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.     

Systemic Family Therapy in Greece: Polyphony and Diversity

The paper aims at presenting the state of the art regarding systemic/family therapy in Greece, in relation to practice, professional and accreditation issues and training. It is argued that systemic/family therapy in Greece constitutes a lively and diverse terrain with roots in the 1960s and a rapid dissemination of the approach following the mid 1980s. The field’s development in Greece is out-sketched by means of ‘data’ collected from a variety of sources, like web sites of associations and training centers, published articles and informal and semi-structured interviews conducted with seminal figures. First, a concise historical overview of the birth of systemic/family therapy is presented in relation to the wider socio-political context and the attempt for the reform of the psychiatric system in Greece during the 1980s. Second, a brief sketch of the existing associations as well as of the contexts where systemic/family therapy is practiced is outlined in relation to issues regarding accreditation and statutory regulations. Third, a non-exhaustive list of currently existing training programs is reviewed in respect of axis, like their content and structure, accreditation issues, entry requirements, etc. The paper concludes with inferences regarding the existing state of the art including future potential directions, whilst hinting to research ventures, which could enrich our understanding of both the history and the potential of the field in the Greek context.     

Family Therapy Training in Selected General Psychiatry Residency Programs

This paper describes the current state of family therapy training in general psychiatry residency programs (GPRP) in the United States. Based on a national survey of 80 GPRP training directors, current practices and attitudes toward family therapy training are assessed. The principal finding is that there has been a significant increase in the amount of required family therapy training in GPRP over previous years and many of the programs would like to expand their current curriculum. Issues concerning course content, definition of family therapy employed, and the meshing of different theoretical paradigms are considered. Recommendations for further research and for the initiation of intradisciplinary and interdisciplinary dialogue are presented.     

An evaluation of a partial training program in psychiatric residency on the later practice of marital and family therapy

Abstract

This paper reports on the results of a survey of psychiatrists and residents who received marital and family therapy training during their second year of residency. The data indicate that such training has an immediate positive effect on practice and is carried forward into later practice. Practicing psychiatrists trained in marital and family therapy during residency report spending 25% of their caseloads in marital and family therapy which was seen as producing positive change in patients. In line with previous training, practicing psychiatrists define the unit of treatment as more than an identified patient and treat marital and family therapy cases themselves or refer to others for such therapy. Variations in practice and techniques raise questions regarding the structure and content of marital and family therapy training in psychiatry residency programs and point out the importance of such training in the later practice of psychiatry.     

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.     

Interpersonal Skills Training to Reduce Aggressive and Delinquent Behavior: Limited Evidence and the Need for an Evidence-Based System of Care

The prevention of aggressive and delinquent behavior during childhood and adolescence is one of the highest priorities for public health and crime prevention. The most common approach to preventing or treating these conduct problems has been to provide interpersonal skills training to the affected youth. This paper reviews all randomized controlled trials evaluating interpersonal skills training programs as an intervention to reduce conduct problems. Research shows that such programs have weak empirical support as isolated interventions. An alternative evidence-based system of care is described. Such a system would include behavioral parent training and behavioral classroom-based interventions for young children at risk of developing problems, as well as multisystemic family therapy or multidimensional treatment foster care for chronic delinquents. Within such a network of services, interpersonal skills training could play an important supportive role. Such a system holds the greatest promise for reducing the prevalence of aggressive and delinquent behavior in communities.     

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.     

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.     

Training Methods for Delivering Difficult News in Genetic Counseling and Genetics Residency Training Programs

Genetic counselors and clinical geneticists are often in the position of delivering difficult news (DDN) to patients and families. Many studies show that healthcare providers require major improvement in the skills needed in DDN in a manner that is satisfactory to their patients. The purpose of this study was to assess the amount and methodology of DDN training received by genetic counselors and medical genetics residents in their training programs, such as observations of DDN or attending didactic lectures. To our knowledge, there is no previous assessment or study of DDN training in genetic counselor and medical genetics residency programs; therefore, we aim to both assess and compare the training in DDN received by genetic counselors and by genetics residents and determine whether there is a desire for recommendations on DDN training. We invited genetic counseling (GC) and genetics residency program directors to participate in an online survey designed to assess coursework, clinical experiences, and directors’ attitudes toward teaching DDN. Response rate was 85% (28/33) for GC program directors and 26% (14/53) for genetics residency program directors. One hundred percent of GC and genetics residency directors who responded to the survey agreed that it is important for genetic counselors and medical geneticists to be able to deliver difficult news effectively and that training programs should formally teach students how to deliver difficult news. Six of the eight common teaching methods are used by at least 75% of GC programs while two of eight are used by at least 75% of genetics residency programs. Seventy-nine percent of GC and 93% of genetics residency program directors agree that there should be recommendations on how to teach students to deliver this news. Our results show that techniques for DDN are integrated more fully into GC program curricula than genetics residency curricula. Directors of both types of programs desire recommendations and more standardized education for training students to deliver difficult news.     

Can psychiatry residents be attracted to analytic training? A survey of five residency programs

In the face of fewer psychiatrist applicants for psychoanalytic training, determining the interest of current psychiatric residents in psychoanalysis and psychodynamic psychiatry is a pressing concern. To gauge this interest, an anonymous online survey was sent to residents from five psychiatry residency programs in the Midwest and South. Seventy-five residents responded, for a return rate of 42%. The data suggest that residents value psychoanalytic concepts and most plan to incorporate the practice of psychodynamic psychotherapy into their careers after graduation; however, residents have little confidence in their level of skill and the adequacy of their training. While 46% express interest in further psychodynamic psychotherapy training, only 22% express interest in psychoanalytic training. Most cite the cost and time involved as reasons they would not pursue further training. This study demonstrates that psychiatric residents have strong interest in and respect for psychodynamic psychotherapy and psychoanalysis. The data suggest that psychiatric residents are a viable pool of applicants for psychoanalytic training, especially if barriers to training can be reduced and creative ways for psychoanalysts to engage residents can be fostered.     

Integrating Family Therapy Training into Psychiatry Residency Programs: Policy Issues and Alternatives

This article explicates policy issues and alternatives in the integration of family therapy training within general psychiatry residency programs. These issues include controversies about the definition of the field; elective versus required teaching; curriculum content; and when, where, and who should teach family therapy in this context. The article concludes with recommendation for further clarification of this training area.     

Applying the Group Process to Psychiatric Occupational Therapy Part 1

The authors trace the current use of group activities in occupational therapy from an historical perspective. A pilot study of thirty-four psychiatric treatment programs located in Wisconsin, Quebec, and Alberta are described. The five most frequent groups used in these facilities include: social skills training, independent living skills, leisure time activities, stress management and exercise. The results are compared to a previous study by Duncornbe and Howe, 1985.     

Social Skills Training for Psychiatric Patients,I

Deficits in social skills are often seen in psychiatric patients. In particular instances these may be a consequence of the psychiatric illness, a contributing cause to that illness, or a feature of the psychiatric disorder. During the last two decades, systematic training programs in social skills have been developed and evaluated for the amelioration of these deficiencies. The author critically reviews basic concepts and methods in social skills training and the results of treatment in case reports, analogue studies, and single-case experimental decisions.     

Patterns and determinants of attitudes of psychiatric residents toward group therapy

The nature and origins of psychiatric residents' attitudes toward group psychotherapy were assessed by means of a semistructured interview. Subjects were 10 PGY-4 residents from five different residency training programs. Questions focused on subjects' perceptions of the possibilities and limitations of group therapy as a treatment modality, the efficacy and dangers of combined and conjoint treatment, the nature and extent of their training experiences in group approaches, the salient characteristics of their group therapy teachers and supervisors, and the attitudes of faculty about group psychotherapy that they were able to infer. Results suggest enormous variability of residents' attitudes. Hypotheses about the reasons for such variability are offered.     

TRANSITIONAL EMPLOYMENT PROJECT

McLean Hospital is a private, non-profit psychiatric hospital in Massachusetts. It is an extensive treatment facility providing outpatient care, patient hospitalization, and an inpatient bed capacity of 328. The psychiatric modalities used are traditional milieu structuring, individual and group psychotherapy, behavior therapy interventions, family and couples therapy, psychopharmacology, and rehabilitation treatment strategies. As in other psychiatric hospitals, vocational rehabilitation treatment strategies were severely challenged in the 1970s with the Supreme Court decision in the case of Souder versus Brennan. In essence, the findings in this class action suit construed traditional, clinical/vocational programs as forms of employment, not therapy. Thus, the issues of work adjustment and employment preparation for the psychiatrically disabled client needed to be creatively readdressed. Rehabilitation staff were called upon to redefine the activities presented to clients not only from the viewpoint of desired therapeutic interventions but also in terms of the new legal constraints. The shortened length of inpatient hospitalization also highlighted the need for aftercare rehabilitation opportunities. Responding to these needs, the Rehabilitation Services Department of McLean Hospital developed an independent transitional employment corporation called Everywhere Limited.     

The Integration of a Family Systems Approach for Understanding Youth Obesity,Physical Activity,and Dietary Programs

Rates of overweight in youth have reached epidemic proportions and are associated with adverse health outcomes. Family-based programs have been widely used to treat overweight in youth. However, few programs incorporate a theoretical framework for studying a family systems approach in relation to youth health behavior change. Therefore, this review provides a family systems theory framework for evaluating family-level variables in weight loss, physical activity, and dietary approaches in youth. Studies were reviewed and effect sizes were calculated for interventions that manipulated the family system, including components that targeted parenting styles, parenting skills, or family functioning, or which had novel approaches for including the family. Twenty-one weight loss interventions were identified, and 25 interventions related to physical activity and/or diet were identified. Overall, family-based treatment programs that incorporated training for authoritative parenting styles, parenting skills, or child management, and family functioning had positive effects on youth weight loss. Programs to improve physical activity and dietary behaviors that targeted the family system also demonstrated improvements in youth health behaviors; however, direct effects of parent-targeted programming is not clear. Both treatment and prevention programs would benefit from evaluating family functioning and parenting styles as possible mediators of intervention outcomes. Recommendations are provided to guide the development of future family-based obesity prevention and treatment programs for youth.     

Evaluation of family therapy trainees: acquisition of cognitive and therapeutic behavior skills

In this study, which describes the evaluation of a structural family therapy training program, we developed an evaluation procedure that can be used with other similar training programs. Trainees were evaluated before and after training as to their improvement in cognitive, case-planning and in-therapy intervention skills. Results suggest a progression of skill learning, beginning with cognitive understanding, followed by case planning, and then intervention skills. Though trainees made significant progress in cognitive and planning skills, this was not the case with intervention skills. Trainees' self-evaluations were similar to their results on other measures.     

Accredited internship and postdoctoral programs for training in psychology: 2011

Presents the official listing of accredited internship and postdoctoral residency programs. It reflects all Commission on Accreditation decisions through July 17, 2011. This list also is provided by electronic means (http://www.apa.org/ed/accreditation/programs/index.aspx), but that listing is for informational purposes only and should not be used for official credential review.