and their supervisors. The purpose of this study was to understand if and how electronic communication is used between marriage and family therapy (MFT) supervisees and supervisors. To accomplish this, we administered a mixed data survey to MFT supervisors and supervisees across the United States regarding frequency of interaction via electronic methods. We also assessed comfort level with online supervision, how supervisory participants make determinations when to use online supervision, and when online communication is believed to be most appropriate within MFT supervision. We report both qualitative and quantitative findings regarding the use of online technologies in supervision. Implications for research, training, and supervision are discussed.     

How Do Master's Level Marriage and Family Therapy Students View Their Basic Therapy Skills? An Examination of Generic and Theory Specific Clinical Approaches to Family Therapy

This study examined the similarities and differences between marital and family therapy (MFT) students' beliefs about the importance of specific MFT skills, and the perceptions of experienced therapists in practice about the same skills. The data suggest overlap but not complete agreement between the perceptions of novice and experienced therapists regarding both generic and theory specific skills. Similarities and differences between these findings and earlier research about common factors in family therapy are addressed. Recommendations about clinical training that is not organized around traditional family therapy theories, but rather based on two trans-theoretical approaches to therapy labeled expert and collaborative are explored.     

Creating a safe place for growth in supervision

When people are afraid, learning is inhibited. In too many disturbed families, institutional settings, rigid organizations, and some supervision groups, a feeling of emotional safety is missing. The first step in teaching, supervising, or therapy is the necessity to provide a safe environment. The author suggests a model applicable to any supervision group, work group, organization, classroom, or family. A group model, specifically applied to the relationship between family therapy students or interns and supervisors, suggests ways to enhance growth by minimizing fear.     

Marriage and Family Therapy Students’ Views on Including Weight Bias Training into Their Clinical Programs

Discussions about diversity rarely focus on overweight, obesity, and bias about body size (i.e., weight bias). These discussions allow students to develop self-awareness about how their biases can affect their clinical work, as well as the challenges and subsequent bias clients may face in their everyday lives and from clinical providers. One consequence of the rising prevalence of overweight and obesity in the United States is the increase in the level of weight bias and discrimination towards individuals who are overweight, which has been documented among mental and healthcare professionals. Thus, it is imperative that training programs integrate weight bias as a part of diversity training. The authors will review weight bias in mental and healthcare professions, and describe several trainings focused on self-awareness about weight bias. The purpose of this study was to pilot and evaluate a training program for marriage and family therapy (MFT) students about developing self-awareness around weight bias and working with clients who are overweight. Following the program, focus groups were conducted to explore participants’ experiences, learning, and feedback on the content and delivery method. Focus Group methodology was used to guide the analysis process. Four themes emerged: training program feedback, challenges for the MFT field, self-of-therapist, and etiology of weight loss/gain. Implications for MFT training programs are discussed.     

Structural Family Therapy and Autism Spectrum Disorder: Bridging the Disciplinary Divide

ABSTRACT

Applied Behavior Analysis (ABA) is an evidence-based practice approach for the treatment of individuals with autism. The systemic effects of autism suggest that family therapy would considerably enhance the treatment of individuals with autism. Marriage and family therapy (MFT) training does not routinely include exposure to autism beyond the associated diagnostic criteria. Structural Family Therapy (SFT) is a systemic model that is familiar to those trained in family therapy and appropriate for the needs of families affected by autism. Therefore, the authors have used SFT as a foundation for supervising MFT trainees working in an autism treatment setting.     

Addressing the Person of the Therapist in Supervision: The Therapist's Inner Conversation Method

In this study a method of retrospective case supervision is presented aimed at helping the supervisee to become a better self‐supervisor. The method pays special attention to the therapist's self‐reflection and has the therapist's inner conversation as a central concept. The starting point of the method is an assignment in which the supervisee reflects on a case using a tape‐assisted recall procedure. The method helps trainees to develop experiential expertise to become more flexible and effective therapists. A case example of one training group of novice family therapists illustrates the use of the method.     

ABSTRACTS OF LITERATURE

An essay describing the method of training for Social Workers learning family therapy (here called "family-group treatment"). Group processes as a method for supervision are used in preference to individual supervision because of "the requirements of treating the family rather than the individual." Specific methods used and discussed here are group supervision, sitting in on a family session, viewing through a one way screen, films, and tape recordings.     

“She was on my side,and grounded me when I needed it:” Research supervision in the field of therapy,based on counsellors’ and psychotherapists’ views on their engagement with research

Research‐supported practice is increasingly emphasised within counselling and psychotherapy at all stages of training. Guided by an interest in how to support therapists in their efforts to develop research knowledge during doctoral training, this paper focuses on research supervision. Research supervision is a surprisingly under‐researched area. Little is known to date about how supervisors “go about their supervision” (Bruce & Stoodley, 2013, p. 5), despite the fact that “high failure rates for research dissertations in the social sciences have been partly attributed to student dissatisfaction with supervision and poor student–supervisor relationships” (Armstrong, 2004, p. 134). Between 2016 and 2019, we explored accredited counsellors' and 'psychotherapists engagement with research during or after their doctoral training. This paper explores research supervision with these two previous studies serving as the backdrop (Bager‐Charleson et al., 2018; Bager‐Charleson et al., 2018b), together with a literature review into research supervision within social sciences and psychotherapy. Supervision is discussed as a crucial coping/support strategy to (a) link research with practice in therapy work, practically and epistemologically; (b) contain and make sense of the use of transformative learning; (c) balance “enculturation” with critical thinking and emancipation; and (d) support reflective and reflexive development. This paper discusses an adaptive research supervision model, akin to a “holding bond” (Stevens, 2016) which supports the student to reflexively position her/himself personally, intersubjectively, theoretically and socio‐culturally, whilst “negotiating the tension” (Lee, 2008) during a process of enculturation into the discipline, and also fostering critical thinking and emancipation to contribute to new knowledge.     

Primary process and peer consultation: an experiential model to work through countertransference

Various models exist for peer supervision and consultation of group therapy. This article documents the authors' experience using an experiential group consultation of group therapy model that relies on primary process to overcome countertransference dilemmas. A review of group therapy supervision and consultation models is followed by vignettes from the authors' experience. Discussion of the vignettes highlight critical issues in group consultation and expound upon the strengths and challenges of using an experiential model.     

Family of origin: An experiential workshop

Abstract

A rationale is presented and a one day, content-free family of origin experiential workshop is described in detail. The workshop is designed for clients in ongoing family therapy. Its purposes are 1) motivating family members to engage in family of origin investigations; 2) supplying information in a supportive experiential learning paradigm for use in ongoing peer and multiple family therapy groups; 3) minimally teaching procedures for conducting a Bowen-like search; 4) contributing to an agency-wide atmosphere of intrigue and support for intergenerational therapeutic work. Sculpture, role-play and dramaturgical techniques are interwoven into a fabric deliberately left unfinished in order to provide maximal material for the ongoing family therapy.     

Challenges Faced by Genetics Service Providers’ Practicing in a Culturally and Linguistically Diverse Population: An Australian Experience

This paper explores the perceived challenges facing clinical genetics practitioners in multicultural Australia. Focus groups conducted with 53 practitioners explored: 1) participants’ experiences and definitions of cultural diversity; 2) their use of educational resources with clients; 3) their experiences with culturally diverse groups/individuals in practice; 4) their experiences working with interpreters; and 5) the impact culturally specific educational training and/or experiential learning had on their confidence or practice when dealing with culturally diverse clients. Participants viewed culture as extending beyond traditional definitions such as ethnicity, language and religion. Most respondents had experienced positive results working with health care interpreters, although at times, this was a challenge for the family as they preferred privacy and the use of family members as interpreters. Another commonly reported challenge was the limited availability of reliable, culturally appropriate translated resources. Some participants expressed concern that learning theories about specific cultures may lead to stereotypes and that opportunities for formal cultural competence training were limited. Recommendations for practice include the targeting of educational resources to meet the needs of a diverse community and placing cultural competence on the agenda for ongoing training and maintenance of professional standards for clinical genetics practitioners to avoid the current ad hoc approach.     

Integrating Spirituality into Family Therapy Training: An Exploration of Faculty Members’ Beliefs

The purpose of this study was to explore the beliefs and attitudes of marriage and family therapy (MFT) faculty as they relate to the appropriateness of addressing spirituality in the context of therapy and training of future MFTs. Ninety-three MFT faculty members at masters and doctoral level programs accredited by the Commission on Accreditation of Marriage and Family Therapy Education completed the electronic survey for this study. The results indicate that the majority of MFT faculty members believe that spirituality is important in their personal lives, in their clinical work, and in MFT training. The findings of the current study are similar to previous studies of clinical and student members of the American Association for Marriage and Family Therapy.