Integrating family therapy in adolescent depression: an ethical stance

Adolescent depression, particularly where suicidal behaviour is involved, is a complex and pressing mental health problem and demanding for families, therapists and services alike. This article reviews the evidence-based literature for adolescent depression including family therapy approaches. It suggests an integrative treatment approach that includes individual psychological treatment like CBT, medication where required and a family therapy intervention is supported by the literature. The focus of the latter is psychoeducation, building resilience and hope, enhancing communication, reducing relational conflict between parents and adolescents and addressing attachment and relationship issues. A systemic framework for integrating family therapy in the evidence- based treatment of adolescent depression is described. This is based on an ethic of hospitality towards different languages of therapy, which is illustrated by a detailed example from family therapy practice.     

Contrasting four major family therapy paradigms: implications for family therapy training

Four major paradigms of family therapy are contrasted: affective-experiential, structural, strategic and Milan. The differences are defined according to the way in which therapists think and behave in relation to their premises about change, and they are discussed under the following headings: historical roots and understanding of symptom formation; therapists' stance and techniques used in change; focus, goals and locus of change; and time perspective in change. Some suggestions are made with regard to training family therapists based on the differences that emerge when contrasting these models of family therapy.     

Integrating couples and family therapy into a community alcohol service: a pantheoretical approach

This paper discusses the contribution of family systems theory and therapy to mainstream alcohol treatment programmes. Systemic psychotherapy is integrated with group analytic psychotherapy in a couples and family therapy service within a community alcohol service (CAS) which uses the Prochaska and Diclemente model of stages of change. Problems and solutions in putting these complex ideas into practice are discussed, with specific reference to issues of engagement. An example of our work with a couple is offered to illustrate our weave of theory and practice.     

Designed experience: a multiple, goal-directed training program in family therapy.

A family-therapy training program, one of three main branches of the "Boston model," is described in detail. Salient features of the program include planned integration of a multiplicity of experiential and cognitive learning modes; grounding in a unified, theoretical framework that is neither eclectic nor limited to a single school of thought; focus on nonpathological process in families; and systematic structuring in terms of specific, articulated, training objectives. The goal-directed design process by which training units are developed is explained.     

Assessment and reflexivity in family therapy training

Educational contexts can be both enriched and impoverished by our relationship with learning and our ‘identity stories’ as learners influence how we construct contexts for learning. Keenoy et al. (2007) describe identity as a ‘transient bridging concept’ between the individual and society which is constructed through ‘reflexive processes of naming, labelling, classifying and associating symbolic artefacts and social actors in a dialogical process of social definition and redefinition’. Can methods of assessment be constructed to afford reflexive, dialogical learning opportunities? This paper outlines the design and methodology of a reflexive framework for the summative assessment of abilities used on the Intermediate Level course at Northumbria University.     

Patterns of learning in family therapy training

This study presents the results of an evaluation of two cohorts of trainees who had completed a 2-year training program in family therapy. The 15 trainees were assessed in the areas of perceptual/conceptual, intervention/executive skills and personal development both pre- and post-training. Although the group results showed skill acquisition in all areas assessed, the individual results revealed a complexity in performance glossed over by the group analysis. Trainees' learning commenced from different baselines, advanced at different rates, and there was a marked discrepancy between self-reports of improvements (or otherwise) and the results of the observer-rated measures. We recommend that increasing attention be paid to individual differences in learning styles in training and in evaluation.     

Chance operations in training: a participatory format for introducing dialogical family therapy

Presenting dialogical approaches to therapy calls for training approaches that are themselves participatory and dialogical. The use of chance operations is one way of enhancing an interactive and co‐constructive learning process.     

Application of family therapy theory to complex social issues: using the WebQuest in family therapy training

This paper describes how the WebQuest is used to foster critical thinking and application of theory to complex social problems in a Master's level class on contemporary family therapy theories. The issue of child trafficking and prostitution is explored through the web‐based inquiry learning where scaffold learning is provided. Scaffolding includes resource links and guidance on cognitive and social skills, which are provided to facilitate the learner's development. The WebQuest design includes the task, the process and the evaluation rubrics. Student feedback on the WebQuest was positive and included increased motivation in learning, critical thinking and global awareness.     

Which skills how: options for family therapy training

This paper looks at some of the issues associated with attempting to provide training in family therapy on a low budget of time and money. It also considers some more general points to do with providing training. The more extensive programmes referred to which take place in the U.S.A. are not yet viable in the U.K. It is not suggested that they should be copied, since professional cultures differ, but some learning can usefully take place. The aims and methods of teaching on introductory and intermediate low budget short courses are described and compared, and some vignettes given in order to propose ways of making such training effective. Course outlines and trainee evaluation of such training are given in the appendices.     

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.     

Family-of-origin work and family therapy skills training: both-and.

Since the inception of field, theoreticians and teachers of family therapy have advocated for either problem-solving, skill-based training, or transgenerational training that emphasizes the therapist's own family-of-origin work. This article proposes an end to these polarized positions and argues for both-and, that is, a model of training that integrates the trainee's own family-of-origin work with live supervision and skills training. A family-of-origin curriculum designed for this purpose is described.     

Fostering a safe atmosphere: A first step in discussing gender in family therapy training programs

Several important aspects of raising gender issues in family therapy training programs have been identified in the last few years. However, an important first step has often not been made explicit: the need to establish an open and safe environment in which these issues can be discussed. Such a safe environment can be developed by using theoretical perspectives with which family therapy students and faculty are already familiar. This paper offers three theoretical perspectives as examples and makes suggestions for facilitating an atmosphere that is conducive to discussing gender issues.The author wishes to thank Dr. Fred P. Piercy for his helpful comments and contributions to this paper.     

Feminist bioethics: toward developing a "feminist" answer to the surrogate motherhood question.

Although a wide variety of feminist approaches to bioethics presently share a common feminist methodology (sometimes referred to as "raising the woman question"), they do not all share the same feminist politics, ontology, epistemology, and ethics. As a result of their philosophical differences, feminist bioethicists do not always agree on which biomedical principles, practices, and policies are best suited to serving women's interests. In other words, some feminist bioethicists insist that so-called "assisted reproduction" enhances women's procreative liberty, while others claim that it does nothing of the sort. Although such disagreement among feminist bioethicists reassures the general public that the feminist "program" for bioethics is not ideologically monolithic, it also confuses the public, especially women. In order to overcome this confusion, feminist bioethicists should work toward developing the kind of shared theoretical base that will foster frequent consensus on the biomedical principles, practices, and policies most likely to serve the interests of most women in the U.S. today.