The evidence base for family therapy and systemic interventions for child‐focused problems

This review updates similar articles published in the Journal of Family Therapy in 2001 and 2009. It presents evidence from meta‐analyses, systematic literature reviews and controlled trials for the effectiveness of systemic interventions for families of children and adolescents with various difficulties. In this context, systemic interventions include both family therapy and other family‐based approaches such as parent training. The evidence supports the effectiveness of systemic interventions either alone or as part of multi‐modal programmes for sleep, feeding and attachment problems in infancy; child abuse and neglect; conduct problems (including childhood behavioural difficulties, attention deficit hyperactivity disorder, delinquency and drug misuse); emotional problems (including anxiety, depression, grief, bipolar disorder and self‐harm); eating disorders (including anorexia, bulimia and obesity); somatic problems (including enuresis, encopresis, medically unexplained symptoms and poorly controlled asthma and diabetes) and first episode psychosis.     

The evidence base for couple therapy,family therapy and systemic interventions for adult‐focused problems

This review updates similar articles published in JFT in 2000 and 2009. It presents evidence from meta‐analyses, systematic literature reviews and controlled trials for the effectiveness of couple and family therapy for adults with various relationship and mental health problems. The evidence supports the effectiveness of systemic interventions, either alone or as part of multi‐modal programmes, for relationship distress, psychosexual problems, intimate partner violence, anxiety disorders, mood disorders, alcohol problems, schizophrenia and adjustment to chronic physical illness.     

Structural family therapy with Mexican-American family systems

Characteristics of traditional Mexican-American families with consequent family rules that affect these family systems are discussed along with selected clinical cases. The specific cases discussed involve: (1) interactions with family of origin in intercultural marriages, (2) intracultural differences in levels of acculturation and traditional family rules, and (3) extended family impact in response to severe life crisis. The development of therapeutic processes from structural and strategic family therapy approaches, which reflect appreciation for cultural differences and strengths, is suggested.This material was presented at the annual meeting of the Texas Association for Marriage and Family Therapy, January, 1994, San Antonio, TX.     

Couple therapy,family therapy and systemic interventions for adult‐focused problems: the current evidence base

This paper updates previous similar reviews published in JFT in 2000, 2009 and 2014. It presents evidence from meta‐analyses, systematic literature reviews and controlled trials for the effectiveness of couple therapy, family therapy, and systemic interventions for adults with a range or relationship and mental health problems. The evidence supports the effectiveness of systemic interventions, either alone or as part of multimodal programmes, for relationship distress, psychosexual problems, intimate partner violence, anxiety disorders, mood disorders, alcohol problems, psychosis and adjustment to chronic physical illness.     

Patient‐focused research supported practices in an intensive family therapy unit

The aim of this study is to explain how families evaluate and describe the use of two measures, the session rating scale and the outcome rating scale, in order to monitor therapeutic work. This study is methodologically based on modifications of methodical hermeneutics and consensual qualitative research. The results confirm the feasibility of these scales although some difficulties were identified. The analysis of the family interviews identified four conversational processes: communicating, focusing, structuring and exploration. These arise through the application of the scales, indicating their usefulness as conversational tools. In general, it is suggested that all the measurements and tools applied can be seen as therapeutic tools that are especially useful for establishing conversations and strengthening collaboration between service users and therapists. This brings the practice of monitoring therapeutic work into close contact with postmodern‐oriented forms of therapy.     

Therapist perspectives on working with fears,blocks and resistances to compassion in compassion focused therapy

Objective

A core aspect of compassion focused therapy (CFT) is addressing fears, blocks, and resistances (FBRs) to compassion. How CFT therapists do this with clients remains unclear. This study aims to explore the perspectives of well-trained, experienced CFT therapists regarding how they work with FBRs in the context of CFT.

Methods

A qualitative study was conducted. Participants were asked five open-ended questions regarding (a) their experiences of working with FBRs to compassion, (b) how they understand and formulate FBRs, (c) specific ways they address FBRs, (d) how other therapists might learn about working with FBRs, and (e) their top recommendations. A total of 64 participants completed the online questionnaire, and the qualitative data were analysed using thematic analysis.

Results

The analysis produced four interrelated superordinate themes: (a) Getting “alongside” and “behind”: The central role of formulation, (b) “It's not your fault”: Psychoeducation, (c) “Get experiential”: An emphasis on experiential interventions, and (d) “Respect the wisdom”: The importance of therapeutic process.

Conclusions

Working with FBRs to compassion is critical in CFT. Understanding the wisdom in the client's FBRs, and validating and de-shaming the client's FBRs are crucial. We provide clinical recommendations regarding working with FBRs as part of CFT.     

A structured approach to disengagement in family therapy with child-focused problems

The aim of this paper is to describe a structured approach to managing the disengagement process. Six distinct disengagement scenarios are first outlined. Thereafter, phasing out therapy, dealing with family belief systems concerning the permanence of improvements and relapse management are discussed. Ways in which disengagement from specific episodes of therapy may be construed as part of an ongoing therapeutic relationship and the practicalities of recontracting for further episodes of therapy, handing over cases, and referring cases on to other professionals are considered. An approach to therapeutic failure analysis is presented. Finally, ways in which disengagement may lead to significant loss experiences are discussed.     

Toward an integration of child and family therapy

Current forms of treatment for the symptomatic child are reviewed and analyzed. There are four general approaches to treatment: individual child psychotherapy, conjoint parent-child psychotherapy and counseling, parent therapy and counseling, and conjoint family therapy. Each approach has certain strengths, but in-and-of itself is an incomplete treatment mode. An integration of child and family therapy is recommended, and recent attempts at this integration are described. These include approaches which work within the framework of conjoint family therapy and those which provide concurrent child and family therapy.     

Structural therapy for a West African family

In West Africa kinship is a very important aspect of social organization; it is a hierarchical system which functions as the domestic group and in the wider realm of politico-jural and economic relations. The individual is constituted through the kinship group. It is suggested that family therapy, especially structural family therapy, may be suitable as a treatment technique in such non-individualistic societies. A case example is given to illustrate how this understanding can lead to successful therapy.     

Outcome studies of family therapy in child and adolescent depression

There is surprisingly little good-quality evidence for the effectiveness of family systemic interventions with child and adolescent depression given the prevalence of depression and the demonstrated association with a range of family factors. What studies there are suggest the possibility of family therapy being an effective intervention but more research is needed before firm conclusions may be drawn. Family interventions may be more effective in children than in adolescents and where other family members are depressed. It is possible that family interventions continue to bring about improvement in symptoms after cessation of treatment. What research there is evaluates older structural models of therapy: there is a real need for more evaluation of newer models of practice.     

Co-creating change within a child protection system: integrating art therapy with family therapy practice

This paper considers family art therapy intervention using a partnership developed between an art therapist and a family therapist within a child protection system. The aim of this co-working relationship is to bring together skills that can amplify the child's voice within the family, using art as a means of extending the family story. The use of metaphor adds to the repertoire of skills available when working with families, and offers a particular form of communication in which children can more easily engage. By co-working, we also bring together our personal and professional stories, creating multiple ideas and ways of seeing and taking account of differences in the life experiences of individual families.     

Family therapy and systemic interventions for child‐focused problems: the current evidence base

This review updates previous similar papers published in JFT in 2000, 2009 and 2014. It presents evidence from meta‐analyses, systematic literature reviews, narrative literature reviews and controlled trials for the effectiveness of systemic interventions for families of children and adolescents with common mental health problems and other difficulties. In this context, systemic interventions include both family therapy and other family‐based approaches such as parent training, or parent implemented behavioural programmes. The evidence supports the effectiveness of systemic interventions either alone or as part of multimodal programmes for sleep, feeding and attachment problems in infancy; recovery from child abuse and neglect; conduct problems, emotional problems, eating disorders, somatic problems, and first episode psychosis.     

Evidence-based practice in family therapy and systemic consultationChild-focused problems

Evidence for the effectiveness of family therapy and family-based interventions from critical literature reviews and controlled trials is considered for families with children and adolescents who present with various difficulties. The evidence supports the effectiveness of family therapy as an effective treatment either alone or as part of a multimodal or multisystemic treatment programme for child abuse and neglect, conduct problems, emotional problems and psychosomatic problems. Implications for practice, training and continuing professional development in the field of family therapy are discussed.     

Unilateral family therapy for alcohol abuse: A working conception

Abstract

Unilateral family therapy is presented as a new mode of family therapy in which intervention is directed toward changing the behavior of an uncooperative family member through working with a cooperative member as mediator. In this initial exposition of the unilateral approach, it is applied to the problem of endeavoring to reach and change an uncooperative alcohol abuser through giving therapeutic assistance to a cooperating spouse. A working conception of this mode of therapy is presented based upon the authors' current clinical research in this area. Directions for further research and development are identified.     

Integrative family therapy for high-conflict divorce with disputes over child custody and visitation

A growing number of divorcing families become locked in intractable disputes over child custody and visitation. This article describes an integrative family therapy approach targeted toward such families. Aspects of this treatment include negotiating a clear therapy contract, creating a multipartial alliance with all parties, assessing through the lens of specific understandings about these cases, incorporating multiple therapy session formats, holding both systemic and individual focused perspectives, incorporating a solution-oriented focus, and drawing upon a wide range of intervention techniques. The treatment aims to create a good-enough postdivorce climate in which a new family structure can be constituted in which parents maintain distance from one another, and conflict and triangulation can be minimized.