Competency,common ground,and challenges: response to the development of systemic therapy competencies for the UK

The recent initiative by the government to delineate the competencies for the delivery of systemic therapies is groundbreaking and represents a fundamental shift with clinical and political implications. In this article the author compares the process and outcomes utilised in the UK with those embarked on in the USA in 2003, culminating in the creation of the marriage and family therapy core competencies by a task force sponsored by the American Association for Marriage and Family Therapy. The development of competencies is just the first step in a development process requiring significant modifications in all of the systems that contribute to the development and delivery of behavioural health services, including clinicians, supervisors, training programmes, regulators and policy‐makers. An elucidation of the challenges faced in the USA is provided as a potential guide to the UK effort.     

Revisiting confidentiality: observations from family therapy practice

Confidentiality has long been recognized as a critical legal and ethical principle for the committed, value‐based practitioner. Vital principles (such as confidentiality) become manifest in material practices and in the language of professional and societal narratives. This articulation into specific practices and performances requires a pragmatic process that transforms the abstract into real‐world activities. This imperfect process has the potential of including the derived practices that in certain ways may extend the principle in unintended or unwanted directions. In the case of confidentiality, the actual practices of confidentiality may be both emancipating and inhibiting – they may protect as well as isolate. Our purpose is to revisit the idea of confidentiality and to deconstruct the way it functions in both positive and negative manners in clinical work.     

A pilot study of a family‐focused intervention for children and families affected by maternal depression

A non‐experimental pilot study examined child, mother and family outcomes of a 10‐session multi‐family group intervention designed to reduce risk and promote resilience for mothers with depression and their families. Positive changes following the Keeping Families Strong intervention included mother‐reported decreases in child behaviour and emotional problems, improvements in the quality of family interactions and routines and improvements in their own well‐being and support from others. Children (9–16 years) reported decreased internalizing symptoms, improved coping, increased maternal warmth and acceptance and decreased stressful family events. Attendance and mother‐reported satisfaction were high, indicating the perceived value of the intervention.     

Child Safety in Australian Family Law: Responsibilities and Challenges for Social Science Experts in Domestic Violence Cases

Understanding the potentially adverse effects of exposure to domestic violence on children is increasing in the Western world. However, in Australian family law, there remain challenges in centralising the special needs of these children in cases before the family courts in the determination of their best interests. This article draws on some key findings of a small qualitative study to highlight and discuss some of the barriers that need to be overcome in order for social science experts to enhance the courts' capacity to protect child subjects of proceedings from possible future harm.     

Multiple family groups for adult cancer survivors and their families: a 1-day workshop model

With marked advances in early detection and aggressive multimodality treatment, many adult cancers are now associated with good prognoses for disease-free survival. A burgeoning literature examining posttreatment quality-of-life issues has highlighted the numerous challenges experienced by patients and families in the aftermath of cancer treatment, further underscoring a need for new family-based psychosocial support interventions for cancer survivors and their families. This paper describes the clinical protocol for one such intervention, a 1-day "workshop" version of a multiple family group (MFG) for head and neck cancer survivors and their families. Data are reported from our experiences in running five 1-day workshops. Families uniformly reported that they were highly satisfied with their MFG participation, leading us to conclude that the abbreviated 1-day MFG model we are advocating is a promising family-focused support intervention for cancer survivors and their families.     

Women's experiential journey toward voluntary childlessness: An interpretative phenomenological analysis

Voluntary childlessness is a relatively novel yet growing phenomenon. This idiographic study explored three women's experiential journeys toward voluntary childlessness. Semi‐structured interviews were carried out and analysed using Interpretative Phenomenological Analysis. Themes identified were: Owning the choice to be childless, social expectations, and models of mothering. Despite defining ‘voluntary childlessness’ as an unequivocal decision, the women's experiential accounts revealed an intrinsic fluidity in their journeys toward childlessness. Factors including beliefs in equality, independence and career aspirations competed with constructs of mothering/motherhood, partnership and choice to create a complex tapestry of contributory factors in these women's childlessness. The findings question the notion of choice and particularly women's ownership of that choice. The journeys toward childlessness these women shared reveal a synthesis of agentic decision‐making, personal histories and challenging lifestyle choices bound up within an existential need to be a woman. More research is needed to determine the place of voluntary childlessness within society. Copyright © 2010 John Wiley & Sons, Ltd.     

Engaging reluctant adolescents in family therapy: an exploratory study of in‐session processes of change

Informed by a trans‐theoretical model of the therapeutic alliance in conjoint family therapy, this exploratory study was the initial stage in a task analysis of critical shifts in adolescent engagement. Specifically, we compared sessions in which a resistant adolescent either did or did not shift from negative to positive engagement during the session. Two successful and two unsuccessful change events were selected from an archival data set based on SOFTA ratings of the therapeutic alliance. The results suggested that one parent element (support) and five therapist elements (structuring therapeutic conversations, fostering autonomy, building systemic awareness, rolling with resistance and understanding the adolescent's subjective experience) seemed critical for successfully facilitating adolescent engagement. The qualitative results were informed by the adolescent's self‐reported target complaints pretreatment, which suggested varying reasons for the teenagers’ active or passive disengagement. Implications for practice and recommendations for future research are offered to continue this line of inquiry.     

The growing pains of family therapy in Singapore

Family therapy in Singapore is both short on history and overdue for development. Through in‐depth interviews with six experienced local family therapists and trainers, this article explores the challenges of family therapy development in Singapore, giving particular attention to practice, supervision, training, and research. Over time, family therapy practitioners in Singapore have gained insights in applying systemic ideas in this pluralistic society where there is a rich mix of race and ethnicity. This article highlights the contribution Singapore's experience of family therapy can make to a more global picture, in view of its rich multicultural context despite significant challenges.     

Forgiveness and Cohesion in Familial Perceptions of Alcohol Misuse

The authors examine the relationships between forgiveness, family cohesion, and alcohol. In Study 1 (N= 190), participants reported lower levels of trust and forgiveness for family members who misuse alcohol. In Study 2 (N= 141), the authors present a model demonstrating family cohesion and trait forgiveness related to state forgiveness of an alcohol‐misusing family member. State forgiveness was related to trust in that family member and, subsequently, higher levels of perceived misuser drinking refusal efficacy.     

Work–family interface from a life and career stage perspective: The role of demands and resources

Work–family conflict and enrichment are experiences that occur daily and have substantial consequences for employees, their families, and the organizations that employ them. The aim of the current review is to make a link between life and career stage, work and family conditions, and the work–family interface. The basic proposition is that life stages partly determine career development, and consequently the specific working conditions (job demands and job resources) and family conditions (family demands and family resources) that individuals are exposed to. As a result, the specific demands and resources in the work and family domains determine to what extent individuals experience that work and family are conflicting or enriching life domains. In this review we suggest that individuals in early adulthood will experience high inter‐role conflict and low facilitation due to high demands and low resources in both life domains, while individuals in late adulthood will experience the opposite pattern; that is, low conflict and high facilitation due to low demands and high resources in both domains. Individuals in middle adulthood will experience high work–family conflict but also high family–work facilitation due to the presence of high job demands and resources in both life domains. Integrating life and career stage perspectives and the experience of work–family interface is of notable practical utility because it provides a mechanism to make more informed decisions about the relative need for and corresponding benefits of work–family programs.