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.     

The integration of individual and family therapy

It is time to put an end to the separation in training programs between individual and family therapy. Competent therapists should be able to think at an intrapsychic and circular level concurrently. Training programs should maintain their current major focus and develop their minor area of expertise sufficiently so that their graduates can practice both individual and family therapy and choose whichever modality is more appropriate to the case at the time. Bridge concepts, essential differences, and some integrative approaches in individual and marriage and family therapy are discussed.     

Depressed youth: treatment outcome and changes in family functioning in individual and family therapy

This study explores the role of family functioning in therapeutic change in focused individual psychodynamic psychotherapy (FIPP) and time‐limited systems integrative family therapy (SIFT) for depressed children and adolescents. After a screening process, 72 participants aged 8 to 15 were randomized to either FIPP or time‐limited SIFT. Assessments took place prior to, at the end of, and 6 months after treatment. Families in both SIFT and FIPP showed a small but significant and sustained improvement in family functioning by the end of treatment in both mothers' self‐reports and family therapists' assessments. Better family functioning at baseline in mothers' self‐reports and improved family functioning during SIFT, as assessed by family therapists, predicted a sustained decrease in self‐reported depressive symptoms. Results indicated that time‐limited SIFT may be more effective with younger children and in patients without a diagnosis of double depression than adolescents.     

Learning family therapy: The dilemmas of an individual therapist

Individual therapists who begin doing family therapy often encounter some special difficulties directly related to their prior training and experience. Some therapeutic techniques of individual therapy, such as understanding and explaining the patient's problems on the basis of faulty parenting, must be relinquished and alternative means of alleviating guilt must be adopted. In doing family therapy individual therapists must adapt to the fact that they are less important than they are used to being and have less control over content and emotional tone of sessions. They must change their conceptions about the importance of privacy and secrecy. This article discusses some of the problems encountered when one is not thoroughly committed to a family therapy approach to treatment. Countertransference difficulties, problems stemming from wanting change, and the differing nature of the gratifications in the two therapeutic modalities are other topics discussed.     

Gender and family therapy: Adding a bi-level belief systems component to assessment

This article proposes that most couples requesting therapy describe gender socialized patterns as part of their relationship issues. Adding a component to assessment derived from principles of strategic and systemic family therapies and post-modernist feminist psychology which examines the couple's gendered belief system context is described. The belief system context is identified as the family's epistemology about gendering at the family belief system and sociocultural belief system level contexts. Three dimensions of the gendered belief system and a method for assessing the functionality of the belief system are discussed.     

The empirical and theoretical base of family therapy and multiple family day therapy for adolescent anorexia nervosa

There is growing empirical evidence that family therapy is an effective treatment for anorexia nervosa, particularly in adolescence. This is in spite of the fact that the theoretical model from which most of the empirically based treatments are derived appears flawed. This paper provides a brief overview of the research evidence from treatment studies and studies of family functioning. It suggests that the main limitation of earlier theoretical models is their focus on aetiology rather than on an understanding of how families become organized around a potentially life-threatening problem. An alternative conceptual model is presented, and its application to family therapy and multiple-family therapy for adolescent anorexia nervosa is described. The treatment approach focuses on enhancing the families' own adaptive mechanism and mobilizing family strengths.     

Concurrent individual and family therapy in a case of elective mutism

In this paper, following a literature review a family containing a child who had been electively mute for four years is described. A concurrent programme of individual and family therapy and the systemic hypothesis which guided these interventions is then presented in detail. Behavioural and psychometric data are presented to illustrate the dramatic improvement which the identified patient showed over the course of treatment. Finally, the probable mechanisms underpinning the child's improvement, and how these differed from our initial expectations, are discussed.     

The impact of structural family therapy training on conceptual and executive therapy skills

The importance of empirical evaluations of family therapy training is gaining increased recognition. This study reports the results of a controlled assessment of a training seminar in structural family therapy. Changes in the conceptual and executive skills of 44 therapy trainees (22 family trainees and 22 controls) were assessed over a 16-week period using repertory grid and videotaped therapy simulation techniques. Results indicated significant conceptual gains in family therapy trainees, but only among those with little previous exposure to family training. Differences in the overall number as well as the type of interventions were also noted. Results generally supported the predicted impact of therapy training, but left unanswered questions regarding the unique impact of family therapy training over individual training. These qualifications are discussed and directions for future work are highlighted.     

Cultural influences on preference consistency: Consistency at the individual and collective levels

Previous research has shown that there are cultural differences in self-concept consistency across situations. However, little is known about cultural differences in preference consistency over time. The present research examined whether Americans are more consistent in their preferences over time than are Japanese. As hypothesized, there were cultural differences in self-reported ( and ) and actual ( and ) preference consistency over time. Further, cultural differences in preference consistency at the individual level (Study 1) were found to aggregate into collective level differences ( and ) in the consistency of preference trends, such as the popularity of baby names. Implications and future directions are discussed.     

Adults returning to school: the impact on family and work

The authors examined the impact of attending a Weekend College (WEC) program on adult students' family, work, and social life. Student participants responded to a 26-item questionnaire and three open-ended questions. Regression analyses of the 566 completed surveys revealed that satisfaction with school and support from family and the work place were predictive of lower levels of stress. Content analyses of responses to open-ended questions showed that expected stress was the result of time constraints but also highlighted the positive aspects of continuing one's education. The study includes suggestions for designing programs to meet the needs of adult students.     

The cost of treating substance use disorders: individual versus family therapy

This study examined the cost of substance use disorders treatment in a large healthcare organization. A survival analysis demonstrated that family therapy utilised the least number of sessions (M = 2.41) when treating substance use disorders followed by individual therapy (M = 3.38) and mixed therapy (M = 6.40). Family therapy was the least costly of the three types, at $124.55 per episode of care for a client, with individual therapy costing $170.22 and mixed therapy $319.55. The ratio of family therapists utilising family therapy was more than three to one compared to other licensed professionals. The percentages of clients coming back for more than one episode of care are fewest for family therapy (8.9%) followed by mixed therapy (9.5%) and individual therapy (12.0%).     

Family psychopathology: Cross training graduate marital and family therapy students in family assessment and psychiatric nosology

The structure of a course entitled Family Therapy with Major Psychopathology taught annually in the Mercer University Graduate Marriage and Family Therapy Program is presented. An epistemological presentation regarding the interface of psychiatric nosology and family systems assessment is discussed. Methods of diagnosing and assessing dysfunctional family systems are presented and training in individual psychiatric nosology is discussed, with particular attention given to family systems dysfunction as an etiological factor in the development of individual psychopathology. Learning techniques are discussed including lecture, discussion, case presentations, readings, and testing methods.     

Supervisors' and Supervisees' perceptions of the effectiveness of family therapy supervisor interpersonal skills

Abstract

This study surveyed a randomly selected group of Approved Supervisors of the American Association for Marriage and Family Therapy (n=318) and their supervisees (n=299) on their perceptions of the effectiveness of several supervisor interpersonal skills. Both supervisors and supervisees had high ratings for the majority of the interpersonal skills and rated “respects the supervisee” most effective. Trends in supervisors' and supervisees' responses were assessed for (a) theoretical orientation, (b) supervision setting, (c) gender, (d) number of years supervising family therapists (for supervisors), and (e) number of years practicing family therapy (for supervisees).     

Examining the potential impact of a family session in therapeutic assessment: a single-case experiment

Most clinicians concede the benefits of conceptualizing children in systemic terms. Yet, many child assessments involve parents only on a limited basis. The Therapeutic Assessment model for children and families (TA-C) emphasizes parental involvement and family-driven collaboration throughout the intervention. Child TA has shown promise as an effective brief intervention (e.g., Smith, Handler, & Nash, 2010; Tharinger et al., 2009). Family intervention sessions (Finn, 2007; Tharinger, Finn, Austin, et al., 2008) are an integral component of the child TA model in facilitating familial changes. However, TA-C research has yet to empirically examine the potential impact of a family session on treatment trajectory. This case study includes an extended presentation of the development and execution of a family session. The authors use a daily measures time-series experiment to empirically examine the clinical effectiveness of the TA-C and the hypothesis that the family session was a tipping point in the trajectory of improvement.