Alternative Methodologies in Research Literature Review: Links Between Clinical Work and MFT Effectiveness

Traditionally, "good outcome research" has referred to laboratory-based, controlled studies that report the efficacy of a given treatment on a specific population. Although useful and needed in the struggle to establish MFTs as accepted mental health service providers, this type of research does not address whether MFT is effective in "real world" settings. In order to highlight the clinical and professional relevance of existing effectiveness research, this article reviews 15 years of clinical research in three major family therapy journals. The results suggest that 1) MFT effectiveness is under-represented in major review articles, 2) clinicians can use a variety of methodologies to establish the effectiveness of their work, and 3) more research is needed that investigates how and why MFT works in "real world" settings. Implications for practice and future research are discussed.     

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.     

Training staff in multiple family therapy in a children's psychiatric hospital: from theory to practice

This article describes a systematized method for training clinical staff from a variety of mental health professions while implementing supportive, process‐oriented multiple family therapy (MFT) in a children's psychiatric hospital. The model uses a step‐by‐step approach based upon learning objectives specific to the theory and practice of MFT for each stage of the process. External consultants skilled and experienced in MFT supported tuition in the initial stages. The method employs seminars with theoretical and experiential components, highlighting the major conceptual features of group, family therapy and MFT. Advanced stages of the training model include experiential learning in small groups and ongoing peer group supervision with live families. The systematic procedure has relevance for ongoing supervision, research and best standards of clinical practice in the hospital.     

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.     

Gender Biases and Therapists’ Conceptualization of Couple Difficulties

In spite of the fact that gender issues have played an important role in many family therapy training programs, little research has been developed to explore the effects of gender and gender biases in therapists’ conceptualizations of client problems. This study explores beginning and advanced marriage and family therapy (MFT) student’s inclusion of gender in the conceptualization of a clinical case. To examine clinician’s thinking, 32 therapists (18 beginning MFT students and 14 advanced MFT students) were asked to 1) view the first 20 minutes of an intake interview conducted by a sex therapist, and 2) identify the couple’s central issues. Qualitative and quantitative analyses were used to explore constructs associated with therapists considerations and inclusion of gender and cultural issues in their conceptualizations of marital difficulties. Results revealed that trained MFT students who considered gender may have analyzed gender issues more extensively than untrained MFT students. In addition, results of qualitative analysis of participant critiques revealed subtle forms of gender and cultural biases. Discussion focuses on how these biases, some of which are linked to clinical theory, can lead to differential expectations and inequality in the treatment of men and women in couple therapy. Implications for clinical training, curriculum development, and future research are also discussed.     

Career Paths of Eminent Researchers in Marriage and Family Therapy

The mental health field of marriage and family therapy (MFT) needs more MFT researchers and more research to validate and verify the effectiveness and efficacy of MFT for the treatment of various mental health and relational problems. Knowing more about how successful researchers have developed their careers would be useful in both inspiring and guiding young MFT researchers toward success. Three eminent researchers whose careers have focused on MFT (James Alexander, John Gottman, and Howard Liddle) and their publications served as the research sample. Research questions addressing types of research, research samples, research questions, therapy model development, funding, and paths of the research careers were answered using content analysis. Results support guidelines that include having a focused research interest area, adhering to the scientist-practitioner model, obtaining funding, maximizing the utility of research samples, and generating publications.     

Socializing Undergraduates to the MFT Field

In this article we outline the facilitation of a marriage and family therapy (MFT) course that introduces undergraduates to MFT theory, research, and professional development. We also examine students’ reports on the influence of the course relative to their development of graduate training aspirations and desired pursuit of MFT as a potential career. Additionally, students offered reflections about what most inspired their learning and attention towards MFT as a potential profession. Results indicate that the course aided students in career path discernment, preparation for MFT graduate program entrance, and socialization to develop future professional relationships with MFTs.     

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.     

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.     

Marital and Family Therapist’s Action Research in Light of Some Research Problems: A One-Cycle Example

Some major problems in marital and family therapy (MFT) research remain evident. Practitioners often see research as insufficiently related to their concerns and want it to be more applicable. Often-used integrative (or eclectic) practices in MFT and their idiographic nature make the applicability of research even more problematic. Greater use of action research, which often has been overlooked in MFT, could be useful for addressing some of these problems. There are many types of action research; one of the most common uses repeating cycles of the four basic steps (observing and gathering information, reflecting, planning, and acting). In this article the authors’ use of these four steps for studying MFT is presented and discussed in the light of some research trends and problems. A one-cycle case example is used to illustrate the process.     

MFT Students’ Recount Experiences of Attending Phone and Online Overeaters Anonymous Meetings

The purpose of this study was to explore Marriage and Family Therapy students’ experiences attending Overeaters Anonymous (OA). Utilizing a qualitative survey administered in an addictions course at an institution located in a rural area of the United States, 18 marriage and family therapy (MFT) graduate students reflected on their participation in both online and telephone meetings. In this study, MFT students provided their perspectives regarding the feasible utilization of Overeaters Anonymous in clinical treatment, with an emphasis on the consideration of social support for clients who may reside in rural areas. Three major themes emerged which included (1) enlightenment through exposure; (2) OA as a viable adjunct to therapy; and (3) convenience and comfort. The study addressed recommendations for MFT education, clinical implications, and future research.     

Milan systemic family therapy: a review of ten empirical investigations

Ten empirical investigations of Milan Family Therapy (MFT) are reviewed in this paper. The studies include both single and comparative group outcome trials; investigations of therapeutic process; clinical audit and consumer satisfaction surveys. Substantive findings and methodological issues are discussed in the light of family therapy and individual psychotherapy research generally. Findings indicate that MFT may lead to symptomatic change in two-thirds to three-quarters of cases and to systemic change in half the treated cases. Engagement of fathers may be important for positive outcome. Technical aspects of MFT, such as the use of screens and teams, may lead to client dissatisfaction in some cases. MFT-based consultation may be effective in resolving therapeutic impasses. Coupled with short-term residential placement, MFT may reduce the risk and complexity of cases as rated by referring social workers.     

Valuing Ideas of Social Justice in MFT Curricula

Training programs committed to the development of culturally sensitive family therapists must support dialogue that creates awareness of social structures promoting inequity and oppression. In order to facilitate meaningful conversations about issues of social justice educators have to critically examine their own philosophies and teaching methods to create a learning environment that promotes this dialogue for all students. This article outlines our philosophy of teaching and presents two core MFT graduate courses as examples of how issues of social justice can be valued in the didactic component of marital and family therapy (MFT) training.     

Theory of Change Projects in MFT Programs

Taibbi (1996) suggests that therapists who have clear ideas of their personal models of therapy will be better therapists. This study attempted to learn more about how marriage and family therapy (MFT) programs use theory of change projects to assist students' development of their personal models. Questionnaires were sent to MFT master's, doctoral, and post-degree programs accredited by the Commission on Accreditation for Marriage and Family Therapy. Nearly 60% of responding programs indicated that they do include theory of change projects in their programs. Data were analyzed for similarities and differences in both the contents and processes of the projects.     

On Becoming a Profession: The Growth of Marriage and Family Therapy in India*

The practice of couple and family therapy has a long history in India. This article tracks some of the people, places, and contexts associated with the growth of marriage and family therapy (MFT) as a profession in the Indian context. Two of the authors outline their own introduction to MFT and work within this field in different cities in India in the last two decades. Based on their professional experiences and a pilot study conducted in Chennai, the authors document the needs of providers in the areas of systems-based therapy training and the practice of MFT. The role of the Indian Association for Family Therapy (IAFT) and suggestions for the future growth of the field are also highlighted. Mudita Rastogi, PhD, Professor, Illinois School of Professional Psychology, Argosy University, 1000 Plaza Drive Schaumburg, IL 60173 (MuditaRastogi@hotmail.com). Rajeswari Natrajan, PhD, Assistant Professor, Alliant International University, 2500 Michelson Drive, Suite 250, Irvine, CA 92612-1548. Volker Thomas, PhD, Associate Professor, Purdue University, 1200 West State Street, Fowler Memorial House, Purdue University, West Lafayette, IN 47907-1269. *Portions of this paper are based on Rajeswari Natrajan’s dissertation at Purdue University. **Rastogi and Natrajan share first authorship for this paper.     

A Systemic Treatment of Families with a Child Diagnosed with Autism Spectrum Disorder Using a Narrative Lens

Abstract

Autism Spectrum Disorder (ASD) is a neurodevelopment disorder that now affects one in 59 children, a 15% increase from the 2012 report. Although there have been numerous studies on the treatment of ASD, interventions focus primarily on the individual diagnosed with ASD. Marriage and family therapists’ (MFT) are in a unique position to handle the systemic dynamics of ASD. As a result, many MFTs find it difficult and outside their scope of practice to work with these families. We will explore aspects of narrative family therapy, conceptualization, and interventions, giving the reader a base understanding of how to implement narrative therapy while working with this population.     

Reconsidering the Term <Emphasis Type="Italic">Marriage</Emphasis> in Marriage and Family Therapy

This article presents a consideration of whether the term marriage in the title of the marriage and family therapy (MFT) profession continues to reflect the work that MFT professionals do. The authors describe relevant historical and professional identity issues, a rationale for revising the title of the profession (including demographic trends related to marriage and relationships, patterns of clinical practice, and the political context surrounding marriage), and a rationale for maintaining the current title of the profession (including administrative costs, value and ideological differences within the MFT profession, and the importance of a cohesive professional identity). The article concludes with recommended future directions for the profession’s decision makers, researchers, and practitioners.