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Journal of Family Therapy

Impact factor: 0.698 5-Year impact factor: 0.892 Print ISSN: 0163-4445 Online ISSN: 1467-6427 Publisher: Wiley Blackwell (Blackwell Publishing)

Subjects: Clinical Psychology, Family Studies

Most recent papers:

  • Measuring competence in systemic practice: development of the ‘Systemic Family Practice – Systemic Competency Scale’ (SPS).
    Catherine Butler, Elizabeth Sheils, Judith Lask, Trish Joscelyne, Helen Pote, Jon Crossley.
    Journal of Family Therapy. October 25, 2018
    --- - "\n\nEnsuring that practitioners are competent in the therapies they deliver is important for training, therapeutic outcomes and ethical practice. The development of the Systemic Practice Scale (SPS) is reported – a measure to assess the competence of students as trialed by Children and Young Person's Improving Access to Psychological Therapies (CYP‐IAPT) training courses. Initial reliability assessment of the SPS with twenty‐eight supervisors of systemic practice evaluating students’ competence using an online recording of a family therapy session is detailed. The SPS was found to be a reliable measure of systemic competence across training settings. Rating variability was noted, with training and benchmarking to improve rating consistency recommended. Further research using the SPS to further establish the reliability and validity of the scale is required.\n\n\nPractitioner points\n\n\n\nSPS represents an important tool, particularly for the supervision and development of more junior staff or students\n\nInitial reliability for use of the SPS as a formative tool has been established. Further benchmarking is required if using the tool in a summative manner \n\n\n\n" - Journal of Family Therapy, EarlyView.
    October 25, 2018   doi: 10.1111/1467-6427.12251   open full text
  • Issue Information.

    Journal of Family Therapy. October 10, 2018
    --- - - Journal of Family Therapy, Volume 40, Issue 4, Page i-iv, November 2018.
    October 10, 2018   doi: 10.1111/1467-6427.12196   open full text
  • In praise of different approaches to writing.

    Journal of Family Therapy. October 10, 2018
    --- - - Journal of Family Therapy, Volume 40, Issue 4, Page 463-465, November 2018.
    October 10, 2018   doi: 10.1111/1467-6427.12246   open full text
  • Thank you to reviewers.

    Journal of Family Therapy. October 10, 2018
    --- - - Journal of Family Therapy, Volume 40, Issue 4, Page 619-619, November 2018.
    October 10, 2018   doi: 10.1111/1467-6427.12245   open full text
  • Family factors associated with self‐harm in adults: a systematic review.
    Ruth Buckmaster, Muireann McNulty, Suzanne Guerin.
    Journal of Family Therapy. September 19, 2018
    --- - |2+ The aim of this study was to systematically review the literature pertaining to family dynamics in the adult self‐harming population. PsycINFO, Medline, Cumulative Index to Nursing and Allied Health Literature (CINAHL) and Applied Social Sciences Index and Abstracts (ASSIA) were searched for studies containing two keywords, one relating to self‐harm and the second relating to a family relationship. The final search was run on 4 August 2017. The electronic search yielded a total of 2,623 studies; 119 texts were selected for full review and twenty‐seven articles were included in the analysis. Thematic analysis was used to synthesize the results. Results indicated that insecure parental attachments, neglectful, overprotective, disempowering and abusive parenting were associated with self‐harm. Similarly, insecure attachments and abusive relationships with romantic partners were linked to self‐harm. Finally, self‐harm was found to be related to poor family functioning. Practitioner points Although this is an under-researched area, emerging evidence suggests that family dysfunction is associated with self-harming behaviours in adults A comprehensive family functioning assessment may help guide family interventions for adults who self-harm Interventions which focus on attachment to both caregivers and romantic partners, parenting styles experienced and abuse history may be useful for adults who self-harm 成年自残行为相关家庭因素:系统性综述 本研究旨在系统梳理成年自残人群的家庭动力的相关文献。所用文献数据库包括PsycINFO,Medline,Cumulative Index to Nursing and Allied Health Literature (CINAHL)以及Applied Social Sciences Index and Abstracts (ASSIA),两个搜索关键词分别与自残和家庭关系相关。最终检索时间为2017年8月4日。从电子数据库中共检索出2623个相关研究,其中119篇被用作全面综述的基础,27篇进入最后的数据分析。结果用主题分析法进行了综合。结果显示,不安全的亲子依恋模式以及忽视型、过度保护型、打击型和虐待型父母与自残行为有相关性。同样,与恋人的不安全的依恋模式和虐待型关系也与自残行为相关。最后,研究还发现,自残行为与较差的家庭功能有关。 对实务工作者的启示 虽然该领域研究不多,但现有证据表明家庭功能失调与成年自残行为有关 一个全面的家庭功能评估工具也许可以为自残成年人的家庭干预起到指导作用 针对与照料人和恋人的依恋关系、所体验到的教养方式和虐待史的干预手段或对自残成年人有所帮助 Factores familiares asociados con autolesiones en adultos: una revisión sistemática El objetivo de este estudio fue revisar sistemáticamente la literatura relativa a las dinámicas familiares en adultos que se autolesionan. Usando PsycINFO, Medline, Cumulative Index to Nursing and Allied Health Literature (CINAHL) y Applied Social Sciences Index and Abstracts (ASSIA) se realizaron búsquedas de estudios que contenían dos palabras clave, una relacionada con autolesiones y la segunda relacionada con una relación familiar. La búsqueda final se hizoel 4 de agosto de 2017. La búsqueda electrónica arrojó un total de 2.623 estudios; se seleccionaron 119 textos para una revisión completa y se incluyeron veintisiete artículos en el análisis. Se usó análisis temático para sintetizar los resultados. Los resultados indicaron que los apegos parentales inseguros y la crianza negligente, sobreprotectora, desempoderadora y abusiva se asociaron con las autolesiones. Del mismo modo, el apego inseguro y las relaciones abusivas con parejas románticas estaban vinculados a la autolesión. Finalmente, se descubrió que la autolesión estaba también relacionada con un mal funcionamiento familiar. Puntos de implicación práctica Aunque esta es un área poco investigada, la evidencia emergente sugiere que la disfunción familiar está asociada con conductas autolesivas en adultos Una evaluación integral del funcionamiento familiar puede ayudar a guiar las intervenciones familiares para adultos que se autolesionan Las intervenciones que se centran en el apego tanto a los cuidadores como a las parejas románticas, en los estilos de crianza experimentados y el historial de abusos, pueden ser útiles para los adultos que se autolesionan. - Journal of Family Therapy, EarlyView.
    September 19, 2018   doi: 10.1111/1467-6427.12232   open full text
  • A measurement to assess transition, maintenance and satisfaction in the swinging lifestyle.
    Claire Kimberly.
    Journal of Family Therapy. September 09, 2018
    --- - |2+ Researchers studying consensual non‐monogamous relationships have traditionally used theoretical lenses that were based on heteronormative, monogamous couples’ experiences. An exception to these theoretical models was a grounded theory formed by Kimberly and Hans (2017) that explored how swinging relationships were initiated and maintained. This study further tests this theory by having 273 self‐identified swingers complete a quantitative, online measurement based on the model’s concepts and themes. Results further supported that theoretical model with two notable exceptions: participants disagreed with having high self‐esteem prior to entering the swinging lifestyle and that men (rather than women) screened potential partners. Nevertheless, therapists can use the measurement as a tool to guide dialogue with couples that are interested in or are currently participating in a non‐monogamous relationship. Practitioner points Interest in consensual non‐monogamous relationships is continuing to grow and resources on how to work with these types of relationships are limited This study produces the first known therapeutic tool that is based on information gathered from individuals currently in non‐monogamous relationships The resulting measurement can be used as a tool to guide dialogue on why clients desire an open relationship and the resources needed to maintain their primary relationship 抽象 一套评估换偶生活方式的过渡、维系和满意度的量表 研究两厢情愿的非单偶制关系的研究者传统上是使用基于异性恋中心的、一夫一妻制夫妻经历的理论视角。与这些理论模型不同的是由Kimberly和Hans(2017)建立的扎根理论,该理论探讨了如何开始和维系换偶关系。本研究进一步测试了这一理论,让273个自认的换偶者在线完成了基于该理论概念和主题的定量测量。结果进一步支持了Kimberly和Hans(2017)建立的理论模型,但有两个值得注意的例外:参与者不同意自己在进入换偶生活方式之前具有高自尊的说法,而男性(而非女性)则会筛选潜在伴侣。然而,治疗师可以使用这一量表作为工具,来引导与对非单偶制关系感兴趣或正在参与此种关系的夫妇的对话。 对实务工作者的启示 对两厢情愿的非单偶制关系的兴趣不断增长,而关于如何处理这些类型的关系的资源却有限 本研究创立了第一个基于从目前处于非单偶制关系的个人收集的信息的已知治疗工具 所得出的量表可用作工具,以指导关于来访者希望建立开放关系的原因以及维持其首要关系所需资源的对话 Abstracto Una medida para evaluar la transición, el mantenimiento y la satisfacción en el estilo de vida con relaciones no monógamas acordadas. Los investigadores que estudian las relaciones consensuadas no monógamas han utilizado tradicionalmente lentes teóricas basadas ​​en experiencias hetero‐normativas de parejas monógamas. Una excepción a estos modelos teóricos fue una teoría planteada por Kimberly y Hans (2017) que exploraron cómo se iniciaron y mantuvieron este tipo de relaciones. El presente estudio añade confirmación a dicha teoría mediante un cuestionario on‐line a 273 personas auto‐identificadas como seguidoras de una relación abierta. Los resultados respaldaron aún más el modelo teórico plantado por Kimberly y Hans (2017) con dos excepciones notables: los participantes no mostraron tener una alta autoestima antes de ingresar al estilo de vida no‐monógamo y los hombres (en lugar de las mujeres) seleccionaban parejas potenciales. Sin embargo, los terapeutas pueden usar la medida como una herramienta para guiar el diálogo con parejas que están interesadas o que actualmente están participando en una relación no monogámica. Puntos de implicación práctica El interés en las relaciones consensuadas no monógamas continúa creciendo y los recursos sobre cómo trabajar con este tipo de relaciones son limitados Este estudio ofrece la primera herramienta terapéutica conocida que se basa en información recopilada de personas que actualmente están en relaciones no monógamas La medida resultante de este estudio se puede utilizar como una herramienta para guiar el diálogo sobre por qué los clientes desean una relación abierta y los recursos necesarios para mantener su relación primaria. - Journal of Family Therapy, EarlyView.
    September 09, 2018   doi: 10.1111/1467-6427.12239   open full text
  • Multiple family therapy for Chinese families of children with attention deficit hyperactivity disorder (ADHD): treatment efficacy from the children's perspective and their subjective experiences.
    Joyce L. C. Ma, Kelly Y. C. Lai, E. S. F. Wan, Lily L. L. Xia.
    Journal of Family Therapy. September 09, 2018
    --- - "\n\nThis paper reports the results of our study that assessed the treatment efficacy of multiple family therapy (MFT) from the perspective of participating Chinese children with attention deficit hyperactivity disorder (ADHD) and identified their subjective experiences. Forty‐three children with ADHD in the experimental group (EG) completed a forty‐two‐hour MFT, whilst forty‐five children with ADHD in the control group (CG) had attended two writing classes scheduled three months apart that were similar to those of the MFT. Data from the outcome study were gathered using standardized questionnaires and data from the qualitative study were drawn from thirteen children with ADHD who had completed the MFT and attended the focus group interviews (n = 5) or individual interviews (n = 8) conducted in the post‐treatment phase. The results of the Paired sample t‐test and MANOVA indicated no significant changes on the scores for the four measures adopted (perception of competence, hopefulness, parent‐child relationship and perceived social support) in the pre‐ and post‐treatment for the EG and the CG. Five themes emerged from the narratives of children with ADHD, which revealed the children's subjective experiences with the MFT: (a) full of fun; (b) building friendships through common experiences; (c) a happy family time; (d) safe space; and (e) positive parental responses and communications.\n\n\nPractitioner points\n\n\n\nMultiple family therapy (MFT) is acceptable to Chinese children with ADHD\n\nThe therapeutic components of an MFT are fun, developing friendship through common experiences, happy family time, safe space and positive parental responses\n\nMore outdoor activities for children with ADHD should be incorporated in the refined MFT\n\n\n\n\n抽象\n\n本研究从参与的患有多动症的中国儿童的角度评估了多重家庭治疗(MFT)的治疗效果,并认识了他们的主观经验,本文呈现了该研究的结果。实验组中的43名患有ADHD的儿童完成了42小时的MFT,而对照组中的45名患有ADHD的儿童参加了两次间隔三个月的写作课程,这些课程与MFT中的相似。结果研究的数据使用标准化问卷收集,而定性研究的数据来自13名ADHD儿童,他们完成了MFT并在治疗后阶段参加了焦点小组访谈(n = 5)或个人访谈(n = 8)。配对样本t检验和MANOVA的结果表明,实验组和控制组治疗前后的四项指标(感知能力,希望,亲子关系和感知社会支持)的得分没有显着变化。从ADHD儿童的叙述中涌现出五个主题,揭示了儿童对MFT的主观体验:(a)充满乐趣(b)通过共同经验建立友谊(c)幸福的家庭时间(d)安全空间(e)积极的父母反应和沟通。\n\n\n对实务工作者的启示\n\n\n\n中国ADHD儿童可接受多种家庭治疗(MFT)\n\n的治疗部分包括趣味性,通过共同的经历建立友谊,快乐的家庭时间,安全空间和积极的父母反应\n\n在改进版的MFT中应该纳入更多适合患有ADHD的儿童的户外活动\n\n\n\n\nAbstracto\n\nEste artículo informa de los resultados de un estudio que evaluó la eficacia del tratamiento de terapia familiar múltiple (MFT) desde la perspectiva de los niños chinos participantes con trastorno por déficit de atención con hiperactividad (TDAH); el estudio identificó también sus experiencias subjetivas. Cuarenta y tres niños con TDAH en el grupo experimental (GE) completaron una MFT de cuarenta y dos horas, mientras que cuarenta y cinco niños con TDAH en el grupo control (GC) asistieron a dos clases de escritura programadas con tres meses de diferencia que eran similares a las de la MFT. Los datos del estudio de resultado se obtuvieron utilizando cuestionarios estandarizados y los datos del estudio cualitativo se obtuvieron de trece niños con TDAH que completaron la MFT y asistieron a las entrevistas de grupos focales (n = 5) o entrevistas individuales (n = 8) realizadas en el fase posterior al tratamiento. Los resultados de la prueba t de muestras pareadas y MANOVA no indicaron cambios significativos en los puntajes de las cuatro medidas utilizadas (percepción de competencia, esperanza, relación entre padres e hijos y apoyo social percibido) antes y después del tratamiento para el GE y el GC. Cinco temas surgieron de las narrativas de niños con TDAH sobre sus experiencias subjetivas con la MFT: (a) mucha diversión; (b) construyeron amistades a través de experiencias comunes; (c) un tiempo familiar feliz; (d) espacio seguro; y (e) respuestas y comunicaciones positivas de los padres.\n\nPuntos de implicación práctica\n\n\n\nLa terapia familiar múltiple (MFT) es aceptable para niños chinos con TDAH\n\nLos componentes terapéuticos de la MFT son: resulta divertido, se desarrolla la amistad a través de experiencias comunes, es un tiempo familiar feliz, es un espacio seguro y ven respuestas positivas de los padres \n\nSe deben incorporar más actividades al aire libre para niños con TDAH en la MFT revisada\n\n\n\n\n" - Journal of Family Therapy, EarlyView.
    September 09, 2018   doi: 10.1111/1467-6427.12240   open full text
  • A. Vetere & J. Sheehan (Eds.), Supervision of Family Therapy and Systemic Practice. Cham, Switzerland: Springer, 2017, 300pp., ISBN 2520‐1190, £53.99.
    Deirdre Hayes, Sarah Houston, Samantha McGarry.
    Journal of Family Therapy. September 06, 2018
    --- - - Journal of Family Therapy, EarlyView.
    September 06, 2018   doi: 10.1111/1467-6427.12233   open full text
  • Peter Rober, In Therapy Together: Family Therapy as a Dialogue. London: Palgrave, 2017, 227 pp., ISBN: 987-1-137-60764-5, €29.99.
    Yang Yang Teh.
    Journal of Family Therapy. August 24, 2018
    --- - - Journal of Family Therapy, EarlyView.
    August 24, 2018   doi: 10.1111/1467-6427.12234   open full text
  • A methodological approach to couples therapy using a conjoint relational drawing process for the description of and intervention with relational patterns and meaning‐attributions.
    María Elisa Molina, Luis Tapia‐Villanueva, Pablo Fossa, Ximena Pereira, Carolina Aspillaga, Sofía de la Puerta.
    Journal of Family Therapy. August 24, 2018
    --- - "\n\nThe consultants’ observation and understanding of relational patterns in couples therapy is a main therapeutic objective and a resource for change. The Conjoint Relational Drawing Process (CRDP) methodology uses a drawing technique to enable the display and efficient observation of relational patterns. It was designed to address the relational process in couples therapy. Two couples participated in making a conjoint drawing that was video‐recorded and later observed and analysed by the couple and the therapist and the researchers. The relational pattern descriptions and meaning attributions about the video‐recorded drawings were analysed in the therapeutic and research contexts. As a result, new perspectives regarding relational patterns and meaning attributions emerged, revealing modes of interaction that allowed new viewpoints about difficulties and ways forward. This approach for the clinical application of CRDP contributed to the evaluation and intervention in the couples’ therapy, and enabled issues to be defined early in the process.\n\n\nPractitioner points\n\n\n\nCRDP is a non‐verbal technique in couples therapy that enables the emergence of relational patterns\n\nCRDP as a dialogical process is itself a relational experience and facilitates therapeutic interventions\n\nCRDP facilitates couples’ reflexivity about their interactions\n\nCRDP offers a non‐blaming context for discussing anger and pain, circumventing the verbal content of conflicts\n\n\n\n\n抽象\n\n咨询师在夫妻治疗中对关系模式的观察和理解是主要的治疗目标和产生变化的源泉。联合关系绘图法(CRDP)使用绘画技术使关系模式得到呈现和有效观察。它旨在处理夫妻治疗中的关系过程。两对夫妇参与了联合绘图,过程被录像并且之后由这对夫妇以及治疗师和研究人员进行了观察和分析。在治疗和研究两种语境中分析了关于视频记录中的绘图的关系模式描述和意义归因。结果,涌现了关于关系模式和意义归因的新观点,揭示了产生关于目前困难和前进方向的新观点的互动模式。这种CRDP的临床应用方法有助于夫妻治疗中的评估和干预,并使问题能够在早期就得到确定。\n\n对实务工作者的启示\n\n\n\nCRDP是夫妻治疗中的一种非语言技巧,可以促进关系模式的显现\n\n作为对话过程的CRDP本身就是一种关系体验,并促进了治疗干预\n\nCRDP有助于夫妻对其互动的反思\n\nCRDP为讨论愤怒和痛苦提供了无指责的环境,规避了冲突的话语内容\n\n\n\n\n\nAbstracto\n\nLa observación y comprensión, por parte de los terapeutas, de los patrones relacionales en la terapia de pareja es un objetivo terapéutico principal y un recurso para el cambio. La metodología del Proceso de Dibujo Relacional Conjunto (PDRC) usa una técnica de dibujo para permitir la visualización y observación eficiente de patrones relacionales. Dicha técnica fue diseñada para abordar el proceso relacional en la terapia de pareja. Dos parejas participaron en un hacer un dibujo conjuntamente y esta tarea fue grabada en video y posteriormente se observó y analizó por la pareja, el terapeuta y los investigadores. Las descripciones de los patrones relacionales y las atribuciones de significado sobre los dibujos grabados en video se analizaron en los contextos terapéuticos y de investigación. Como resultado surgieron nuevas perspectivas con respecto a los patrones relacionales y las atribuciones de significado, revelando modos de interacción que permitieron nuevos puntos de vista sobre las dificultades y las formas de avanzar. Este enfoque para la aplicación clínica del PDRC contribuyó a la evaluación y la intervención en la terapia de pareja, y permitió definir los problemas al principio del proceso.\n\n\nPuntos de implicación práctica\n\n\n\nPDRC es una técnica no verbal en terapia de pareja que facilita la aparición de patrones relacionales \n\nPDRC como proceso dialógico es en sí mismo una experiencia relacional y facilita intervenciones terapéuticas \n\nPDRC facilita la reflexividad de las parejas sobre sus interacciones \n\nCRDP ofrece un contexto sin culpas para discutir la ira y el dolor, eludiendo el contenido verbal de los conflictos \n\n\n\n" - Journal of Family Therapy, EarlyView.
    August 24, 2018   doi: 10.1111/1467-6427.12241   open full text
  • Issue Information.

    Journal of Family Therapy. July 11, 2018
    --- - - Journal of Family Therapy, Volume 40, Issue 3, August 2018.
    July 11, 2018   doi: 10.1111/1467-6427.12195   open full text
  • How far can our systemic model reach?
    Philip Messent.
    Journal of Family Therapy. July 11, 2018
    --- - - Journal of Family Therapy, Volume 40, Issue 3, Page 299-301, August 2018.
    July 11, 2018   doi: 10.1111/1467-6427.12230   open full text
  • Multiple Family Therapy: forever promising? Commentary on Gelin et al. (2018) and Cook‐Darzens et al. (2018), The evidence base for Multiple Family Therapy in psychiatric and non‐psychiatric conditions: a review (parts 1 and 2).
    Tom Jewell, Gilbert Lemmens.
    Journal of Family Therapy. July 11, 2018
    --- - - Journal of Family Therapy, Volume 40, Issue 3, Page 344-348, August 2018.
    July 11, 2018   doi: 10.1111/1467-6427.12231   open full text
  • Special Issue of the Journal of Family Therapy on Family Therapy and Trauma.

    Journal of Family Therapy. July 11, 2018
    --- - - Journal of Family Therapy, Volume 40, Issue 3, Page 462-462, August 2018.
    July 11, 2018   doi: 10.1111/1467-6427.12229   open full text
  • Couple therapy, family therapy and systemic interventions for adult‐focused problems: the current evidence base.
    Alan Carr.
    Journal of Family Therapy. June 13, 2018
    --- - |2+ 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. - Journal of Family Therapy, EarlyView.
    June 13, 2018   doi: 10.1111/1467-6427.12225   open full text
  • Jim Wilson, Creativity in Times of Constraint: A Practitioner's Companion in Mental Health and Social Care. London: Karnac, 2017, pp. 168, ISBN: 978 1 78220 201 1, £25.99.
    Jo Bownas.
    Journal of Family Therapy. April 27, 2018
    --- - - Journal of Family Therapy, EarlyView.
    April 27, 2018   doi: 10.1111/1467-6427.12228   open full text
  • Family therapy and systemic interventions for child‐focused problems: the current evidence base.
    Alan Carr.
    Journal of Family Therapy. April 27, 2018
    --- - |2- 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. 抽象 针对儿童问题的家庭治疗和系统干预:当前的实证基础 本文对2000年、2009年和2014年发表在JFT上的相似综述进行了更新。本文提供了统合分析、系统文献综述、叙事文献综述和对有常见心理健康问题以及其他障碍的青少年儿童进行系统干预有效性的对照试验的实证数据。在本文中,系统性干预包括家庭治疗和其他家庭为基础的方法,如家长培训或家长实施的行为计划。数据支持单独使用或作为多模式计划一部分的系统性干预措施对于婴儿期睡眠、喂养和依恋问题;儿童虐待和忽视的恢复;行为问题、情绪问题、饮食失调、躯体问题和首发精神病的有效性。 Abstracto Terapia familiar e intervenciones sistémicas para problemas centrados en los niños: revisión actualizada de la evidencia de resultados Esta revisión actualiza artículos similares anteriores publicados en JFT en 2000, 2009 y 2014. Presenta evidencia de meta‐análisis, revisiones sistemáticas de literatura, revisiones de literatura narrativa y ensayos controlados para la efectividad de intervenciones sistémicas para familias de niños y adolescentes con problemas habituales de salud mental y otras dificultades. En este contexto, las intervenciones sistémicas incluyen tanto la terapia familiar como otros enfoques basados ​​en la familia, como la capacitación de los padres o los programas conductuales implementados por los padres. La evidencia apoya la efectividad de las intervenciones sistémicas, ya sea de forma independiente o como parte de programas multimodales para el sueño, la alimentación y los problemas de apego en la infancia; recuperación del abuso y negligencia infantil; problemas de conducta, problemas emocionales, trastornos alimenticios, problemas somáticos y primer episodio de psicosis. - Journal of Family Therapy, EarlyView.
    April 27, 2018   doi: 10.1111/1467-6427.12226   open full text
  • ‘Se llevaron el padre de mis hijos’: Latina mothers coping with the deportation of their partner.
    Jessica Escobar, Mariana Falconier, Bertranna Muruthi.
    Journal of Family Therapy. April 27, 2018
    --- - |2+ In recent years, Latinos in the U.S. have been significantly impacted by increasing deportation rates. This study aimed to explore the experiences of Latina women whose partners were deported and how women managed these events guided by the Double ABCX Model of Family Stress. Qualitative semi‐structured interviews were administered to a community sample of 8 Latina women from the greater D.C. metropolitan area whose partners had been deported between 1 and 10 years ago. All women had at least one child under the age of 18 years living in the home at the time of the deportation. Data were analyzed using Thematic Analysis. Findings suggest that despite facing numerous stressors, women rely on various resources to overcome consequences resulting from their partner’s deportation including religious resources, family and friends, and social service agencies. Implications for clinical practice and recommendations for future research are discussed. Practitioner points Women in the current study took steps to seek formal sources of support despite the fact that many had unauthorized legal status Clinicians or service providers can partner with local churches in the immigrant community to provide support and resources for this population Clinicians can help parents with age appropriate ways of telling children that a family member has been deported 抽象 近年来,美国的拉美裔人受到日益升高的驱逐出境率的严重影响。在家庭压力双重ABCX模型指导下的该研究旨在探讨伴侣被驱逐出境的拉丁裔妇女的经历,以及她们如何应对这些事件。在一个来自大都市区的八位拉丁裔妇女的样本中进行了定性半结构化访谈,这些妇女的伴侣均在一至十年前被驱逐出境。在驱逐出境时,所有妇女都至少有一名18岁以下的儿童在家中居住。对数据进行主题分析的结果显示,尽管面临许多压力因素,但妇女仍依靠各种资源克服伴侣驱逐出境所带来的后果,包括宗教资源、家人和朋友以及社会服务机构。本文讨论了结果的临床意义和对未来研究的建议。 对实务工作者的启示 本研究中的妇女采取措施寻求官方的支持来源,尽管许多人并不具有合法身份 临床医生或服务提供者可以与移民社区的当地教会合作,为这一群体提供支持和资源 临床医生可以帮助父母采用适合孩子年龄段的方式告诉孩子家人被驱逐出境 Abstracto En los últimos años los latinos en los Estados Unidos se han visto significativamente afectados por el aumento de las tasas de deportación. Este estudio tuvo como objetivo explorar las experiencias de mujeres latinas cuyos compañeros fueron deportados y cómo las mujeres manejaban estos eventos guiados por el modelo doble ABCX de estrés familiar. Se administraron entrevistas cualitativas semi‐estructuradas a una muestra comunitaria de ocho mujeres latinas del área metropolitana de D.C., cuyas parejas habían sido deportadas entre uno y diez años atrás. Todas las mujeres tenían al menos un hijo menor de 18 años que vivía en el hogar en el momento de la deportación. Los datos se analizaron mediante análisis temático. Los hallazgos sugieren que a pesar de afrontar numerosos factores de estrés, las mujeres se apoyan en diversos recursos para superar las consecuencias derivadas de la deportación de su pareja, incluidos los recursos religiosos, familiares y amigos, y las agencias de servicios sociales. Se discuten las implicaciones para la práctica clínica y las recomendaciones para futuras investigaciones. Puntos de implicación práctica Las mujeres en el estudio tomaron medidas para buscar fuentes formales de apoyo a pesar del hecho de que muchas tenían un estatus legal no autorizado Los clínicos o proveedores de servicios podrían asociarse con las iglesias locales en la comunidad de inmigrantes para brindar apoyo y recursos a esta población Los clínicos pueden ayudar a los padres, con formas apropiadas para la edad, en la labor de decirle a los niños que un miembro de su familia ha sido deportado - Journal of Family Therapy, EarlyView.
    April 27, 2018   doi: 10.1111/1467-6427.12227   open full text
  • An outcome evaluation of Functional Family Therapy for court‐involved youth.
    Katarzyna Celinska, Hung‐En Sung, Chunrye Kim, Margret Valdimarsdottir.
    Journal of Family Therapy. April 19, 2018
    --- - |2+ This article presents the results of a study on the effectiveness of Functional Family Therapy (FFT), a family intervention designed to prevent delinquency. The sample includes 155 court‐involved youth. This study employs two complementary outcomes: court‐obtained recidivism data and clinical therapeutic data, the Strengths and Needs Assessment (SNA). Adolescents in the treatment and in the comparison groups experienced statistically significant improvements in the majority of the SNA domains. Although youths in the treatment group improved more, the differences between the groups were not statistically significant. Multivariate analysis showed that youths in FFT had significantly lower odds of recidivism as measured by reconvictions for drug offences, property offences and technical violations. The results suggest that FFT was effective in reducing recidivism; however, such reductions cannot be attributed to improvements in the SNA scores. Practitioner points Functional Family Therapy is an intervention that improves the psychosocial functioning of delinquent youths Participating in Functional Family Therapy reduces recidivism as measured by reconvictions for new drug offences, property crimes and technical violations There were differences in FFT effectiveness across different groups. Females were less likely to be reconvicted and Latinos were more likely to be re‐institutionalized 抽象 针对涉法青少年的功能性家庭治疗的成果评估 本文介绍了一项旨在预防青少年犯罪的家庭干预措施——功能家庭治疗(FFT)的有效性研究结果。该样本包括155名涉法的青少年。这项研究采用了两种互补的结果数据:从法庭获得的累犯数据以及优势和需求评估(SNA)所提供的临床治疗数据。治疗中和对照组中的青少年在大多数SNA领域中都经历了统计学显著的改善。尽管治疗组青少年的改善更多,但两组之间的差异无统计学意义。多变量分析显示,根据毒品犯罪、侵犯财产行为和技术违规行为的再犯数据,FFT中的青少年的再犯概率明显较低。结果表明FFT可以有效减少累犯;然而,这种减少不能归功于SNA分数的改善。 对实务工作者的启示 功能性家庭治疗是一种改善犯罪青少年心理社会功能的干预措施 参加功能性家庭治疗可以减少毒品犯罪、侵犯财产行为和技术违规行为有关的重新犯罪 不同群体的FFT效果存在差异。女性重新获罪的可能性更低,而拉美族裔更有可能再次被收监 Abstracto Una evaluación de resultados de la Terapia Familiar Funcional para jóvenes involucrados en medidas judiciales Este artículo presenta los resultados de un estudio sobre la efectividad de la Terapia Familiar Funcional (FFT), una intervención familiar diseñada para prevenir la delincuencia. La muestra incluye 155 jóvenes involucrados en una medida judicial. Este estudio usa dos resultados complementarios: datos de reincidencia obtenidos en la corte y datos clínicos terapéuticos mediante la Evaluación de Fortalezas y Necesidades (SNA). Tanto los adolescentes en tratamiento como en los grupos de comparación experimentaron mejoras estadísticamente significativas en la mayoría de las dimensiones de la SNA. Aunque los jóvenes en el grupo de tratamiento mejoraron más, las diferencias entre los grupos no fueron estadísticamente significativas. El análisis multivariado mostró que los jóvenes en FFT tenían probabilidades de reincidencia significativamente menores, según lo medido por las reincidencias por delitos relacionados con drogas, delitos contra la propiedad y violaciones de las medidas judiciales. Los resultados sugieren que la FFT fue efectiva para reducir la reincidencia; sin embargo, tales reducciones no pueden atribuirse a mejoras en los puntajes de SNA. Puntos de implicación práctica Functional Family Therapy es una intervención que mejora el funcionamiento psicosocial de los jóvenes delincuentes La participación en Terapia Familiar Funcional reduce la reincidencia según lo medido por las reincidencias de nuevos delitos relacionados con drogas, delitos contra la propiedad y violaciones de las medidas judiciales Hubo diferencias en la efectividad de FFT en diferentes grupos. Las mujeres tenían menos probabilidades de ser recondenadas y los latinos tenían más probabilidades de ser re‐institucionalizados - Journal of Family Therapy, EarlyView.
    April 19, 2018   doi: 10.1111/1467-6427.12224   open full text
  • J. M. Gottman and J. S. Gottman, The science of couples and family therapy. Behind the scenes at the love lab. New York: Norton, 2018, pp. 340, ISBN‐10: 0393712745. ISBN‐13: 978‐0393712742. Hard cover £26. Kindle £24.11.
    Alan Carr.
    Journal of Family Therapy. March 24, 2018
    --- - - Journal of Family Therapy, EarlyView.
    March 24, 2018   doi: 10.1111/1467-6427.12223   open full text
  • A pilot study evaluation of Marte Meo for divorced fathers.
    David S. DeGarmo, Jeremy Jones, Laura A. Rains.
    Journal of Family Therapy. March 24, 2018
    --- - |2+ Abstract A Marte Meo strengths‐based video feedback programme for improving divorced fathers' self‐conceptions and parenting was tested. By identifying and reinforcing fathers' skills in child communication, we hypothesized that fathers would exhibit pre‐post improvements in fathering self‐evaluations and behaviours. Therapists treated eleven divorced fathers with three to five home‐visit, video feedback sessions over twelve months. Data showed reductions in harsh discipline and inept parenting, and some evidence of improvements in efficacy and father involvement. Changes in fathering identity were significantly associated with changes in parental efficacy (r = .47), harsh parenting (r = −.64), and inept parenting (r = −.42). Programme acceptability was rated high on positive experiences and low on negative experiences. The data suggest promise for promoting fathers' effective parenting, quality involvement and self‐conceptions through video feedback. Practitioner points Single fathers are relatively under‐represented in clinical treatment and evidence‐based science relative to practice with mothers and couples This article shows evidence of promise for Marte Meo, a strengths‐based video feedback treatment, to improve parenting skills of at‐risk fathers Reinforcing and building upon existing skills can be a complementary treatment component and/or an alternative to deficit‐based practice 抽象 Marte Meo应用于离异父亲的先导性研究评估 本研究测试了用于改善离异父亲的自我概念和子女教养的Marte Meo, 一个优势导向的视频反馈项目。通过识别和加强父亲在儿童沟通方面的技能, 我们假设父亲会在子女教养的自我评估和行为方面展现出事前的进步。治疗师在十二个月内为十一位离异的父亲提供治疗, 包括三至五次家庭访问和视频反馈会议。数据显示, 严苛管教和不适当的育儿方式有所减少, 一些证据还显示效能和参与度有所改善。父亲身份的变化与教养效能(r = 0.47), 严苛管教(r = −.64)和不当教养(r = −.42)的变化显著相关。该项目的可接受性在积极经历方面被评为高, 在负面经历方面被评为低。这些数据表明, 有望通过视频反馈促进父亲的有效教养、高质量参与和自我概念 对实务工作者的启示 在临床治疗和实证科学方面, 单亲父亲相较于母亲和夫妻没有得到足够的关注 本文展示了Marte Meo, 一个优势导向的视频反馈治疗项目, 有望改善高风险父亲的育儿技能 加强和发展现有技能可以成为一个辅助治疗单元和/或劣势导向方法的替代方案 Abstracto Una evaluación de estudio piloto de Marte Meo para padres divorciados Se probó un programa de retroalimentación de video basado en las fortalezas de Marte Meo para mejorar la autoconceptualización y la crianza de los padres divorciados. Al identificar y reforzar las habilidades de los padres en la comunicación infantil, planteamos la hipótesis de que los padres exhibirían mejoras pre‐post en su auto‐evaluación la paternidad y en sus comportamientos. Los terapeutas trataron a once padres divorciados con tres a cinco visitas domiciliarias, con sesiones de video feed‐back durante doce meses. Los datos mostraron reducciones claras en la disciplina severa y la crianza de los hijos inepta, y también algunas pruebas de mejoras en la eficacia y la implicación de los padres. Los cambios en la identidad patrnal se asociaron significativamente con los cambios en la eficacia parental (r = .47), el estilo de crianza severa (r = −.64) y la crianza inepta (r = −.42). La aceptabilidad del programa recibió una calificación alta en experiencias positivas y baja en experiencias negativas. Los datos sugieren que el video‐feedback es una técnica prometedora para promover la crianza efectiva de los padres, la participación de calidad y la auto‐conceptualización. Puntos de implicación práctica Los padres solteros están relativamente poco representados en el tratamiento clínico y en la investigación en comparación con la práctica con madres y parejas Este artículo muestra evidencia prometedora para Marte Meo, un tratamiento de retroalimentación de video basado en fortalezas, para mejorar las habilidades parentales de los padres en riesgo Reforzar y desarrollar las habilidades existentes puede ser un componente de tratamiento complementario y/o una alternativa a la práctica basada en el déficit - Journal of Family Therapy, EarlyView.
    March 24, 2018   doi: 10.1111/1467-6427.12221   open full text
  • Introducing client feedback into marriage and family therapy supervision: a qualitative study examining the transition to empirically informed supervision.
    Jennifer L. McComb, Rachel M. Diamond, Douglas C. Breunlin, Anthony L. Chambers, Kimberly S. F. Murray.
    Journal of Family Therapy. March 15, 2018
    --- - |2+ Abstract The use of client feedback in clinical supervision provides a way for supervisors to access clients' experiences of the treatment process and monitor clinical progress of their trainees' cases. The present qualitative study investigated a marriage and family therapy training programme's early experience of introducing the Systemic Therapy Inventory of Change (STIC®; Pinsof et al., ) into clinical supervision. Supervisors (N = 8) and trainees (N = 14) were interviewed to elicit their experience using the STIC in supervision with a focus on understanding the frequency of use as well as the facilitators and constraints to implementation. The analysis of the narratives resulted in the development of five themes (time, supervisors' expectations, broader training system influences, client feedback training, and perceived helpfulness) that contributed to decreased usage over time. Recommendations to the field for integrating client feedback into empirically informed training and supervision are provided. Practitioner points Training programmes should consider the potential benefits of utilizing client feedback measures for outcome‐based training and supervision Training programmes adopting a client feedback measure need to be aware of the potential challenges of implementation The additional time needed to use a client feedback measure in the clinical supervision process must be considered as it is the most notable constraint to implementation 抽象 将来访者反馈引入婚姻家庭治疗督导:考察向实证引导的督导过渡的定性研究 在临床督导中使用来访者反馈为督导提供了了解来访者治疗过程体验的方法, 并掌握学员案例的临床进展。该定性研究调查了一项婚姻家庭治疗培训计划在早期将系统治疗变化量表(STIC)引入临床督导的经历。对督导(N = 8)和学员(N = 14)进行了访谈, 以引出他们在督导中使用STIC的经验, 重点在于了解使用频率以及促进和阻碍实施的因素。分析产生五个主题(时间、督导期望、大培训系统影响、来访者反馈培训和感知帮助), 而它们导致了使用频率随着时间的推移减少。文末建议这一领域将来访者反馈纳入实证引导的培训和督导 对实务工作者的启示 培训计划应考虑利用来访者反馈措施进行结果导向的培训和督导的潜在优势 采用来访者反馈措施的培训计划需要意识到实施中存在的潜在挑战 必须考虑到在临床督导过程中使用来访者反馈措施所需的额外时间, 因为这是实施过程中最显著的制约因素 Abstracto Introducción de retroalimentación de los clientes en la supervisión de la terapia familiar y de pareja: un estudio cualitativo que examina la transición a una supervisión empíricamente informada. El uso de retroalimentación de comentarios de los clientes en la supervisión clínica proporciona una forma de que los supervisores accedan a las experiencias de los clientes sobre el proceso de tratamiento y monitoreen así el progreso clínico de los casos de sus supervisados. El presente estudio cualitativo investigó la experiencia inicial de un programa de entrenamiento en terapia de pareja y familia para introducir el Inventario de Cambio de Terapia Sistémica (STIC®; Pinsof et al., 2009) en supervisión clínica. Se entrevistó a supervisores (N = 8) y novatos supervisados (N = 14) para conocer su experiencia con el STIC en supervisión, con un enfoque en la comprensión de la frecuencia de uso, así como de los facilitadores y las dificultades de su aplicación. El análisis de las narrativas extraídas de las entrevistas resultó en el desarrollo de cinco temas (tiempo, expectativas de los supervisores, influencias más amplias del sistema formación, entrenamiento en la retroalimentación de los clientes y percepción de ayuda) que contribuyeron a la disminución del uso del STIC. Se proporcionan recomendaciones para integrar la retroalimentación de comentarios de los clientes en la capacitación y supervisión informadas empíricamente. Puntos de implicación práctica Los programas de capacitación deberían considerar los beneficios potenciales de utilizar medidas de retroalimentación de los clientes para la capacitación y supervisión basadas en los resultados Los programas de capacitación que adoptan una medida de retroalimentación de los clientes deben ser conscientes de los posibles desafíos de su implementación Se debe considerar el tiempo adicional necesario para usar una medida de retroalimentación del cliente en el proceso de supervisión clínica ya que es la restricción más notable para su implementación. - Journal of Family Therapy, EarlyView.
    March 15, 2018   doi: 10.1111/1467-6427.12222   open full text
  • M. Watts and A. Higgins, Narratives of Recovery from Mental Illness: the role of peer support. London: Routledge, Advances in Mental Health Research Series, 2017, pp. 157. ISBN‐13: 978‐1‐138‐84799‐6. £95.00.
    Charlotte Marston.
    Journal of Family Therapy. February 28, 2018
    --- - - Journal of Family Therapy, EarlyView.
    February 28, 2018   doi: 10.1111/1467-6427.12218   open full text
  • M. Rivett and J. Buchmüller with K. Oliver, Family Therapy Skills and Techniques in Action. Oxford: Routledge, 2018, 217pp., 978‐1‐138‐83143‐8.
    Kiran Flynn.
    Journal of Family Therapy. February 26, 2018
    --- - - Journal of Family Therapy, EarlyView.
    February 26, 2018   doi: 10.1111/1467-6427.12219   open full text
  • Family of origin experiences on relationship satisfaction: a mediation model.
    Ruoxi Chen, Dean M. Busby.
    Journal of Family Therapy. February 20, 2018
    --- - |2+ Abstract This study tested a mediation model of the intergenerational transmission process of the relationship satisfaction of four ethnic groups in the US: Whites, Blacks, Latinos, and Asians. The influence of past relationships is a positive mediator of the effect of family of origin on relationship satisfaction for all four groups, and low neuroticism is a positive mediator of this effect for Whites, Blacks, and Latinos, but not Asians. The effect of family of origin experiences on relationship satisfaction and the effects of the two mediators vary in ways that could be attributed to cultural differences between the four groups. This mediation model offers plausible explanations of the mechanisms governing the intergenerational transmission of relationship satisfaction and, in particular, elevates the significance of past relationships' influence in this process. The findings are discussed with a focus on cultural differences and implications for relationship education and clinical practice. Practitioner points FoO experiences affect one's current relationship satisfaction through past relationships' influence and neuroticism Resolving past relationship issues may reduce the negative effect of FoO experiences Helping individuals reduce their neuroticism may enhance therapeutic approaches applying an FoO lens to current relationships Therapy should pay attention to differences in the intergenerational transmission process of relationship experiences according to ethnic group 抽象 原生家庭经历对关系满意度的影响:中介模型 本研究使用美国四个族裔(白人、黑人、拉丁裔和亚洲人)作为样本测试了关系满意度代际传递过程的中介模式。过往关系的影响是所有四个群体的原生家庭对关系满意度的正中介变量, 而低神经质在白人、黑人和拉丁裔人中是这种影响的正中介变量。原生家庭经历对关系满意度的影响以及两个中介变量的影响因四个群体之间的文化差异而有所不同。这一中介模型对关系满意度的代际传递机制提供了合理的解释, 特别是提升了过往关系在这一过程中的重要性。对于研究结果的讨论聚焦于文化差异以及关系教育和临床实践方面的意义。 对实务工作者的启示 通过过往关系的影响和神经质的中介, 原生家庭经历会影响当前的关系满意度 解决过往关系的问题可能会减少原生家庭经历的负面影响 帮助个人减少他们的神经质水平可能会有利于运用原生家庭角度治疗当前关系的治疗方法 在治疗中, 应该注意不同族群之间关系经验的代际传递过程中的差异 Abstracto Experiencias de la familia de origen sobre la satisfacción de las relaciones: un modelo de mediación Este estudio probó un modelo de mediación del proceso de transmisión intergeneracional de la satisfacción relacional de cuatro grupos étnicos en los Estados Unidos: blancos, negros, latinos y asiáticos. La influencia de las relaciones pasadas es un mediador positivo del efecto de la familia de origen en la satisfacción con las relaciones para los cuatro grupos, y el bajo neuroticismo es un mediador positivo de este efecto para blancos, negros y latinos, pero no asiáticos. El efecto de las experiencias de la familia de origen en la satisfacción con las relaciones y los efectos de los dos mediadores varía en formas que podrían atribuirse a las diferencias culturales entre los cuatro grupos. Este modelo de mediación ofrece explicaciones plausibles de los mecanismos que rigen la transmisión intergeneracional de la satisfacción de las relaciones y, en particular, eleva la importancia de la influencia de las relaciones pasadas en este proceso. Los hallazgos se discuten poniendo el foco en las diferencias culturales y las implicaciones para la educación relacional y la práctica clínica. Puntos de implicación práctica: Las experiencias de Familia de Origen (FdO) afectan a la satisfacción de la relación actual de uno a través de la influencia de las relaciones pasadas y el neuroticismo La resolución de problemas de relaciones pasadas puede reducir el efecto negativo de las experiencias de FdO Ayudar a las personas a reducir su neuroticismo puede mejorar los enfoques terapéuticos aplicando una lente de FdO a las relaciones actuales La terapia debe prestar atención a las diferencias en el proceso de transmisión intergeneracional de las experiencias de relación según el grupo étnico - Journal of Family Therapy, EarlyView.
    February 20, 2018   doi: 10.1111/1467-6427.12217   open full text
  • Determining the primary caregiver for disabled older adults in Mainland China: spouse priority and living arrangements.
    Mengting Li, Haijing Dai.
    Journal of Family Therapy. February 20, 2018
    --- - |2+ Abstract Researchers have widely discussed the key role of having a spouse and proximity of family in the provision of elder care, but the relationship between kinship and living arrangements in primary caregiver selection has not been fully examined. Based on the 2011–2012 Chinese Longitudinal Healthy Longevity Survey, multinomial logistic regression models were built to test the effects of kinship and living arrangements on primary caregiver selection. This study found that spouses were most likely to assume the primary caregiver role, even when the elderly couple lived with their adult children. This study suggests that more social services should be provided to support spousal caregivers, and that the different needs of spouse and adult child caregivers should be considered in interventions. Practitioner points Be mindful that the prevalence of non co‐residence between aging parents and adult children affects the provision of elder care Support programmes should be developed for spousal caregivers Be aware of the different needs of spouse and adult child caregivers when designing family interventions for them 抽象 中国内地残疾老年人主要照顾者的选择决策:配偶优先和居住安排 研究者已经普遍讨论过配偶和近距离的家人在照顾老年人方面的关键作用, 但亲属关系和居住安排在选择主要照料人员过程中的关系尚未得到充分研究。基于2011‐2012年中国老年人健康长寿影响因素调查, 建立了多项逻辑回归模型来检验亲属关系和居住安排对主要照料者选择的影响。 这项研究发现, 配偶最有可能担任主要照料者的角色, 即使这对老年夫妇与他们的成年子女住在一起。这项研究表明, 应该提供更多的社会服务来支持配偶照料者, 并且应该在干预措施中考虑配偶和成年子女照料者的不同需求。 对实务工作者的启示 请注意老年父母和成年子女之间分开居住的盛行影响了照料提供的情况 应为配偶照料人设计支持项目 在为他们设计家庭干预措施时, 注意配偶和成人子女照料者的不同需求 Abstracto Determinar el cuidador principal para adultos mayores con discapacidad en China continental: la prioridad del cónyuge y los acuerdos de convivencia Los investigadores han discutido ampliamente la función clave de tener un cónyuge y la proximidad de la familia en la provisión de la atención a personas mayores, pero la relación entre el parentesco y los acuerdos de vivienda en la selección del cuidador primario no se ha examinado por completo. Con base en la Encuesta de Longevidad Saludable Longitudinal China 2011‐2012, se construyeron modelos de regresión logística multinomial para probar los efectos del parentesco y los arreglos de vida en la selección de cuidadores primarios. Este estudio encontró que los cónyuges eran más propensos a asumir el papel de cuidador principal, incluso cuando la pareja de ancianos vivía con sus hijos adultos. Este estudio sugiere que se deben proporcionar más servicios sociales para apoyar a los cuidadores conyugales, y que las diferentes necesidades del cónyuge y de los cuidadores adultos deben considerarse en las intervenciones. Puntos de implicación práctica Tenga en cuenta que la prevalencia de no co‐residencia entre padres ancianos e hijos adultos afecta la provisión de atención a personas mayores Se deben desarrollar programas de apoyo para cuidadores conyugales Tenga en cuenta las diferentes necesidades que tienen los cuidadores cónyuges y los cuidadores hijos adultos cuando diseñen intervenciones familiares para ellos - Journal of Family Therapy, EarlyView.
    February 20, 2018   doi: 10.1111/1467-6427.12213   open full text
  • Jo Bownas and Glenda Fredman (eds.), Working with embodiment in supervision: a systemic approach. London: Routledge, 2017, 165pp. £24.99. Arlene Vetere and Peter Stratton (eds.), Interacting selves: systemic solutions for personal and professional development in counselling and psychotherapy. London‐New York: Routledge, 2016, 142pp. £24.99. Two books and a mind map: interacting selves and embodiment, systemic approaches to supervision, personal and professional development.
    Yang Yang Teh.
    Journal of Family Therapy. January 18, 2018
    --- - - Journal of Family Therapy, EarlyView.
    January 18, 2018   doi: 10.1111/1467-6427.12206   open full text
  • The experiences of non‐Muslim, Caucasian licensed marriage and family therapists working with South Asian and Middle Eastern Muslim clients.
    Zara Arshad, Mariana K. Falconier.
    Journal of Family Therapy. January 15, 2018
    --- - |2+ Abstract This qualitative study investigated the experiences of eight non‐Muslim, Caucasian licensed marriage and family therapists working with South Asian and Middle Eastern Muslim clients. Semi‐structured interviews were used to examine the challenges and benefits that resulted from ethnic/racial and religious differences in therapy with clients of this population, and the strategies used or suggested by therapists in managing these differences. The data were analysed using thematic analysis and the themes that emerged were organized based on the areas of inquiry. Participants reported several challenges, including managing clients’ therapy expectations, engaging clients in therapy, understanding and accepting differences, and staying neutral. Participants described strategies they used and made recommendations on how to manage these challenges, including being aware of and acknowledging these differences and clarifying roles in therapy. Participants also identified benefits that derived from ethnic/racial and religious differences, such as finding it easier to make clients the experts and being able to provide an outsider perspective to clients. Practitioner points Non‐Muslim, Caucasian MFTs should be prepared to experience some challenges, but also some benefits, when working with South Asian and Middle Eastern Muslim clients When working with this population, managing bias might be hard for therapists, and may require ongoing attention and work Recommendations provided by therapists in this study might be useful in managing the challenges that might arise from ethnic/racial and religious differences when working with the South Asian and Middle Eastern Muslim population 抽象 非穆斯林白人执业婚姻家庭治疗师与南亚、中东穆斯林来访者的治疗经历 这项定性研究调查了八名非穆斯林白人执业婚姻家庭治疗师与南亚、中东穆斯林来访者开展治疗的经历。该研究使用半结构式访谈以检视民族/种族和宗教差异对该群体来访者的治疗带来的挑战和益处, 以及治疗师在处理这些差异时使用或建议的策略。数据采用主题分析方法进行分析, 并根据调查领域将所涌现的主题归类。参与者反映了若干挑战, 包括管理来访者的治疗期望, 吸引来访者参与治疗, 理解和接受差异, 并保持中立。参与者描述了他们所使用的策略, 并就如何应对这些挑战提出了建议, 包括意识到并承认差异以及澄清治疗中的角色。参与者还列出了民族/种族和宗教差异所带来的好处, 例如更容易使来访者成为专家, 并能够向来访者提供外部视角。 对实务工作者的启示 当与南亚、中东的穆斯林来访者开展治疗时, 非穆斯林的白人婚姻家庭治疗师应做好遇到挑战的心理准备, 但也会收获一些好处 在与这个人群开展治疗时, 管理偏见可能对治疗师来说很难, 可能需要持续的注意力和努力 治疗师在本研究中提供的建议可能有助于处理与南亚和中东穆斯林人群开展治疗时可能因民族/种族和宗教差异而出现的挑战 Abstracto Las experiencias de terapeutas matrimoniales y familiares no musulmanes y caucásicos que trabajan con clientes de países del sur de Asia y del Medio Oriente Este estudio cualitativo investigó las experiencias de ocho terapeutas de pareja y familia acreditados, no musulmanes y caucásicos que trabajan con clientes musulmanes de países del sur de Asia y del Medio Oriente. Se utilizaron entrevistas semi‐estructuradas para examinar los desafíos y beneficios que resultaron de las diferencias étnicas/raciales y religiosas en la terapia con clientes de esta población, y las estrategias utilizadas o sugeridas por los terapeutas para manejar estas diferencias. Los datos se analizaron mediante análisis temáticos y los temas que surgieron se organizaron en función de las áreas investigadas. Los participantes informaron varios desafíos, incluida la gestión de las expectativas de la terapia de los clientes, la participación de los clientes en la terapia, la comprensión y la aceptación de las diferencias, y mantenerse neutral. Los participantes describieron las estrategias que utilizaron e hicieron recomendaciones sobre cómo manejar estos desafíos, lo que incluye conocer y reconocer estas diferencias y aclarar los roles en la terapia. Los participantes también identificaron los beneficios que se derivan de las diferencias étnicas/raciales y religiosas, como resultar más fácil hacer que los clientes se sientan los expertos y poder proporcionarles una perspectiva externa. Puntos de implicación práctica Las terapeutas no musulmanas y caucásicas deberían estar preparadas para experimentar algunos desafíos, pero también algunos beneficios, cuando trabajen con clientes del sur de Asia y del Medio Oriente. Cuando se trabaja con esta población, la gestión de sesgos puede ser difícil para los terapeutas y puede requerir atención y trabajo constantes. Las recomendaciones proporcionadas por los terapeutas en este estudio podrían ser útiles para manejar los desafíos que podrían surgir de las diferencias étnicas/raciales y religiosas al trabajar con la población musulmana de Asia del Sur y del Medio Oriente. - Journal of Family Therapy, EarlyView.
    January 15, 2018   doi: 10.1111/1467-6427.12203   open full text
  • Culture and reflexivity: systemic journeys with a British Chinese family.
    Yang Yang Teh, Evonne Lek.
    Journal of Family Therapy. January 15, 2018
    --- - |2+ Abstract This paper describes a reflective space created between two Singaporean Chinese systemic psychotherapists and a British Chinese family – the Chans. The family attended the Marlborough Cultural Therapy Centre (MCTC) in London and was given two separate culture‐specific systemic treatments by different therapists, which were reflected upon collaboratively with the Chans. A brief literature review of British Chinese and mental health, culture and reflexivity is described. The authors discuss clinical implications including the impact of British Chinese cultures and the effect of mental health issues on the family. The process and outcomes of the treatment are explained using the frame of reflexivity. Clinical implications discussed include the impact of British Chinese cultures and the effects of schizophrenia and anxiety on the family. Practitioner points Reflexivity is an interactional process creating change through repeated awareness, reflection and action related to our similarities and differences This process may helpfully guide practitioners through therapeutic journeys Reflexivity is especially important when considering both similarities and differences – even when the therapist is working with clients from a similar (ethnic) culture Involving clients in the writing process enhances reflexivity for both therapists and clients and in itself can be thought of as a further intervention 抽象 文化与反思:与一个英国华人家庭的系统性旅程 这篇论文描述了两个新加坡华人系统心理治疗师与一个英国华人家庭——Chans之间的反思空间。 这个家庭参与了伦敦的马尔堡文化治疗中心(MCTC), 并且由两位不同的治疗师给予了不同的文化特定系统治疗。随后治疗师与Chans共同对治疗方法进行了反思。本文简要回顾了英国华人和心理健康、文化和反思的文献。作者讨论了临床意义, 包括英国华人文化的影响以及心理健康问题对家庭的影响。治疗的过程和结果在反思框架下进行了解释。所讨论的临床意义包括英国华人文化的影响以及精神分裂症和焦虑对家庭的影响。 对实务工作者的启示 反思是一个相互作用的过程, 通过有关相似和差异的反复意识、思考和行动来产生改变 这个过程可能有助于指导实践者完成治疗旅程 反思在考虑相似性和差异性时尤其重要——即使是当治疗师在与来自相似(民族)文化的来访者开展治疗时 让来访者参与写作过程可以增强治疗师和来访者双方的反思, 并且其本身可以被看作进一步干预 Abstracto Cultura y reflexividad: viajes sistémicos con una familia británica china Este artículo describe un espacio reflexivo creado entre dos psicoterapeutas sistémicos chinos de Singapur y una familia británica china: los Chan. La familia asistió al Centro de Terapia Cultural Marlborough (MCTC) en Londres y realizaron dos tratamientos sistémicos específicos de cada cultura con dos terapeutas diferentes, tratamientos que se reflejaron en colaboración con los Chan. Se describe una breve revisión de la literatura sobre Chino‐Británico y la salud mental, la cultura y la reflexividad. Los autores discuten las implicaciones clínicas, incluido el impacto de las culturas británicas chinas y el efecto de los problemas de salud mental en la familia. El proceso y los resultados del tratamiento se explican utilizando el marco de la reflexividad. Las implicaciones clínicas discutidas incluyen el impacto de las culturas británico‐chinas y los efectos de la esquizofrenia y la ansiedad en la familia. Puntos de implicación práctica La reflexividad es un proceso de interacción que crea cambios a través de la conciencia, la reflexión y la acción relacionadas con nuestras similitudes y diferencias. Este proceso puede ayudar a los practicantes a través de viajes terapéuticos La reflexividad es especialmente importante cuando se consideran las similitudes y las diferencias, incluso cuando el terapeuta trabaja con clientes de una cultura (étnica) similar. Involucrar a los clientes en el proceso de escritura mejora la reflexividad tanto para los terapeutas como para los clientes, y en sí misma puede considerarse como una intervención adicional. - Journal of Family Therapy, Volume 40, Issue 4, Page 520-536, November 2018.
    January 15, 2018   doi: 10.1111/1467-6427.12205   open full text
  • Ideas of the change process: family and therapist perspectives on systemic psychotherapy for children with conduct disorder.
    Yuriko Morino.
    Journal of Family Therapy. January 09, 2018
    --- - "\nAbstract\n\nThis report is based on a small‐scale qualitative study exploring therapist and client perspectives on the therapeutic change process in home‐based family therapy for children with conduct disorder. The study consisted of focus group discussions with therapists, interviews with client families and audiotaped therapy sessions. The findings suggested that home‐based therapy (home visits) was effective in improving hard‐to‐reach clients’ access to help, resources, and opportunities, as well as the therapists’ access to invaluable information about their clients. Home‐based therapy also helped the therapists to develop professionally, making it possible for them and their clients to engage in different power relationships, which were seen by both parties as one of the principal motivating forces and important aspects of the change process. In addition, exploring clients’ perspectives appeared to be useful.\n\n\nPractitioner points\n\n\nThe process of engaging with hard‐to‐reach families starts in the context of specific therapist‐client power relationships with the therapist encouraging the family to take charge\nHome‐based therapy is useful for children with conduct disorder\nHome‐based therapy provides children, family and therapists with information, resources, opportunities and good access, which are not always available in customary clinical settings \n\n\n\n抽象\n\n关于改变过程的想法:家庭和治疗师对于行为障碍儿童的系统心理治疗的看法\n本报告基于一项小规模定性研究, 探讨治疗师和来访者对儿童行为障碍的驻家家庭治疗的改变过程的看法。研究数据来自与治疗师进行焦点小组讨论, 与来访者家庭进行访谈, 和治疗过程中的录音。研究结果表明, 驻家治疗(家访)有效地改善了平时很难接触到的来访者获得帮助、资源和机会的条件, 也有利于治疗师获得有关其客户的宝贵信息。以家庭为基础的治疗也帮助治疗师在专业上有所发展, 使他们和来访者能够体验不同的权力关系, 而这是双方所认为的变化过程中的主要激励力量和重要方面之一。此外, 探索来访者的看法看来也是有用的。\n\n\n对实务工作者的启示\n\n\n与难以接触的家庭进行接触的过程始于治疗师与来访者在具体情境下的权力关系, 即治疗师鼓励家庭主动担起责任。\n家庭为基础的治疗对于有品行障碍的儿童是有用的。\n以家庭为基础的治疗为儿童、家庭和治疗师提供信息、资源、机会和良好条件, 而这些在传统的临床环境中并不总是具备的。\n\n\n\nAbstracto\n\nIdeas del proceso de cambio: perspectivas de la familia y el terapeuta sobre la psicoterapia sistémica para niños con trastorno de la conducta Yuriko Morino\nEste artículo presenta un estudio cualitativo a pequeña escala que explora las perspectivas del terapeuta y del cliente sobre el proceso de cambio terapéutico en la terapia familiar domiciliaria para niños con trastorno de la conducta. El estudio consistió en discusiones grupales con terapeutas, entrevistas con familias de clientes y sesiones de terapia grabadas. Los hallazgos sugieren que la terapia domiciliaria (visitas domiciliarias) fue efectiva para mejorar el acceso de los clientes con dificultades para acceder a la ayuda, a los recursos y a las oportunidades, así como el acceso de los terapeutas a información muy valiosa sobre sus clientes. La terapia domiciliaria también ayudó a los terapeutas a desarrollarse profesionalmente, posibilitando que ellos y sus clientes participaran en diferentes relaciones de poder, que ambas partes consideraron como una de las principales fuerzas motivadoras y aspectos importantes del proceso de cambio. Además, explorar las perspectivas de los clientes parece ser útil.\n\n\nPuntos de implicación práctica:\n\n\nEl proceso de involucrar a las familias de difícil acceso comienza en el contexto de las relaciones de poder entre el terapeuta y el cliente, cuando el terapeuta anima a la familia a responsabilizarse\nLa terapia domiciliaria es útil para niños con trastorno de conducta\nLa terapia basada en el hogar brinda a niños, familiares y terapeutas información, recursos, oportunidades y buen acceso, que no siempre están disponibles en los entornos clínicos habituales.\n\n\n" - Journal of Family Therapy, EarlyView.
    January 09, 2018   doi: 10.1111/1467-6427.12202   open full text
  • In sickness and in health: the longitudinal associations between marital dissatisfaction, depression and spousal health.
    Sarah B. Woods, Jacob B. Priest, Tara L. Signs, Candice A. Maier.
    Journal of Family Therapy. January 09, 2018
    --- - |2+ Abstract The present study explored how spouses’ reports of marital dissatisfaction (independent variable) are associated with depression symptoms (mediator) and physical health (dependent variable) over time. Data were from the Marriage Matters Panel Survey (Nock et al., ). We used autoregressive cross‐lagged models to test temporal connections between variables for newlywed husbands, wives and couples (N=707 couples) at Waves 1, 2 and 3, spanning five years. Results indicated physical health is an important predictor, as are wives’ depression symptoms and husbands’ marital dissatisfaction (all three demonstrate partner effects). However, the effects of health are no longer observed at Time 2. For wives there is a reciprocal relationship between marital dissatisfaction and depression symptoms; for husbands, marital dissatisfaction leads to increased depression. This study provides additional support that marital dissatisfaction, depression and physical health are interrelated across time. Practitioner points Assessment and treatment using a biopsychosocial approach is critical to fully understanding connections between marriage, depression and health for couples Repeated assessment of marital dissatisfaction in couple therapy may be necessary, as effects of dissatisfaction are corrosive over time and predict other areas of wellbeing Attending to and exploring gender differences in couples may be helpful, as links between marital dissatisfaction, depression and health vary for men and women 抽象 无论疾病还是健康:婚姻不满, 抑郁和配偶健康之间的纵向联系 本研究探讨配偶的婚姻不满(自变量)报告与抑郁症状(中介变量)和身体健康(因变量)随时间变化的关系。数据来自婚姻问题小组调查(Nock et al., 2012)。我们使用自回归交叉滞后模型, 在五年的时间内分三次测试了新婚丈夫、妻子和夫妻(707对)的变量之间的时间关系。结果显示, 身体健康是一个重要的预测因素, 同样, 妻子的抑郁症状和丈夫的婚姻不满也是(三者都显示出伴侣效应)。然而, 在第二次测量时, 健康的影响不再能观察到。对于妻子来说, 婚姻不满与抑郁症状之间存在相互关系。对于丈夫来说, 婚姻不满导致抑郁症加重。这项研究进一步表明, 随着时间的推移, 婚姻不满、抑郁症和身体健康是相互关联的。 对实务工作者的启示 使用生理心理社会方法进行评估和治疗对于充分理解夫妻的婚姻、抑郁和健康之间的联系至关重要。 可能需要在夫妻治疗中反复评估婚姻不满, 因为不满的影响随着时间的推移会更加具有破坏性, 并能预测其他方面的健康。 关注和探索夫妻之间的性别差异可能会有所帮助, 因为婚姻不满、抑郁和健康之间的联系对于男女来说各不相同。 Abstracto En la enfermedad y en la salud: las asociaciones longitudinales entre la insatisfacción matrimonial, la depresión y la salud conyugal El presente estudio exploró cómo los informes de cónyuges sobre la insatisfacción matrimonial (variable independiente) se asocian con síntomas de depresión (mediador) y salud física (variable dependiente) a lo largo del tiempo. Los datos provienen de la Encuesta de Panel de Asuntos Matrimoniales (Nock et al., 2012). Utilizamos modelos estadísticos de regresión y secuenciales para probar las conexiones temporales entre variables para esposos, esposas de parejas recién casadas ​​(N=707 parejas) en oleadas 1, 2 y 3, abarcando cinco años. Los resultados indican que la salud física es un importante predictor, al igual que los síntomas de depresión de las esposas y la insatisfacción matrimonial de los esposos (los tres demuestran los efectos del compañero). Sin embargo, los efectos de la salud ya no se observan en el segundo punto temporal del diseño (T2). Para las esposas hay una relación recíproca entre la insatisfacción marital y los síntomas de depresión; para los maridos, la insatisfacción matrimonial conduce a una mayor depresión. Este estudio proporciona apoyo adicional a la idea de que la insatisfacción conyugal, la depresión y la salud física están interrelacionadas a lo largo del tiempo. Puntos de implicación práctica: La evaluación y el tratamiento con un enfoque biopsicosocial es fundamental para comprender completamente las conexiones entre el matrimonio, la depresión y la salud de las parejas Puede ser necesaria una evaluación repetida en el tiempo de la insatisfacción conyugal en terapia de pareja, ya que los efectos de la insatisfacción son corrosivos con el tiempo y predicen otras áreas de bienestar. Explorar y considerar las diferencias de género en las parejas puede ser útil, ya que los vínculos entre la insatisfacción conyugal, la depresión y la salud varían para hombres y mujeres - Journal of Family Therapy, EarlyView.
    January 09, 2018   doi: 10.1111/1467-6427.12207   open full text
  • Laura Smith (ed.), Clinical Practice at the Edge of Care: Developments in working with At‐Risk Children and their Families. Palgrave Macmillan, 2016, 255pp., ISBN 978‐3‐319‐43569‐5. £ 42.99.
    Sara Barratt.
    Journal of Family Therapy. November 29, 2017
    --- - - Journal of Family Therapy, EarlyView.
    November 29, 2017   doi: 10.1111/1467-6427.12200   open full text
  • Family‐based interventions for children and adolescents with functional somatic symptoms: a systematic review.
    Ditte Hulgaard, Gitte Dehlholm‐Lambertsen, Charlotte Ulrikka Rask.
    Journal of Family Therapy. November 27, 2017
    --- - |2+ Abstract Functional somatic symptoms (FSS), defined as physical symptoms that cannot be fully explained by organic pathology, are prevalent in youngsters worldwide. When severe, they can pose a major burden on the affected individual as well as on society. FSS seem to aggregate in families, and family variables may play a key role in symptom development and perpetuation. It may, therefore, be important to work with the family when managing FSS. The aim of this systematic review was to explore and describe family‐based interventions used for children and adolescents with FSS, further to evaluate the overall quality of the research in this area. Sixteen studies were included. The psychological orientation for the applied treatment was based on systemic or cognitive behavioural therapy. Treatment focused on family illness beliefs and on a shift away from somatic symptom attribution to alternative explanations that were shaped by the psychological orientation of the applied treatment. Practitioner points Family influences are significant for functional somatic symptoms in youngsters Family intervention may be a relevant treatment approach for youngsters with functional somatic symptoms Family‐based psychotherapy for youngsters with functional somatic symptoms is mainly based on cognitive behavioural therapy or on systemic family therapy Illness beliefs of the child/adolescent as well as illness beliefs of the family as a whole could be important treatment targets in young people with functional somatic symptoms 抽象 针对具有功能性躯体症状的儿童和青少年的家庭干预:系统综述 功能性躯体症状(FSS)的定义为不能完全由器质性病理解释的身体症状, 其在世界范围内的青少年中普遍存在。严重时, 它可以给受影响的个体和社会造成重大负担。FSS似乎多发于家庭中, 而家庭变量可能在症状发展和延续中起关键作用。因此, 在应对FSS时, 与家庭的合作可能很重要。本系统综述的目的是探索和描述FSS儿童和青少年的家庭干预措施, 并进一步评估该领域研究的总体质量。综述包括十六项研究。应用治疗的心理学取向是基于系统或认知行为疗法。治疗侧重于家庭疾病信念, 以及从躯体症状归因转变为由应用治疗的心理取向所形成的替代性解释。 对实务工作者的启示 家庭对于青少年功能性躯体症状有重要影响。 家庭干预可能是具有功能性躯体症状的青少年的合适治疗方法。 针对具有功能性躯体症状的青少年的家庭心理治疗主要基于认知行为疗法或系统家庭治疗。 对于患有功能性躯体症状的年轻人来说, 儿童/青少年的疾病信念以及整个家庭的疾病信念可能是重要的治疗目标。 Abstracto Intervenciones basadas en la familia para niños y adolescentes con síntomas somáticos funcionales: una revisión sistemática Los síntomas somáticos funcionales (SSF), definidos como síntomas físicos que no pueden explicarse completamente por patología orgánica, prevalecen en los jóvenes de todo el mundo. Cuando son graves, pueden representar una carga importante para el individuo afectado y para la sociedad. Los SSF parecen agregarse en familias, y las variables familiares pueden jugar un papel clave en el desarrollo y la perpetuación de los síntomas. Por lo tanto, puede ser importante trabajar con la familia cuando se afrontan SSF. El objetivo de esta revisión sistemática fue explorar y describir las intervenciones basadas en la familia utilizadas para niños y adolescentes con SSF, además de evaluar la calidad general de la investigación en esta área. Dieciséis estudios fueron incluidos. La orientación psicológica para el tratamiento aplicado se basó en la terapia sistémica o cognitivo conductual. El tratamiento se centró en las creencias sobre enfermedades familiares y en un cambio de la atribución de síntomas somáticos a explicaciones alternativas que se formaron por la orientación psicológica del tratamiento aplicado. Puntos de implicación práctica Las influencias familiares son significativas para los síntomas somáticos funcionales en los jóvenes La intervención familiar puede ser un enfoque de tratamiento relevante para jóvenes con síntomas somáticos funcionales La psicoterapia basada en la familia para jóvenes con síntomas somáticos funcionales se basa principalmente en la terapia cognitiva conductual o en la terapia sistémica familiar. Las creencias sobre la enfermedad del niño/adolescente, así como las creencias sobre la enfermedad de la familia en su conjunto, podrían ser objetivos de tratamiento importantes en personas jóvenes con síntomas somáticos funcionales. - Journal of Family Therapy, EarlyView.
    November 27, 2017   doi: 10.1111/1467-6427.12199   open full text
  • Adult report of childhood exposure to parental alienation at different developmental time periods.
    Maria Christina Verrocchio, Amy J. L. Baker, Daniela Marchetti.
    Journal of Family Therapy. October 10, 2017
    --- - |2+ Abstract The purpose of this study was to determine the relationship between exposure to Parental Alienation (PA) at different developmental time periods and psychological maltreatment. Three hundred and sixty‐one adults in Chieti, Italy completed an anonymous and confidential paper and pencil survey regarding their childhood exposure to twenty PA behaviours across three developmental time periods as well as a measure of psychological maltreatment by each parent. Results revealed that exposure to PA at each time period was significantly associated with psychological maltreatment. Moreover, the number of time periods of exposure to PA (from 0 to 3) was associated with psychological maltreatment. This was true for PA by mothers and PA by fathers. Implications for policy and practice are discussed. Practitioner points Mental health professionals can use the results of this study to guide their intervention efforts Co‐parenting educators can incorporate these results into their routine efforts to help parents be aware of PA and its effects Targeted parents can use these findings to make the case for timely legal and mental health interventions 抽象 成人报告其童年在不同发育时间段所面临的父母疏远 这项研究的目的是确定在不同发展阶段的父母疏远经历(PA)和心理虐待之间的关系。意大利基耶蒂市的316名成人完成了一项匿名保密的纸笔调查, 调查内容有关他们在童年三个发育时期内面临过的二十种父母疏远行为以及一项对父母各方心理虐待程度的测量。结果显示, 在每个时间段接触PA都与心理虐待显著相关。而且, 接触PA的时间段数量(从0到3)也与心理虐待有关。父母双方的PA都是这样的。本文讨论了该结果对政策和实践的影响。 对实务工作者的启示 精神卫生专业人员可以使用这项研究的结果来指导他们的干预工作。 共同养育的教育者可以在日常工作中结合本研究结果, 以帮助父母知道PA及其影响。 目标家长可以利用这些调查结果来及时进行法律和心理健康干预。 Abstracto Informe de adultos sobre la exposición infantil a la alienación de los padres en diferentes períodos del desarrollo evolutivo El propósito de este estudio fue determinar la relación entre la exposición a la Alienación Parental (AP) en diferentes períodos de desarrollo evolutivo y el maltrato psicológico. Trescientos sesenta y un adultos en Chieti, Italia, completaron una encuesta anónima y confidencial en lápiz y papel sobre su exposición infantil a veinte comportamientos de AP a lo largo de tres períodos de desarrollo, así como una medida de maltrato psicológico por parte de cada padre. Los resultados revelaron que la exposición a AP en cada período de tiempo se asoció significativamente con el maltrato psicológico. Además, el número de períodos de tiempo de exposición a AP (de 0 a 3) se asoció también con maltrato psicológico. Esto fue cierto para AP por las madres y AP por los padres. Se discuten las implicaciones para la política y la práctica. Puntos de implicación práctica: Los profesionales de salud mental pueden usar los resultados de este estudio para guiar sus esfuerzos de intervención. Los educadores de co‐parentalidad pueden incorporar estos resultados en sus esfuerzos rutinarios para ayudar a los padres a conocer la AP y sus efectos. Los padres afectados pueden usar estos hallazgos para justificar intervenciones oportunas de tipo legal y de salud mental. - Journal of Family Therapy, Volume 40, Issue 4, Page 602-618, November 2018.
    October 10, 2017   doi: 10.1111/1467-6427.12192   open full text
  • A Portuguese translation of the Systemic Clinical Outcome and Routine Evaluation (SCORE): the psychometric properties of the 15‐ and 28‐item versions.
    Margarida Vilaça, Ana Paula Relvas, Peter Stratton.
    Journal of Family Therapy. September 29, 2017
    --- - |2+ Abstract The Systemic Clinical Outcome and Routine Evaluation (SCORE) is one of the most effective evaluation instruments to assess family functioning and to test family therapy results. To determine its applicability in the Portuguese context, we analysed the psychometric characteristics of the short (SCORE‐15) and long (SCORE‐28) versions using a combined sample of 538 Portuguese participants. Results indicate that both versions demonstrate good internal consistency, replicate the original trifactorial solution and significantly differentiate between clinical and community samples. The SCORE‐15 predicted 93.3 per cent of the SCORE‐28 results. Both instruments' reference values and cut‐off points were established. These findings allow us to claim that the current Portuguese translation provides data that are comparable with, and of the same quality as, those obtained using the English language versions. The Portuguese versions can therefore be recommended to measure family functioning in routine clinical practice and research. Practitioner points SCORE‐15 and 28 are effective in the measurement of the family relationships in general and the family strengths, communication and difficulties in particular They represent sound and useful tools that may be used for research and intervention purposes, both in clinical and community contexts, when a Portuguese version is required The short version is most appropriate for the clinical context due to its conciseness and stronger capacity to predict family functioning 抽象 系统性临床结果和常规评估(SCORE)的葡萄牙语版:15项和28项版本的心理测量属性 系统临床结果和常规评估(SCORE)是评估家庭功能和测试家庭治疗结果的最有效的评估工具之一。为了确定它在葡萄牙语环境中的适用性, 我们使用538个葡萄牙参与者的组合样本分析了短(SCORE‐15)和长(SCORE‐28)版本的心理测量特征。结果表明, 两个版本都表现出良好的内部一致性, 复现了原始的三因子解决方案, 并显著区分了临床和社区样本。SCORE‐15预测了SCORE‐28结果的93.3%。两个工具的参考值和分界点都已建立。有了这些发现, 我们便可以称, 目前葡萄牙语版提供的数据与使用英语版本获得的数据具有可比性, 并具有相同的质量。因此, 可以推荐使用葡萄牙语版来测量常规临床实践和研究中的家庭功能。 对实务工作者的启示 SCORE‐15和28在测量一般家庭关系, 又尤其是家庭力量、沟通和困难方面是有效的。 它们代表了可用于临床和社区背景下的研究和干预目的的合理有用的工具, 因而需要葡萄牙语版本。 由于其简洁性和较强的预测家庭功能的能力, 短版本最适合于临床情况。 Abstracto Una traducción al portugués del Systemic Clinical Outcome and Routine Evaluation (SCORE): las propiedades psicométricas de las versiones de 15 y 28 ítems El Systemic Clinical Outcome and Routine Evaluation (SCORE) es uno de los instrumentos más efectivos para evaluar el funcionamiento familiar y los resultados de la terapia familiar. Para determinar su aplicabilidad en el contexto portugués, analizamos las características psicométricas de las versiones corta (SCORE‐15) y larga (SCORE‐28) usando una muestra combinada de 538 participantes portugueses. Los resultados indican que ambas versiones demuestran una buena consistencia interna, replican la solución trifactorial original y diferencian significativamente entre muestras clínicas y comunitarias. El SCORE‐15 predijo el 93.3 por ciento de los resultados de SCORE‐28. Se establecieron los valores de referencia y los puntos de corte de ambos instrumentos. Estos hallazgos nos permiten afirmar que la traducción actual en portugués proporciona datos que son comparables y de la misma calidad que los obtenidos utilizando las versiones en inglés. Por lo tanto, se pueden recomendar las versiones portuguesas para medir el funcionamiento familiar en la práctica e investigación clínica. Puntos de implicación práctica: SCORE‐15 y 28 son efectivos en la medición de las relaciones familiares en general y en particular en la medición de las fortalezas de la familia, la comunicación y las dificultades. Cuando se requiere una versión en portugués, estas herramientas resultan sólidas y útiles, de forma que pueden utilizarse con fines de investigación e intervención, tanto en contextos clínicos como comunitarios. La versión corta es la más adecuada para el contexto clínico debido a su concisión y capacidad más fuerte para predecir el funcionamiento familiar - Journal of Family Therapy, Volume 40, Issue 4, Page 537-556, November 2018.
    September 29, 2017   doi: 10.1111/1467-6427.12197   open full text
  • How to lose your clinical balance, while holding on to your therapeutic bearings, and other ideas on working therapeutically with a ‘treatment resistant’ client diagnosed with Borderline Personality Disorder.
    Don Boardman.
    Journal of Family Therapy. August 23, 2017
    --- - |2+ Abstract This article describes a clinical case where an Advanced Brief Strategic Therapy Model (Gibson and Boardman, ; Gibson et al., ; Nardone and Watzlawick, ) was used with a woman presenting with presumed Borderline Personality Disorder (BPD). In the world of therapy, the process of change can often be hard to predict at the best of times and extremely unpredictable during the worst. It can be difficult for the curious therapist to know how and what to look for as indicators of change when the larger picture may appear to remain unchanged in a client's life. I am curious about those therapy cases which present with great difficulties attached to them and which often drain much of our energy, vim and vigour as psychotherapists with often little apparent return on the investment we make. That is, if we measure that return in terms of reported change by the client, as opposed to privileging therapeutic disposition. Practitioner points This article explores how an Advanced Brief Strategic Therapy Model was used with a client diagnosed with Borderline Personality Disorder I critique the often misunderstood idea of embodied cybernetics as an interpretation of the therapeutic process Drawing on clinical practice, I describe some of the challenges in working with a client who often dispensed with rationality and employed non‐ordinary logic in her modus operandi 抽象 如何在临床中坚持治疗方向的同时乱了阵脚, 以及关于治疗一个“抗拒治疗型”的边缘性人格障碍患者的其他想法 本文介绍了一个临床案例, 其中高级短期战略治疗模型(Gibson and Boardman, 2016; Gibson et al., 2014; Nardone and Watzlawick, 2005)被用来治疗呈现假定的边缘性人格障碍(BPD)的女性。在治疗的世界里, 变化的过程在最好的情况下往往很难预测, 而在最坏的情况下是极不可预测的。好奇的治疗师可能很难知道, 当来访者生活的总体情况看似保持不变的时候, 如何寻找以及寻找什么来作为变化的指标。我对于那些对治疗师造成极大困难的治疗病例感到十分好奇, 它们经常耗尽心理治疗师的精力, 而且使他们的努力看上去毫无成效。这即是说, 如果我们是根据患者报告的变化, 而不是以治疗倾向为准来衡量这种回报。 对实务工作者的启示 本文探讨了如何使用高级短期战略治疗模型来治疗诊断为边缘性人格障碍的患者 我批评了常被误解的用具现控制论解释治疗过程的观念 借鉴临床实践, 我介绍了一些与缺乏理性并经常非逻辑性地行事的患者工作中的一些挑战 Abstracto Cómo perder tu equilibrio clínico, mientras te aferras a tu orientación terapéutica, y otras ideas sobre cómo trabajar terapéuticamente con un cliente ‘resistente al tratamiento’ diagnosticado con Trastorno de Personalidad Límite Este artículo describe un caso clínico en el que se utilizó un modelo de terapia estratégica breve avanzada (Advanced Brief Strategic Therapy Model; Gibson y Boardman, 2016; Gibson et al., 2014; Nardone y Watzlawick, 2005) con una mujer que presentaba un presunto trastorno límite de la personalidad (TLP). En el mundo de la terapia, el proceso de cambio a menudo puede ser difícil de predecir en el mejor de los casos y extremadamente impredecible en el peor de los casos. Puede ser difícil para el terapeuta curioso saber cómo y qué buscar como indicadores de cambio cuando la imagen más general de la vida parece no cambiar en la vida del cliente. Tengo curiosidad por esos casos de terapia que se presentan con grandes dificultades asociadas y que a menudo agotan gran parte de nuestra energía y vigor como psicoterapeutas; casos que a menudo nos proporcionan muy poco retorno aparente para la inversión de energía y atención que hacemos. Es decir, si medimos ese rendimiento en términos de cambios informados por el cliente, en lugar de privilegiar la disposición terapéutica. Puntos de implicación práctica: Este artículo explora cómo se utilizó un modelo de terapia estratégica breve avanzada con un cliente diagnosticado con un trastorno límite de personalidad. Critico la idea a menudo malentendida de la cibernética incorporada como una interpretación del proceso terapéutico Basándome en la práctica clínica, describo algunos de los desafíos al trabajar con un cliente que a menudo prescinde de la racionalidad y emplea lógica no ordinaria en su modus operandi. - Journal of Family Therapy, Volume 40, Issue 4, Page 503-519, November 2018.
    August 23, 2017   doi: 10.1111/1467-6427.12188   open full text
  • Involving relatives in emergency psychiatry: an observational patient‐control study in a crisis resolution and home treatment team.
    Flip Jan van Oenen, Suzy Schipper, Rien Van, Irene Visch, Jaap Peen, Jurgen Cornelis, Robert Schoevers, Jack Dekker.
    Journal of Family Therapy. August 11, 2017
    --- - |2+ Abstract The involvement of relatives is seen as an important element of treatment in crisis resolution and in home treatment teams. The aim of the study was to investigate the effects of involving relatives in treatment during a crisis situation. The outcomes for patients from a relatives‐involved group (RIG) and relatives‐not‐involved group (RNIG) were compared. Relatives were provided with general information about the service and assessments, psycho‐education and, in some cases, additional family interventions. Relatives were involved in the treatment of 168 of 263 patients (64 per cent). There were no significant differences between the RIG and RNIG in terms of mean scores for BSI at T12. The involvement of relatives was achieved in the majority of cases. No link with outcomes was found. Since involvement of relatives was not randomized and the number and duration of contacts with relatives were limited, these findings should be interpreted cautiously. Practitioner points Using a structured motivational model, it is possible to involve relatives in the treatment of psychiatric crisis patients in the majority of cases There is no reason to be reticent about involving relatives in treatment, even if patients seem to be reluctant at first sight Living alone was in this study identified as a negative predictor of family involvement 抽象 在精神病急救中纳入亲属: 危机解决和家庭治疗团队中进行观察性患者控制研究 在危机解决和家庭治疗团队中, 亲属的参与被视为治疗的重要因素。研究的目的是调查危机期间亲属参与治疗的影响。对亲属参与组(RIG)和亲属不不参与组(RNIG)患者的结果进行了比较。向亲属提供了有关服务和评估的信息, 心理教育以及某些情况下的额外家庭干预。263例中, 168例患者的治疗(64%)有亲属参与。RIG和RNIG在T12平均得分方面没有显着性差异。在大多数情况下实现了亲属参与。没有发现与治疗结果的联系。 由于亲属的参与不是随机的, 与亲属接触的次数和持续时间也有限, 所以这些结论应该谨慎解读。 对实务工作者的启示 使用结构化的激励模式, 在大多数情况下, 有可能让亲属参与治疗精神病急救患者 即使病人一开始显得不情愿, 也没有理由对亲属参与治疗赶到迟疑 在这项研究中, 独自生活被确定为家庭参与的负面预测因素 Abstracto Involucrar a familiares en la psiquiatría de emergencia: un estudio observacional de control del paciente en una resolución de crisis y un equipo de tratamiento domiciliario La participación de familiares se considera un elemento importante del tratamiento en la resolución de crisis y en los equipos de tratamiento en domiciliario. El objetivo del estudio fue investigar los efectos de involucrar a familiares en el tratamiento durante una situación de crisis. Se compararon los resultados para los pacientes de un grupo con involucración de familiares (GIF) y un grupo con familiares no implicados (GNIF). A los familiares se les proporcionó información general sobre el servicio y las evaluaciones, psico‐educación y, en algunos casos, intervenciones familiares adicionales. Los familiares participaron en el tratamiento de 168 de 263 pacientes (64 por ciento). No hubo diferencias significativas entre GIF y GNIF en términos de puntajes promedio para BSI en T12. La participación de familiares se logró en la mayoría de los casos. No se encontró ninguna asociación de esa participación con los resultados. Dado que la participación de los familiares no se asignó al azar y el número y la duración de los contactos con los familiares fueron limitados, estos hallazgos deben interpretarse con cautela. Puntos de implicación práctica: Usando un modelo motivacional estructurado es posible involucrar a familiares en el tratamiento de pacientes con crisis psiquiátricas en la mayoría de los casos No hay razón para ser reticente a la participación de familiares en el tratamiento, incluso si los pacientes parecen reacios a primera vista. Vivir solo fue en este estudio identificado como un predictor negativo de la participación familiar - Journal of Family Therapy, Volume 40, Issue 4, Page 584-601, November 2018.
    August 11, 2017   doi: 10.1111/1467-6427.12189   open full text
  • The adaptation of a Solution Focused Brief Therapy domestic violence perpetrator programme: a case study with a client with a learning disability.
    Rosemary Banting, Catherine Butler, Charlotte Swift.
    Journal of Family Therapy. July 28, 2017
    --- - |2+ Abstract Re‐offending rates of perpetrators of domestic violence are high (Hester et al., ) and there is a need for perpetrator programmes to reduce victimization. There is no clear evidence for the effectiveness of existing programmes (Bowen, Gilchrist and Beech, ; Herman, Rotunda, Williamson and Vodanovich, ; Smedslund et al., ). A new perpetrator programme based on Solution Focused Brief Therapy has been developed (Bowen, ), and whilst in its infancy it has received positive feedback from services and clients (International Innovation, ). Solution Focused Brief Therapy has been found to be effective in the reduction of aggression and criminal behaviours (Gingerich and Peterson, ), and has been effectively used with people with a learning disability (Smith, ). This case study will explore the effectiveness of the new perpetrator programme with someone with a learning disability on their attitudes towards domestic violence and abuse as well as self‐esteem. Practitioner points Solution Focused Therapy for domestic violence has been found to successfully change the behaviour and improve the self‐esteem of a man with a learning disability Where children are at risk of harm, longer‐term interventions remain the recommended therapy The mainstream model for treatment was adapted by using visual aids and role play to work with someone with learning disabilities and these were found to be useful by the client 抽象 家庭暴力犯罪者焦点解决短期治疗项目的改造: 针对学习障碍来访者的案例研究 家庭暴力肇事者的再犯罪率很高(Hester et al., 2006), 需要采取针对犯罪者的治疗项目来减少受害。没有明确证据表明现有项目的有效性(Bowen, Gilchrist和Beech, 2005; Herman, Rotunda, Williamson and Vodanovich, 2016; Smedslund et al., 2011)。一种新的、基于焦点解决短期治疗的犯罪者项目得到开发(Bowen, 2013), 而在初期它就已经获得了服务机构和来访者的积极反馈(International Innovation, 2016)。 焦点解决短期治疗已被发现能够有效减少侵略和犯罪行为(Gingerich and Peterson, 2013), 并已被有效运用于学习障碍人士(Smith, 2005)。本案例研究将探讨新的犯罪者项目在学习障碍人士在家庭暴力和虐待以及自尊问题的观点上的有效性。 对实务工作者的启示 针对家庭暴力的焦点解决治疗方法已被发现可以成功地改变行为并提高一个学习障碍人士的自尊心 在儿童受到危害的地方, 长期干预仍然是推荐的治疗方法 主流治疗模式通过融入视觉辅助和角色扮演得到调整, 使其可以适应学习障碍人士, 而这些调整被来访者证明是有用的 Abstracto La adaptación de un programa de Terapia Breve Centrada en Soluciones para perpetradores de violencia doméstica: un estudio de caso con un cliente con una discapacidad de aprendizaje Las tasas de reincidencia de los perpetradores de violencia doméstica son altas (Hester et al., 2006) y existe la necesidad de que los perpetradores reduzcan la victimización. No hay evidencia clara de la efectividad de los programas existentes (Bowen, Gilchrist y Beech, 2005; Herman, Rotunda, Williamson y Vodanovich, 2016; Smedslund et al., 2011). Se presenta un nuevo programa para perpetradores basado en la Terapia Breve centrada en Soluciones (Bowen, 2013) que, en su fase inicial, ha recibido comentarios positivos de los servicios y clientes (Innovación Internacional, 2016). Se ha encontrado que la terapia breve enfocada a la solución es efectiva en la reducción de la agresión y las conductas delictivas (Gingerich y Peterson, 2013), y se ha utilizado eficazmente con personas con discapacidad de aprendizaje (Smith, 2005). Este estudio de caso explora la efectividad del nuevo programa para perpetradores con alguien con una discapacidad de aprendizaje, tanto en sus actitudes hacia la violencia doméstica y el abuso, así como a la autoestima. Puntos de implicación práctica: Se ha encontrado que la Terapia Centrada en Soluciones para la violencia doméstica cambia con éxito el comportamiento y mejora la autoestima de un hombre con una discapacidad de aprendizaje Donde los niños corren el riesgo de sufrir daños, las intervenciones a largo plazo siguen siendo la terapia recomendada El modelo principal para el tratamiento se adaptó mediante el uso de ayudas visuales y juegos de roles para trabajar con alguien con discapacidades de aprendizaje, y el cliente los consideró útiles. - Journal of Family Therapy, Volume 40, Issue 4, Page 489-502, November 2018.
    July 28, 2017   doi: 10.1111/1467-6427.12186   open full text
  • The importance of adoption of formal client feedback in therapy: a narrative review.
    Sara Lappan, Zain Shamoon, Adrian Blow.
    Journal of Family Therapy. July 21, 2017
    --- - |2+ Abstract Couple and family therapy has well‐established benefits. Although the majority of clients benefit, some worsen, some show no positive change, and some drop out early. This suggests that existing treatment modalities require further advancement. One promising avenue to achieve advancement involves instituting, as the standard of care, formalized client feedback, which has been shown to improve outcomes. This paper is a non‐systematic review that outlines several formalized feedback systems currently available and highlights each system's utility with application to couple and family therapy. While couple and family therapists have unique obstacles in therapy due to multiple therapeutic alliances, the use of formalized feedback has potential to strengthen alliances and improve outcomes for all clients who participate. We advocate for the use of formalized feedback in the training of new therapists and to augment the supervision process. Practitioner points Encourage the couple and family therapy field to implement the use of formalized client feedback systems both clinically and in research Demonstrate the importance of implementing formalized client feedback systems to decrease premature termination and improve client outcomes Provide information about existing client feedback systems to give practitioners the opportunity to choose a method that most benefits their clients 抽象 在治疗中采用正式客户反馈的重要性: 叙述性综述 伴侣和家庭治疗具有明确的好处。虽然大多数来访者受益, 有些恶化, 有些显示没有积极的变化, 有些中途退出了。这表明现有治疗方式需要进一步改进。改进的一个可能途径包括制定正式的来访者反馈制度作为服务标准流程, 而已有证据证明这种做法可以改善结果。本文为非系统性综述, 概述了目前可用的几种正式的反馈系统, 并强调了每个系统应用在伴侣和家庭治疗上的实用性。虽然伴侣和家庭治疗师由于多种治疗联盟而在治疗方面有独特的障碍, 但采用正式反馈可能会加强联盟并改善所有参与来访者的治疗结果。我们主张在培训新治疗师时采用正式反馈, 并用它来提升督导过程。 对实务工作者的启示 鼓励伴侣和家庭治疗领域在临床和研究中采用正式的来访者反馈系统 表明采用正式来访者反馈系统以减少提前终止并改善来访者结果的重要性 提供有关现有来访者反馈系统的信息, 使从业者可以选择最有利于来访者的方法 Abstracto La importancia de incluir retroalimentación formal del cliente en la terapia: una revisión narrativa La terapia de pareja y familiar tiene beneficios bien establecidos. Sin embargo, aunque la mayoría de los clientes se benefician, algunos empeoran, algunos no muestran cambios positivos y algunos abandonan temprano. Esto sugiere que las modalidades de tratamiento existentes requieren un mayor avance. Una vía prometedora para lograr el avance implica instituir, como el estándar de atención, la retroalimentación formal de información del cliente, que ha demostrado mejorar los resultados. Este documento es una revisión no sistemática que describe varios sistemas de retroalimentación formalizados actualmente disponibles y resalta la utilidad de cada sistema con la aplicación de terapia familiar y de pareja. Si bien los terapeutas de pareja y familiares tienen obstáculos únicos en la terapia debido a múltiples alianzas terapéuticas, el uso de comentarios formales tiene el potencial de fortalecer las alianzas y mejorar los resultados para todos los clientes que participan en la terapia. Abogamos también por el uso de retroalimentación formal en la capacitación de nuevos terapeutas y para aumentar el proceso de supervisión. Puntos de implicación práctica: Alentar al campo de la terapia familiar y de pareja a implementar el uso de sistemas formales de retroalimentación de los clientes, tanto clínicamente como en investigación. Demostrar la importancia de implementar sistemas formales de retroalimentación de los clientes para disminuir la terminación prematura y mejorar los resultados del cliente Proporcionar información sobre los sistemas actuales de retroalimentación de los clientes para brindar a los profesionales la oportunidad de elegir el método que más beneficie a sus clientes. - Journal of Family Therapy, Volume 40, Issue 4, Page 466-488, November 2018.
    July 21, 2017   doi: 10.1111/1467-6427.12183   open full text
  • Effects of Ecologically‐Based Family Therapy with substance‐using, prostituting mothers.
    Aaron Murnan, Qiong Wu, Natasha Slesnick.
    Journal of Family Therapy. July 20, 2017
    --- - |2+ Abstract Studies report that high rates of prostituting women seek substance use treatment, and that most of these women have children in their care. However, compared to non‐prostituting women, they show poorer treatment outcomes. Effective intervention for this population is needed, and the current study is the first to test family therapy with mothers seeking substance use treatment, who also reported prostitution. Sixty‐eight treatment‐seeking women with children in their care were randomly assigned to receive twelve sessions of Ecologically‐Based Family Therapy or twelve sessions of individual treatment. Results showed that women who received family therapy reported greater reductions in substance use and depressive symptoms as well as greater improvements in their mother‐child interactions. Findings underscore the importance of offering family therapy as a treatment option when prostituting women with children seek substance use treatment. Practitioner points It has proved difficult to meet the unique needs of prostituting women, and this article offers practical assistance to practitioners serving this population Ecologically‐Based Family Therapy (EBFT) shows promise, having some superior outcomes compared to an individual therapy with prostituting mothers Substance use treatment facilities should strongly consider including EBFT for these women and their children as an adjunct to treatment 抽象 生态基础家庭治疗对于物质滥用的卖淫母亲的效用 研究报告指出, 卖淫妇女中很大一部分寻求物质使用治疗, 而且这些妇女中大多数有孩子需要照顾。然而, 与非卖淫妇女相比, 她们的治疗结果较差。需要对这个人群进行有效的干预, 目前的研究是第一次对寻求物质使用治疗并汇报了卖淫行为的母亲尝试家庭治疗。68名接受治疗的有子女的妇女被随机分配接受12节生态基础家庭治疗或12次个人治疗。结果显示, 接受家庭治疗的妇女报告她们在物质使用和抑郁症状方面有较大幅度的减少, 母子互动也得到了更大改善。调查结果强调, 为有子女的、寻求物质使用治疗的卖淫妇女提供家庭治疗, 是一种重要的治疗方案。 对实务工作者的启示 卖淫妇女的独特需求已被证明是难以满足的, 这篇文章为服务于这个人群的从业人员提供了实际的帮助 生态基础家庭治疗(EBFT)显示出潜力, 针对卖淫妇女人群比个人治疗效果更佳 物质使用治疗机构应强烈考虑将EBFT作为这些妇女及其子女的辅助治疗手段 Abstracto Efectos de la Terapia Familiar Ecológica con madres prostitutas que abusan de sustancias Los estudios informan que altas tasas de mujeres que se prostituyen buscan tratamiento para el abuso de sustancias y que la mayoría de estas mujeres tienen hijos a su cuidado. Sin embargo, en comparación con las mujeres no prostitutas, muestran peores resultados de tratamiento. Se necesita una intervención efectiva para esta población, y el estudio actual es el primero en probar la terapia familiar con madres que buscan tratamiento por abuso de sustancias que también informaron sobre su actividad de prostitución. Sesenta y ocho mujeres en busca de tratamiento con niños a su cargo fueron asignadas aleatoriamente para recibir doce sesiones de terapia familiar con base ecológica o doce sesiones de tratamiento individual. Los resultados mostraron que las mujeres que recibieron terapia familiar informaron mayores reducciones en el uso de sustancias y síntomas depresivos, así como mayores mejoras en sus interacciones madre‐hijo. Los hallazgos subrayan la importancia de ofrecer terapia familiar como una opción de tratamiento cuando mujeres que se prostituyen y tienen niños a su cargo solicitan un tratamiento para su problema de adicción a sustancias. Puntos de implicación práctica: Está comprobado que es difícil atender las necesidades de tratamiento de mujeres que se prostituyen, y este artículo ofrece ayuda práctica a los profesionales que atienden a esta población La terapia familiar ecológica (EBFT, por sus siglas en inglés) es prometedora, ya que presenta algunos resultados superiores en comparación con una terapia individual con madres que se prostituyen Los dispositivos de ayuda para el tratamiento del uso de sustancias deben considerar seriamente incluir EBFT para estas mujeres y sus hijos como un complemento al tratamiento de adicción - Journal of Family Therapy, Volume 40, Issue 4, Page 557-583, November 2018.
    July 20, 2017   doi: 10.1111/1467-6427.12187   open full text
  • Parenting advice for intercultural couples: a systemic perspective.
    Dharam Bhugun.
    Journal of Family Therapy. July 18, 2017
    This article presents advice for intercultural parents, based on findings of a qualitative study that examined how intercultural parents negotiated their cultural differences. Semi‐structured in‐depth interviews were conducted with fourteen intercultural heterosexual couples/parents in South East Queensland. Thematic analysis was used to analyse data and understand the meanings of participants’ experiences. The findings revealed that not only aspects of cultural background, but also systemic and contextual factors impacted on the experiences of intercultural parents. Advice for intercultural parents is described from three systemic perspectives: the individual sphere, the couple/parent sphere and the child's sphere. Practical implications for therapists and counsellors working with intercultural parents are discussed. Practitioner points Find value in cultural differences and similarities in parenting style to form a balanced view Explore benefits and opportunities of intercultural parenting as source of strength Use culture as a valuable source for change Assume the role of mediator and interpreter when dealing with conflicts in cultural code Practice cultural sensitivity and reflexivity Conflict may be due to processes other than culture, such as emotional processes. Explore power dynamics in parenting 跨文化夫妇的教养建议:系统角度 本文提出了一些针对跨文化父母的建议, 建议是基于一项调查跨文化父母如何处理文化差异的定性研究结果。昆士兰东南部的十四对跨文化异性恋夫妇/父母接受了半结构的深度访谈。研究运用了主题分析法来分析数据并了解参与者体验的意义。调查结果显示, 除了文化背景的一些方面之外, 系统和情境因素也影响到跨文化父母的经历。本文从三个系统角度阐述了对跨文化父母的建议:个人领域, 夫妇/父母领域和儿童领域。本文还讨论了研究结果对与跨文化父母合作的治疗师和咨询师的实际意义。 对实务工作者的启示 发现教养风格里的文化差异和相似点的价值, 形成平衡的观点 探索跨文化教养的好处和机会, 作为优势的来源 将文化作为改变的宝贵来源 在处理文化规范冲突时, 担任调解员和解释者的角色 践行文化敏感性和反思性 冲突可能是由于文化之外的变化过程, 如情绪变化。 探索教养中的权力动态 关键词:文化;跨文化夫妇;教养;挑战;建议;社会建构主义;系统角度 Asesoramiento de padres para parejas interculturales: una perspectiva sistémica Este artículo presenta consejos para padres interculturales basados ​​en hallazgos de un estudio cualitativo que examinó cómo los padres interculturales negociaban sus diferencias culturales. Se realizaron entrevistas en profundidad semi‐estructuradas con catorce parejas/padres heterosexuales interculturales en el sureste de Queensland. Se utilizó la metodología de Análisis Temático para analizar os datos y comprender los significados de las experiencias de los participantes. Los hallazgos revelaron que no sólo los aspectos de los antecedentes culturales, sino también los factores sistémicos y contextuales, repercutieron en las experiencias de los padres interculturales. El asesoramiento para padres interculturales se describe desde tres perspectivas sistémicas: la esfera individual, la esfera pareja/parental y la esfera del niño. Se discuten las implicaciones prácticas para terapeutas y consejeros‐orientadores que trabajan con padres interculturales. Puntos de implicación práctica Encontrar valor en las diferencias y similitudes culturales en el estilo de crianza para formar una visión equilibrada Explorar los beneficios y oportunidades de la parentalidad intercultural como fuente de fortalezas Usar la cultura como fuente valiosa de cambio Asumir el papel de mediador e intérprete cuando se tratan conflictos en el código cultural Practicar la sensibilidad cultural y la reflexividad El conflicto puede deberse a procesos distintos de la cultura, como los procesos emocionales. Explorar la dinámica de poder en la crianza de los hijos Palabras clave: cultura; parejas interculturales; parentalidad; desafíos; consejo; construccionismo social; perspectiva sistémica.
    July 18, 2017   doi: 10.1111/1467-6427.12156   open full text
  • Systemic psychotherapists as expert witnesses in the family court: ‘visitors to another world’?
    Susan Hickman.
    Journal of Family Therapy. July 18, 2017
    This article is based on research on the interface between systemic psychotherapists who as expert witnesses write reports for the family court in England and the judges who receive them. It explores how well a systemic stance is suited to this type of work and whether there is scope for more systemic therapists to involve themselves in it. The research was conducted through semi‐structured interviews with systemic psychotherapists with experience of acting as expert witnesses and with family court judges. The results were analysed using grounded theory. In the process of the research the focus expanded from an abstract epistemological enquiry to include more practical aspects of connection and difference. Findings indicated that whilst a systemic and relational approach would seem particularly well suited to this work, it was not ‘visible’ as such to lawyers involved in commissioning expert witnesses. This raises the question as to whether there is an ethical responsibility on practitioners to highlight the potential usefulness of systemic thinking in this context. Practitioner points An approach which promotes relational thinking and addresses issues of marginalization is under‐represented in family court work but is well suited to and needed in it Systemic practitioners face theoretical, personal and practical challenges in undertaking it The systemic community has an ethical responsibility to consider whether there is scope for it to make a greater contribution in this area 系统心理治疗师作为家事法庭的专家证人:”来到另一个世界的访客”? 本文基于的研究是关于在英格兰家事法庭作为专家证人撰写报告的系统心理治疗师和和接收报告的法官之间的交互。它探讨了系统的立场如何适合此类工作, 以及是否还有空间供更多系统治疗师参与其中。研究对具有专家证人经验的系统心理治疗师和家事法官进行了半结构访谈, 并运用扎根理论分析了结果。在此过程中, 研究重心从抽象的认识论探索扩展到更多实际方面, 如联系与差异。结果表明, 虽然系统的、关系的方法看上去特别适合于这项工作, 但参与委托专家证人的律师并没有”看到”这一点。这提出了一个问题, 即治疗师是否有道德义务强调系统思维在这方面的潜力。 对实务工作者的启示 家事法庭中很少见到能促进关系层面的思考和处理边缘化问题的方法, 但这种方法非常适合和必要。 系统治疗师在实施过程中面临着理论、个人和实践的挑战。 系统理论群体有道德责任考虑是否有空间让系统思维在这一领域作出更大的贡献。 关键词:法医工作; 定性研究; 儿童工作; 伦理问题; 专家证人; 家事法庭 Psicoterapeutas sistémicos como testigos expertos en el tribunal de familia: “visitantes de otro mundo”? Este artículo se basa en la investigación sobre la interconexión entre psicoterapeutas sistémicos que como testigos expertos escriben informes para el tribunal de familia en Inglaterra y los jueces que los reciben. Explora en qué medida una postura sistémica es adecuada para este tipo de trabajo y si hay margen para que más terapeutas sistémicos se involucren en ella. La investigación se realizó a través de entrevistas semi‐estructuradas con psicoterapeutas sistémicos con experiencia de actuar como testigos expertos y con los jueces de tribunales de familia. Los resultados se analizaron utilizando el modelo de la teoría fundamentada. En el proceso de la investigación el enfoque se expandió a partir de una investigación epistemológica abstracta para incluir aspectos más prácticos de la conexión y la diferencia. Los resultados indican que, si bien un enfoque sistémico y relacional parecería particularmente adecuado a este trabajo, no era «visible» como tal para los abogados que participan en la comisión de peritos. Esto plantea la cuestión de si existe una responsabilidad ética en los profesionales para resaltar la utilidad potencial del pensamiento sistémico en este contexto. Puntos de implicación práctica Un enfoque que promueve el pensamiento relacional y aborda las cuestiones de marginación está subrepresentado en el trabajo de los tribunales de familia, pero está bien adaptado y sería necesario Los profesionales sistémicos enfrentan retos teóricos, personales y prácticos en este contexto La comunidad sistémica tiene la responsabilidad ética de considerar si hay margen para que se haga una mayor contribución en esta área Palabras clave: trabajo forense; investigación cualitativa; trabajando con niños; cuestiones éticas; testigos expertos; tribunal de familia.
    July 18, 2017   doi: 10.1111/1467-6427.12176   open full text
  • A dialogical research methodology based on Buber: intersubjectivity in the research interview.
    Judith M. Brown.
    Journal of Family Therapy. July 18, 2017
    Buber's concepts of I‐It and I‐Thou are well known, yet his understandings of a dialogical process and dialogical knowing are less evident in the literature. This article briefly details a unique Buberian dialogical research methodology, devised for research into psychological and emotional abuse in families. Informed by Buber's premise that dialogue is the source of knowing, this methodology privileges the intersubjectivity between participant and researcher. It is operationalized in methods that highlight the dialogical process within the research interview, from which dialogical knowing may emerge. Analysis of the intersubjective process is based on the conceptualization of five poetic images that recur in Buber's work, as illustrated in the micro‐analysis contained in this article. It suggests that a Buberian methodology offers deeper and more nuanced understandings of the subjective experiences of vulnerable participants and of theoretical knowledge about a sensitive topic. Practitioner points Buber's scholarship highlights the ideas of dialogical process and dialogical knowing A Buberian research methodology requires intersubjectivity to be privileged in analysis, before the consideration of subjective experience or theoretical knowledge Intersubjective analysis may be operationalized by a conceptualization of Buber's poetic images Dialogical moments may occur within the research interview, from which dialogical knowing may emerge 基于布伯的对话研究方法:研究访谈中的主体间性 布伯的“我—它”和“我—你”的概念是众所周知的, 但他关于对话过程和对话产生的知识的理解在文献中体现得不太明显。本文简要介绍了一种独特的布伯式对话研究方法, 用来研究家庭中的心理和情绪虐待。受布伯的“对话是知识的来源”这一前提影响, 这种方法特别关注参与者和研究者之间的主体间性。它的实施方法强调研究访谈中的对话过程, 从中可能出现对话产生的知识。主体间过程的分析是基于布伯著作中反复出现的五个诗意图像的概念化, 如本文包含的微观分析所示。这表明, 布伯式方法对于脆弱参与者的主观经验和敏感话题的理论知识提供了更深入和更细微的理解。 对实务工作者的启示 布伯的研究强调了对话过程和对话知识的概念。 布伯式研究方法要求在分析中强调主体间性, 甚于对主观经验或理论知识的考虑。 主体间分析可以通过布伯概念化的诗意图像来实现。 研究访谈中可能会出现对话时刻, 其中可能会出现对话知识。 关键词:布伯;对话研究;定性;主体间;研究访谈;心理和情绪虐待 Una metodología de investigación dialógica basada en Buber: inter‐subjetividad en la entrevista de investigación Los conceptos de Buber de I‐It y I‐Thou son bien conocidos, pero su conceptualización de un proceso dialógico y del conocimiento dialógico son menos evidentes en la literatura. Este artículo detalla brevemente una metodología única de investigación dialógica Buberiana, ideada para la investigación sobre el abuso psicológico y emocional en las familias. Informada por la premisa de Buber de que el diálogo es la fuente del conocimiento, esta metodología privilegia la inter‐subjetividad entre participante e investigador. Está operacionalizada en métodos que destacan el proceso dialógico dentro de la entrevista de investigación, de la que puede surgir el conocimiento dialógico. El análisis del proceso intersubjetivo se basa en la conceptualización de cinco imágenes poéticas que se repiten en la obra de Buber, como se ilustra en el microanálisis contenido en este artículo. Sugiere que una metodología Buberiana ofrece una comprensión más profunda y matizada de las experiencias subjetivas de los participantes vulnerables y del conocimiento teórico sobre un tema sensible. Puntos de implicación práctica Los estudios de Buber destacan las ideas del proceso dialógico y del conocimiento dialógico Una metodología de investigación Buberiana requiere que la intersubjetividad sea privilegiada en el análisis, antes de considerar la experiencia subjetiva o el conocimiento teórico El análisis intersubjetivo puede ser operacionalizado por una conceptualización de las imágenes poéticas de Buber Momentos dialógicos pueden ocurrir dentro de la entrevista de investigación, de la que puede surgir el conocimiento dialógico Palabras llave: Buber; investigación dialógica; cualitativo; intersubjetivo; entrevista de investigación; abuso psicológico y emocional.
    July 18, 2017   doi: 10.1111/1467-6427.12174   open full text
  • New paradigms of parenthood: researching practice in a fertility clinic incarnating new forms of family.
    Helen Bohme.
    Journal of Family Therapy. July 18, 2017
    Traditional notions of parenthood are being challenged by the requests for treatment in a licensed fertility clinic. The unprecedented fast‐moving changes in assisted reproductive technology, especially gamete (sperm, eggs, embryo) donation, are enabling the creation of new forms of family. For this to be the subject of new systemic research, a reflexive intertwining of both research activities and professional practice activities is required with each informing and forming the other. Indeed, practitioners are researchers by virtue of rigorously using reflexive analytical processes in daily practice moment by moment. If we author ourselves in conversation with others, the ‘thing’ we are studying are ways of talking and relating to each other. Thus a paradigm shift has to be made, from examining entities to attending to language or language processes – especially in the counselling conversation that precedes treatment. This article presents a model where the ‘small’ stories of everyday lives are turned from a passing event into a research enterprise as witness to social change. For the social skills we use to do both practice and research attach us to real human beings in deeply human ways. Practitioner points One counselling conversation can help people to reflect on creating the new forms of family they envision and place this in an ethical context. Conversational practice challenges institutional traditions and moves towards a more philosophical model of collaborative inquiry Clients telling their story become observers of their own thinking and see themselves as experts in their own lives The practitioner uses reflexive analytical processes, foregrounding the ethical in order to minimize social and power inequalities 父母身份的新范式:研究代表新兴家庭形式的生育诊所的实践 在正规生育诊所接受治疗的需求正在挑战传统生育观。辅助生殖技术, 特别是配子(精子, 卵子, 胚胎)捐赠, 正经历前所未有的快速变化, 使新的家庭形式成为可能。为了让该主题成为系统研究的新课题, 需要对研究活动和专业实践进行反身性结合, 让它们相互影响、相互塑造。事实上, 从业者就是研究人员, 因为他们在日常生活中一直在严格地使用反身分析过程。如果我们在与他人交谈的过程中创造自我, 我们研究的”东西”就是谈话和相互交流的方式。因此, 范式必须从观察独立个体转移到关注语言或语言过程, 尤其是在治疗之前的咨询谈话中。这篇文章提出一个模式, 即将日常生活的”小”故事从转瞬即逝的小事转变为研究项目, 作为社会变革的见证。在实践和研究中用到的社交技能, 将我们与其他鲜活的生命深刻地连接在一起。 对实务工作者的启示 咨询谈话可以帮助人们对创造其设想的新式家庭进行反思, 并从伦理角度思考该问题。 对话式实践挑战传统惯例, 朝着更具哲学性的合作调查模式迈进。 讲述自己故事的客户成为自己思想的观察者, 并将自己视为自己生活中的专家。 从业者使用反身性分析过程, 突出伦理道德, 以尽量减少社会和权力的不平等。 关键词:新系统研究;生育治疗;辅助生殖技术;配子捐赠;咨询对话;反身实践 Nuevos paradigmas de la paternidad: investigación de la práctica en una clínica de fertilidad encarnando nuevas formas de familia Las nociones tradicionales de paternidad están siendo cuestionadas por las solicitudes de tratamiento en una clínica autorizada de fertilidad. Los rápidos cambios sin precedentes en la tecnología de reproducción asistida, especialmente la donación de gametos (esperma, huevos, embriones), están permitiendo la creación de nuevas formas de familia. Para que esto sea foco y objeto de la nueva investigación sistémica, se requiere un entrelazamiento reflexivo de las actividades de investigación y las actividades de la práctica profesional con cada una informando y formando la otra. De hecho, los profesionales en su práctica son investigadores en virtud de usar rigurosamente los procesos analíticos reflexivos en la práctica diaria momento a momento. Si nos hacemos nuestros propios autores en la conversación con otros, la “cosa” que estamos estudiando son las formas de hablar y relacionarse unos con otros. Por lo tanto, tiene que provocarse un cambio de paradigma, desde el examen de entidades de a atender al lenguaje o los procesos de lenguaje –especialmente en la conversación de asesoramiento que precede al tratamiento. Este artículo presenta un modelo en el que las “pequeñas” historias de la vida cotidiana pasan de ser un acontecimiento pasajero a convertirse en una propuesta de investigación como testigo del cambio social. Las habilidades sociales que usamos para hacer tanto la práctica como la investigación nos unen a seres humanos reales de maneras profundamente humanas. Puntos de implicación práctica Una conversación de asesoramiento puede ayudar a las personas a reflexionar sobre la creación de las nuevas formas de familia que imaginan y colocar esto en un contexto ético. La práctica conversacional cuestiona las tradiciones institucionales y se mueve hacia un modelo más filosófico de indagación colaborativa Los clientes que cuentan su historia se convierten en observadores de su propio pensamiento y se ven a sí mismos como expertos de sus propias vidas El profesional en su práctica utiliza procesos analíticos reflexivos, poniendo en primer plano lo ético para minimizar las desigualdades sociales y de poder Palabras clave: nueva investigación sistémica; tratamiento de fertilidad; tecnología de reproducción asistida; donación de gametos; asesoramiento de conversación; práctica reflexiva.
    July 18, 2017   doi: 10.1111/1467-6427.12173   open full text
  • Multi family member interview studies: a focus on data analysis.
    Hanna Van Parys, Veerle Provoost, Petra De Sutter, Guido Pennings, Ann Buysse.
    Journal of Family Therapy. July 18, 2017
    Although qualitative research about couples and families is becoming increasingly widespread, the aspect of data analysis remains largely underrepresented in the literature. In this methodological paper, we outline one specific approach to data analysis in the context of multi family member interview studies. Inspired by Interpretative Phenomenological Analysis and Dyadic Interview Analysis, this approach allows for the detailed and systematic analysis of family practices and the co‐construction of shared family realities. Based on an example study in the field of medically assisted reproduction, we give a detailed explanation of the aim of this approach, the different steps in the analysis process and the output of a multi family member interview study. The findings of this example study are discussed in light of the methodological challenges and opportunities. Practitioner points Multi family member interview analysis allows for the systematic analysis of family practices and the co‐construction of shared family realities The findings might approximate to the therapeutic complexities that systemic therapists often encounter better than classical quantitative or qualitative research One specific data analysis approach in the context of multi family member interview studies is outlined as data analysis remains underrepresented in the literature 多家庭成员访谈研究:关注数据分析 虽然关于夫妻和家庭的定性研究越来越普遍, 但是数据分析方面的文献仍非常不足。 在这篇研究方法文章中, 我们概述了一种在多家庭成员访谈研究的情况下进行数据分析的具体方法。以解释现象学分析和对偶访谈分析为基础, 这种方法可以对家庭行为和家庭现实的共建进行详细和系统的分析。借助医学辅助生殖领域的一项实例研究, 我们详细解释了这种方法的目的, 分析过程中的不同步骤和多家庭成员访谈研究的结果。在讨论研究结果的同时, 本文也论述了该方法存在的挑战与机遇。 对实务工作者的启示 多家庭成员访谈分析提供了对家庭行为和家庭现实的共建进行系统分析的机会。 比起经典定量、定性研究, 该研究发现可能更接近于系统治疗师在治疗中经常遇到的复杂情况。 我们概述了一种文献鲜少涉及的数据分析方法, 即针对多家庭成员访谈研究的一种数据分析具体方法。 关键词:定性研究; 研究方法论; 采访; 多人家庭访谈; 家庭治疗 Estudios de entrevistas para varios miembros de la familia: un enfoque en el análisis de datos Aunque la investigación cualitativa sobre las parejas y las familias se está extendiendo cada vez más, el aspecto del análisis de los datos sigue estando muy poco representado en la literatura. En este trabajo metodológico, esbozamos un enfoque específico para el análisis de datos en el contexto de los estudios de entrevistas con varios miembros de las familias. Inspirado por la Análisis Fenomenológico Interpretativo y por el Análisis de Entrevistas Diádicas, este enfoque permite el análisis detallado y sistemático de las prácticas familiares y la co‐construcción de realidades familiares compartidas. Sobre la base de un estudio ilustrativo en el campo de la reproducción asistida médicamente, damos una explicación detallada del objetivo de este enfoque, las diferentes etapas en el proceso de análisis y el resultado de un estudio de entrevistas con varios miembros de familias. Los resultados de este ejemplo de estudio se discuten a la luz de los retos y oportunidades metodológicas. Puntos de implicación práctica El análisis de entrevistas de múltiples miembros familiars permite el análisis sistemático de las prácticas familiares y la co‐construcción de realidades familiares compartidas Los resultados podrían aproximar a lector, de una manera mejor que la clásica dicotomía investigación cualitativa versus cuantitativa, a las complejidades terapéuticas que los terapeutas sistémicos a menudo encuentran en su práctica Se presenta un enfoque específico de análisis de datos en el contexto de los estudios de entrevistas multi miembros familiares, ya que el análisis de este tipo de datos sigue siendo insuficientemente tratado en la literatura Palabras clave: investigación cualitativa; metodología de investigación; entrevistas; entrevistas a miembros multifamiliares; terapia familiar.
    July 18, 2017   doi: 10.1111/1467-6427.12169   open full text
  • Research as resistance and solidarity: ‘spinning transformative yarns’‐ a narrative inquiry with women going on from abuse and oppression.
    Leah Salter.
    Journal of Family Therapy. July 18, 2017
    In this paper I set out the methodological framework for, and offer some emerging themes from, my ongoing narrative inquiry with women who have experienced abuse and oppression. The paper positions research as an act of resistance and solidarity and highlights the transformative nature of systemic group work and of narrative inquiry. The emergent themes of ‘power’, ‘transparency’ and ‘personal and collective transformation’ are brought forth from the conversations within the narrative inquiry. The process of which included three stages of conversational inquiry (with women I have co‐facilitated groups with and with women who were part of groups I co‐facilitated), followed by a five‐stage analysis of the transcribed conversations, the design and process of which is briefly described. There is reference to how women ‘go on’ after abuse and oppression and after being with other women in a ‘transformative’ group context. Extracts from the conversations I have been part of are interwoven with my own reflections, that form part of the rich tapestry of a narrative inquiry and are part of a story of transformation, solidarity and resistance. Practitioner points Narrative inquiry offers a frame for meaning making through the telling and re‐telling of stories Insider research is viewed as a generative and transformative process for all involved, including the ‘researcher’ Transparency within practice/research is put forward as an act of resistance, bringing less visible stories of resourcefulness into the light Research as solidarity is a joint movement towards social justice, contributing to ‘better social worlds’ 作为抵抗和团结的研究:“编写改变人生的故事”—与曾受虐待和压迫的妇女开展叙事调查 在本文中, 我以与曾经遭受虐待和压迫的妇女的叙事调查为基础, 提出了一个方法论框架以及一些浮现主题。本文将研究被视为抵抗和团结的一种行为, 突出了系统小组和叙事调查的变革性本质。从叙事调查中的对话中, “权力” “透明度”和“个人、集体转变”的主题浮现出来。其进程包括三阶段的对话式调查(对象为与我一起组织小组讨论的女性, 以及小组中的女性), 然后是五阶段的转录对话分析, 文中简要描述了这一设计和过程。文中有提到妇女在虐待和压迫之后以及与其他妇女一起体验“变革性”小组环境之后的情况。我所参与对话的摘录与我自己的思考交织在一起, 构成了叙事调查丰富画面的一部分, 是一个关于转变、团结和抵抗的故事的一部分。 对实务工作者的启示 叙事性探究通过故事的讲述和重述来提供形成意义的框架。 局内人研究被视为所有参与者的一个生成和变革过程, 包括”研究者”在内。 行为/研究中的透明度被提为一种抵抗行为, 揭示了平常不太可见的足智多谋的故事。 作为团结的研究是一项推动社会正义的联合运动, 为实现”更好的社会世界”做出贡献。 关键词:抵抗;研究;团结;叙事调查;系统的 La investigación como resistencia y solidaridad: “hilando tejidos de transformación”: –una investigación narrativa con mujeres que salen del abuso y la opresión En este trabajo he expuesto el marco metodológico y algunos temas emergentes de mi investigación narrativa en curso con mujeres que han experimentado el abuso y la opresión. El trabajo sitúa la investigación como un acto de resistencia y solidaridad y destaca la naturaleza transformadora del trabajo grupal sistémico y de la indagación narrativa. Los temas emergentes de “poder”, “transparencia” y “transformación personal y colectiva” son extraídos de las conversaciones que conforman la investigación narrativa. El proceso incluyó tres etapas de investigación conversacional (con las mujeres que he co‐facilitado en grupos con y con las mujeres que eran parte de los grupos que co‐facilité), seguidas de un análisis en cinco etapas de las conversaciones transcritas, todo ello parte del diseño y proceso que se describe someramente. Se hace referencia a cómo las mujeres “avanzan” después del abuso y la opresión y después de estar con otras mujeres en un contexto de grupo “transformador”. Extractos de las conversaciones de las que he formado parte se entrelazan con mis propias reflexiones, que forman parte del rico tapiz de una investigación narrativa y forman parte de una historia de transformación, solidaridad y resistencia. Puntos de implicación práctica La investigación narrativa ofrece un marco para la creación de significado a través de la narración y re‐narración de historias La investigación participante es vista como un proceso generador y transformador para todos los involucrados, incluyendo el ‘investigador' La transparencia dentro de la práctica/investigación se presenta como un acto de resistencia, trayendo a la luz historias menos visibles La investigación como solidaridad es un movimiento conjunto hacia la justicia social, contribuyendo a “mejores mundos sociales” Palabras clave: resistencia; investigación; solidaridad; indagación narrativa; sistémica.
    July 18, 2017   doi: 10.1111/1467-6427.12172   open full text
  • The ethics of researching one's own practice.
    Sarah Helps.
    Journal of Family Therapy. July 18, 2017
    Practice‐based research is increasingly utilized as a postmodern, qualitative research method. It can help systemic practitioners understand, develop and communicate about their everyday practice to others. In this article I review some of the literature on practitioner research and focus on the challenges of researching one's own practice. Using illustrative examples from transcripts and field notes gathered during my research on how I begin conversations with families who seek a diagnostic assessment for an autism spectrum condition for their child, I explore the ethics involved in the twofold task of providing a clinical service and conducting systematic research. I argue that a dynamic relational ethics of care can be employed to navigate the challenges of adopting a dual research and clinical focus. Practitioner points Navigating the dual task of ‘doing’ clinical practice and researching that practice is ethically complex The complexity should not be avoided and can be safely managed using a dynamic relational ethics of care Insider research exploring one's own practice fits neatly within a postmodern, social constructionist epistemology and with contemporary reflexive systemic practice 研究自身实践的伦理 实务研究越来越多地被用作一种后现代、定性的研究方法。它可以帮助系统治疗师理解、发展他们的日常实践, 并就其与他人交流。在这篇文章中, 我回顾了一些关于实践者研究的文献, 并着重关注了研究自身实践的挑战。我进行了一项研究, 关于如何与那些寻求儿童自闭症诊断评估的家庭开始对话, 从研究过程中收集的转录对话和田野笔记等具有说明性的例子中, 我探讨了提供临床服务和进行系统研究的双重任务所涉及的伦理标准。我认为, 可以采用一种动态关系的关怀伦理来应对研究、临床双重焦点的挑战。 对实务工作者的启示 处理 “做” 临床实践和研究这种实践的双重任务的过程, 包含复杂的伦理 复杂性不应该被回避, 并且可以使用动态关系的关怀伦理来安全地掌控 用局内人研究探索自己的实践完全符合后现代、社会建构主义认识论和当下的反思系统实践 关键词:伦理;局内人研究;实践者研究;自闭症;定性研究 La ética de la investigación de tu propia práctica La investigación basada en la práctica se utiliza cada vez más como un método de investigación cualitativa posmoderna. Puede ayudar a los profesionales sistémicos a comprender, desarrollar y comunicar acerca de su práctica cotidiana a los demás. En este artículo reviso parte de la literatura sobre investigación realizada por los que practican la terapia y me enfoco en los desafíos de investigar tu propia práctica. Utilizando ejemplos ilustrativos de transcripciones y notas de campo recogidos durante mi investigación sobre cómo iniciar conversaciones con familias que buscan una evaluación diagnóstica para una condición de espectro autista para su hijo, exploro la ética involucrada en la doble tarea de proporcionar un servicio clínico y realizar una investigación sistemática. Sostengo que una ética relacional dinámica de la atención se puede emplear para navegar los retos de adoptar un doble foco de investigación y clínico. Puntos de implicación práctica. Navegar por la doble tarea de “hacer” la práctica clínica y investigar esa práctica es algo éticamente complejo La complejidad no debe ser evitada y puede ser manejada con seguridad usando una ética relacional dinámica del cuidado del cliente Las investigaciones que exploran la propia práctica desde dentro encajan perfectamente dentro de una epistemología posmoderna y construccionista social y con la práctica sistémica reflexiva contemporánea Palabras clave: ética; investigación desde dentro; investigación del profesional; autismo; investigación cualitativa.
    July 18, 2017   doi: 10.1111/1467-6427.12166   open full text
  • Creating a space to think in adversarial contexts: researching network meetings in statutory childcare interventions.
    Philippe Mandin.
    Journal of Family Therapy. July 18, 2017
    This research investigated complex relationships between parents and professionals involved in care proceedings, through detailed observations of network meetings – a practice developed in a Child and Adolescent Mental Health Service to engage with families and professionals in adversarial contexts. These take place at the border between the domain of court, often dominated by structural preoccupations, and the clinic valuing experience and relationships. Six meetings were recorded and observed by the researcher in the room. The methodology drew on a number of epistemological traditions to capture the complexity and multi‐layered nature of knowledge and experience. The study evolved into an ethnography‐inspired exploration of structures, relationships and emotions emerging in meetings and the adversarial context of care proceedings. Successful meetings managed tensions between a structure‐dominated domain and the experience‐near domain of the clinic while avoiding being dominated by either. Practitioner points Structure can be both enabling and constraining Direct observation and bringing stakeholders together without legal representatives can allow new information and a deeper understanding of human stories to emerge Chairs have to emphasize the need to work together in order to create a genuine space to think A three‐phase approach to meetings and assessments can provide a level of containment in order to move between the security of structure and the domain of experience. 创造空间, 在敌对场景中思考:研究法定保育干预中的网络会议 这项研究通过网络会议——一项儿童和青少年心理健康服务开发的一种实践, 目的是与敌对场景中的家庭和专业人士建立关系——的详细观察, 研究了保育程序中父母和专业人士之间的复杂关系。它们发生在法庭领域和临床领域的交界处, 前者通常由结构性的考量主导, 而后者关注经验和关系。研究员在房间里记录并观察了六次会议。该方法借鉴了许多认识论传统, 以捕捉知识和经验的复杂性和多层性质。这项研究发展成为一次由民族志研究激发的探索, 对象为会议和保育程序的敌对场景中出现的结构、关系和情绪。成功的会议掌控了结构主导的领域和靠近体验的临床领域之间的紧张关系, 同时避免了被这两者之中任一个主导。 对实务工作者的启示 结构既可能授予权利, 也可能产生约束 直接观察, 以及将没有法定代表人陪同的利益相关者聚集在一起, 可以产生新的信息和对个人故事更深入的了解 会议主持必须强调需要共同努力才能创造一个真正的思考空间 一种会议和评估的三步法可以提供一定程度的遏制,以便在结构安全感和体验的领域之间切换 关键词:参与;流程研究;网络会议;两极化系统;系统社会工作 Crear un espacio para pensar en contextos adversarios: investigando reuniones de red en intervenciones legales de cuidado infantil Esta investigación estudió las relaciones complejas entre padres y profesionales involucrados en los procedimientos de cuidado y protección a la infancia a través de observaciones detalladas de las reuniones de la red –una práctica desarrollada en un Servicio de Salud Mental Infantil y Adolescente para crear involucración de familias y profesionales en contextos adversarios. Éstos ocurren en la frontera entre el dominio de la Justicia, a menudo dominado por las preocupaciones estructurales, y la clínica que valora la experiencia y las relaciones. Seis reuniones fueron registradas y observadas por el investigador en la sala. La metodología se basó en una serie de tradiciones epistemológicas para captar la complejidad y la naturaleza multi‐nivel del conocimiento y la experiencia. El estudio se convirtió en una exploración, inspirada en la etnografía, de las estructuras, relaciones y emociones que emergen en las reuniones y el contexto contradictorio de los procedimientos de atención. Las reuniones exitosas gestionaron las tensiones entre un dominio dominado por la estructura y el dominio más cercano a la experiencia de la clínica, evitando ser sometido por cualquiera de ellos. Puntos de implicación práctica La estructura puede ser tanto facilitadora como restrictiva La observación directa y el acercamiento de las partes interesadas sin representantes legales puede facilitar que surja nueva información y una comprensión más profunda de las historias humanas Los directores deben enfatizar la necesidad de trabajar juntos para crear un espacio genuino para pensar Un enfoque trifásico de las reuniones y evaluaciones puede proporcionar un nivel de contención para pasar de la seguridad de la estructura al dominio de la experiencia. Palabras clave: compromiso; investigación de procesos; reuniones de la red; sistemas polarizados; trabajo social sistémico
    July 18, 2017   doi: 10.1111/1467-6427.12167   open full text
  • Analysing the relational components of systemic family therapy through the lenses of self positions and therapeutic alliance: an exploratory study.
    Francesca Balestra.
    Journal of Family Therapy. July 18, 2017
    Several studies have stressed how relational components of therapy account for successful treatment more than techniques and therapeutic models. The relational domain lies at the heart of family therapy, yet systemic research on therapeutic relationship is still scarce. Process research developed different approaches identifying different aspects of the relational components that contribute to a successful psychotherapy. They have been usually considered separately. Building upon a qualitative analysis of the different Self positions in conversation by means of MAPP (Balestra and Fruggeri, ), and the analysis of therapeutic alliance by means of SOFTA (Friedlander et al., ), the purpose of this study is to explore how therapeutic alliance, which has often been considered the main component of the therapeutic relationship in common factors research, interrelates with the discursive construction of Self positions and contexts of meaning. The study stresses how these relational aspects interact in systemic marital and family therapy. Practitioner points Outcomes and process studies underline that engagement, alliance, and the emergence of new meanings are the key elements for a successful psychotherapy Process research tools can detect the different components of the therapeutic relationship and their interconnection in the development of a session By being aware of the multifaceted components of the therapeutic relationship, clinicians may improve their ability to manage change processes while therapy is progressing 从自我定位和治疗联盟的角度分析系统家庭治疗的关系成分:一项探索性研究 有多项研究强调, 治疗的关系成分对于成功的治疗结果的作用比技术和治疗模型更大。关系是家庭治疗的核心, 但关于治疗关系的系统研究仍然很少。过程研究开发了不同的方法, 以辨别有助于治疗成功的关系成分的不同方面。通常, 它们单独列为考虑。建立在MAPP对谈话中的不同自我定位的定性分析以及SOFTA对治疗联盟的分析的基础上, 本研究的目的是探索治疗联盟(在共同因素研究中经常被认为是治疗关系的主要组成部分)如何与话语建构的自我定位和意义语境相关。该研究强调了这些关系因素在系统婚姻家庭治疗中如何相互作用。 对实务工作者的启示 结果和过程研究强调参与、联盟和新意义的显现是成功的心理治疗的关键要素。 过程研究工具可以检测到治疗关系的不同组成部分及其在治疗发展中的相互联系。 通过了解治疗关系的多方面因素, 治疗师可以提高在治疗进展期间管理变化过程的能力。 关键词:治疗联盟;定位;婚姻和家庭治疗;共同因素;过程研究 Analizando los componentes relacionales de la terapia familiar sistémica a través de las lentes de las posiciones del Yo y de la alianza terapéutica: un estudio exploratorio Varios estudios han subrayado cómo los componentes relacionales de la terapia explican el éxito del tratamiento más que las técnicas y los modelos terapéuticos. El dominio relacional está en el corazón de la terapia familiar, sin embargo la investigación sistémica sobre la relación terapéutica es todavía escasa. La investigación de procesos desarrolló diferentes enfoques identificando diferentes aspectos de los componentes relacionales que contribuyen a una psicoterapia exitosa. Generalmente se han considerado por separado. A partir de un análisis cualitativo de las diferentes posiciones del Yo en la conversación a través de MAPP (Balestra y Fruggeri, ), y el análisis de la alianza terapéutica mediante el SOFTA (Friedlander, Escudero & Heatherington, ), el propósito de este estudio es explorar cómo la alianza terapéutica, que a menudo ha sido considerada el principal componente de la relación terapéutica en la investigación de factores comunes, se interrelaciona con la construcción discursiva de las posiciones del Yo y contextos de significado. El estudio enfatiza cómo interactúan estos aspectos relacionales en la terapia sistémica marital y familiar. Puntos de implicación práctica Los estudios de resultado y de proceso subrayan que el enganche, la alianza y la aparición de nuevos significados son los elementos clave para una psicoterapia exitosa Las herramientas de investigación de procesos pueden detectar los diferentes componentes de la relación terapéutica y su interconexión en el desarrollo de una sesión Al ser conscientes de los componentes multifacéticos de la relación terapéutica, los clínicos pueden mejorar su capacidad para gestionar los procesos de cambio mientras la terapia está progresando Palabras clave: alianza terapéutica; posicionamiento; terapia matrimonial y familiar; factores comunes; investigación de proceso.
    July 18, 2017   doi: 10.1111/1467-6427.12175   open full text
  • Practice Based Evidence Based Practice. Navigating based on coordinated improvisation, collaborative learning and multi‐methods research in Feedback Informed Systemic Therapy.
    Robert van Hennik, Bruno Hillewaere.
    Journal of Family Therapy. July 18, 2017
    In times when therapy is legitimized by transparency through control, standardization and benchmarking, the authors present a fluid manual of Feedback Informed Integrative Therapy within Systems (FITS) as a Practice Based Evidence Based Practice (PBEBP). The fluid manual FITS corresponds to the locality and complexity of social and cultural life and is substantiated by practice‐based research. The FITS therapist navigates her reflected responses on the basis of coordinated improvisation, organized feedback, collaborative learning and multi‐methods research. Accountability and transparency are offered through i) quantitative measurement of effects, developments and points of collaboration in therapy and ii) qualitative inquiry into navigational activities using improvisation and collaborative learning. FITS is a Practice Based Evidence Based Practice (PBEBP). The therapist is both practitioner and researcher and involves clients as co‐researchers. Therapist and clients examine the effects of their collaboration. The output of research is input for therapy in the ‘collaborative learning community’ constituted together. Practitioner points This article may inspire practitioners to manualize and research their own family therapy practice as a Practice Based Evidence Based Practice In FITS, a PBEBP therapist and family members constitute a ‘collaborative learning community’, learning together how they learn and evaluating their collaboration in therapy Practice Based Evidence Based Practice could be an alternative to standardized therapy models and manuals 以基于实践的证据为本的实践:在反馈导向系统治疗中基于有组织的即兴发挥、合作学习和多方法研究的应对 在控制、标准化和基准测试所带来的透明度使治疗合法化的时代, 作者提出了一种灵活的系统内反馈导向综合治疗(FITS)的手册, 作为一种以基于实践的证据为本的实践(PBEBP)。该灵活手册FITS呼应社会和文化生活的地域和复杂性, 并基于以实践为基础的研究。 FITS治疗师在有组织的即兴发挥、反馈、合作学习和多方法研究的基础上应对她所接收的反馈。通过1)对治疗中的效果、发展和合作点进行定量测量, 以及2)使用即兴发挥和合作学习对引导活动进行定性调查, 以提供责任制、保证透明度。 FITS是一种以基于实践的证据为本的实践(PBEBP)。治疗师既是从业者, 也是研究人员, 并将来访者看作共同研究人员。治疗师和来访者一起调查这种合作的效果。研究产出的结果成为共同构建的“合作学习团体”治疗投入。 对实务工作者的启示 本文或许会启发实务工作者将他们自己的家庭治疗实践作为以基于实践的证据为本的实践, 来进行手册化和研究 在FITS中, PBEBP治疗师和家庭成员组成一个“合作学习团体”, 一起弄清他们如何学习, 并评估他们在治疗中的协作 以基于实践的证据为本的实践可以替代标准化治疗模型和手册 关键词:反馈; 手册化实践; 即兴; 合作学习; 多方法研究; 家庭治疗研究; 系统治疗 Práctica Basada en la Evidencia Basada en la Practica. Navegación basada en la improvisación coordinada, el aprendizaje colaborativo y la investigación multi‐método en la Terapia Sistémica Informada por Retroalimentación En estos tiempos en los que la terapia se legitima mediante la transparencia a través del control, la estandarización y el benchmarking, los autores presentan un manual de Terapia Integrativa Informada por Retroalimentación Intra‐Sistemas (FITS, por sus siglas en inglés); dicho manual se concibe como una Práctica Basada en la Evidencia Basada en la Práctica (PBEBP). El manual FITS responde a las características de localidad y complejidad de la vida social y cultural y está sustanciado por la investigación basada en la práctica. El terapeuta FITS navega sus respuestas reflejadas sobre la base de la improvisación coordinada, la retroalimentación organizada, el aprendizaje colaborativo y la investigación de múltiples métodos. Se ofrece transparencia y se da cuenta responsablemente a través de (i) medidas cuantitativas de efectividad, desarrollo y puntos de colaboración en la terapia y (ii) indagación cualitativa en las actividades que se recorren usando improvisación y aprendizaje colaborativo. FITS es una Práctica Basada en la Evidencia Basada en la Practica (PBEBP). El terapeuta es tanto profesional como investigador e involucra a los clientes como co‐investigadores. El terapeuta y los clientes examinan los efectos de su colaboración. El resultado de la investigación es a su vez un input para la terapia en la “comunidad de aprendizaje colaborativo” constituida en conjunto. Puntos de implicación práctica Este artículo puede inspirar a los terapeutas a manualizar e investigar su propia práctica de la terapia familiar como una Práctica Basada en la Evidencia Basada en la Práctica En FITS un terapeuta PBEBP y los miembros de la familia constituyen una “comunidad de aprendizaje colaborativo”, aprendiendo juntos cómo aprenden y evaluando su colaboración en terapia La Práctica Basada en la Evidencia Basada en la Práctica puede ser una alternativa a los modelos y manuales de terapia estandarizados Palabras clave: retroalimentación; práctica manualizada; improvisación; aprendizaje colaborativo; investigación multi‐métodos; investigación en terapia familiar; terapia sistémica.
    July 18, 2017   doi: 10.1111/1467-6427.12159   open full text
  • Alliance formation in high‐conflict custody mediation: a serial case analysis.
    Peder Kjøs, Hanne Weie Oddli.
    Journal of Family Therapy. June 23, 2017
    --- - |2+ Abstract Through an in‐depth qualitative analysis of five cases of mandatory high‐conflict custody mediation, we analysed interpersonal processes associated with the early formation of a working alliance in a three‐way interaction. The analysis showed that the mediator efficiently managed the focus of the conversation and validated the parents’ perspectives, but was reticent in addressing interactional issues. Our findings suggest that mediators in high‐conflict custody mediation cases can facilitate the formation of an alliance between the parents, as well as between the mediator and the parents, by taking into account three main aspects of the interaction: (1) the management of the focus of the conversation; (2) validation of the parties’ perspectives; and (3) adapting interventions and tasks to the cohesion of the parent dyad. Practitioner points Mediators support the formation of a collaborative alliance by managing the focus of the conversation and validating parties’ perspectives Low parent dyad cohesion may bar cooperation on seemingly minor issues and a working alliance should be established early on Ample spacing between mediation sessions allows parents time to try out and evaluate different practical arrangements Working on concrete items of a parenting plan contributes to improving cooperation 抽象 高度冲突的监护权调解中联盟的形成: 序列案例分析 通过对五个强制性、高冲突的监护权调解案例的深入定性分析, 我们分析了在三方互动早期形成的工作联盟相关的人际关系过程。分析表明, 调解人有效地管理了谈话重点、认同了父母的观点, 但在处理互动问题方面保持沉默。我们的调查结果表明, 调解人在高度冲突的监护调解案件中, 可以通过对互动的三个主要方面的考虑, 促进父母之间以及调解人与父母之间的联盟形成:(1)管理谈话的焦点;(二)认同当事人的观点;以及(3)根据父母双方之间的凝聚力程度调整干预手段和任务。 对实务工作者的启示 调解人通过管理对话焦点和认同各方观点来支持合作性质的联盟的形成 亲属双方的低凝聚力可能会阻碍在看似微小的问题上的合作, 所以应尽早建立工作联盟 两次调解会议之间留出足够的时间, 让父母有时间尝试并评估不同的安排 制定具体的育儿计划项目有助于改善合作 Abstracto Formación de la Alianza en la mediación de la custodia de alto conflicto: una serie de análisis de caso A través de un análisis cualitativo en profundidad de cinco casos de mediación de custodia obligatoria de alto conflicto, analizamos los procesos interpersonales asociados con la formación temprana de una alianza de trabajo en una interacción de tres vías. El análisis mostró que el mediador administró eficientemente el foco de la conversación y validó las perspectivas de los padres, pero se mostró reticente al abordar los problemas de interacción. Nuestros hallazgos sugieren que los mediadores en casos de mediación de custodia de alto conflicto pueden facilitar la formación de una alianza entre los padres, así como entre el mediador y los padres, teniendo en cuenta tres aspectos principales de la interacción: (1) la gestión de el foco de la conversación; (2) validación de las perspectivas de las partes; y (3) adaptar intervenciones y tareas a la cohesión de la díada parental. Puntos de implicación práctica: Los mediadores apoyan la formación de una alianza gestionando el foco de la conversación y validando las perspectivas de las partes La baja cohesión matrimonial de los padres puede impedir la cooperación en cuestiones aparentemente menores y debe establecerse una alianza de trabajo desde el principio. Un amplio espacio entre las sesiones de mediación les permite a los padres probar y evaluar diferentes compromisos prácticos Trabajar en elementos concretos de un plan parental contribuye a mejorar la cooperación - Journal of Family Therapy, Volume 40, Issue 3, Page 378-397, August 2018.
    June 23, 2017   doi: 10.1111/1467-6427.12180   open full text
  • Taking conversations forward: a systemic exercise for teams threatened by service restructures.
    James Randall‐James, Annabel Head.
    Journal of Family Therapy. June 23, 2017
    --- - |2+ Abstract This paper describes a systemic exercise for clinical staff facing multiple changes to team structure and threats to their sense of belonging. The exercise was adapted from a consultation intervention that addressed a team's resourcefulness in responding to behaviours that challenge in intellectual disabilities (Smyly, 2006). As clinical psychology trainees from outside the Child and Adolescent Mental Health Service (CAMHS), we aimed to facilitate a context in which staff could share past experiences of collectively overcoming challenges, and in this way nourish a sense of belonging. Through building layers of dialogue, taking the observer perspective and reflection in the context of such threats to personal, professional and team identities, a shared direction may be claimed again. Practitioner points Providing space for teams to reflect on past experiences of overcoming challenging situations may empower teams and enhance a sense of belonging during difficult transitions Moving towards an explorative and interactive space for personal and professional selves, away from problem‐saturated narratives, creates a context for innovation and change Exercises that develop layers of conversation can scaffold relational risk‐taking, celebrate difference, and guide collaboration towards developing narratives of belonging 抽象 针对服务重组威胁下的团队的系统练习 本文介绍了一种系统性练习, 其针对人群是面临团队结构的多种变化和自身归属感受到威胁的临床工作人员。该练习的原型是一项咨询干预, 这项干预使团队能够应对智力障碍中的挑战性行为(Smyly, 2006)。作为非儿童和青少年心理健康服务(CAMHS)的临床心理学学员, 我们的目标是促成一种环境, 使员工可以在其中分享过去集体克服挑战的经验, 从而滋养归属感。通过建立不同层次的对话, 采取观察者视角, 以及在个人、专业和团队认同受到威胁的背景下思考, 团队可能会再次形成一致的方向。 对实务工作者的启示 为团队提供空间以反思过去克服挑战的经验, 可以增强团队力量以及困难的转型期间的归属感 向探索个人和职业自我的互动空间引导, 远离充满问题的话语, 会为创新和变革创造环境 可以引出不同层面谈话的练习可以为关系性冒险和赞美差异提供基础, 并对建立归属感的合作提供指引 Abstracto Llevando las conversaciones adelante: un ejercicio sistémico para equipos amenazados por reestructuraciones de servicios Este documento describe un ejercicio sistémico para el personal clínico que enfrenta múltiples cambios en la estructura del equipo y amenazas a su sentido de pertenencia. El ejercicio se adaptó a partir de una intervención de consulta que abordó los recursos de un equipo para responder a comportamientos desafiantes en discapacidad intelectual (Smyly, 2006). Como estudiantes en prácticas de psicología clínica externos en una unidad de salud mental infanto‐juvenil, nuestro objetivo fue facilitar un contexto en el cual el personal pudiera compartir experiencias pasadas de superación colectiva de desafíos, y de esta manera alimentar un sentido de pertenencia. Al construir capas de diálogo, tomando la perspectiva y la reflexión del observador en el contexto de tales amenazas a las identidades personales, profesionales y de equipo, se puede reclamar nuevamente una línea de trabajo compartida. Puntos de implicación práctica: Proporcionar espacio para que los equipos reflexionen sobre las experiencias pasadas de superar situaciones desafiantes puede empoderar a los equipos y mejorar el sentido de pertenencia durante las transiciones difíciles. Avanzar hacia un espacio exploratorio e interactivo para el yo personal y profesional, lejos de las narrativas saturadas de problemas, crea un contexto para la innovación y el cambio Los ejercicios que desarrollan capas de conversación pueden mejorar la toma de riesgos relacional, celebrar la diferencia y guiar la colaboración hacia el desarrollo de narrativas de pertenencia. - Journal of Family Therapy, Volume 40, Issue 3, Page 447-458, August 2018.
    June 23, 2017   doi: 10.1111/1467-6427.12184   open full text
  • Long‐term psychosocial outcomes after face transplantation: a patient's and a partner's perspective.
    Gilbert M.D. Lemmens, Hannelore Hendrickx, Carine Poppe, Nathalie A. Roche, Patrick C. Peeters, Hubert F. Vermeersch, Xavier Rogiers, Kristiane Van Lierde, Phillip N. Blondeel.
    Journal of Family Therapy. June 16, 2017
    --- - |2+ Abstract To date, psychosocial outcomes after face transplantation are promising, although the impact on family relationships is less well investigated. Depressive and anxiety symptoms, resilience, spousal support, dyadic adjustment, family functioning of a patient and the partner were assessed before, and two, three and four years after the face transplantation. Most psychological, marital and family scores of both partners remained within a normative and healthy range at follow‐up. Resilience, illness cognitions, physical quality of life, and family affective responsiveness and communication of the patient further improved, whereas the partner reported higher resilience and dyadic consensus at four years after transplantation. The results of this study point to positive long‐term psychosocial outcomes of a blind patient and his partner after face transplantation. Practitioner points Psychological health of patient and partner remains good after face transplantation Marital and family functioning remains stable after face transplantation and may even improve Face transplantation may strengthen the resilience of the patient and the partner 抽象 面部移植的长期心理社会结果: 患者和伴侣的观点 到目前为止, 面部移植后的社会心理结果是乐观的, 虽然其对家庭关系的影响没有得到同样程度的调查。 在面部移植之前和手术后两、三、四年内评估了抑郁和焦虑症状、复原力、配偶支持、二元适应、患者和伴侣的家庭功能。两名伴侣的绝大多数心理、婚姻和家庭得分在回访中保持在正常、健康的范围之内。 患者的复原力、情感反应、疾病认知、生活质量和家庭情感反应及沟通进一步改善, 而其伴侣在移植四年后报告了更高的复原力和二者共识。 这项研究的结果指出了盲人患者及其伴侣在面部移植后积极的长期心理社会结果。 对实务工作者的启示 患者和伴侣的心理健康在面部移植后保持良好 面部移植后, 婚姻和家庭功能保持稳定, 甚至可能改善 面部移植可增强患者和伴侣的复原力 Abstracto Resultados psicosociales a largo plazo después del trasplante facial: la perspectiva de un paciente y su pareja Hasta la fecha, los resultados psicosociales después del trasplante de cara son prometedores, aunque el impacto en las relaciones familiares está menos investigado. Los síntomas depresivos y de ansiedad, la resiliencia, el apoyo conyugal, el ajuste diádico, el funcionamiento familiar de un paciente y su pareja se evaluaron antes, y dos, tres y cuatro años después del trasplante facial. La mayoría de los puntajes psicológicos, maritales y familiares de ambos compañeros se mantuvieron dentro de un rango normativo y saludable en el seguimiento. La resiliencia, la capacidad de respuesta afectiva, las cogniciones de enfermedad, la calidad de vida física y la respuesta afectiva familiar y la comunicación del paciente mejoraron aún más, mientras que su pareja informó una mayor resiliencia y consenso diádico a los cuatro años del trasplante. Los resultados de este estudio apuntan a resultados psicosociales positivos a largo plazo de un paciente ciego y su pareja después del trasplante facial. Puntos de implicación práctica: La salud psicológica del paciente y la pareja sigue siendo buena después del trasplante facial El funcionamiento de pareja y familiar permanece estable después del trasplante facial e incluso puede mejorar El trasplante facial puede fortalecer la capacidad de recuperación del paciente y de su pareja - Journal of Family Therapy, Volume 40, Issue 3, Page 398-412, August 2018.
    June 16, 2017   doi: 10.1111/1467-6427.12182   open full text
  • The evidence base for Multiple Family Therapy in psychiatric disorders: a review (part 1).
    Zoé Gelin, Solange Cook‐Darzens, Stéphan Hendrick.
    Journal of Family Therapy. June 06, 2017
    --- - |2+ Abstract This article provides an updated and comprehensive overview of the empirical literature regarding Multiple Family Therapy (MFT)'s applications to major psychiatric disorders. It shows that MFT's strongest evidence base is for schizophrenia and chronic psychoses, making its psychoeducational model one of the best available practices for these disorders. There is also a growing body of evidence regarding the usefulness of MFT for mood disorders (particularly in children), eating disorders and alcohol‐substance abuse, but more controlled research is needed for these conditions. Other disorders such as anxiety disorders, autism and attention deficit hyperactivity disorder have been studied in a more anecdotal fashion and require more rigorous investigations. Future research efforts should focus on: (1) the specific advantage of MFT over other active treatment modalities, (2) the comparative efficacy of various MFT models for a given population, and (3) MFT's change processes. Practitioner points McFarlane's psychoeducational MFT model is considered best practice for schizophrenia and other psychoses (and possibly mood disorders), facilitated by its manual‐based approach The Maudsley model is a valuable treatment for adolescent anorexia nervosa. Family therapists who are less ED‐focused in their interventions can also use more generic MFT models MFT practitioners should attempt to operationalize their MFT model and include an evaluation component in their therapeutic implementation 抽象 多家庭治疗(MFT)在非精神病情况和问题中的证据基础: 综述(第1部分) 本文针对多重家庭治疗(MFT)在主要精神障碍上的应用的相关实证文献进行了最新的全面概述。概述表明, MFT最有力的证据是针对精神分裂症和慢性精神病, 使其心理教育模式成为针对这些疾病最有效的手段之一。关于MFT对心境障碍(特别是儿童)、饮食紊乱和酒精性物质滥用的有用性也有越来越多的证据, 但是针对这些情况还需要进行控制更严格的研究。关于诸如焦虑症、自闭症和注意缺陷多动症的其它障碍的研究多采用轶事方法, 需要更严谨的调查。未来研究应着重于:(1)MFT相较于其他积极治疗方式的具体优势, (2)各种MFT模型针对给定人群的比较性功效, 以及(3)MFT的变化过程。 给实务工作者的启示 McFarlane的心理教育MFT模型被认为是针对精神分裂症和其他精神病(心境障碍亦有可能)的最佳实践, 其手册化的方法强化了这一点 Maudsley模型是青少年神经性厌食症的有效治疗方法。在其干预中关注ED较少的家庭治疗师也可以采用更通用的MFT模型 MFT从业者应尝试将其MFT模式可操作化, 并将评估部分纳入到其治疗的实施当中 Abstracto La base de evidencia empírica para la terapia familiar múltiple en trastornos psiquiátricos: una revisión (parte 1) Este artículo proporciona una visión general actualizada y completa de la literatura empírica sobre las aplicaciones de Terapia Familiar Múltiple (TFM) a los principales trastornos psiquiátricos. Muestra que la base de evidencia más sólida de TFM es para la esquizofrenia y las psicosis crónicas, por lo que su modelo psico‐educativo es una de las mejores prácticas disponibles para estos trastornos. También hay un creciente cuerpo de evidencia con respecto a la utilidad de TFM para los trastornos del estado de ánimo (particularmente en niños), trastornos de la alimentación y abuso de sustancias alcohólicas, pero se necesita una investigación más controlada para estas afecciones. Otros trastornos como los trastornos de ansiedad, el autismo y el trastorno por déficit de atención con hiperactividad se han estudiado de forma más anecdótica y requieren investigaciones más rigurosas. Los futuros esfuerzos de investigación deberían enfocarse en: (1) la ventaja específica de TFM sobre otras modalidades de tratamiento activo, (2) la eficacia comparativa de varios modelos de TFM para una población dada, y (3) los procesos de cambio de TFM. Puntos de mplicación práctica: El modelo TFM psicoeducativo de McFarlane se considera la mejor práctica para la esquizofrenia y otras psicosis (y posiblemente trastornos del estado de ánimo), facilitado por su enfoque basado en el manual El modelo Maudsley es un tratamiento valioso para la anorexia nerviosa adolescente. Los terapeutas familiares que tienen menos foco ED en sus intervenciones también pueden usar modelos de TFM más genéricos Los profesionales de TFM deben intentar operacionalizar su modelo de TFM e incluir un componente de evaluación en su implementación terapéutica - Journal of Family Therapy, Volume 40, Issue 3, Page 302-325, August 2018.
    June 06, 2017   doi: 10.1111/1467-6427.12178   open full text
  • Evidence base for Multiple Family Therapy (MFT) in non‐psychiatric conditions and problems: a review (part 2).
    Solange Cook‐Darzens, Zoé Gelin, Stéphan Hendrick.
    Journal of Family Therapy. June 06, 2017
    --- - |2+ Abstract This article provides an updated overview of the empirical literature regarding Multiple Family Therapy's (MFT) applications to non‐psychiatric conditions and problems. Although the evidence is not as strong for these disorders as for psychiatric disorders, the benefits of MFT approaches are apparent in the following areas: family management of several severe chronic medical illnesses; prevention of educational failure and exclusion; and treatment of marital distress. MFT research in non‐psychiatric settings has been faced with unique challenges that have mitigated the quality and quantity of outcome and process research produced over the past decade. Future research efforts should focus on: (1) stronger commitment to the evaluation of ongoing MFT programmes; (2) identification and manualization of major MFT programmes; (3) more Randomized Clinical Trials (RCTs) on the effectiveness of MFT programmes in community settings; and (4) higher priority for research on MFT's change processes and patterns of interaction. Practitioner points The treatment of chronic physical diseases is optimized by involving family members, and MFT is a valuable way of doing so: workshops delivered in brief formats are most feasible MFT should be considered for non‐psychiatric problems with the risk of isolation and stigmatization. The presence of other families sharing the same challenges is very useful MFT practitioners should attempt to operationalize their MFT model and include an evaluation component in their therapeutic implementation as routine practice 抽象 多家庭治疗(MFT)在非精神病情况和问题中的证据基础: 综述(第2部分) 本文针对多家庭治疗(MFT)应用于非精神病症和问题的实证文献进行了最新概述。尽管有关这些障碍的实证并不如有关精神障碍的那样有力, 但在以下几个方面, MFT方法的好处还是显而易见的:针对数种严重慢性医学疾病的家庭管理;预防教育上的失败和排斥;以及处理婚姻方面的困扰。针对非精神病情况的MFT研究一直以来面临着独特的挑战, 以至于影响了过去十年中产出的实效研究和过程研究的质量和数量。未来的研究工作应着重于:(1)更加着力于评估正在进行的MFT项目;(2)推动主要MFT项目的识别和手册化;(3)更多针对社区环境中的MFT项目的有效性的随机临床试验(RCT);和(4)优先研究MFT中的变化过程和互动模式。 对实务工作者的启示 家庭成员的参与有利于慢性生理疾病的治疗, 而MFT是一种有价值的方法:形式简单的工作坊最可行 对于具有孤立和污名化风险的非精神病问题, 应考虑使用MFT。有面临同样挑战的其他家庭在场是非常有用的 MFT从业者应尝试将其MFT模式可操作化, 并在治疗中纳入评估部分, 作为一种常规做法 Abstracto La base de evidencia empírica para la terapia familiar múltiple (MFT) en condiciones y problemas no psiquiátricos: una revisión (parte 2) Este artículo proporciona una visión general actualizada de la literatura empírica sobre las aplicaciones de la Terapia Familiar Múltiple (TFM) a problemas y condiciones no psiquiátricas. Aunque la evidencia no es tan sólida para estos trastornos como para los trastornos psiquiátricos, los beneficios de los enfoques TFM son evidentes en las siguientes áreas: manejo familiar de varias enfermedades médicas crónicas graves; prevención del fracaso educativo y la exclusión; y el tratamiento de problemas de pareja. La investigación de TFM en entornos no psiquiátricos se ha enfrentado a desafíos únicos que han mitigado la calidad y cantidad de los resultados y la investigación de procesos producidos durante la última década. Los esfuerzos futuros de investigación deben enfocarse en: (1) un mayor compromiso con la evaluación de los programas de TFM en curso; (2) identificación y manualización de los principales programas de TFM; (3) más ensayos clínicos aleatorizados sobre la efectividad de los programas TFM en entornos comunitarios; y (4) mayor prioridad para la investigación de los procesos de cambio y los patrones de interacción en TFM. Puntos de implicación práctica: El tratamiento de las enfermedades físicas crónicas se optimiza mediante la participación de los miembros de la familia, y TFM es una forma valiosa de hacerlo: los talleres en formatos breves son los más factibles TFM debe considerarse para problemas no psiquiátricos con riesgo de aislamiento y estigmatización. La presencia de otras familias que comparten los mismos desafíos es muy útil Los profesionales de TFM deben intentar operacionalizar su modelo de TFM e incluir un componente de evaluación en su implementación terapéutica como práctica de rutina - Journal of Family Therapy, Volume 40, Issue 3, Page 326-343, August 2018.
    June 06, 2017   doi: 10.1111/1467-6427.12177   open full text
  • Results of the Jyväskylä research project on couple therapy for intimate partner violence: topics and strategies in successful therapy processes.
    Berta Vall, Helena Päivinen, Juha Holma.
    Journal of Family Therapy. May 30, 2017
    Despite controversy over the indications of couple therapy for IPV, current research has indicated some benefits. This article examines some crucial aspects when dealing with couple therapy for IPV, such as how dominance and power abuse are present, and which important issues should be taken into account during the therapeutic process and be brought up in therapeutic conversations. It also proposes strategies for therapists conducting couple therapy for IPV. Ten studies conducted within the Jyväskylä research project on couple therapy for IPV were reviewed. Findings highlighted the importance of the therapists’ awareness of the presence of violence, dominance and power during the sessions, and of how cultural issues could prevent their recognition. Responsibility and couple agreement on the violent behaviour seemed especially relevant at the beginning of the treatment. Potentially useful therapeutic strategies are directedness, use of reflective dialogue, and continuous assessment. Practitioner points In couple treatment for IPV therapists should (a) actively bring up violence, responsibility and parenting, and (b) reflect on the culturally dominant understandings of IPV To regulate the presence of dominance, therapists’ directivity might promote equal distribution of talk, and increase the therapeutic alliance Therapist strategies such as multivoiced addresses, reflective dialogue and a directive approach may promote clients’ responsibility and reflexivity
    May 30, 2017   doi: 10.1111/1467-6427.12170   open full text
  • What can systemic psychotherapy offer clinical practice and public debates on assisted dying?
    Liz Forbat.
    Journal of Family Therapy. May 21, 2017
    --- - |2+ Abstract Debates around assisted dying have not to date been informed by family and systemic psychotherapy. This article sets the context of legalized assisted dying with a précis of the international terrain. Case examples of people facing terminal or chronic illness are presented alongside the research literature, to illustrate the bio‐psycho‐social domains inhabited by those seeking assisted dying. The article then presents a case for what systemic psychotherapy has to offer, suggesting a range of approaches, methods and techniques. Following core tenets of systemic psychotherapy, the article is not predicated on an either/or standpoint. Rather, neutrality and curiosity are centralized, to facilitate discussion, debate and new insights. The article concludes that systemic psychotherapists have a latent and untapped skill‐set in understanding the repercussions of someone who wants assisted dying. The profession can usefully contribute to and explicate understandings regarding the wider systemic reverberations of one person's desire to end their life, including the impact on family, clinicians and communities. Further, systemic practitioners can draw on specific family therapy theories and methods in order to both contribute to public debates, and to be key members of a multidisciplinary team providing direct support for families affected by assisted dying. Practitioner points Assisted dying debates have not been informed by family and systemic psychotherapy Assisted dying is a systemic issue, with impacts on the individual, their family, clinicians and communities Systemic practitioners can draw on family therapy theories and methods to contribute to public debates, and be key members of a multidisciplinary team The core tenets of neutrality and curiosity can fruitfully facilitate discussion, debate and new insights 抽象 对于协助死亡的临床实践和相关公共讨论, 系统心理治疗能提供什么? 关于协助死亡的辩论迄今尚未受到家庭和系统心理治疗的影响。本文描述了合法协助死亡的背景, 并概述了国际情况。本文呈现了面临晚期或慢性疾病的人群案例及相关研究文献, 以说明寻求协助死亡的患者所处的身‐心‐社状态。然后, 文章介绍了一个关于系统心理治疗能提供什么的案例, 给出一系列手段、方法和技术的建议。遵循系统心理治疗的核心原则, 该文章不以任何一个立场为前提。相反, 重心放在中立和好奇上, 以促进讨论、辩论和新见解的产生。该文章的结论是, 系统心理治疗师具备一些潜在、未开发的技能, 可以了解想接受协助死亡的人所产生的影响。该职业可以有助于理解一个人对于结束生命的渴望所产生的广泛的系统性后果, 包括对家庭、临床医生和社区的影响。此外, 系统治疗师可以利用具体的家庭治疗理论和方法, 促进公众辩论, 并成为一个多学科团队的关键成员, 为受到协助死亡影响的家庭提供直接支持。 对实务工作者的启示 家庭和系统心理治疗尚未影响到关于协助死亡的讨论。 协助死亡是一个系统性问题, 对个人、家人、临床医生和社区均产生影响。 系统治疗师可以利用家庭治疗理论和方法来促进公众辩论, 并成为多学科团队的关键成员。 中立和好奇的核心原则有助于讨论、辩论和新见解的产生。 Abstracto ¿Qué puede ofrecer la psicoterapia sistémica la práctica clínica y los debates públicos sobre la muerte asistida? Los debates sobre la muerte asistida no han sido informados hasta la fecha por la psicoterapia familiar y sistémica. Este artículo establece el contexto de la muerte asistida legalizada con un resumen del terreno internacional. Se presentan ejemplos de casos de personas con enfermedades terminales o crónicas junto con la literatura de investigación, para ilustrar los dominios biopsicosociales habitados por aquellos que buscan la muerte asistida. El artículo presenta un caso de lo que la psicoterapia sistémica tiene para ofrecer, sugiriendo una variedad de enfoques, métodos y técnicas. Siguiendo los principios básicos de la psicoterapia sistémica, el artículo no se basa en un punto de vista del tipo “o esto o aquello”. Por el contrario, la neutralidad y la curiosidad están centralizadas, para facilitar la discusión, el debate y nuevas ideas. El artículo concluye que los psicoterapeutas sistémicos tienen un conjunto de habilidades latentes y no aprovechadas para comprender las repercusiones de alguien que quiere morir asistido. La profesión puede contribuir útilmente y explicar la comprensión con respecto a las reverberaciones sistémicas más amplias del deseo de una persona de terminar con su vida, incluido el impacto en la familia, los médicos y las comunidades. Además, los profesionales sistémicos pueden recurrir a teorías y métodos de terapia familiar específicos para contribuir a los debates públicos y ser miembros clave de un equipo multidisciplinar que brinda apoyo directo para las familias afectadas por la muerte asistida. Puntos de implicación práctica: Los debates de muerte asistida no han sido informados por la psicoterapia familiar y sistémica La muerte asistida es un problema sistémico, con impactos en el individuo, su familia, médicos y comunidades Los profesionales sistémicos pueden recurrir a las teorías y métodos de terapia familiar para contribuir a los debates públicos y ser miembros clave de un equipo multidisciplinar. Los principios centrales de la neutralidad y la curiosidad pueden facilitar fructíferamente la discusión, el debate y nuevos conocimientos - Journal of Family Therapy, Volume 40, Issue 3, Page 413-427, August 2018.
    May 21, 2017   doi: 10.1111/1467-6427.12171   open full text
  • A work‐individual‐family inquiry on mental health and family responsibilities of dealers employed in the Macau gaming industry.
    Simon Tak‐mau Chan.
    Journal of Family Therapy. May 03, 2017
    --- - |2+ Abstract The anxiety, depression and sleep quality levels of a sample of 1124 Macau casino dealers are examined in this study which uses a mixed method study with a work‐individual‐family approach. In total, 113 dealers are interviewed on the impacts of casino employment on their family life. The results of the quantitative analysis shows that over half of the participants (55.4%) have a score that is over the cut‐off point for depression, a quarter (25.8%) are considered to have anxiety, and about two‐thirds (77%) report poor sleep quality. The qualitative analysis results indicate that despite the financial benefits, family responsibilities and dynamics, such as family activities and plans, parental care and guidance, child‐parent interaction and bonding, marital intimacy, communication patterns, and gender roles are negatively affected to some degree by casino employment. Practitioner points Sensitivity towards work‐family conflicts, families‐in‐transition, gender and class can facilitate engagement and intervention with the families of dealers in Macau Gender is a significant predictor of depression and anxiety levels Respondents with a lower income range have lower quality of sleep Absence from family activities, missed opportunities to carry out parental care, reduced marital intimacy and communication with family members are key concerns 抽象 澳门博彩业发牌员的心理健康和家庭责任的工作—个人—家庭调查 本研究对1124名澳门赌场发牌员样本的焦虑、抑郁和睡眠质量水平进行了调查, 采用了一种工作—个人—家庭方法的混合方法研究。共有113名发牌员接受了关于赌场就业对家庭生活影响的访谈。定量分析结果显示, 超过一半的参与者(55.4%)的得分超过抑郁症的临界点, 四分之一(25.8%)被认为有焦虑, 约三分之二(77 %)报告睡眠质量差。定性分析结果表明, 尽管经济收益高, 赌场就业还是在一定程度上影响了家庭责任和互动, 如家庭活动和计划、家长照顾和指导、亲子互动和亲密关系的形成、夫妻亲密度、沟通模式和性别角色等 对实务工作者的启示 对工作家庭冲突、转型家庭、性别和阶级的敏感性有利于与澳门发牌员家庭进行接触和干预 性别是抑郁和焦虑程度的重要预测因素 收入更低的受访者睡眠质量更差 没有家庭活动、错过照顾子女的机会、夫妻亲密度和与家人的沟通减少是关键问题 Abstracto Una investigación de trabajo‐individuo‐familia sobre la salud mental y las responsabilidades familiares de los empleados en la industria del juego de Macao Los niveles de ansiedad, depresión y calidad del sueño de una muestra de 1124 empleados de casinos de Macao se examinan en este estudio que utiliza un diseño de método mixto con un enfoque trabajo‐persona‐familia. En total, 113 distribuidores son entrevistados sobre los impactos del empleo en casinos en su vida familiar. Los resultados del análisis cuantitativo muestran que más de la mitad de los participantes (55.4%) tienen una puntuación que está por encima del punto de corte para la depresión, una cuarta parte (25.8%) se consideran con ansiedad, y aproximadamente dos tercios (77 %) informan mala calidad del sueño. Los resultados del análisis cualitativo indican que a pesar de los beneficios financieros, las responsabilidades y dinámicas familiares, como actividades y planes familiares, cuidado y orientación parental, interacción y vinculación niño‐padre, intimidad conyugal, patrones de comunicación y roles de género se ven afectados negativamente hasta cierto punto por el empleo del casino. Puntos de implicación práctica La sensibilidad hacia los conflictos entre el trabajo y la familia, las familias en transición, el género y la clase pueden facilitar el enganche y la intervención con la familia de los empleados en Macau El género es un predictor significativo de los niveles de depresión y ansiedad. Los encuestados con un rango de ingresos más bajo tienen una calidad de sueño inferior. La ausencia de actividades familiares, las oportunidades perdidas para llevar a cabo la atención de los padres, la reducción de la intimidad conyugal y la comunicación con los miembros de la familia son preocupaciones clave . - Journal of Family Therapy, Volume 40, Issue 3, Page 428-446, August 2018.
    May 03, 2017   doi: 10.1111/1467-6427.12168   open full text
  • Sara Barratt and Wendy Lobatto (eds.) Surviving and Thriving in Care and Beyond – Personal and Professional Perspectives. London: Karnac, 2016, 303pp., ISBN 978 1 78220 301 8, £24.66.
    Paula Boston.
    Journal of Family Therapy. April 19, 2017
    --- - - Journal of Family Therapy, Volume 40, Issue 3, Page 459-461, August 2018.
    April 19, 2017   doi: 10.1111/1467-6427.12163   open full text
  • Influence of autism on fathering style among Black American fathers: a narrative inquiry.
    Michael D. Hannon, Ebony E. White, Tyce Nadrich.
    Journal of Family Therapy. March 31, 2017
    Attention to Black men's fathering styles, especially those who have children with autism, has been largely overlooked. This study presents the narratives of six Black American fathers of individuals with autism and how autism influences their fathering practice. Results suggest fathering individuals with autism can yield greater patience in fathering practice, amidst some normative challenges associated with the diagnosis. Family therapists serving Black families and fathers of children with autism can enhance the therapeutic alliance by acknowledging cultural influences on fathering and family practices. Recommendations for clinical practice and research are shared. Practitioner points Autism influences family systems in unique ways across racial groups that can require family therapy There is little scholarship about how children's autism diagnoses influences Black fathers and families Children's autism influence on Black fathers can yield changes in fathering practice, including increased patience Culturally responsive practice includes acknowledging cultural influences on fathering style and personal growth as a consequence of autism 自闭症对黑人父亲教养风格的影响:一项叙事研究 黑人父亲的教养风格, 特别是那些有自闭症儿童的父亲, 长久以来都被忽视。 这项研究呈现了六位孩子有自闭症的美国黑人父亲的叙述, 以及自闭症如何影响他们作为父亲的行为。结果表明, 除了在与该疾病相关的一些常规困难以外, 自闭症孩子的父亲可以在养育孩子的过程中获得更大的耐心。 为黑人家庭和自闭症儿童父亲服务的家庭治疗师, 可以通过承认文化对父亲和家庭行为的影响来增强治疗同盟。本文还分享了对临床实践和研究的建议。 对实务工作者的启示 在需要家庭治疗的不同族裔群体中, 自闭症以独特的方式影响着家庭系统 几乎没有学术研究调查儿童自闭症诊断如何影响黑人父亲和家庭 儿童自闭症可能会引起黑人父亲的行为变化, 包括提升耐心 具有文化敏感的实践包括承认文化对父亲教养风格的影响以及自闭症带来的个人成长 关键词:黑人父亲;自闭症家庭;家庭治疗
    March 31, 2017   doi: 10.1111/1467-6427.12165   open full text
  • Immigrant family members negotiating preferred cultural identities in family therapy conversations: a discursive analysis.
    Inés Sametband, Tom Strong.
    Journal of Family Therapy. March 31, 2017
    In this article we present a discursive analysis of how immigrant family members relationally recognize and co‐articulate with each other's preferred cultural memberships during family therapy conversations. This article draws from a qualitative study of family therapy conversations with a sample of sixteen video‐recorded sessions with nine immigrant families and their therapists, and from separate interviews with each family member. Selected segments of therapy conversations and subsequent individual interviews were transcribed verbatim for the analysis. We show exemplars of how therapists help immigrant family members move beyond dis‐preferred cultural membership ascriptions (i.e. misrecognition) by foregrounding cultural identities family members deem more appropriate. We conclude by discussing how this preference‐animated research can be useful for practitioners to help immigrant family members co‐construct cultural identities that suit them better as individuals and members of a family. Practitioner points Misrecognition occurs when immigrant family members’ preferred cultural identities are disregarded or not acknowledged in family conversations and interactions By foregrounding cultural identities at play in family therapy, practitioners can facilitate dialogues helping family members recognize preferred cultural identities Discursive research methods may enhance therapists’ awareness of how discursive negotiations of cultural identities influence family members’ relationships 移民家庭成员在家庭治疗对话中处理文化身份偏好:一项话语分析研究 在这篇文章中, 我们开展了一项话语分析, 说明移民家庭成员如何在家庭治疗对话中关系式地认识和共同表达彼此的文化身份偏好。本文基于一项关于家庭治疗对话的定性研究中与九个移民家庭及其治疗师进行的十六次会面的视频资料, 以及与每个家庭成员的单独采访。其中一些治疗对话和随后的个人访谈被逐段转录用于分析。我们展示了治疗师如何帮助移民家庭成员超越不喜欢的文化成员身份(即错误认知), 强调家庭成员认为更合适的文化身份。我们最后讨论这种由偏好激发的研究, 如何有助于从业者帮助移民家庭成员共同塑造更适合作为个人和家庭成员的自我的文化身份。 对实务工作者的启示 当移民家庭成员的文化身份偏好在家庭对话和互动中被忽视或未得到承认时, 错误认知便会产生 通过在家庭治疗中突出文化身份, 实务工作者可以促进对话, 帮助家庭成员认识到文化身份偏好 话语研究方法可能会增强治疗师对文化身份对话如何影响家庭成员关系的认知 关键词:文化身份;移民家庭;家庭治疗;话语分析;社会建构主义。
    March 31, 2017   doi: 10.1111/1467-6427.12164   open full text
  • Living in the line of fire: the impact of the exposure to warfare on couple relationships.
    Michal Shamai, Guy Enosh, Ronit Machmali‐Kievitz, Dvorit Gilad.
    Journal of Family Therapy. March 31, 2017
    --- - |2+ Abstract The study explored how civilians living in the line of fire perceived the impact of the exposure to war on their relationships. Couple resilience and loss and gain of couple resources were hypothesized to mediate between the level of exposure and couple relationships. Data were collected from sixty‐one individuals living in Israel close to the border with the Gaza Strip and 121 individuals living some distance from the border. No differences were found between the groups on couple relationships. However, the high exposure group reported significantly higher negative and positive implications of the security situation for couple relationships. Recommendations for couple and systemic intervention focused on the positive impacts for couples and on a broader macro‐level approach, through group work with couples and training medical and education workers. Practitioner points Many therapists working with populations in war situations tend to focus on the painful and stressful aspects, emphasizing traumatic symptoms and their impact on relationships This study shows that stress created by exposure to war might also enrich some aspects of couple relationships This enrichment, such as in the ability to communicate, to share, and to reach agreement and trust, should be taken into consideration when planning and implementing therapy 抽象 生活在火线上:战争暴露对夫妻关系的影响 这项研究探讨了生活在火线上的平民如何看待战争暴露对他们的关系的影响。研究假设, 夫妻的复原力以及夫妻资源的得失在战争暴露程度和夫妻关系之间起中介因素作用。收集的数据来自生活在以色列、接近加沙地带边界的六十一人, 以及居住地与边界更远一些的121人。两组在夫妻关系上没有发现差异。然而, 高暴露组报告了显著更高的当下安全状况对夫妻关系的负面和正面影响。对夫妻和系统性干预的建议集中在对夫妻的积极影响和更为宏观层面的方法, 通过与夫妻、培训医师和教育工作者的小组合作。 对实务工作者的启示 许多对经历战争的人群开展工作的治疗师往往侧重于痛苦和压力的方面, 强调创伤性症状及其对关系的影响 这项研究表明, 战争暴露造成的压力也可能会丰富夫妻关系的某些方面 在规划和实施治疗时, 应考虑这种强化, 比如在沟通能力、分享和达成协议和信任的能力等方面的强化 Abstracto Vivir en la línea de fuego: el impacto de la exposición a la guerra en las relaciones de pareja El estudio exploró cómo los civiles que viven en la línea de fuego percibieron el impacto de la exposición a la guerra en sus relaciones. Se planteó la hipótesis de que la capacidad de recuperación y la pérdida y ganancia de los recursos de la pareja mediarían entre el nivel de exposición y las relaciones de pareja. Se recolectaron datos de 61 personas que viven en Israel cerca de la frontera con la Franja de Gaza y 121 personas que viven a cierta distancia de la frontera. No se encontraron diferencias entre los grupos en las relaciones de pareja. Sin embargo, el grupo de alta exposición informó significativamente de mayores implicaciones negativas y positivas de la situación de seguridad para las relaciones de pareja. Las recomendaciones para la intervención en pareja y sistémica se centraron en los impactos positivos para las parejas y en un enfoque más amplio a nivel macro, mediante el trabajo en grupo con parejas y la capacitación de trabajadores sanitarios y educativos. Puntos de implicación práctica: Muchos terapeutas que trabajan con poblaciones en situaciones de guerra tienden a enfocarse en los aspectos dolorosos y estresantes, enfatizando los síntomas traumáticos y su impacto en las relaciones Este estudio muestra que el estrés creado por la exposición a la guerra también puede enriquecer algunos aspectos de las relaciones de pareja Este enriquecimiento, como la capacidad de comunicarse, compartir y llegar a un acuerdo y confianza, debe tenerse en cuenta al planificar e implementar la terapia. - Journal of Family Therapy, Volume 40, Issue 3, Page 349-377, August 2018.
    March 31, 2017   doi: 10.1111/1467-6427.12162   open full text
  • Attachment and relationship satisfaction among first married, remarried, and post‐divorce relationships.
    Rachel M. Diamond, Andrew S. Brimhall, Michael Elliott.
    Journal of Family Therapy. March 10, 2017
    This study examined relationship satisfaction and adult attachment in a sample of 562 participants: 340 in a first marriage (60.5%); 122 separated/divorced from their first spouse (21.7%); and 100 in a second marriage (17.8%). For participants in a relationship (dating or married), findings indicated no differences between groups on relationship satisfaction; instead, attachment served as a better predictor of satisfaction. Further, no differences existed when comparing first‐ and second‐married participants on attachment. Differences existed between separated/divorced participants and first‐ and second‐married participants on most attachment indexes; similarities existed between separated/divorce and second‐married participants on levels of preoccupation and model of self. When comparing non‐dating and dating separated/divorced participants, dating participants reported higher secure attachment and models of others and lower fearful attachment. Clinical and research implications will be discussed. Practitioner points Contrary to most extant literature, attachment styles and behaviour may be a better predictor of relationship satisfaction than relationship type (e.g. first vs. second marriage) Consider the important role of attachment within relationships throughout adulthood and how attachment styles may differ in different types of relationships Attachment frameworks should be used when developing interventions for couples to increase relationship satisfaction and attachment security 首婚, 再婚和离婚后关系的依恋和关系满意度 本研究对562名参与者样本的关系满意度和成人依恋进行了调查: 340人为首次结婚(60.5%);122与其首任配偶分居/离婚(21.7%);100人为再婚(17.8%)。对于处在关系之中的参与者(恋爱或已婚), 研究结果表明, 各组在关系满意度上没有差异;相反, 依恋能更好地预测满意度。此外, 首婚和再婚的参与者在依恋上没有差异。分居/离异参与者在大多数依恋指标上与首婚和再婚参与者之间存在差异;分居/离异与再婚参与者的关注程度和自我模型有相似性。比较未恋爱和恋爱中的分居/离异的参与者, 恋爱中的参与者报告了更高的安全依恋和他人模型, 以及更低的恐惧型依恋。文中讨论了研究结果对临床和未来研究的影响。 对实务工作者的启示 与大多数现有文献相反, 依恋类型和行为可能比关系类型(如首婚和再婚)更能预测关系满意度 考虑依恋在整个成年期间的关系中的重要作用, 以及在不同类型的关系中, 依恋类型可能会有所不同 在为夫妇开发增加关系满意度和安全依恋的干预措施时, 应使用依恋框架 关键词:依恋理论;夫妇;离婚;关系满意度;重组伴侣
    March 10, 2017   doi: 10.1111/1467-6427.12161   open full text
  • Challenging core cultural beliefs and maintaining the therapeutic alliance: a qualitative study.
    Katherine Yon, Rabia Malik, Philippe Mandin, Nick Midgley.
    Journal of Family Therapy. February 27, 2017
    Engaging black and minority‐ethnic (BME) individuals in therapy and maintaining a positive therapeutic alliance can be a complex task, especially when challenging a family's core belief system. This study examines how therapists working within a specialist cultural service in London, UK were able to question a family's core cultural belief system whilst building and maintaining a strong therapeutic alliance. Video‐assisted semi‐structured interviews were carried out with two family members and their two therapists, and analysed using thematic analysis. The findings suggest that core beliefs can be effectively challenged within the context of a strong therapeutic alliance if topics are approached in a sensitive and respectful manner, by trusted therapists who have a degree of knowledge and awareness of their own cultural positioning, as well as an understanding of their clients’ culture. We propose that engaging with culture in this way can strengthen alliance and facilitate positive change. Practitioner points Core cultural belief systems can be effectively challenged by therapists within the context of a positive therapeutic alliance Topics need to be approached sensitively with a degree of authenticity, curiosity and respect Respectfully challenging core beliefs while being aware of one's own cultural construction and positioning, can strengthen the therapeutic alliance and promote positive change 挑战核心文化信念, 维护治疗同盟:定性研究 使黑人和少数族裔个体参与治疗和维持积极的治疗同盟会是一项复杂的任务, 特别是在挑战家庭的核心信念系统时。这项研究调查了英国伦敦的一家专业文化服务机构的治疗师如何能够在质疑一个家庭的核心文化信仰系统的同时, 建立并保持强大的治疗同盟。我们对两名家庭成员及他们的两名治疗师进行了视频辅助的半结构访谈, 并用主题分析法对访谈进行了分析。研究结果表明, 如果以敏感和尊重的方式谈及话题, 且治疗师受到信任、充分了解和意识到自己的文化定位, 并了解来访者的文化, 那么核心信念在强大的治疗同盟的环境下可以有效地受到挑战。我们提出, 这种方式处理文化可以加强同盟, 促进积极的变化。 对实务工作者的启示 在积极的治疗同盟的环境下, 治疗师可以有效地挑战核心文化信仰系统 谈及话题的时候需要一定程度的真实性、好奇心和尊重 在意识到自己的文化构建和定位的同时, 以尊重的方式挑战核心信念, 能够加强治疗同盟, 促进积极改变 关键词:文化;治疗同盟;家庭信念;定性研究;黑人和少数族裔来访者群体
    February 27, 2017   doi: 10.1111/1467-6427.12158   open full text
  • Cross‐cultural supervision in international settings: experiences of foreign supervisors and native supervisees in Cambodia.
    Desiree M. Seponski, Lorien S. Jordan.
    Journal of Family Therapy. February 24, 2017
    With the global expansion of family therapy, it is vital to engage in culturally responsive methods of training and supervision. This is especially critical when international training involves Western‐based therapy models and supervision from non‐native supervisors. This study explores how native Cambodian therapists experience clinical supervision conducted by non‐native supervisors. In this responsive evaluation, data were triangulated across multiple stakeholders (N = 95) and collection methods, including focus groups, interviews, and live supervision observations. Emergent themes highlight the need for intentionally culturally responsive supervision and included challenges with non‐native supervisors, unresponsive methods of learning and power imbalances. Therapists emphasized that they were less likely to attend supervision and felt discouraged when it was not culturally responsive. Data‐driven suggestions for increasing cultural responsiveness in supervision are provided. Practitioner points Supervisors can challenge personal cultural assumptions and deepen contextual understanding by seeking local cultural knowledge Supervision contracts created with input from stakeholders can attend to likely cultural differences The supervisory relationship can be supported through open discussion and negotiation of cultural differences In cultures with high regard for those in authority, supervisors can use a strengths‐based approach to feedback and demonstration 国际跨文化督导:柬埔寨境内外国和本国督导的经验 随着家庭治疗的全球性发展, 开展具有文化敏感性的培训和督导至关重要。当国际化培训涉及西方的治疗模式和非本地督导时, 这尤其重要。本研究探讨了柬埔寨当地治疗师如何体验非当地督导的临床督导。在这项回应性评估中, 对从多个利益相关者(N=595)和数据采集方法, 包括焦点小组、访谈和实时督导观察, 得到的数据进行了三角检验。浮现的主题强调了刻意注重文化敏感性的督导, 并包括非当地督导面对的挑战、不具备敏感性的学习方法和权力不平衡。治疗师强调, 对于没有文化敏感度的督导, 他们不太可能参加, 即使参加也会感到灰心。本文提供了提高督导文化敏感度的实证建议。 对实务工作者的启示 督导可以通过寻求当地文化知识来挑战其个人文化假设, 深化语境认知 结合了利益相关者意见的督导合同能考虑到可能的文化差异 督导关系可以通过对文化差异的公开讨论和处理来得到支持 在高度重视权威的文化中, 督导可以利用优势方法进行反馈和示范 关键词:文化敏感性;文化能力;督导;柬埔寨
    February 24, 2017   doi: 10.1111/1467-6427.12157   open full text
  • Differentiation of self as a predictor of Asian‐American immigrants’ perceptions of cultural harmony.
    Hsin‐Hua Lee, Rachel W. Johnson.
    Journal of Family Therapy. February 10, 2017
    The purpose of the study was to examine whether Bowen's () construct, differentiation of self, would predict cultural harmony (Benet‐Martínez and Haritatos, ) among Asian‐American immigrants. The study was a correlational design, with a sample of 154 adults who identified as first‐generation Asian Americans and had lived in the US for at least five years. Results of regression analyses showed that greater overall differentiation of self, measured by the Differentiation of Self Inventory‐Revised (DSI‐R; Skowron and Schmitt, ), had a positive significant association with participants’ perceptions of cultural harmony. That is, highly differentiated individuals perceived their host and ethnic cultural orientations as compatible rather than in constant conflict. Furthermore, analyses of the subscales of the DSI‐R showed there were differences across the four underlying dimensions of differentiation of self in terms of associations with cultural harmony. Implications for theory, clinical practice, and future research are included. Practitioner points A lack of self‐differentiation may be indicative of struggles to achieve identity integration among first‐generation Asian Americans Exploring the pattern of emotional cutoff, fusion with others, emotional reactivity and ability to take an I‐position potentially decreases conflict between cultural orientations The use of family diagram may help increase one's ability to balance two cultural orientations
    February 10, 2017   doi: 10.1111/1467-6427.12154   open full text
  • The Shit Painter grows up.
    Wai Yung Lee.
    Journal of Family Therapy. February 10, 2017
    There is no abstract available for this paper.
    February 10, 2017   doi: 10.1111/1467-6427.12155   open full text
  • Resistant to change? The transition to parenthood among married adults in China.
    Yuying Tong, Martin Piotrowski, Yueyun Zhang.
    Journal of Family Therapy. February 09, 2017
    Using retrospective life history data from the 2008 Chinese General Social Survey (CGSS) and discrete time event history analysis, this study investigates the transition to parenthood of adult males and females for the 1965 to 2004 marriage cohorts. We find that Chinese people generally prefer to become parents soon after marriage. We also find that more recent marriage cohorts are less likely to become parents compared to earlier cohort for males, but this is not the case for women. This indicates that economic or role incompatibility in general does not prevent women from becoming mothers, which in general supports the idea that there are alternative resources available for women to balance the role incompatibility in China's context. The extended family is an important resource for married couples to rely upon to raise young children. This study sheds light on China's family therapy practice, which should take into consideration the demographic trends and cultural factors in understanding the role conflict within the family, such as intergenerational relations and gender ideology. Practitioner points Role incompatibility of having children can be relieved by extended family, so therapy programmes dealing with intergenerational relationship should be developed Family therapists should consider the pace of gender ideology change in child rearing during negotiation of the husband‐wife relationship Training programmes can be more specific to the extended family for dealing with child rearing skills and potential conflict resolutions.
    February 09, 2017   doi: 10.1111/1467-6427.12150   open full text
  • Inequity of sacrifice and marital satisfaction in Chinese young couples.
    Jing Lan, Xiaomin Li, Hongjian Cao, Nan Zhou, Xiuyun Lin, Linyuan Deng, Xiaoyi Fang.
    Journal of Family Therapy. February 06, 2017
    There is an emerging body of research focusing on the positive and negative effects of sacrifice on relationship quality, but few of them have investigated the effects of the inequity of sacrifice. In the light of social exchange theory and equity theory, this study examines the roles inequity of sacrifice plays in marital satisfaction in China. Based on the questionnaires completed by 115 Chinese young couples, we find that wives’ perceived inequity of sacrifice, rather than husbands’ perceived inequity or the actual inequity of sacrifice, is predictive to both spouses’ marital satisfaction. In addition, wives’ perceived overbenefit positively predicts, while underbenefit negatively predicts both spouses’ marital satisfaction, which means when wives perceive their husbands’ sacrifice more than themselves, both of them have higher satisfaction. In accordance with social exchange theory but not equity theory, our findings highlight the important and subtle roles perceived inequity of sacrifice behaviours plays in the marriages of Chinese young couples. Practitioner points The importance of perceived inequity implies that clients’ perceptions should be paid more attention than the content of their stories The strong predictive power of wives’ but not husbands’ perceived inequity suggests we should keep gender difference in mind when working with couples, especially young couples Young couples may care about their own advantages more than the equity of their relationship, which should be accommodated in clinical work
    February 06, 2017   doi: 10.1111/1467-6427.12153   open full text
  • Joining revisited in family therapy: discourse analysis of cross‐cultural encounters between a therapist and an immigrant family.
    Eunjung Lee, A. Ka Tat Tsang, Marion Bogo, Gabrielle Wilson, Marjorie Johnstone, Jessica Herschman.
    Journal of Family Therapy. January 30, 2017
    With increasing diversity in therapeutic dyads, there has been renewed attention to the process of ‘joining’ in cross‐cultural encounters. Inspired by discourse analysis, we conducted a close reading of therapy transcripts between a Pakistani immigrant mother‐daughter dyad and a Canadian white female therapist in an outpatient clinic. Our findings illustrate detailed discursive interactions for joining techniques – selective joining, confirmation, and tracking – (1) where the therapist facilitates joining moments with the family and (2) where the same techniques are used to preclude further exploration of the family's cultural views. Consequently, the joining process is at times limited by the therapist's enactment of her own assumptions about the family's culture. Due to the doxic nature of cultural assumptions, a discursive analysis may help to prevent therapists from silencing their clients’ cultural voices and to be more reflexive of their assumptions, thus promoting joining. Practitioner points Joining in family therapy is a dynamic process The detailed analysis of joining moments can serve as an example for training therapists to examine their moment‐to‐moment responses to culturally diverse clients Therapeutic constructs/techniques (e.g. joining) cannot be decontextualized or conceptualized as apolitical and acultural Critical reflexivity may prevent therapists from unknowingly oppressing culturally diverse clients’ experiences and cultural identities 重新思考家庭治疗里的”加入”:治疗师和移民家庭跨文化会面的话语分析 当治疗关系变得越来越多样化, 跨文化会面中的”加入”过程正在重新受到关注。受到话语分析的启发, 我们对发生在一对巴基斯坦移民母女和一位加拿大白人女治疗师之间的门诊治疗对话进行了细致解读。研究发现呈现了详细的加入技巧的对话互动——选择性加入、确认, 和跟进——(1)治疗师在什么地方与家庭推进加入时刻, 以及(2)在什么地方, 同样的技巧被再次使用, 以便停止对家庭文化观念的进一步探索。因此, 加入过程有时候受到治疗师对家庭文化假设的具体实施的限制。因为文化假设的性质是理念的, 因此话语分析或许可以帮助治疗师避免压制来访者的文化表达, 并更多地反思自己的假设, 以此来促进加入。 对实务工作者的启示 家庭治疗中的加入是一个动态过程 对于加入时刻的详细分析可以作为例子, 来训练治疗师检查自己对来自其他文化的来访者的每时每刻的反应 治疗概念/技巧(如加入)不能去背景化, 也不能被当做是与政治、文化无关的 批判性反思或许能防止治疗师不自觉地压抑其他文化的来访者的经历和身份 关键词:加入;移民;多样性;批判性反思;话语分析
    January 30, 2017   doi: 10.1111/1467-6427.12148   open full text
  • Embodiment and reflective practices: conjoint therapy for psychological intimate partner violence.
    Berta Vall, Jaakko Seikkula, Aarno Laitila, Juha Holma.
    Journal of Family Therapy. December 26, 2016
    The idea of meta‐dialogue has evolved over the past twenty years. The study reported here focuses on meta‐dialogue, analysing the importance of reflective practices for thoughtfulness and embodiment in couple therapy for psychological Intimate Partner Violence (IPV). The study also sought to determine whether, in a case of psychological IPV, reflective practices helped the couple to acquire a new, shared understanding of violence. The results showed that the use of both meta‐dialogue and of a reflective team was related to clients' use of the reflexive mode. Moreover, embodiment could be understood as a precursor of reflectivity and reflective practices. Finally, the results indicated that it was possible to discuss the issue of violence through the use of meta‐dialogue, and that, through the therapists' reflective dialogue, the clients were able to reflect on their own relational patterns. The importance of meta‐dialogue and embodiment for conjoint therapy in psychological IPV is discussed. Practitioner points Meta‐dialogue is present in therapy as: (a) reflective practices (therapists' strategies to promote a reflective stance); and (b) reflectivity (i.e. action of reflecting) Consider the importance of therapist sensitivity to embodiment in conjoint therapy for IPV in helping to reflect on what is happening in therapy, thus promoting use of meta‐dialogue 具体化和反思性实践:针对亲密伴侣精神暴力的联合疗法 元对话的概念在最近二十年有所发展。本研究聚焦于元对话, 分析夫妻治疗中以体贴和具体化为目的的反思性实践对于处理亲密伴侣精神暴力的重要性。本研究也尝试确认, 在亲密伴侣暴力的情况下, 反思性实践是否会帮助伴侣双方获得一种新的对暴力的共同认知。研究成果显示, 运用元对话和反思性小组都与来访者使用反思性模式有关。此外, 具体化可以被认为是反思和反思性实践的前兆。最后, 研究结果显示, 通过元对话的运用来讨论暴力话题是可能的, 并且, 通过治疗师的反思性对话, 来访者能够反思他们自己的关系模式。本文最后讨论了元对话和具体化对于亲密伴侣暴力的联合治疗的重要性。 对实务工作者的启示 元对话作为治疗中的:(a)反思性实践(治疗师为了促进反思态度的策略);以及(b)反思性(即反思的行为) 考虑治疗师在亲密伴侣暴力联合治疗中对具体化的敏感性对于帮助反思治疗过程和促进元对话的使用的重要性 关键词:元对话;反思性实践;具体化;亲密伴侣暴力;夫妻治疗
    December 26, 2016   doi: 10.1111/1467-6427.12142   open full text
  • A brief family intervention for depression in primary care.
    Noosha Niv, Nikki Frousakis, Bonnie G. Zucker, Shirley Glynn, Lisa Dixon.
    Journal of Family Therapy. December 26, 2016
    This study tested the feasibility and outcomes of a brief psychoeducational intervention for family members of depressed veterans in primary care. Family members of veterans enrolled in TIDES, a VA collaborative care programme for depression in primary care, were invited to participate. High enrolment rates, high treatment retention and completion, and high levels of satisfaction with the intervention indicate that the programme is feasible and acceptable to family members. Veterans showed a decrease in depression severity, improvements in symptom and occupational global functioning, and an increase in general life satisfaction. Family members' attitudes about antidepressant medication use became more positive, and their knowledge of depression increased. There were no changes in behavioural activation or in family functioning. Overall, family members and clinical staff rated the intervention very positively. Staff members did note some obstacles to implementation and made suggestions to overcome identified obstacles. Practitioner points The use of Motivational Interviewing was an important contributor to generating interest in the family programme Family members involved in depression treatment evidence gains in positive attitudes towards medication use and an increased knowledge of depression Systematic training and ongoing contact with clinicians are key factors in improving their confidence and skills in working with families and increasing their commitment to implementing the intervention 基层医疗对抑郁症的简短家庭干预 本研究测试了在基层医疗中实行一项针对抑郁退伍军人家属的简短的心理教育干预的可行性和结果。参与了TIDES(退伍军人事务部的抑郁合作照料基层医疗项目)的退伍军人家属受邀参加。干预的高参与率、高治疗维持率和完成率以及高满意度显示, 该项目是可行的、被家属接受的。退伍军人表现出抑郁严重程度降低、症状及整体职业功能的改善和普遍生活满意度的提升。家属关于使用抗抑郁药的态度变得更加积极, 且他们关于抑郁症的知识增加了。行为激活和家庭功能方面没有变化。总体来说, 家属和临床人员对此项干预都有非常积极的评价。工作人员也注意到了一些实施方面的障碍, 并提出了克服已知障碍的建议。 对实务工作者的启示 激励性访谈的运用是激发对家庭项目的兴趣的重要因素 参加抑郁治疗的家属显示出对于药物使用的积极性增加和对于抑郁症知识的增加 系统性培训和与临床医师持续的接触对于增强他们的自信、提升他们与家庭工作的技巧、增强他们实施干预的决心的关键因素 关键词:家庭治疗;抑郁症;基层医疗;退伍军人
    December 26, 2016   doi: 10.1111/1467-6427.12147   open full text
  • Family‐based outpatient treatments: a viable alternative to hospitalization for suicidal adolescents.
    Mary K. Lear, Carolyn M. Pepper.
    Journal of Family Therapy. December 07, 2016
    Historically, inpatient hospitalization has historically been a primary approach for managing risk in suicidal adolescents. However, hospitalization is disruptive and its efficacy in reducing suicide risk for adolescents is unclear. Preliminary data suggest that hospitalization may be iatrogenic and result in increased risk for subsequent hospitalizations and continued suicidal behaviour (Linehan, April 2016; Prinstein et al., ). This paper first discusses potential theoretical pitfalls of psychiatric hospitalization for suicidal adolescents, specifically poor triage to outpatient treatment, stigma, and social isolation. Secondly, we present outpatient family‐based therapy as an alternative evidence‐based approach for treating suicidal adolescents. To achieve this aim we review the existing research base examining specific family‐based outpatient treatments and discuss practical considerations concerning the implementation of family‐based approaches with suicidal adolescents. Practitioner points Inpatient hospitalization is a frontline treatment for treating suicidal adolescents despite the lack of evidence supporting this approach and growing evidence of negative effects Suicidal adolescents can be treated effectively and safely in outpatient settings Several family‐based therapies for suicidal adolescents have been shown to be safe and effective in reducing suicidality and improving family functioning 基于家庭的门诊疗法:有自杀倾向的青少年入院治疗的可行替代疗法 一直以来, 住院治疗都是处理青少年自杀风险的主要手段。然而, 住院治疗会对生活造成干扰, 且其降低自杀风险的效果仍然未知。初步研究结果显示, 住院治疗可能是医原性的, 并可能增加患者今后住院的可能性和导致持续的自杀行为(Linehan, April 2016; Prinstein et al., 2008)。本文首先讨论了有自杀倾向青少年精神性住院的潜在理论隐患, 尤其是门诊治疗的治疗类选法较差、耻感和社会孤立。然后, 我们介绍了一种基于家庭的门诊疗法, 作为治疗有自杀倾向的青少年的一种替代性的实证疗法。为了达到这一目标, 我们回顾了针对具体的基于家庭的门诊疗法的现有研究, 并讨论了这种基于家庭的疗法在实施中的实际考量。 对实务工作者的启示 住院治疗是针对有自杀倾向的青少年的一线治疗, 虽然并没有证据支持该疗法, 且有证据显示其负面作用 有自杀倾向的青少年可以在门诊环境下得到有效和安全的治疗 一些基于家庭的疗法已被证明安全, 且能有效减轻自杀倾向以及改善家庭功能 关键词:循证实践;预防;抑郁症;儿童和青少年心理健康
    December 07, 2016   doi: 10.1111/1467-6427.12146   open full text
  • Co‐parenting conversation process: a qualitative study of Chinese Singaporean parents.
    Charles T. K. Sim.
    Journal of Family Therapy. November 17, 2016
    Although co‐parenting in two‐parent families has been an increasingly important area of research, little is known about the co‐parenting conversation as a crucial aspect of co‐parenting. This study used grounded theory methodology to explore how Chinese Singaporean parents perceive their co‐parenting conversations in light of the influence of their families of origin. Interviews were conducted with mothers and fathers in sixteen families. Findings revealed a central category, ‘conversations along the co‐parenting journey’, and two main categories, ‘conversations that connect and collaborate in co‐parenting’, and ‘conversations on family heritage and practices’. A substantive theory of co‐parenting conversation process was generated from the synthesis of the findings. This study serves as the foundation for future research in co‐parenting conversation, and its implications for clinicians and researchers are presented and discussed. Practitioner Points The typology of co‐parenting conversation can serve as a common language of communication for family practitioners, clinicians, and researchers working with parents of young children The scheme of co‐parenting conversation process, and the classification for decision‐making conversations, can provide a working framework to consider how, when, and where to intervene in therapy for parents dealing with co‐parenting issues Co‐parenting intentionality is potentially important in addressing family‐of‐origin issues in co‐parenting therapy sessions 共同教养过程:一项关于新加坡华裔的质性研究 虽然双亲家庭中的共同教养已经越来越成为一个重要的研究领域, 但是关于共同教养对话在共同教养中的关键性, 我们还知之甚少。本研究运用了扎根理论方法, 探索新加坡华裔父母在其原生家庭的影响下如何看待他们的共同教养对话。来自十六个家庭的母亲和父亲参与了访谈。研究结果呈现了一个中心类别 “共同教养旅程中的对话”, 以及两个主要类别 “共同教养中起到联结和合作作用的对话” 和 “关于家庭传统和行为方式的对话”。对研究发现所进行的整合产生出了一个关于共同教养对话的实质性理论。该研究为未来关于共同教养对话的研究打下了基础, 其对临床工作者和研究者的意义也在文中得到阐述。 对实务工作者的启示 对共同教养对话的分类可以作为一种通用的沟通语言, 服务于家庭工作者、临床工作者, 以及以家长、儿童为研究对象的研究者。 共同教养对话过程体系, 以及决定性对话的分类, 可以在针对有共同教养问题的家长的治疗中, 提供一个有用的框架来决定怎样、何时以及在何处进行干预。 在共同教养主题的治疗中, 共同教养意向或许在处理原生家庭问题方面具有重要性。 关键词:共同教养对话;扎根理论;新加坡华裔父母
    November 17, 2016   doi: 10.1111/1467-6427.12140   open full text
  • Understanding the complex family experiences of Behavioural Family Therapy.
    Brendan O'Hanlon, Laura Hayes, Amaryll Perlesz, Carol Harvey.
    Journal of Family Therapy. October 28, 2016
    Family psychoeducational interventions including Behavioural Family Therapy have an impressive evidence base in the treatment of schizophrenia. While there are challenges in their implementation including the engagement of families, in the few qualitative studies of Behavioural Family Therapy, families report largely positive experiences. Understanding more about families’ experiences of Behavioural Family Therapy could guide changes to practice to improve implementation. This qualitative study involved interviews with twenty clients diagnosed with schizophrenia and twenty relatives who participated in Behavioural Family Therapy in Australia. Participants valued sharing experiences between family members and their relationship with the practitioner. Unlike previous studies they reported discomfort in sessions and disappointment in aspects of Behavioural Family Therapy. Greater emphasis on addressing this discomfort and on therapeutic alliance may help overcome implementation challenges. Practitioner points Practitioners can use their therapeutic alliance with families to promote shared understanding by providing information as well as facilitating information sharing between family members Practitioners need to recognize and respond to the high levels of discomfort experienced by families and particularly the vulnerability of the person with schizophrenia An increased focus on engagement and the therapeutic alliance may improve the implementation of BFT in services 理解家庭在行为家庭治疗中的复杂经历 家庭心理教育干预, 包括行为家庭治疗, 在治疗精神分裂症方面有着相当可观的证据基础。虽然在其实施方面存在着一些包括家庭参与在内的挑战, 在关于行为家庭治疗的几个质性研究中, 家庭还是报告了总体上积极的经历。更多地理解家庭在行为家庭治疗中的经历可以指导实践方面的调整, 以改进治疗实施情况。该质性研究采用了访谈方式, 访谈对象为在澳大利亚参加行为家庭治疗的二十位诊断患有精神分裂症的来访者和二十位亲属。参与者非常重视家庭成员之间的经历分享以及他们与医师的关系。与已有研究不同的是, 他们也报告了在治疗过程中的不适感, 以及对行为家庭治疗某些方面的失望。在处理不适和治疗性结盟方面加强关注可能会有利于减少实施中的挑战。 对实务工作者的启示 治疗师可以利用他们与家庭的治疗性结盟来促进共同理解, 方式包括提供信息以及协助家庭成员之间的信息分享 治疗师需要认识到并回应家庭所经历的高度不适感, 又尤其是精神分裂症患者的脆弱性。 对参与和治疗性结盟增强关注或许可以改善服务机构中的行为家庭治疗的实施情况。 关键词:成人心理健康;社会心理和心理教育方法;治疗关系;质性研究
    October 28, 2016   doi: 10.1111/1467-6427.12139   open full text
  • Recommendations for best practice in response to parental alienation: findings from a systematic review.
    Kate Templer, Mandy Matthewson, Janet Haines, Georgina Cox.
    Journal of Family Therapy. October 03, 2016
    This study aimed to systematically review the literature pertaining to parental alienation to determine best practice for therapists and legal practitioners. Medline, Embase, and PsycINFO academic databases, the Cochrane Central Register of Controlled Trials and conference abstracts were searched. Included articles were peer reviewed journal articles or books published in English pertaining to a psychological or legal intervention for parental alienation. Ten articles were included in the review. It was found that changes in custodial or residential arrangements in favour of the targeted parent are effective in ameliorating parental alienation. Specialized family therapy addressing the alienation is effective in restoring family relationships and family functioning. A coordinated approach from therapists and legal practitioners is important in resolving parental alienation. Practitioner points Parental alienation requires legal and therapeutic management to enhance family functioning Awarding primary parental responsibility to the targeted parent and providing specialized family therapy is effective in ameliorating parental alienation A specialized form of systemic family therapy for parental alienation can improve family functioning and prevent further parental alienation 针对亲子疏远的最佳实践建议:系统综述的发现 该研究旨在对有关亲子疏远的文献进行系统回顾, 以确定治疗师和法律工作者的最佳实践。为此, 研究者查找了Medline, Embase, 和PsycINFO三个学术数据库, Cochrane Central Register of Controlled Trials和会议摘要。纳入综述的文献包括同行评审的学术期刊文章以及关于亲子疏远的心理或法律干预的英文书籍。综述包含十篇文章。研究发现, 改变监护或者居住安排以有利对象家长, 可以有效缓解亲子疏远。专门针对疏远问题的家庭治疗在重建家庭关系和家庭功能方面十分有效。要彻底解决亲子疏远, 治疗师和法律工作者的共同干预是至关重要的。 对实务工作者的启示 亲子疏远需要法律上和治疗上的处理以增强家庭功能 将主要家长责任赋予对象家长并提供有针对性的家庭治疗可以有效缓解亲子疏远 一种针对亲子疏远的特定的系统家庭治疗形式可以改善家庭功能, 避免进一步的亲子疏远 关键词:亲子疏远;监护权;住处;疏远的家长;干预;恢复性的
    October 03, 2016   doi: 10.1111/1467-6427.12137   open full text
  • The role of cultural factors in engagement and change in Multisystemic Therapy (MST).
    Simone Fox, Fatima Bibi, Hayleigh Millar, Amaryllis Holland.
    Journal of Family Therapy. September 28, 2016
    Evidence has shown that Multisystemic Therapy (MST) has been particularly effective in the treatment of youth with antisocial behaviour from ethnically diverse backgrounds. Although the process of change within MST has been explored, there is a dearth of research in looking at this for families from ethnic minority backgrounds. This qualitative study aimed to explore ethnic minority caregiver experiences of MST and understand how this might impact on engagement, the presenting problems and the process of change. Semi‐structured interviews were conducted with seven ethnic minority caregivers who had completed treatment. A constructivist version of grounded theory was used to analyse the data. Specific cultural theoretical codes that emerged were around the consideration of cultural difference in terms of the engagement process, the conceptualisation of difficulties and the therapist acting as cultural broker in the process of change. This research integrates culturally specific ideas into the existing MST Analytical Process. Practitioner points Being culturally understood, cultural sensitivity and respecting difference can help engagement with ethnic minority caregivers The role of culture may be important to consider in the conceptualisation of difficulties For change to occur therapists may need to act as cultural brokers 多系统治疗(MST)中的文化因素对于参与和改变的作用 证据显示, 多系统治疗(MST)在治疗不同族裔背景的呈现反会行为的青少年时尤其有效。虽然已有究探索MST中的改变过程, 但是以少数族裔家庭为相关对象的究却很少。该质性究旨在探索少数族裔照料人对MST的体验, 并理解这一体验如何影响参与、主诉和改变过程。与七位完成了治疗的少数族裔照料人开展了半结构式访谈。数据分析运用了扎根理论的一个建构主义版本。数据得出的特定文化理论代码有关参与过程中对文化差异的考量, 对困难的念化, 以及治疗师在改变过程中充当文化中间人的角色。该究文化特定的观念与现有MST的分析过程相结合。 对实务工作的示 理解文化背景、文化敏感度和尊重差异能够促进少数族裔照料人的参与。 在将困难念化的时候, 要考虑到文化的作用。 要使改变发生, 治疗师需要充当文化中间人的角色。 关键词:多系统治疗;青少年犯;数族裔;文化;扎根理论
    September 28, 2016   doi: 10.1111/1467-6427.12134   open full text
  • Multi‐stressed families, child violence and the larger system: an adaptation of the nonviolent model.
    Peter Jakob.
    Journal of Family Therapy. September 16, 2016
    Non Violent Resistance (NVR) aims to change family relationships, when children and young people show violent, aggressive or self‐destructive behaviour. Trauma in multi‐stressed families necessitates an adaptation of the original NVR approach in order to meet these clients' specific therapeutic needs when child violence arises. The author has developed such an adaptation. This article gives an overview of the larger system aspect of the adapted NVR model, illustrating how NVR core principles are applied to help family members develop a sense of safety within the larger system, so the nuclear family itself can become a safe and supportive recovery environment. Practitioner points By differentiating between interaction patterns, parents identify safe supporters within the larger system to help develop effective responses to harmful child behaviour Therapeutic conversation centres parents’ own formulation of their support needs, in order to regain their voice and experience personal agency Effective resistance to problem behaviour grows by engaging other adults in ways that facilitate parents’ access to internal and interpersonal resources 多重压力下的家庭, 儿童暴力和大环境:对非暴力模式的一种调整 非暴力抵抗(NVR)旨在当儿童和青少年呈现暴力、攻击或者自残行为时, 改变家庭关系。多重压力下的家庭经历的创伤使对原有NVR方法的调整变得必要, 这样才能在儿童暴力行为出现时满足来访者特定的治疗需求。本文作者进行了这样一种调整。本文对于调整后的NVR模式的大环境方面进行了概述, 阐释了NVR的核心原则如何在大环境下运用于家庭成员, 以帮助他们发展安全感, 并事核心家庭自身成为痊愈过程的安全、支持性的环境。 对实务工作者的启示 通过辨别不同的互动模式, 家长可以在大环境中辨识出安全的支持者, 来协助形成对有害儿童行为的有效回应。 治疗性谈话将家长自己关于支持需求的想法置于中心地位, 以便家长能够重新获得话语权并体验自我效能感。 通过促进家长获得自身和他人资源的方式让其他成年人参与, 可以增强对于问题行为的有效抗拒。 关键词:行为问题, 儿童青少年心理健康, 家庭暴力, 会网络, 创伤
    September 16, 2016   doi: 10.1111/1467-6427.12133   open full text
  • EFT‐C's understanding of couple distress: an overview of evidence from couple and emotion research.
    Gaëlle Vanhee, Gilbert M. D. Lemmens, Agnes Moors, Céline Hinnekens, Lesley L. Verhofstadt.
    Journal of Family Therapy. July 12, 2016
    Despite the growing body of research on Emotionally Focused Couple Therapy (EFT‐C), less research attention has been paid to the validity of EFT‐C's description of the relationship dynamics that characterize distressed couples. The current theoretical paper provides a narrative review of evidence from existing emotion and couple research for EFT‐C's assumptions on the origin of relationship distress (according to Johnson and to Greenberg and Goldman). Our findings lead to three conclusions: first, the general assumptions outlined by EFT‐Cs on need frustration, emotional responses, and interaction patterns are largely supported by the couple and emotion literature. Second, less straightforward evidence was found for the specific elaborations of these principles made by EFT‐Cs. Third, a lack of systematic research on EFT‐C's assumptions hampers strong conclusions. We suggest future research on this issue with attention toward current insights in the emotion and couple literature. Practitioner points Evidence supports EFT‐C's basic assumptions that partners’ unmet needs lead to relationship distress and negative emotions, which give rise to negative interaction cycles between partners Direct empirical evidence is available for attachment‐related assumptions, whereas assumptions on identity and attraction/liking needs have been less investigated Some of EFT‐C's more specific assumptions need to be more systematically researched 夫妻情绪聚焦治疗对于夫妻危机的理解:来自夫妻和情绪研究的证据概述 虽然有关夫妻情绪聚焦治疗(EFT‐C)的研究与日俱增, 却很少有研究探索了EFT‐C对于危机中夫妻特有的关系动态的描述是否具有效度。这篇理论文章总结了现有情绪和夫妻研究中与EFT‐C关于关系危机起源的假设的证据(依据Johnson, Greenberg和Goldman的说法), 并提供了叙述性综述。从文中的发现得出三个结论:首先, EFT‐C列出的关于需求挫折、情感回应和互动模式的普遍性假设在很大程度上得到了夫妻和情绪相关文献的支持。第二, 关于EFT‐C针对这些原则的特定阐述的证据较为间接。第三, 关于EFT‐C假设的系统性研究的缺乏, 阻碍了有力结论的形成。我们在现有夫妻和情绪相关文献中的见解的基础上, 建议今后研究关注这一话题。 对实务工作者的启示 证据支持EFT‐C的基本假设, 即伴侣未被满足的要求会导致关系危机和负面情绪, 从而进一步引起伴侣之间的负面互动循环。 有直接的实证证据支持与依恋相关的假设, 但关于身份和吸引/喜爱需求的假设没有得到太多研究。 EFT‐C的一些更为特定的假设需要更加系统性的研究。 关键词:夫妻情绪聚焦治疗;关系需求;情绪;关系危机/冲突;专题综述
    July 12, 2016   doi: 10.1111/1467-6427.12128   open full text
  • Couple therapy following prostate cancer surgery: a manual to guide treatment.
    Liz Forbat, Jane Robertson, Phillip McNamee.
    Journal of Family Therapy. June 28, 2016
    Prostate cancer is the third most common cancer in the UK. Ten‐year survival is high; consequently a service priority is addressing survivorship issues to support men living with the longer‐term consequences of the disease and its treatments. This paper presents a treatment manual which has been tested with couples following prostate cancer surgery to decrease distress in sexual functioning, and improve relational functioning. The content of the manual is described alongside a fictionalized case vignette that illustrates the content and process of sessions. The paper presents the RIPSToP Model (RelatIonal PSychosexual Treatment for couples with Prostate cancer). The manual was developed and piloted in a mixed‐method feasibility and acceptability randomized pilot control trial. Qualitative interviews with clinicians delivering the intervention indicate that the manual was acceptable. Practitioner points A systemic manual for supporting couples after prostate cancer surgery has been developed The manual presents a new model, derived from the literature, focusing on family context and the couple dynamic The model impacts psychological wellbeing, relationship functioning and distress related to sexual functioning Practitioners reported positive views of the manual and adhered to its content and structure 前列腺癌手术之后的伴侣治疗:治疗指导手册 在英国, 前列腺癌是第三普遍的癌症。十年生存率较高;因此治疗首要考虑的是处理与存活有关的问题, 以帮助男性适应该疾病及其治疗的长期影响。本文介绍了一份治疗手册, 该手册已经过测试, 用于降低前列腺癌手术之后伴侣在性功能方面的困扰, 并改善关系情况。在手册内容的描述之外, 加入了一个虚构的案例片段, 以展示疗程的内容和过程。本文体现了RIPSToP模型(前列腺癌伴侣的性心理关系治疗)。该手册是基于一项混合方法、随机控制的、可行性和接受度的初步研究。与开展该种治疗的临床医师的质性访谈显示, 该手册是可被采用的。 对实务工作者的启示 一份支持前列腺癌手术之后的伴侣的系统性手册已被开发出来 该手册体现了一种新模式, 基于相关文献, 关注家庭背景和伴侣之间的动态 这种模式影响心理健康状况、关系状况和性功能方面的困扰 医师对该手册评价积极, 并严格遵守了它的内容和结构 关键词:手册化治疗;癌症;慢性病状况;亲密度;前列腺;性关系
    June 28, 2016   doi: 10.1111/1467-6427.12129   open full text
  • Couples’ depression and relationship satisfaction: examining the moderating effects of demand/withdraw communication patterns.
    Pei‐Fen Li, Lee N. Johnson.
    Journal of Family Therapy. June 24, 2016
    This study used systemic perspectives and actor and partner interdependence model to examine actor and partner effects of depression on couples’ relationship satisfaction in sixty‐three clinical couples. We also examined if a demand/withdraw communication pattern served a unique communication context that modified the impacts of depression on relationship satisfaction. Couples participated in a treatment‐as‐usual situation. The results showed that male depression had a negative impact on female relationship satisfaction. Males and females had different perceptions of male demand/female withdraw behaviours and it created different influences on each partner's depression in relation to relationship satisfaction. Practitioner points Depression is an interpersonal event that therapists must always assess while providing intervention in relational issues Females’ relationship satisfaction is influenced by males’ depression and couple‐based therapy can be beneficial for treating men's depression and women's relational well‐being Couples therapists need to intervene in demand/withdraw behaviours at different levels corresponding to which gender is executing demand/withdraw behaviours 伴侣抑郁症与关系满意度:研究要求/退缩沟通模式的调节作用 本研究运用系统视角和主客体互倚模型, 以63对临床治疗中的伴侣为样本, 研究了抑郁症的主客体影响对伴侣关系满意度的影响。研究人员还考察了要求/退缩的沟通模式, 作为一种独特的沟通情境, 是否在抑郁症对伴侣关系满意度的影响上起到了缓解作用。伴侣按照普通程序参加了治疗。结果显示, 男性抑郁症对于女性的关系满意度有负面影响。男性和女性对于男性要求/女性退缩的行为有不同的看法, 这种不同造成了他们各自抑郁症与其关系满意度的相关程度的差别。 对实务工作者的启示 抑郁症是与人际关系相关的事件, 治疗师应当时时评估这一事件, 并提供针对关系问题的干预 女性的关系满意度受男性抑郁症的影响, 伴侣治疗能够对这两者都起到有益的作用 伴侣治疗师应该对要求/退缩行为在不同的程度上进行干预, 干预手段应与展现该行为的性别相匹配 关键词:伴侣;抑郁症;关系满意度;要求/退缩
    June 24, 2016   doi: 10.1111/1467-6427.12124   open full text
  • Why are couples fighting? A need frustration perspective on relationship conflict and dissatisfaction.
    Gaëlle Vanhee, Gilbert M. D. Lemmens, Lara Stas, Tom Loeys, Lesley L. Verhofstadt.
    Journal of Family Therapy. June 07, 2016
    The present study investigated whether partners’ frustration of relational needs for autonomy, competence, and relatedness was associated with relationship dissatisfaction and conflict (frequency, topics, communication patterns). Self‐report measures were completed by 230 committed heterosexual couples. APIM and regression analyses revealed that (1) need frustration is associated with how dissatisfied partners are with their relationship, how frequently they initiate conflict, and how they communicate during conflicts, but not with the number of conflict topics; (2) relatedness‐frustration matters most, whereas only limited evidence was found for autonomy‐ and competence‐frustration; (3) both one's own and one's partner's need frustration play a role in dissatisfaction and conflict; and (4) although most of the results were consistent across gender, gender differences were found for how need frustration affects couples’ conflict communication. Therapeutic implications are discussed. Practitioner points Addressing need frustration in couples may help to reduce relationship dissatisfaction, conflict, and destructive conflict communication Therapists should especially focus on relatedness‐frustration of men and women, but also pay attention to their autonomy‐frustration Destructive conflict communication patterns in couples reflect relatedness‐frustration in both men and women and autonomy‐ and competence‐frustration in men. 伴侣为何争吵?运用需求挫折视角看待关系冲突和不满 本研究调查了伴侣对于自主、能力和关系度的关系需求的挫败是否与其关系不满和冲突情况(频率、话题、沟通模式)有关。230对关系稳定的异性恋伴侣完成了自我报告量表。对象互倚性模型和回归分析结果显示(1)需求挫折与伴侣对关系的不满程度、伴侣发起冲突的频率, 以及他们在冲突中如何沟通都有关系, 但与冲突话题的数量无关;(2)关系度有关的挫败感影响最大, 而自主性和能力相关的挫败感影响的证据较少;(3)自身与伴侣的需求挫折都在不满和冲突中起到了作用;以及(4)虽然大多数研究结果不受性别影响, 但是在需求挫折如何影响伴侣的冲突沟通方面, 还是发现一些性别差异。文中讨论了该研究结果的临床治疗意义。 对实务工作者的启示 处理伴侣的需求挫折问题或许会有助于减少关系不满程度、冲突, 以及破坏性的冲突沟通。 治疗师应当尤其注意男性和女性与关系度有关的需求挫折, 但同时也要关注其与自主性相关的需求挫折 伴侣之间破坏性的冲突沟通模式反映了男性和女性的关系度需求挫折, 以及男性的自主性和能力相关需求挫折。 关键词:需求挫折;关系不满;关系冲突
    June 07, 2016   doi: 10.1111/1467-6427.12126   open full text
  • Family factors associated with adolescent self‐harm: a narrative review.
    Sarah Fortune, David Cottrell, Sarah Fife.
    Journal of Family Therapy. May 06, 2016
    This narrative literature review focuses on family factors that might be amenable to intervention using family therapy (n=126). Domains of interest include parent/child interactions, inter‐parental relationships, child characteristics, parental characteristics, wider system factors, treatment needs and moderators. The focus of family‐orientated treatment with this population should focus on maximizing cohesion, attachment, adaptability, family support, parental warmth while reducing maltreatment, scapegoating and moderating parental control. Close working relationships with child protection services and schools represent additional opportunities. Practitioner points Over and above any inherited risk, a range of family interactional factors are strongly associated with self‐harming behaviours in young people Therapy has the potential to make a positive difference by focusing on enhancing family cohesion and adaptability, whilst reducing discord and violence. Discussions that enhance perceived parental support and warmth may be particularly helpful Therapists should attend to issues of perceived difference and potential victimization (bullying, gender orientation and identity, ethnic minority status) as these may play an important role in self‐harm 和青少年自残相关的家庭因素:一个叙述性的回顾 摘要: 这个叙述性的文献回顾集中在用于家庭治疗干预中的可能被修复的家庭因素(数量=126)。这里涉及到父母/儿童的交互, 父母之间的关系, 儿童的特点, 家长的特点, 更广泛的系统特点, 干预需要和催化因素。针对这一群体的家庭为导向的干预应该集中在最大化凝聚力, 依恋, 适应性, 家庭支持, 父母温暖, 与此同时减少错误对待, 迁怒, 和调解家庭的控制。和儿童保护服务和学校的亲密工作关系呈现了额外的机会。 对实践者有用的几点建议 除了遗传的风险外, 一系列的家庭互动因素和青年人的自残行为有很强烈的相关。 治疗有潜力促使积极转变的发生, 这可以通过加强家庭的凝聚力和适应性, 同时减少不和谐和暴力。对加强感知到的家长的支持和温暖的讨论可能尤其有帮助 治疗师应该关注感知到的不同和潜在的欺骗(欺凌, 性别取向和认知, 少数民族身份)因为这些可能对自残行为的发生起到了作用。 关键词:自残, 儿童和青少年精神健康, 家庭事实
    May 06, 2016   doi: 10.1111/1467-6427.12119   open full text
  • Gender in family therapy education: reflections of cis‐females.
    Karen Mui‐Teng Quek, Christie Eppler, Martha L. Morgan.
    Journal of Family Therapy. April 12, 2016
    Purpose: Research indicates that family therapy courses in gender studies affect both female and male students to the same degree. How female students experience a gender‐focused family therapy class has yet to be explored. This qualitative study focused on self‐identified cis‐female students' experiences in a ten‐week course on gender in family therapy. The purpose of this study was to present female students' critical reflections of taking a clinical training course dedicated to gender studies. Method: Using transcendental phenomenology, we analysed reflections from 86 student‐participants regarding how they perceived themselves as gendered and how new information had transformed their thoughts and actions. Thematic analysis from the data was inductive, we read and reread the reflections and then generated several main themes. Results: Participants were challenged to revisit gendered assumptions about significant and insignificant concerns in their development. We organized women's self‐reports into four domains: Affect, Identity, Empowerment, and Action. Conclusions: In summary, addressing gender‐related topics in the classroom had impacted students intra‐personally and interpersonally. As they processed internally, they began to reshape their relationships. Additionally, they planned to become agents of change in therapy room. Practitioner points Therapists recognize how gender‐related power differences, gender roles in societal and familial systems, and the ways unequal gender relations affect relationships Therapists address not only the position of women in their cultures but also how their social environment reproduces this positioning within its own ranks Educators ensure that their pedagogies and therapeutic practices constantly reflect gender‐aware practices in order to be culturally competent
    April 12, 2016   doi: 10.1111/1467-6427.12122   open full text
  • Trials and Tribulations ‐ an RCT comparing manualized family therapy with Treatment as Usual and reflections on key issues that arose in the implementation.
    Paula Boston, David Cottrell.
    Journal of Family Therapy. April 06, 2016
    SHIFT has been one of the largest RCTs in the field of systemic family therapy in the UK. The study took place over five years, including three major centres with fifteen Trusts and twenty‐five family therapists who worked with a manualized treatment in CAMHS with adolescents who self‐harmed. While the results are not available at the time of this publication, this paper will briefly describe the pre‐ existing factors which were helpful in developing a successful bid, clinical and managerial elements of ‘real world research’ of complex psychological processes and the construction of the manualized systemic family therapy. It also offers examples of some of the unanticipated events in the life of such a large trial. Practitioner Points Large trials develop from small studies and clinicians are urged to look for opportunities for research partnerships Investment in time for consideration of difficult issues as they arise is essential for effective trial management The balance between research rigour and ‘real life’ practice is an inevitable area of tension and requires consideration of both immediate and outcome consequences 尝试和痛苦 – 一种随机对照试验对比下的把干预当作惯常和在实施过程中出现的重要事件上的反思的家庭治疗 人工家庭治疗 摘要: SHIFT目前是英国家庭治疗领域最大的随机对照试验之一。本研究历时5年, 囊括了三个主要的中心在内的15个信托, 25位曾在CAMHS对自残青少年进行人工治疗的家庭治疗师。因为在发表这篇文章的时候, 结果还没有出来, 本文将简短地描述1)有助发展成功bid的已经存在的因素, 2)临床以及管理方面的复杂心理过程的”真实情况研究”元素, 3)以及人工系统家庭治理的建构。本文还提供了生活在这样一种大的的尝试下的一些意想不到事件的例子。 对实践者有用的几点建议 大的尝试发展自小的研究, 临床工作者急需寻找研究合作者的机会 困难事件需要及时解决, 不然就会对有效尝试管理产生重要影响 研究活力和”真实生活”实践的平衡是一种不可避免的引起紧张的领域, 这需要对当下和结果的同时考虑 关键词:实证实践, 研究, 儿童和青少年精神健康, 培训
    April 06, 2016   doi: 10.1111/1467-6427.12118   open full text
  • Talking About Versus Talking With: an experiential self of the therapist exercise for family therapy training.
    Michael E. Sude, Laura Eubanks Gambrel.
    Journal of Family Therapy. April 06, 2016
    This article describes an experiential self of the therapist exercise for use in family therapy training. It provides guidelines for instructors to integrate the activity into their courses including step‐by‐step directions, examples of processing questions, and potential readings to accompany the activity. The Talking About Versus Talking With exercise was designed to help family therapy students have a felt sense of some of the differences between individual and relational therapy. It provides trainers with a way to teach therapists in training about clients’ experiences in relational therapy where they talk about relational difficulties directly with someone, as opposed to talking about those same difficulties in individual therapy. The exercise also offers an opportunity for students to do self of the therapist work with a strained relationship in their personal lives, and students report that it is both rewarding and emotionally intense. Practitioner points Differences between individual and relational therapy may not be easily understood by family therapy students Self of the therapist work, including working with difficult personal relationships, is a vital component of family therapy training The experiential nature of the exercise provides students with a felt sense of some differences between individual and relational therapy
    April 06, 2016   doi: 10.1111/1467-6427.12121   open full text
  • Therapist implementation and parent experiences of the three phases of Functional Family Therapy.
    Dan Hartnett, Alan Carr, Elena Hamilton, Thomas L. Sexton.
    Journal of Family Therapy. April 06, 2016
    Despite the widespread adoption of manualized model‐driven approaches to family therapy, little is known about how therapists implement and families experience the specific guiding practices involved in individual models. The aim of the present study was to use a qualitative methodology to describe therapist implementation and family experiences of the three phases of Functional Family Therapy (FFT). Five FFT therapists and four parents of families who had been treated by those therapists were interviewed and thematic analysis performed to analyse the data. Results suggest that both common factor and model‐specific treatment elements, flexibility within model delivery, and strategies which aim to improve parental self‐efficacy and communication are key elements of successful therapy when practised within a manualized model‐driven framework. Limitations such as the retrospective nature of the study, and avenues for future research, such as the inclusion of the entire client family, are discussed. Practitioner points Early in FFT, combine basic therapeutic skills such as empathy, warmth and unconditional positive regard with model specific skills such as reframing In the middle sessions of FFT, match the development of specific behaviour change skills (e.g. communication, conflict management, and emotional regulation) to families’ particular goals In later sessions of FFT, support the generalization of gains made within therapy to other contexts and future situations to prevent relapse 功能家庭治疗三个阶段的治疗师执行情况及家长体验 虽然手册化、模式驱动的家庭治疗方法已被广泛使用, 对于个体模式的特定指导实践的治疗师执行情况和家庭的体验却鲜有资料。该研究的目的在于用质性研究方法描述功能家庭治疗(FFT)三个阶段的治疗师执行情况和家庭体验。五位FFT治疗师和四位他们治疗过的家庭中的家长参加了访谈, 访谈数据通过系统方法进行了分析。分析结果显示, 在手册化、模式驱动的治疗框架下, 共同元素和模式特定的治疗因素、模式执行的灵活性, 以及着眼于改善家长自我效能感和沟通的策略都是成功治疗的关键因素。文中还讨论了本研究的缺陷, 如回溯性的本质, 并讨论了未来研究的方向, 比如将整个被治疗家庭纳入研究。 对实务工作者的启示 在FFT的早期阶段, 在使用模式特定的技巧如重构的同时, 融合基本的治疗技巧, 如共情、情感温暖和无条件的积极视角 在FFT的中期阶段, 将特定行为变化技巧(如沟通、冲突处理和情绪调节)的发展与家庭的具体目标相匹配 在FFT的后期阶段, 支持治疗成果在其他情境和未来情况中的普遍化, 以预防病情反复 关键词:循证实践;功能家庭治疗;手册化
    April 06, 2016   doi: 10.1111/1467-6427.12120   open full text
  • Emotion talk in the context of young people self‐harming: facing the feelings in family therapy.
    Alice Rogers, Petra Schmidt.
    Journal of Family Therapy. March 15, 2016
    This article describes the use of emotion talk in the context of using a manualised approach to family therapy where the presenting problem is self‐harm. Whilst we understand that there is an internal aspect to emotion, we also consider emotions to be socially purposeful, culturally constructed and interactional. We found that within the presenting families, negative emotions were often talked about as located within the young person. Through using ‘emotion talk’ (Fredman, ) in deconstructing and tracking emotions and exploring how emotions connected to family‐of‐origin and cultural contexts, we developed an interactional understanding of these emotions. This led to better emotional regulation within the family and offered alternative ways of relating. The article discusses the use of relational reflexivity, and using the therapist and team's emotions to enable the therapeutic process, encouraging reflexivity on the self of the therapist in relation to work with emotions. Practitioner points Emotions can be seen as both a reflection of feelings experienced by the individual and as a communication. An interactional understanding of emotions can be used therapeutically. Therapists should explore emotional displays and track the interactional patterns within the therapeutic system. Therapists should self‐reflexive about ways of doing emotions and use this awareness in practice. 青少年自残情境下的情感谈话:在家庭治疗中面对情绪 摘要: 本文描述了在针对自残问题的手册化家庭治疗中使用情感对话的方法。我们清楚情绪有着内化的一面, 但我们同时也认为情绪有其社会性的作用、是文化构建的和互动性的。我们发现, 来访的家庭通常认为负面情绪是存在于青少年自身内部的。通过用”情感谈话”(Fredman, 2004)来解构和追踪情绪, 并探索情绪是如何与原生家庭和文化背景相关, 我们对这些情绪有了一种互动式的理解。这一举动促进了家庭内部更好的情绪控制, 并提供了家庭成员之间互相联系的其他方式。本文讨论了关系性自反的运用以及利用治疗师和治疗团队的情绪来推进治疗过程, 并鼓励治疗师在处理情绪时开展自我反思。 关键词:情绪;自残;系统家庭治疗;SHIFT项目 对实务工作者的启示 情绪既可以被看作是自身感受的反映, 也可以被看作是一种沟通 对情绪的互动式理解可以协助治疗 治疗师应探索情绪的表现, 并追踪治疗系统之内的互动模式 治疗师应对其处理情绪的方法和在实践中应用该方法的过程具有自我反省意识
    March 15, 2016   doi: 10.1111/1467-6427.12115   open full text
  • Constructing a SHIFT adherence measure (SAM): the development of a family therapy integrity measure for the SHIFT trial.
    Ciara Masterson, Christina Barker, David Jackson, Paula Boston.
    Journal of Family Therapy. February 01, 2016
    We were tasked with establishing treatment integrity for the SHIFT trial. In this article we discuss the concepts of treatment adherence and competence; arguing that the design of the trial, in particular the flexibility of the manual and the training and supervision of qualified systemic therapists, guarantees some level of treatment integrity. Despite this we decided, on the basis of a systematically informed literature review, that a post hoc evaluation of therapy tapes was in line with best practice. Our literature review found no measures that were appropriate for the needs of the trial, so we used the literature to guide our development of a SHIFT adherence measure (SAM). We outline our experience of constructing SAM in the hope of increasing transparency in this complex area of psychotherapy research. We also consider whether SAM can be transported into practice and outline future areas of research. Practitioner points Developing measures of treatment integrity for a flexible systemic family therapy manual is a challenge but necessary for treatment to be delivered as intended. Clinicians may wish to consider whether such measures can be used in everyday practice, potentially with a role in supporting supervision or skill development. 构建SHIFT附着量表:对SHIFT尝试和一个家庭治疗整合量表的发展 摘要: 我们的任务是为SHIFT尝试构建干预整合。在本文中我们讨论了干预附着和效能感的概念;主张这一尝试的设计尤其是手册以及培训和督导合格系统治疗师的灵活性, 保证了某种程度上的干预整合。 尽管如此, 我们决定在系统性地文献综述的基础上, 把治疗磁带的后期评估和最好的实践放在一起。我们的文献综述发现没有量表满足尝试的需要, 于是我们应用文献在指导我们对SHIFT附着量表的发展。我们概括了我们在构建SAM时候的经验以希望增加心理治疗研究这一复杂领域的透明度。我们还考虑把SAM转化成实践并列出了未来研究的领域。 对实践者有用的几点建议 为了一个灵活的系统家庭治疗手册, 发展干预整合的量表是一个挑战, 但对干预按照设计的方式实施很有必要。 临床工作者可能希望考虑应用这样的有可能支持督导和技能发展的量表到所有的实践中。 关键词:心理治疗整合, 手册, 附着, 效能感
    February 01, 2016   doi: 10.1111/1467-6427.12104   open full text
  • Couple emotional experience: effects of attachment anxiety in low and high structure couple interactions.
    Ryan B. Seedall, Karen S. Wampler.
    Journal of Family Therapy. February 01, 2016
    This study used data from 63 heterosexual couples to investigate the effects of attachment anxiety and how they relate to emotional experience (i.e. psychophysiological distress and feelings towards a partner) in the context of two therapy‐like conditions (low and high structure). We examined both the effect of an individual's anxiety on his/her own emotional experience (actor effects) and on the partner's experience (partner effects). During both interactional conditions, female partners of men higher in attachment anxiety experienced greater psychophysiological distress. In addition, men and women higher in attachment anxiety were not significantly different from others in terms of their feelings towards their partner during the low structure condition. However, their feelings were significantly more positive than others during the high structure condition, providing some evidence that attachment‐based interventions can be especially useful for clients higher in attachment anxiety. Practitioner points Not only should therapists take into account couple distress and volatility when facilitating couple interaction, but they should also account for self‐reported attachment Clients high in attachment anxiety may benefit from the emotional containment provided by having a therapist buffer the couple interaction Clients high in attachment anxiety may especially benefit from therapy process that is anchored in facilitating attachment‐based expression 伴侣情绪体验:依恋焦虑在低结构和高结构伴侣互动中的影响 该研究基于63对异性恋伴侣的数据, 探索了在两种类治疗情境下(低结构、高结构), 依恋焦虑的影响以及这些影响与情绪体验(比如身心不适和对伴侣的感觉)的关系。我们考察了个人焦虑对其自身(行为者作用)以及伴侣的情绪体验(伴侣作用)的影响。在两种互动情境下, 具有更高依恋焦虑的男性被试的女性伴侣都经历了更严重的身心不适。另外, 在低结构情境下, 高焦虑的男女被试在对伴侣的感觉方面并没有显著差异。然而, 在高结构情境下, 他们的感觉比其他人明显要更加积极, 这在某种程度上支撑了以依恋为基础的治疗可能会对高依恋焦虑的来访者尤其有效。 对实务工作者的启示 治疗师在促进伴侣互动的时候不光应该考虑到伴侣不适和不稳定性, 他们也应该将自我报告的依恋状态纳入考量。 治疗师在伴侣互动中起的缓冲作用可能会起到一种有利于有较高依恋焦虑的来访者的情绪抑制作用。 聚焦于有关依恋的表达的治疗过程可能尤其有利于有较高依恋焦虑的来访者。 关键词:依恋焦虑;情绪;治疗过程;伴侣互动
    February 01, 2016   doi: 10.1111/1467-6427.12113   open full text
  • Using interviews to understand parent and family perspectives of the August 2011 London riots.
    Yvanna Deeny Coopoosamy.
    Journal of Family Therapy. February 01, 2016
    This article presents findings from interviews with London parents and families, to explore their perspective of the August 2011 London riots in the UK. This article is based on a doctorate thesis where the researcher adopted a critical position on constructions of parent‐blaming within political rhetoric. A separate paper (forthcoming) presents clinical implications developed from the research findings. The research was influenced by systemic and narrative therapy approaches. Nine parents and three young people, from five families across three London boroughs, were interviewed together to explore how they constructed the riots. A Foucauldian‐informed thematic analysis identified themes of inequality and exclusion, rioting as a criminal threat, youth as problematic, parenting and morality, and reclaiming normality. These themes highlighted discourses of crime, punishment, parenting and youth, the relevance of socio‐political factors, parent‐blaming and community resources within parent and family constructions of the 2011 London riots. Practitioner points Support inclusion of the perspective of parents and families in academic literature, clinical discussion and debates on the 2011 London riots Highlight discourses of crime, punishment, parenting and youth from parent and family constructions of the 2011 London riots 通过面谈理解家长和家庭对2011年8月伦敦暴乱事件的看法 本文呈现了与伦敦家长和家庭面谈的结果, 探索了他们对2011年8月伦敦暴乱事件的看法。这篇文章基于一篇博士论文, 在该论文中, 研究者对政治语境中谴责家长的建构采用了一种批判的姿态。另外一篇文章(即将在2016年发表)呈现了由这些研究发现发展出来的临床应用启示。本研究受系统的叙事疗法的影响。来自伦敦的3个镇上的5个家庭的9个父母和3个年轻人在一起接受了面谈, 谈论他们怎么理解这次暴乱。福柯式的主题分析揭示了以下这些主题:不平等和排外, 暴乱作为犯罪威胁, 年轻人有问题, 父母教养和道德, 以及恢复正常。这些主题强调了家长和家庭对2011年伦敦暴乱的看法中关于犯罪、惩罚、父母教养和年轻人、社会政治因素的相关性、谴责家长和社区资源等话题。 对实务工作者的启示 对包含家长和家庭对2011伦敦暴乱的看法的学术和临床讨论应给予支持。 强调家长和家庭对2011 伦敦暴乱看法中对犯罪、惩罚、父母教养和年轻人的讨论。 关键词:2011伦敦暴乱;谴责家长;问题家庭项目;家庭;政治语境
    February 01, 2016   doi: 10.1111/1467-6427.12112   open full text
  • Childhood abuse and family obligation in middle adulthood: findings from the MIDUS II National Survey.
    Elizabeth Oshrin Parker, Candice Maier, Armeda Wojciak.
    Journal of Family Therapy. February 01, 2016
    This study examined associations between reported histories of childhood abuse and later reports of obligation towards their family of origin from a family life cycle perspective. Data from this study included a subsample of 725 single and married, English‐speaking adult participants (57.1% female, M age = 49.8 years) from the National Survey of Midlife Development in the United States (MIDUS II): Biomarker Project. Findings suggest that childhood abuse impacts later family obligation in many ways, and that different categories of abuse (e.g. emotional, neglect, physical and sexual) and severity levels (e.g. none, less severe, more severe) differ in their impacts on adults’ reports of obligation to their families. Implications for future research and clinical practice are suggested. Practitioner points Clinicians should be aware that different categories of childhood abuse may have unique effects on clients' feelings of obligation towards their families later in life The intersection between severity of childhood abuse and category of childhood abuse is important to explore in therapy due to nuanced effects on feelings of family obligation later in life 中年时期的童年虐待和家庭责任:MIDUS II全国调查的发现 该研究从家庭生活周期的理论角度, 考察了自我报告的童年虐待经历和之后对于原生家庭责任履行情况报告之间的联系。研究所使用的样本为“美国中年生活发展全国调查(MIDUS II):生物学标志项目”的一个子样本, 包括725名单身或已婚的、以英语为主要语言的参与者(57.1%为女性, 平均年龄49.8岁)。研究结果表明, 童年受虐待的经历会在很多方面影响今后家庭责任的履行, 而且不同种类的虐待(如情感虐待、忽视、身体和性虐待)以及虐待的不同程度(如没有, 不太严重, 十分严重)对于成人家庭责任的报告都有不同影响。本文讨论了该研究结果对未来研究和临床实践的意义。 对实务工作者的启示 临床医师应该意识到不同类型的童年虐待对于来访者在中年之后的家庭责任感有着不同的影响。 童年虐待的严重程度和类型的交互影响是治疗中要探索的重要对象, 因为其对于中年以后家庭责任感的影响存在细微差别。 关键词:童年虐待;家庭生活周期;家庭责任;中年
    February 01, 2016   doi: 10.1111/1467-6427.12114   open full text
  • Validation of 28 and 15 item versions of the SCORE family assessment questionnaire with adult mental health service users.
    Kevin O'Hanrahan, Megan Daly White, Alan Carr, Paul Cahill, Mairi Keenleyside, Mark Fitzhenry, Elizabeth Harte, Jennifer Hayes, Hester Noonan, Helen O'Shea, Avril McCullagh, Shaun McGuinness, Catherine Rodgers, Neal Whelan, Noel Sheppard, Stephen Browne.
    Journal of Family Therapy. February 01, 2016
    The SCORE (Systemic Clinical Outcome and Routine Evaluation) is a 40‐item questionnaire for completion by family members 12 years and older to assess outcome in systemic therapy. Twenty‐eight and 15‐item short versions of the SCORE have previously been validated with samples containing some families attending adult mental health services and some attending child and adolescent services; or samples containing families exclusively from child and adolescent services. This study aimed to investigate psychometric properties of two short versions of the SCORE with a sample drawn exclusively from adult mental health services. Data were collected from 199 service users attending inpatient and outpatient adult mental health services in the south‐east of Ireland. Both instruments had good internal consistency reliability. They also showed construct and criterion validity, correlating with measures of global functioning, service need, and childhood trauma. The 28 and 15‐item versions of the SCORE are brief psychometrically robust family assessment instruments which may be used to evaluate systemic therapy with adult mental health service users. Practitioner points Brief 15 and 28‐item versions of the SCORE may be used to assess family adjustment, monitor progress and assess outcome in adult mental health cases The SCORE‐28 is in the appendix to Cahill et al. (). The SCORE‐15 and a 29‐item version that contains items for both the SCORE‐28 and SCORE‐15 is in Fay et al. () A web‐based system for administering and scoring the SCORE‐15 and SCORE‐28 is available at this link: 在成年心理健康服务使用者之中验证SCORE家庭评估问卷的28题和15题版本 SCORE(系统临床效果和常规评估)是一份40个问题的问卷, 由12岁及以上的家庭成员填写, 以评估系统治疗的疗效。SCORE的两个简短版, 28题版和15题版, 曾经在一些接受成年心理健康服务的家庭和一些接受儿童和青少年心理健康服务的家庭中得到验证;或者是仅参加儿童和青少年心理健康服务的家庭。该研究的目的在于通过一个全部接受成人心理健康服务的样本, 调查SCORE两个简短版的心理测量特性。数据来源于爱尔兰东南部199位成人心理健康住院和门诊服务的使用者。两种量表都显示出较好的内部一致性信度。它们也显示出概念和标准效度, 并与整体机能、服务需求、童年创伤的量表有相关性。SCORE的28题和15题版本是简短的、具有良好的心理测量特性的家庭评估工具, 可以用于评估成人心理健康服务使用者的系统治疗情况。 对实务工作者的启示 SCORE的简短版, 15题和28题版, 可以用于成人心理健康案例中的评估家庭适应度、监测进度和评估效果。 SCORE‐28可以在Cahill et al. (2010)的附录中找到。SCORE‐15, 以及另一个包含15题版和28题版问题的29题版可以在Fay et al. (2013)中找到。 SCORE‐15和28的使用和记分系统网络版在以下网址: 关键词:家庭评估;SCORE;成人心理健康
    February 01, 2016   doi: 10.1111/1467-6427.12107   open full text
  • Non‐violent resistance parent training for the parents of young adults with High Functioning Autism Spectrum Disorder.
    Ofer Golan, Hila Shilo, Haim Omer.
    Journal of Family Therapy. January 21, 2016
    A ‘dependence trap’ between parents and young adults with High Functioning Autism Spectrum Disorder (HF‐ASD) develops when parents accommodate to the needs of their grown‐up child in ways that may hinder development and cause distress. Non‐Violent Resistance (NVR) parent training may help parents reduce their accommodation, manage arising conflicts through de‐escalation techniques, and amass external support for themselves and their child. Parents of four young adults with HF‐ASD received a ten‐week modified NVR parent training. Cases were evaluated through semi‐structured interviews and self‐report questionnaires. The parents reported improved independent functioning, reduced parental helplessness and accommodation, and enhanced support. Questionnaires showed improvements in reported parental hopefulness and reduced parental depression. Practitioner points Families with a grown‐up child with HF‐ASD may be characterised by excessive parental accommodation that is detrimental to optimal functioning Accommodation increases dependence, which in turn requires continued accommodation, forming a ‘dependence trap’ NVR parent training may help parents to young adults with HF‐ASD reduce parental accommodation, helplessness and depression, while improving hopefulness and adaptation 对患有高功能自闭症谱系疾病的青年人的家长开展非暴力抵抗家长培训 当家长对患有高功能自闭症谱系疾病(HF‐ASD)的青年人的迁就开始妨碍青年人的发展并给他们造成痛苦时, 家长与成年孩子之间就产生了一个“依赖陷阱”。非暴力抵抗(NVR)家长培训或许可以帮助家长减少迁就行为, 通过缓和技巧来处理出现的冲突, 并为自己和孩子大量寻找外部支援。四位患有HF‐ASD的青少年的家长参加了十周的调整版NVR家长培训。个案评估通过半结构式访谈和自我报告问卷进行。家长报告了独立行动能力的改善、家长无助感和迁就行为的减轻, 以及支持的增加。问卷结果显示, 自我报告的家长乐观感有所增加, 而家长抑郁情况有所减轻。 对实务工作者的启示 有罹患HF‐ASD青年人的家庭或许会出现家长过度迁就的情况, 而这种情况是不利于青年人发展最佳自理功能的。 迁就强化了依赖, 然后又会需要更多的迁就, 形成了一个“依赖陷阱”。 NVR家长培训或许可以帮助患有HF‐ASD的青年人家长减轻迁就行为、无助感和抑郁状况, 同时改善他们的乐观感和适应性。 关键词:自闭症谱系疾病;青年人;依赖;迁就;家长培训;非暴力抵抗
    January 21, 2016   doi: 10.1111/1467-6427.12106   open full text
  • Bringing forth stories of blame and shame in dialogues with families affected by adolescent self‐harm.
    Sarah Amoss, Monica Lynch, Mary Bratley.
    Journal of Family Therapy. January 20, 2016
    Feelings of blame and shame seemed to figure significantly in the interactional patterns of some families seen within the self‐harm intervention family therapy (SHIFT) trial. Taking the SHIFT manual as a starting point, we elaborate the links between blame, shame, emotional regulation and adolescent self‐harm, drawing on various theoretical models. We note the importance of attending to these emotional processes both in the family and the therapy team, arguing that these unhelpful patterns of interaction, emotion and meaning‐making may also signal a motivation for change. We offer some ideas about using blame and shame as platforms for understanding and intervention in the context of adolescent self‐harm and illustrate the application of these ideas with case vignettes. Practitioner points Consider offering the young person and parents parallel sessions to scaffold better communication in family sessions. If you can, work with a team to help reflect on your own emotional responses and their meanings. When attempts to lessen blame provoke more, try to understand what underlies blaming behaviour. When a family's reported lack of difficulties seems incongruent with the presence of self‐harm, consider the possible silencing effect of shame. 和有青少年自残行为的家庭讨论责备和羞愧的发生 责备和羞愧似乎常出现在自残干预类家庭治疗案例中的一些家庭的相互作用中。以SHIFT手册作为转折的起点, 应用各种理论模型, 我们阐释了责备, 羞愧和情感约束和青少年自残之间的关系。我们注意到这些情绪过程在家庭以及治疗中的重要性, 认为这些无益的交互模式, 情绪, 以及意义构建可能也预示了转变的动机。我们提供了一些关于应用责备和羞愧作为理解的平台以及有关青少年自残背景下的干预的想法, 并阐释了这些想法在案例场景中的应用。 对实践者有用的几点建议 考虑提供年轻人和家长平行进行的的治疗会面用于支持更好的家庭会面时的交流。 如果可以的话, 和一个团队一起工作以帮助反思你自己的情绪性回复和背后的意义。 当试图减少责备更多地出现的时候, 试图理解责备行为背后隐藏的是什么。 当一个家庭报告出和自残行为的存在不一致的家庭状态时(不同在困难), 考虑可能是羞愧的沉默效果。 关键词:责备, 羞愧, 儿童和青少年精神健康, 自残, 家庭治疗
    January 20, 2016   doi: 10.1111/1467-6427.12101   open full text
  • Clinical implications from research exploring parent and family perspectives of the August 2011 London riots.
    Yvanna Deeny Coopoosamy.
    Journal of Family Therapy. December 09, 2015
    Political rhetoric and media reports following the August 2011 London riots in the UK drew attention to poor parenting to explain the cause of the riots, thus, a parent‐blaming discourse emerged. This article presents findings from a PhD thesis about how London parents and families constructed the riots and relevant clinical implications. A separate paper focuses on the method and findings from the PhD thesis with an aim to include parent and family perspectives on the riots in the academic literature. A Foucauldian‐informed thematic analysis indicated that social exclusion, gentrification, criminality, parenting, morality and neighbourhood were relevant to the 2011 London riots from interviews with parents and families. This article aims to support clinical work with parents and families, especially as clinicians were positioned as useful in supporting such groups, through the Troubled Families Programme following the London riots. Clinical implications were developed from themes about socio‐political issues and parent‐blaming discourses and the notion of positioning, as influenced by the Foucauldian‐informed analysis adopted. Practitioner points Consider the relevance of socio‐political issues and parent‐blaming discourses to the August 2011 London riots. Use ‘social context’ questions to explore socio‐political issues when conducting therapy. Use ‘parenting expectations’ questions to explore possible parent‐blaming discourses when conducting therapy. Consider the ways in which clients may be positioned within their relationships. 研究关于2011年8月伦敦暴乱事件的家长和家庭视角的临床应用意义 2011年8月, 英国伦敦发生暴乱之后, 政治言论和媒体报道都将关注点聚焦于不良的家庭教育, 以此解释暴乱的发生。因此, 一种声讨家长的言论出现了。本文呈现了一篇关于伦敦家长和家庭对暴乱理解的博士论文的研究结果, 以及它的临床应用意义。另一篇文章则聚焦于该博士论文的研究方法和研究结果, 目的是在在学术文献中纳入家长和家庭关于暴乱的视角。通过福柯式的主题分析方法分析了与家长和家庭的访谈, 结果显示, 社会排斥、地区贵族化、犯罪活动、家庭教育、道德状况和社区这些因素与2011年伦敦暴乱相关。本文的目的是支持针对家长和家庭开展的临床工作, 尤其是像暴乱之后的“困难家庭项目”一样将临床医师置于支持这些群体的立场之上。在福柯式分析的影响下, 本文讨论了关于社会政治话题、声讨家长的言论和确定立场等主题的临床应用意义。 对实务工作者的启示 思考社会政治话题和声讨家长的言论与2011年8月伦敦暴乱的相关性。 在开展治疗时, 使用 “社会环境” 问题来探索社会政治话题。 开展治疗时, 使用 “家长期望” 问题来探索可能的声讨家长的言论。 思考来访者在其家庭关系中的可能立场位置。 Implicaciones clínicas de la investigación que explora las perspectivas de los padres y las familias sobre los disturbios de agosto de 2011 en Londres La retórica política y los informes de los medios después de los disturbios de Londres de agosto de 2011 en el Reino Unido llamaron la atención sobre la parentalidad deficiente para explicar la causa de los disturbios, por lo que surgió un discurso que culpa a los padres. Este artículo presenta los resultados de una tesis doctoral sobre cómo los padres y las familias de Londres interpretaron los disturbios y las implicaciones clínicas relevantes. En un trabajo separado se describe el método y los resultados de la tesis doctoral con el objetivo de incluir las perspectivas de los padres y la familia sobre los disturbios en la literatura académica. Un análisis temático Foucaultiano indicó que la exclusión social, la gentrificación, la criminalidad, la crianza de los hijos, la moralidad y el vecindario eran relevantes para los disturbios de Londres de 2011 a partir de entrevistas con padres y familias. Este artículo tiene como objetivo apoyar el trabajo clínico con los padres y las familias, especialmente como los clínicos se posicionaron como útiles en el apoyo a estos grupos, a través del programa denominado Troubled Families Programme, después de los disturbios de Londres. Las implicaciones clínicas se desarrollaron a partir de temas sobre debates sociopolíticos y discursos de culpabilidad de padres y la noción de posicionamiento, influenciada por el análisis basado en el enfoque de Foucault. Puntos de implicación práctica: Considerar la importancia de las cuestiones sociopolíticas y los discursos que culpan a los padres en relación con los disturbios de Londres de agosto de 2011. Utilice preguntas de “contexto social” para explorar cuestiones sociopolíticas al realizar la terapia. Utilice preguntas sobre las “expectativas de los padres” para explorar posibles discursos de culpabilidad de los padres al realizar la terapia. Considerar las diferentes maneras en que los clientes pueden ser posicionados dentro de sus relaciones.
    December 09, 2015   doi: 10.1111/1467-6427.12102   open full text
  • From family to relational SCORE‐15: an alternative adult version of a systemic self‐report measure for couples and LGB People.
    Yang Yang Teh, Judith Lask, Peter Stratton.
    Journal of Family Therapy. November 26, 2015
    SCORE‐15 is a self‐report measure developed for systemic approaches to therapy. This article describes a pilot study designed to test the reliability and content validity of the original SCORE‐15 for lesbian, gay and bisexual (LGB) adults in the UK. Quantitative data analyses conducted with an LGB sample (n = 59) and a non‐LGB sample (n = 57) found sufficient temporal and internal reliability in the SCORE‐15 but with some exceptions for the communication subscale. The content validity of SCORE‐15 was checked via group discussions with two clinical professionals groups (n = 7) and a gay/bisexual men group (n = 8). An alternative adult version of SCORE‐15 named the relational SCORE‐15 or the R‐SCORE‐15 was constructed and its content validity was checked by the original clinical professionals and an additional professional group (n = 8). The R‐SCORE‐15 has content validity for clinical use with couples and LGB people in relationship therapy. Practitioner points SCORE‐15 is a systemic self‐report measure reliable for routine clinical use with LGB people and couples in the UK to measure relational changes. The use of the term family affects the content validity of SCORE‐15 for LGB people and couples who may not regard family as their primary relationships. R‐SCORE‐15 is a recommended alternative to SCORE‐15 for couples, LGB people and those who may not define significant relationships via biology or marital ties. 从家庭到关系版SCORE‐15:为伴侣和LGB群体另行设计的成人版系统自我报告量表 SCORE‐15是为系统性治疗方法设计的一份自我报告量表。 本文描述了一项初步研究, 其目的在于测试原版SCORE‐15在英国女同性恋、男同性恋和双性恋(LGB)群体中的信度和内容效度。对一个LGB群体样本(n = 59)和一个非LGB群体样本(n = 57)的数据进行定量分析的结果显示, 除了其中的沟通分量表之外, SCORE‐15具有足够的跨时间信度和内部一致性信度。对SCORE‐15的内容效度的检测是通过与两个专业临床人士小组(n = 57)和一个同性/双性恋男性小组(n = 58)的小组讨论来进行的。在此基础上, 新设计了另一份成人版SCORE‐15, 将其命名为关系版SCORE‐15或者R‐SCORE‐15。在原有的专业临床人士上, 新加了一个专业人士组(n = 8), 以确定这一新量表的内容效度。R‐SCORE‐15具有足够的内容效度以供关系治疗中的伴侣和LGB人群的临床使用。 对实务工作者的启示 SCORE‐15是一种系统性的自我报告量表, 在测试英国LGB群体和伴侣关系变化的临床用途上具有信度。 对于LGB群体和伴侣来说, “家庭” 这个词的使用影响了SCORE‐15的内容效度, 因为他们可能并不把家庭看作他们的首要关系。 对于伴侣、LGB群体和不将血缘或婚姻关系当作重要关系的人群, 推荐使用R‐SCORE‐15作为代替。 关键词:LGB;女同性恋;男同性恋和双性恋;SCORE‐15;关系版SCORE‐15;R‐SCORE‐15;常规测量指标;系统性自我报告量表;信度和效度;伴侣治疗;LGB适用的SCORE‐15
    November 26, 2015   doi: 10.1111/1467-6427.12103   open full text
  • Working with Chinese families in China and around the world Call for papers.

    Journal of Family Therapy. October 22, 2015
    There is no abstract available for this paper.
    October 22, 2015   doi: 10.1111/1467-6427.12100   open full text
  • The role of relationships and families in healing from trauma.
    Gabriela López‐Zerón, Adrian Blow.
    Journal of Family Therapy. October 07, 2015
    The effects of trauma and its treatment have a central role in health discussions in that trauma exposure is associated with an array of mental health issues, including depression, anxiety, and substance abuse. Treatment approaches are varied, but most empirically based protocols are individually focused, targeting intrapersonal difficulties. Although these protocols are critical, they do not directly address the relationship difficulties that may arise for survivors. In addition, limited empirical evidence supports using systemic approaches in trauma treatment. This article addresses this issue by summarizing the most salient individual and relational evidence‐based trauma protocols and by providing a description of common factors among these approaches, while also challenging the field to generate more research that emphasizes systemic interventions as a core consideration in treatment. A case study is included to illustrate the global relevance and benefit of systemic trauma approaches. Practitioner points Trauma should be treated as an event that affects everyone in the family and is nested in societal and cultural contexts. Close relationships can maintain or exacerbate problems, but they can also be a powerful source of healing. Systemic protocols that not only address intrapersonal difficulties, but also focus on survivors’ relationships are critical for healing in the aftermath of trauma. 关系和家庭在创伤恢复方面的角色 创伤的影响及其治疗在健康话题中具有重要的地位, 因为创伤性暴露和一系列的精神健康问题相关,包括抑郁、焦虑和药物滥用。治疗手段多种多样, 但是大部分基于实证的方法是关注个人、针对个体内部困难的。虽然这些手段很重要, 但它们并不直接处理经历者可能存在的关系方面的困难。此外, 一些有限的实证证据支持在创伤治疗中应用系统性方法。这篇文章通过总结最主要的个人性、关系性的实证创伤治疗方法并描述它们的相同点来讨论这一话题。本综述还介绍了一个临床案例, 用来阐释系统创伤治疗方法的国际适用性和益处。 对实务工作者的启示 应当认识到创伤会影响家庭中的每个人, 而且是发生在具体的社会文化的背景中的事件。 亲密关系可以维持或者加重问题, 但他们也可以成为强大的治愈力量的源泉。 既考虑到个体内的困难又注重经历者关系的系统治疗方法对创伤后的恢复至关重要。 El papel de las relaciones y las familias en la curación del trauma Los efectos del trauma y su tratamiento tienen un papel central en las discusiones de salud en las que la exposición al trauma está asociada con una serie de problemas de salud mental, incluyendo depresión, ansiedad y abuso de sustancias. Los enfoques de tratamiento son variados, pero la mayoría de los protocolos de base ​​empírica están enfocados individualmente, dirigidos a las dificultades intrapersonales. Aunque estos protocolos son esenciales, no abordan directamente las dificultades de relación que pueden surgir para los supervivientes. Además, existen ya algunas evidencias empíricas que apoyan el uso de enfoques sistémicos en el tratamiento de trauma. Este artículo aborda esta cuestión resumiendo los protocolos de trauma basados ​​en las evidencias, tanto individuales como relacionales, más sobresalientes y proporcionando una descripción de los factores que son comunes a ambos enfoques. Esta revisión también incluye un caso clínico que ilustra la relevancia global y el beneficio de los enfoques sistémicos para el trauma. Puntos de implicación práctica: El trauma debe ser tratado como un evento que afecta a todos en la familia y está anidado en contextos sociales y culturales. Las relaciones cercanas pueden mantener o exacerbar los problemas, pero también pueden ser una poderosa fuente de sanación. Los protocolos sistémicos que no sólo abordan las dificultades intrapersonales sino que también se centran en las relaciones de los supervivientes son fundamentales para la curación posterior del trauma.
    October 07, 2015   doi: 10.1111/1467-6427.12089   open full text
  • Coparents and parenting programmes: do both parents need to attend?
    Corinne Huntington, Arlene Vetere.
    Journal of Family Therapy. October 07, 2015
    Numerous parents participate in parenting programmes to promote child development, but few programmes consider relationships within family systems. While both parents’ attendance can improve outcomes, both are rarely able to attend, with mothers typically being the participant. The study aims to understand whether changes to parenting practices can occur from one parent's attendance and, if so, what factors promote the non‐attending parent's modified parenting practices. A mixed‐method evaluation was conducted: semi‐structured interviews, surveys and focus groups. In this study, both parents attributed changes to their parenting practices to programme participation. This was facilitated by mothers giving programme information to fathers and positive coparent relationships. Ideally, both parents would attend every session; however, it is posited that this may not always be necessary for promoting positive parenting. Implications to support families are discussed. Practitioner points Fathers can be included in parenting interventions through mothers, if the coparents’ relationship is positive. If practitioners conducted relationship assessments with coparents, necessary delivery modifications could be made to facilitate both parents’ participation. Alternatively, parenting practitioners could provide couples’ counselling to coparents, either before or during the delivery of parenting interventions. 双亲与教养课程:需要双亲都参加吗? 许多父母都参加了教养课程以促进孩子的发展, 但是很少有课程考虑到了家庭系统里的关系。虽然父母的共同参加能产生更好的结果, 但是这种情况实际上很少发生, 而大多数时候则是母亲在参加。该研究旨在考察父母一方的单独参与是否能产生教养方式的变化, 并且, 如果是的话, 推动未参加家长的教养方式变化的因素是什么。我们使用混合研究法进行了评估:半结构式访谈, 调查问卷和焦点小组。在本研究中, 父母双方都将其教养方式的改变归功于在课程中的参与。母亲向父亲传达课程内容以及良好的双亲关系也起到了推动作用。理想的情况是父母双方都能参加每一次的课程;然而, 我们认为在促进良性教养的过程中, 这并不是必需的。本文也讨论了支持家庭的一些建议。 对实务工作者的启示 如果父母双方的关系良好的话, 可以通过母亲来将父亲纳入到教养方面的干预之中。 如果实务工作者针对父母双方开展关系评估的话, 需要在措辞上做一些调整以保证双方的参与。 或者, 实务工作者可以在教养干预之前或之后向父母双方提供夫妻咨询。 关键词:双亲;教养课程;家庭关系
    October 07, 2015   doi: 10.1111/1467-6427.12092   open full text
  • Accessible polyvocality and paired talk: how family therapists talk positive connotation into being.
    Lynsey Williams, Tim Auburn.
    Journal of Family Therapy. October 07, 2015
    In this article we identify one particular way in which the reflecting team process is used by family therapists. We show that reflecting teams draw upon occasions in the main session to intensify and extend positivity in the reflecting session. This analysis identified positive connotation as a device by which a hopeful orientation is established. Videos of family therapy sessions were obtained and transcripts of these sessions made. Excerpts with hope and positivity were identified and conversation analysis was used to gain insight into the organization and function of this talk. In addition, therapist interventions occurring during the main therapy session and which were reworked in the reflecting session were identified and analyzed. Sixteen examples of this paired talk are presented, and two exemplars are analyzed in full. Main session interpretations of talk and the reflecting team second versions (a device identified as paired talk) were found to work together as a resource for the construction and reinforcement of positive connotation in family therapy. Practitioner points Positive connotation is constructed through therapists’ talk; this study shows in close detail how positive connotation is ‘talked into being’. There is little opportunity for family members themselves to ratify or challenge these constructions. Practitioners could engage family members by gaining feedback on the constructions of positive connotation. 触手可得的多种声音和配对谈话:家庭治疗师们怎样在谈话中创建积极意义 本文谈论家庭治疗师运用小组反思过程的一种特别方式。我们发现反思小组会利用主要会面中的一些场景来加强和延伸反思会面中的积极性。本研究分析揭示了积极意义可以作为一种工具来建立充满希望的导向。我们获取了家庭治疗会面的录像, 并对这些录像进行了转录。充满希望和积极性的部分被选取出来并进行了对话分析, 以获得对这次谈话的组织和功能的深入理解。此外, 我们还提取并分析了发生在主要咨询会面里, 而在反思会面中又重新被处理的治疗过程。我们呈现了16个配对谈话的案例, 并全面分析了其中2个。研究发现, 主要会面中对对话的解读以及反思小组的第二个解读版本(即配对谈话的方法)能够共同在家庭治疗过程中建构和加强积极性。 对实务工作者的启示 积极意义通过治疗师们的谈话来构建;这一研究从细节上展示了具体怎样营造积极意义。 家庭成员自己很少有机会评估或者挑战这些构建。 实践者们可以通过获得在积极意义构建方面的反馈来吸引家庭成员的参与。 关键词:积极意义;反思小组;对话分析
    October 07, 2015   doi: 10.1111/1467-6427.12096   open full text
  • What's in a name? Clients’ experiences of single session therapy.
    Imogen O'Neill.
    Journal of Family Therapy. September 28, 2015
    A growing body of research suggests that single session therapy (SST) can offer an efficient and effective service. In order to complement this research a recent exploratory study set out to examine client experiences of participating in a service offering single session family therapy. Telephone interviews were conducted with twenty‐five clients to explore their experience of SST and their satisfaction with the service they had received. Although the study was limited in scope and design, the results suggest that (i) most clients found SST had been helpful and responsive to their needs and (ii) most respondents did not report being discomforted or discouraged at the prospect that their contact with the service might involve one or two contacts. Though a small minority of clients expressed some concerns that SST might indicate a lack of availability of service, these worries were alleviated once they had met the therapist. Practitioner points SST therapy is a framework for family therapy practice that is generally experienced by clients as helpful and responsive to their needs. Therapists can maximize their potential effectiveness with clients by viewing every contact with families as complete in itself. SST therapy offers opportunities for family therapists to make their services more accessible. 名字代表什么?来访者在单次会面治疗中的经历 越来越多的研究表明, 单次会面治疗能够提供有效且高效的干预。作为这一研究的补充, 近期开展的一项探索性的研究调查了一项单次会面家庭治疗服务中来访者的经历。通过与25位来访者的电话访谈, 该研究探索了他们的治疗经历以及服务满意度。虽然该研究在范围和设计上都有局限性, 但是结果似乎显示(1)绝大多数来访者认为单次会面治疗有用, 能够回应他们的需求, 以及(2)大多数调查对象对于自己跟服务提供者将会有一到两次的接触这一事实并不感到不安或者灰心。虽然有一小部分来访者表示了担心, 认为单次会面治疗可能说明服务的供不应求, 但是他们的疑虑都在见到治疗师之后得到缓解。 对实务工作者的启示 单次会面治疗作为一种家庭治疗实践的框架, 被来访者普遍认为是有效且回应需求的。 为了实现治疗效果的最大化, 治疗师可以把每一次与家庭的接触当成是一次完整的会面。 单次会面治疗为家庭治疗师提供了机会, 让他们提供的服务能为更多人所用。 关键词:单次会面治疗;来访者治疗结果;家庭治疗;评估;短期治疗
    September 28, 2015   doi: 10.1111/1467-6427.12099   open full text
  • Effects of parental infidelity and interparental conflict on relational ethics between adult children and parents: a contextual perspective.
    Alexandra E. Schmidt, Mary S. Green, Anne M. Prouty.
    Journal of Family Therapy. September 09, 2015
    Little research within the couple and family therapy field has specifically addressed the influence of infidelity on members of the family outside the couple sub‐system. The purpose of this exploratory quantitative study was to utilize the lens of contextual therapy to explore the influence of parental infidelity and interparental conflict on adult children's (N = 703) reports of vertical relational ethics, including subscales measuring trust and justice, loyalty, and entitlement. Results from multiple regression analyses demonstrated that both higher levels of interparental conflict and the occurrence of parental infidelity were associated with lower levels of vertical relational ethics, which often takes the form of decreased trust in family members and increased potential for loyalty conflicts. Implications for addressing relational dynamics related to parental infidelity through systemic family therapy, as well as recommendations for future research, are discussed. Practitioner points Therapeutic assessment should include questions about influence of transgenerational patterns of infidelity and conflict between partners on parenting experiences. Acknowledge young and adult children who feel caught in a split loyalty between parents and how they cope with these loyalty conflicts. Engage clients in dialogue concerning how to restore the balance of offering and receiving care, support, and connection within family's unique cultural context. 父母不忠和父母间冲突对成年子女和父母之间的关系道德的影响:从情境的角度思考 在夫妻和家庭治疗领域, 鲜有专门针对不忠行为对夫妻亚系统以外的家庭成员的影响的研究。这一探索性的定量研究的目的是运用情境疗法的视角探索父母不忠行为和父母关系冲突对成年子女(N=703)在纵向关系道德方面(包括信任和正义, 忠诚, 和权利的分量表)的影响。多元回归分析结果显示较高的父母间冲突以及父母之中存在不忠行为都和较低的纵向关系道德相关, 通常表现为对家庭成员的信任度降低和有关忠诚的冲突的可能性增加。本文讨论了用系统家庭治疗处理与父母不忠行为有关的关系动态的可能性, 以及对未来研究的建议。 对实务工作者的启示 治疗性评估应该包括不忠行为的跨代传递模式的影响和伴侣之间在教养方面的冲突。 认识到幼年和成年子女可能经历的对父母忠诚度不一致以及他们如何处理这一情况的问题。 与来访者开展关于在家庭的独特文化背景下重新平衡地给予和接受关心、支持、联系的讨论。 关键词: 成年子女, 情境疗法, 不忠, 代际关系, 父母间冲突, 亲子关系, 关系道德, 信任
    September 09, 2015   doi: 10.1111/1467-6427.12091   open full text
  • Bulimia nervosa in adolescents: a new therapeutic frontier.
    Kim Hurst, Shelly Read, Tiegan Holtham.
    Journal of Family Therapy. September 09, 2015
    Enhanced cognitive behaviour therapy (CBT‐E) is the first‐line treatment for bulimia nervosa (BN) in adulthood. There is limited evidence for therapies for children and adolescents with BN; however family‐based treatment (FBT) is being increasingly used. This case study contrasts the delivery of FBT with an augmented version (CBT‐E) in two adolescents presenting with BN. In both cases, the adolescents achieved remission from BN symptoms, (cessation of bingeing and compensatory behaviour) at the end of treatment. The families reported that FBT provided a platform for them to work together and view BN as a family issue, rather than leaving the onus on the young person to recover independently. The addition of CBT‐E strategies assisted with managing cognitions associated with bodyweight and shape concerns and appeared to be useful in a more complex presentation with comorbidities. Future research should examine the effectiveness of augmenting CBT‐E strategies to FBT using larger samples and more rigorous research designs. Practitioner points Involving families in the treatment of adolescent BN is both effective and acceptable to young people and their families. Two promising treatment approaches, FBT‐BN and CBT‐E, can effectively be combined to provide a therapy which has the strengths of both modalities alone. Adolescents with comorbidities or complex presentations may benefit most from combining the two modalities to develop additional skills and strategies. 青少年中的神经性贪食症:治疗新前线 强化认知行为治疗是针对成年人神经性贪食症的一线疗法。关于青少年神经性贪食症的治疗手段的实证不多;然而, 家庭为本的治疗越来越多地得到使用。该个案研究对比了两个患有神经性贪食症的青少年接受家庭为本治疗附加强化认知治疗的情况。在两个案例中, 青少年的神经性贪食症症状都在治疗结束时有所缓解(停止暴食和补偿行为)。根据家庭的报告, 家庭为本治疗为他们提供了一个一起努力的平台, 且神经性贪食症被视为一个家庭问题, 而不是把独立康复的责任全部推到青少年身上。增加的强化认知疗法的策略有助于管理与体重和体型担忧相关的认知, 似乎在更为复杂的共病情况下十分有用。今后的研究应当在更大的样本和更严谨的实验设计之下, 考察增加了强化认知疗法策略的家庭为本治疗的有效性。 对实务工作者的启示 将家庭纳入青少年神经性贪食症的治疗过程既有效, 又能被青少年和家庭所接受。 两种有潜力的治疗手段, 家庭为本治疗和强化认知行为治疗, 可以有效结合, 以提供吸取两者长处的治疗方法。 有共病情况或者复杂病情的青少年或许会从两种疗法的结合中获益更多, 因为他们可以发展额外的技能和策略。 关键词:青少年神经性贪食症;强化认知行为治疗;家庭为本治疗;个案研究;家庭治疗;饮食紊乱
    September 09, 2015   doi: 10.1111/1467-6427.12095   open full text
  • Building a case for good parenting in a family therapy systemic environment: resisting blame and accounting for children's behaviour.
    Michelle O'Reilly, Jessica Nina Lester.
    Journal of Family Therapy. September 09, 2015
    Systemic family therapy promotes a systemic reframing of individual problems to an understanding of the familial processes influencing family functioning. Parents often attend therapy identifying their child as the key problem, which raises issues of accountability and blame. In this article, we explored the discursive practices used by parents for constructing themselves as ‘good parents’. Using the basic principles of conversation analysis and discursive psychology, we analysed actual therapeutic sessions and found that parents used a range of strategies to display their good parenting. This included directly claiming to be a good parent, illustrating how they act in their child's best interests, showing that they parent in appropriate ways and by making appeals to scientific rhetoric. It was concluded that family therapists have a challenging task in managing competing versions of events and we discussed implications for practice. Practitioner points Parents tend to blame their children for the problems experienced and this blaming tends to be done in front of the children during the therapy. By being explicitly aware of the discursive strategies parents employ in therapy, therapists can reflect on how to manage these challenging conversational practices. Conversation analysis may serve as a tool to support reflection, as therapists examine their own interactions during the therapy. 在家庭治疗系统环境里支持良好父母教养:抑制责备与解释儿童行为 系统家庭治疗鼓励对个人问题用系统视角重新构建, 用于理解家庭过程对家庭功能的影响。参加治疗的父母通常认为孩子是问题的关键, 由此产生归咎和责备。在本文中, 我们探索父母在展现自身“良好教养方式”时所采用的话语行为 。 我们用对话分析的基本原则和话语心理学分析了实际的治疗过程, 并发现父母用了一系列的策略显示他们的良好教养行为。这包括直接宣称自己是好父母、解释他们是怎样为孩子考虑、展示他们是怎样采用合适而科学的教养方式等。研究结论是, 家庭治疗师所面临的一个挑战是处理对事件的互相矛盾的解释。本文也对研究结果对实践的启示做了讨论。 对实务工作者的启示 父母经历问题时倾向于责备他们的孩子, 而且这种责备通常发生在咨询室里、在孩子面前。 治疗师通过明确地意识到父母在治疗过程中采取的话语策略, 可以反思怎样处理这些具有挑战性的对话行为。 治疗师在检视自己在治疗中的互动时, 对话分析可以成为支持反思的一种工具。 关键词: 家庭治疗;儿童;责备;归咎;对话分析。
    September 09, 2015   doi: 10.1111/1467-6427.12094   open full text
  • Sustaining change following multisystemic therapy: caregiver's perspectives.
    Pinder Kaur, Helen Pote, Simone Fox, Daphne A. Paradisopoulos.
    Journal of Family Therapy. September 09, 2015
    Multisystemic therapy (MST) is an empirically supported intervention for young people presenting with antisocial behaviour. This study explored the process of sustaining positive outcomes following MST from caregiver perspectives. Semi‐structured interviews were carried out 5–21 months post‐MST with 12 caregivers. A grounded theory methodology was used to analyse the data. Caregivers in this study identified the following themes as contributing to sustaining change; improvements in their relationship with their child, shifting how they viewed difficulties and solutions and feeling personally strengthened and resilient. The therapeutic alliance in MST was described as important in initiating these changes. Clinical implications and how the themes from this study fit into the existing model of change in MST are discussed. Practitioner points Caregivers validated the therapeutic alliance as key to the MST approach. Experiencing a positive therapeutic alliance was also identified as important in improving relationships within the family even after therapy was completed. Positive experiences of MST developed caregivers’ experiences of feeling more resilient in the face of later difficulties helping sustain positive outcomes. 多系统治疗之后的变化维持:照料人的视角 多系统治疗是针对具有反社会行为的年轻人的实证支持的干预手段。本研究从照料人的角度探索了多系统治疗之后维持积极治疗效果的过程。在治疗结束后的5-21个月期间, 对12位照料人进行了半结构式访谈, 并采用扎根理论的方法进行了数据分析。研究中的照料人识别了如下一些有助于维持变化的主题:他们与孩子关系的改善, 他们看待困难和解决办法的方式的改变, 以及自我感觉更有力量和复原力。多系统关系中的治疗同盟被描述为促成这些改变的重要的因素。本文讨论了该研究的临床学意义以及研究结果中的主题在多系统治疗的已有改变框架中的位置。 对实务工作者的启示 照料人证实了治疗同盟对于多系统治疗手段的重要性。 经历积极的治疗同盟也被认为是促进家庭内部关系改善的重要因素, 其影响甚至持续到治疗结束之后。 在多系统治疗中的积极体验帮助照料人发展了在今后的困难面前迅速适应和恢复的体验, 这有助于维持积极治疗效果。 关键词:多系统治疗;质性研究;服务使用者角度;变化过程;扎根理论
    September 09, 2015   doi: 10.1111/1467-6427.12093   open full text
  • Exploring the process of family interventions for psychosis in relation to attachment, attributions and problem‐maintaining cycles: an IPA study.
    Estelle H. S. Rapsey, Frank R. Burbach, Janet Reibstein.
    Journal of Family Therapy. July 23, 2015
    This study sought to understand how the experience of family interventions (FI) for psychosis helped family members to develop their thinking about their attachment experiences and the attributions made about a relative, and how these discussions helped to inform their understanding about problem‐maintaining cycles, that is, the interactional way in which difficulties could be maintained. Ten individuals who had attended an FI service participated in a semi‐structured interview. The transcript analysis used interpretative phenomenological analysis. The analysis yielded four themes: a supportive therapeutic relationship and safe therapeutic space; understanding patterns of relating and identifying when family interactions become unhelpful; making sense of psychosis and developing a sense of agency. The FI was experienced as helpful in bringing about changes in the way family members construed each other and psychosis, and this influenced patterns of relating. Practitioner points A safe therapeutic space for both client and family can help them discuss sensitive issues, restore emotional connections and reach better understandings of psychosis. Exploring family relational experiences, attachment and attributions can be helpful in gaining understanding of how problems in psychosis are maintained. Family intervention can help families identify helpful versus unhelpful interactions and make positive changes.
    July 23, 2015   doi: 10.1111/1467-6427.12085   open full text
  • Psychological symptoms among parents of adolescents with anorexia nervosa: a descriptive examination of their presence and role in treatment outcome.
    Sarah Forsberg, Alison Darcy, Susan W. Bryson, Katherine D. Arnow, Nandini Datta, Daniel Le Grange, James Lock.
    Journal of Family Therapy. July 23, 2015
    Parent psychological symptoms were examined in a randomized controlled trial comparing family‐based treatment (FBT) and adolescent‐focused therapy (AFT) for anorexia nervosa, and were explored across treatments and in relation to treatment outcomes. Moderator and mediator analyses were completed with parent symptoms as predictors and weight remission and recovery status as outcome variables. Few parents had clinically significant symptoms at presentation. At the end of treatment (EOT), parents had decreased psychological symptoms in both treatment arms. Higher baseline levels of overall maternal symptomology and improvement in maternal symptomology were non‐specific predictors of adolescent weight outcome at EOT and 12‐month follow up. Mothers with few to no depressive symptoms had children with the greatest improvement in weight at EOT when assigned to family treatment. In sum, parent symptoms did not appear to negatively impact on the treatment outcome among adolescents with anorexia nervosa. Practitioner points Parent involvement is considered best practice in the treatment of adolescent anorexia nervosa (AN). There are limited data on psychological symptoms among parents of individuals with AN, and their impact on treatment outcome. Among a sample of adolescents with AN, parent psychological symptoms improved across individual and family treatment. Future studies may wish to explore the impact of maternal depression on refeeding efforts in family‐based treatment. 患神经性厌食症青少年的家长的心理症状:对其存在和在治疗结果中的角色的描述性研究 在一个比较家庭为本治疗和青少年导向疗法的随机控制实验中, 家长的心理症状得到了调查, 以研究其在不同疗法中的情况及其与治疗结果的关系。以家长症状作为预测变量, 体重恢复和康复状态作为结果变量, 进行了调节变量分析和中介变量分析。参与研究时, 几乎没有家长显示出具有临床意义的心理症状。治疗结束时, 在两种疗法下, 家长的心理症状都有所减少。较高的母亲总体症状特征基线水平和母亲症状特征的改善是治疗结束时和12个月之后跟进时青少年体重的非特定预测变量。很少到几乎没有抑郁症状的母亲的孩子, 在接受了家庭治疗过后, 于治疗结束时在体重上呈现出最大的进步。总体来说, 家长症状似乎并不会对患有神经性厌食症的青少年的治疗结果产生不利影响。 对实务工作者的启示 在治疗青少年神经性厌食症的过程中, 家长参与被认为是最佳实践。 关于神经性厌食症患者家长的心理症状及其对治疗效果影响的数据很少。 在一个患有神经性厌食症的青少年的样本中, 家长的心理症状在个体治疗和家庭治疗中都得到了改善。 今后的研究可以考察母亲抑郁症对于家庭为本治疗中的再进食努力的影响。 关键词:神经性厌食症;家长精神机能障碍;家庭为本治疗;青少年导向心理治疗;治疗结果
    July 23, 2015   doi: 10.1111/1467-6427.12088   open full text
  • Clinician perspective on parental empowerment in family‐based treatment for adolescent anorexia nervosa.
    Gina Dimitropoulos, Victoria E. Freeman, James Lock, Daniel Le Grange.
    Journal of Family Therapy. July 23, 2015
    This qualitative study explored which core principles of family‐based treatment (FBT) for adolescents with anorexia nervosa (AN) are perceived as most necessary for FBT to be effective in clinical practice. Paediatric interdisciplinary teams were recruited to discuss the delivery of FBT in eating disorder programmes in Ontario, Canada (N = 6). Thematic analysis was used to analyze the data generated from focus groups. Three major themes emerged: (i) parental empowerment (PE) is the most salient principle of FBT; (ii) various adolescent, parental and family factors are viewed as interfering with or enhancing PE; (iii) a variety of clinical interventions are utilized by clinicians to cultivate and increase PE. PE is identified as essential for adolescents with AN to successfully recover. Greater focus on addressing barriers to empowering parents is needed throughout FBT. Future studies should include measurements of PE to ascertain effects on treatment outcomes. Training and supervision protocols focused on promoting PE are recommended. Practitioner points PE is the most salient principle of FBT. Strategies to enhance PE in phase 1 are imperative if there has been a long illness duration or parents experience mental health issues/burnout. Special clinical attention to individual factors is recommended: comorbid diagnoses, affect dysregulation and enduring eating disorder symptoms. Efforts to enhance parental involvement throughout the treatment is paramount to supporting adolescents to recover from AN. 针对青少年神经性厌食症的家庭为本治疗中的家长赋权的临床视角 该质性研究探索了针对青少年神经性厌食症的家庭为本治疗的哪些核心原则被认为是其在临床实践中发挥有效性的必要因素。研究召集了一队跨学科的儿科医生以讨论加拿大安大略省的六个饮食紊乱项目中家庭为本治疗的执行。对焦点小组讨论的数据通过主题分析法进行了分析, 结果呈现出三个重要主题:一、家长赋权是家庭为本治疗的最显著突出的原则;二、不同的青少年、家长和家庭相关因素被认为是起到了干扰或者加强家长赋权的效果;三、临床医师采用了不同的临床干预手段来培养和促进家长赋权。家长赋权被确认是帮助青少年从神经性厌食症中痊愈的关键因素。在家庭为本的治疗过程中, 需要更加强调如何减少实现家长赋权过程中的阻碍。未来的研究中应该纳入家长赋权的指标, 以确认其在治疗结果中起到的作用。强调提升家长赋权的培训和督导指南是值得推荐的。 对实务工作者的启示 家长赋权是家庭为本治疗的最显著突出的原则 如果病情持续时间较长或者家长经历了心理健康问题/心理耗竭, 那么在第一阶段采取策略加强家长赋权是必要的。 建议临床医师特别关注个体因素:共病诊断, 情绪失调, 以及持续的饮食紊乱症状。 在整个治疗过程中努力增强家长赋权是支持青少年从饮食紊乱中痊愈的首要之务。 关键词:临床医师;饮食紊乱;家庭为本的治疗;家长赋权;质性研究
    July 23, 2015   doi: 10.1111/1467-6427.12086   open full text
  • Intersectionality in family therapy training: inviting students to embrace the complexities of lived experience.
    Catherine Butler.
    Journal of Family Therapy. July 17, 2015
    While intersectionality has become an established and much used theory in feminist and critical race studies, the concept remains relatively underused by systemic family therapists and on family therapy training courses. And yet systemic therapy embraces the multiplicity of human existence and examines the interplay of power relations. This article attempts to fill this gap by emphasizing the usefulness of intersectionality in representing the complexities of lived experience and by presenting an exercise to introduce students to intersectionality in family therapy training. Practitioner points Therapists and trainers should be aware of the privileges and oppressions that the intersections of their social locations create. Therapists and trainers should be ready to initiate conversations with clients and students about intersecting identities and their influence. Help students to apply intersectionality theory through structured, well‐paced exercises with plenty of in‐built reflexive discussion.
    July 17, 2015   doi: 10.1111/1467-6427.12090   open full text
  • Intensive multi‐family therapy for adolescent anorexia nervosa: an open study of 30 families.
    Eva Salaminiou, Mari Campbell, Mima Simic, Elizabeth Kuipers, Ivan Eisler.
    Journal of Family Therapy. July 03, 2015
    The article reports on an innovative treatment for adolescent anorexia nervosa (AN) – intensive multi‐family therapy – in terms of symptoms, patients’ and parental psychological functioning and treatment acceptability. In all, thirty patients and their families took part in the study and were assessed at baseline, 3 and 6 months. At 6 months two‐thirds had gained sufficient weight to be in the normal weight range with significant improvements in AN cognition, mood and self‐esteem. Only two of the thirty families discontinued treatment early and both patients and parents scored high on treatment satisfaction, though parents scored significantly higher than patients. These results compare favourably with outcome data from larger more rigorous evaluations of single family therapy for adolescent AN currently considered to be the treatment of choice. While larger, randomized studies are needed, the results are promising and suggest that multi‐family therapy may be a useful additional treatment approach for this group of young people. Practitioner points Multi‐family therapy may provide an effective intervention for adolescent anorexia nervosa and compares well with other, more rigorously evaluated interventions. Multi‐family therapy is highly successful in engaging families in treatment leading to minimal dropout rates. Satisfaction with multi‐family therapy is high for both adolescents and parents. 青少年神经性厌食症的多家庭强化治疗:一项针对30个家庭的开放式研究 本文介绍了一种针对青少年神经性厌食症的创新疗法——多家庭强化治疗。其创新之处在于症状、病人和家长的心理功能和疗法接受度。总共有30位病人及其家庭参加了本研究, 他们接受了基线、三个月和六个月时的评估。在六个月时, 三分之二病人的体重增加至正常范围之内, 并在对厌食症的认识、心情和自尊三个方面有明显的进步。三十个家庭中, 只有两个家庭提前中断治疗。病人与家长对治疗满意度都比较高, 虽然家长的满意度要显著高于病人。该研究结果与针对目前治疗青少年神经性厌食症的首选疗法——单家庭疗法的更加大型和严谨的评估结果相比是更优的。虽然还需要更大样本的随机研究, 但是目前的研究结果十分乐观, 它昭示着多家庭治疗可能会成为针对这一类年轻人的有效的新疗法。 对实务工作者的启示 多家庭治疗或许会成为针对青少年神经性厌食症的一种有效干预手段。与其它经过了更严谨评估的干预手段相比, 它的治疗结果更好。 多家庭治疗在促进家庭参与方面非常成功, 使得流失率降到最低。 青少年和家长对于多家庭治疗的满意度都非常高。 关键词:青少年神经性厌食;饮食紊乱;多家庭治疗;治疗效果评估;实效研究
    July 03, 2015   doi: 10.1111/1467-6427.12075   open full text
  • Family therapists’ adult attachment styles and the therapeutic alliance.
    Yusmarhaini Yusof, John Carpenter.
    Journal of Family Therapy. July 03, 2015
    Therapists’ adult attachment style may affect their ability to form effective therapeutic alliances. An analysis of semi‐structured interviews with eleven family therapists explored the relationship between their adult attachment styles, as assessed using a self‐report measure, and their perceptions of the therapeutic alliance. A framework analysis was employed, using four dimensions of the therapeutic alliance: engagement in the therapeutic process, emotional connection to the therapist, safety within the therapeutic system and shared sense of purpose within the family. Responses were compared between therapists with secure and insecure attachment styles according to different dimensions of the therapeutic alliance. There were no substantial differences in therapists’ accounts of their approach to engagement and creating a sense of safety; however they differed in their approaches to managing clients’ hostility. Secure and insecure therapists differed in one of the dimensions of therapeutic alliance; emotional connections to family members. Training and supervision could incorporate an understanding of attachment style. Suggestions are made for future research based on this exploratory study. Practitioner Points The ability to co‐create a secure base may be related to the therapist's adult attachment style. Therapists with insecure attachment styles appear to have difficulty in managing clients’ hostility and close emotional connections. Trainees may benefit from understanding their own adult attachment styles and resolving outstanding family‐of‐origin issues. Clinical supervision could reflect on the interaction between the therapist's and family attachment styles.
    July 03, 2015   doi: 10.1111/1467-6427.12079   open full text
  • Factors related to perceived parental approval of adult sons’ and daughters’ heterosexual engagements.
    Jeffry H. Larson, Marietta Malnar, Dean Busby.
    Journal of Family Therapy. July 03, 2015
    This study examined factors that may predict perceived parental approval of an adult child's heterosexual engagement relationship as parental approval has been shown in previous studies to be an important predictor of later couple quality and stability. A total of 4175 engaged individuals completed the RELATE inventory. Among the items in the questionnaire were measures of perceived parental approval of the relationship, parents’ marital quality, autonomy from the family of origin and couple relationship quality. The individuals also reported their age, education, length of their relationship, parents’ marital status and parents’ socioeconomic status. The results showed that adult sons’ and daughters’ age, parental marital quality, autonomy and couple relationship quality predicted parental approval. Length of the relationship and parental marital status did not influence parental approval for either gender. Clinical implications and directions for future research are discussed. Practitioner points Perceived parental approval of an adult child's heterosexual engagement relationship should be assessed with engaged couples. Assess current couple relationship as this is not always as high as we may assume. Perceived quality of each partner's parents’ marriage should be discussed as to how it may affect perceptions of parental approval. Assess differentiation of self in the family of origin and increase it using transgenerational couple therapy approaches. 与家长对成年子女与异性订婚的感知认可度相关的因素 因为以往的研究表明家长认可度是影响婚后夫妻关系质量和稳定度的重要预测因素, 本研究调查了可能预测家长对成年子女与异性订婚关系的感知认可度的因素。共4175位订婚被试完成了RELATE问卷。该问卷包含了家长对关系的感知认可度量表, 以及家长的婚姻质量, 个人相对于原生家庭的自主性和夫妻关系质量。被试同时报告了其年龄、教育背景、关系持续时间、家长婚姻状况和家长的社会经济背景。结果显示成年子女的年龄、家长婚姻质量、自主性和婚姻关系质量都可预测家长的感知认可度。关系持续时间和家长的婚姻状况不对任一性别的感知家长认可产生影响。本文探讨了该研究在临床方面的启示和未来的研究方向。 对实务工作者的启示 应当测量已订婚的成年异性伴侣的家长对其关系的感知认可度。 对目前的婚姻关系做评估, 因为这一关系的质量通常不如设想那样高。 订婚双方应对各自家长的感知婚姻质量进行讨论, 因为这可能影响家长对订婚关系的感知认可度。 评估原生家庭的自体分化程度, 并利用跨代夫妻治疗方法增加自体分化程度。 关键词:家长认可;订婚伴侣, 成年子女。
    July 03, 2015   doi: 10.1111/1467-6427.12080   open full text
  • Seselelame: feelings in the body: working alongside systemic ideas.
    Julia Jude.
    Journal of Family Therapy. July 03, 2015
    This article explores the way I use my cultural heritage as a tool to expand upon and develop skills in working with families, and how I then experience my position as a systemic therapist, interweaving systemic ideas and the intimacies of my own cultural heritage I examine the differences and similarities between systemic knowledge and practice, and African oral traditional ideas. Reclaiming my cultural heritage is the focus of this article and I explore the useful contribution it can make in the systemic field. Practical examples are given to illustrate the applicability of the ideas. Practitioner points African oral traditions (seselelame) characterize a dialogical feeling in the body that complements systemic family therapy and practice. In seselelame human knowing is as valuable as western theories of knowledge. Seselelame offers an appreciation of lived moments and encourages awareness of self (human knowing) as a means of sense‐making. Seselelame practice reinforces the idea that the senses are natural resources. Seselelame: 身体里的感受:结合系统观点的实践 本文探索了我将自己文化背景作为工具来拓展和发展家庭治疗技能的过程, 以及我作为一名系统治疗师, 将系统观点与我本身文化背景紧密交织的体验。我考查了系统理论知识和实践与非洲口述传统观点的相似性和差异性。本文重点是重拾我自己的文化传统, 并探索了其在系统领域的有益贡献。本文提供了实际案例以举例说明本文观点的实际应用。 对实务工作者的启示 非洲口述传统(Seselelame)刻画了一种身体里的对话感受, 作为对系统家庭治疗和实践的一种补充。 在Seselelame中, 人类自身的觉知是和西方理论知识一样有价值的。 Seselelame提倡对亲历时刻的重视, 并鼓励将对自我的觉察(人的觉知)作为理解意义的一种手段。 Seselelame的实践强调了感官是自然资源的观点。 关键词:家庭治疗;身体里的感觉;驻家系统家庭治疗;非洲口述传统观点;Seselelame
    July 03, 2015   doi: 10.1111/1467-6427.12087   open full text
  • Parent‐therapist alliance and parent attachment‐promoting behaviour in attachment‐based family therapy for suicidal and depressed adolescents.
    Menachem M. Feder, Gary M. Diamond.
    Journal of Family Therapy. July 03, 2015
    This study examines whether the strength of the parent‐therapist alliance, measured during the task of alliance building with parents alone, predicted the extent of parents’ attachment‐promoting behaviour in the subsequent conjoint parent‐adolescent attachment task in the context of attachment‐based family therapy (ABFT). Nineteen suicidal and depressed adolescents and their parents received 12 weeks of ABFT. The parent‐therapist alliance and parents’ attachment‐promoting behaviour were each measured observationally by two separate and independent groups of raters. The findings show that the strength of the parent‐therapist alliance predicted parents’ subsequent attachment‐promoting behaviour. However, parents’ attachment‐promoting behaviour did not predict the post‐treatment outcomes. Clinical and methodological implications are discussed. Practitioner Points Good parent-therapist alliances are linked to parents being empathic, curious and non‐defensive during emotional conversations with their suicidal and depressed adolescents. Parental attachment‐promoting behaviour, including attunement, empathy, and active listening, may not always be sufficient curative factors. Once the parent‐adolescent attachment relationship improves, parents may support their adolescent as they cope with school and peer conflict.
    July 03, 2015   doi: 10.1111/1467-6427.12078   open full text
  • Selecting self‐report outcome measures for use in family and systemic therapy.
    Patricia Moran.
    Journal of Family Therapy. June 16, 2015
    This article describes some of the challenges involved in the selection of self‐report outcome measures for use in family and systemic therapeutic services, and potential ways of overcoming them. It highlights factors that may undermine the demonstration of the effectiveness of services related to the characteristics of services, client groups and the measures themselves. Choosing appropriate self‐report outcome measures is particularly difficult for practitioners responding flexibly to the needs of heterogeneous client groups and those working with multiple family members. Measures need to be acceptable to both clients and practitioners, addressing constructs relevant to individual and systemic level change, and incorporating features that enhance sensitivity to client change. Possible solutions are discussed, with the aim of enabling services to make more informed choices when selecting outcome measures for use in the monitoring and evaluation of family and systemic therapy. Practitioner points Develop a logic model to identify possible mechanisms of change and key impacts. For heterogeneous client groups, consider assessing overarching constructs or using idiographic in addition to nomothetic approaches. To enhance the chances of capturing change within a family system, use more than one instrument and ask different family members to complete them. Select measures with appropriate language, structure and length for piloting with clients and practitioners. 选择用于家庭和系统治疗的自我报告式疗效指标 本文描述了在选择用于家庭和系统治疗过程中的自我报告式疗效指标时存在的一些挑战, 以及一些可能的应对方法。文中突出了一些可能影响疗效呈现的因素, 这些因素与治疗过程的特点、来访者类型以及指标本身有关。对于需要灵活回应不同类型的来访者和同时与多个家庭成员开展工作的从业者来说, 选择一种合适的自我报告式疗效指标是尤其困难的。指标需要被来访者和从业者双方接受, 针对个人和系统层面改变的概念, 并且包含某些特征以增强对于来访者变化的敏感度。本文讨论了可能的解决方式, 目的在于帮助家庭治疗服务机构在选择用于监督和评估家庭和系统治疗的疗效指标时做出更加明智的决定。 对实务工作者的启示 开发一套逻辑模型以识别变化的种种可能机制及其关键影响。 对于不同类型的来访者, 考虑评估首要概念, 或者用个案代替通则式研究方法。 为了增加在家庭系统中捕捉到变化的机会, 应使用不止一种测量工具, 并让不同的家庭成员参与完成。 为来访者和从业者参与的初步研究选择语言、结构和长度合适的指标。 关键词:自我报告式疗效指标;家庭和系统治疗;评估;判定变化
    June 16, 2015   doi: 10.1111/1467-6427.12082   open full text
  • Family‐of‐origin experience and emotional health as predictors of relationship self‐regulation in marriage.
    Matthew Brown, Jeffry Larson, James Harper, Thomas Holman.
    Journal of Family Therapy. May 08, 2015
    The purpose of this study was to understand differences in one's ability to implement relationship self‐regulation (RSR) in marriage based on the family‐of‐origin variables of parent–child relationship quality, parental marital satisfaction and current emotional health. The participants were 484 married couples who completed the relationship evaluation. Structural equation modelling was used to test a model that showed that the actor and partner's emotional health were associated with RSR in marriage, while most family‐of‐origin factors were not directly associated with RSR. However, the perceived mother–child relationship quality was associated with RSR for wives, but not husbands, when controlling for the other variables in the model. There were no significant relationships between father–child relationship quality or parental marital satisfaction and RSR. Implications for couple therapists and educators are discussed. Practitioner points Relationship self‐regulation (RSR) involves recognizing one's own positive and negative contribution to the relationship. Emotional health affects RSR and should be attended to in work with couples. Helping partners address emotional health issues may increase a couple's ability to collaboratively work on their relationship. Open expression of emotions and positive communication skills may decrease emotional health symptomology and increase the couples' use of RSR. 用原生家庭经历和情绪健康状况预测婚姻中的关系自我调节 本研究的目的是根据亲子关系质量、父母婚姻关系满意度等原生家庭变量, 以及当下的情绪健康状况来理解个人在关系自我调节(RSR)方面能力的不同。被试是484对完成关系评估的已婚夫妻。结构方程模型用于分析检测模型, 结果表明被试及其伴侣的情绪健康和婚姻中的关系自我调节存在相关, 而大部分原生家庭因素和关系自我调节不存在直接相关。然而, 感知母子关系质量在控制其他变量的情况下和妻子的(而不是丈夫的)关系自我调节存在相关。父子关系质量或者父母婚姻满意度和关系自我调节之间不存在显著的相关关系。本文探讨了该结果对婚姻治疗师和婚姻教育人员的启示。 对实务工作者的启示 关系自我调节(RSR)指某人意识到自己对关系的积极和消极影响。 情绪健康状况影响关系自我调节, 并应该在和夫妻开展工作时加以注意。 帮助伴侣处理情绪健康问题可能增加夫妻协作改善婚姻关系的能力。 开放的情绪表达和积极的交流技巧可能减少情绪病症并增加夫妻关系自我调节的使用。 关键词:关系自我调节;情绪健康;原生家庭;婚姻
    May 08, 2015   doi: 10.1111/1467-6427.12066   open full text
  • Does partners’ differentiation of self predict dyadic adjustment?
    Jessica Lampis.
    Journal of Family Therapy. May 04, 2015
    The present study expands on Bowen's systemic multigenerational theory to analyse the role of individual trajectories of differentiation of self in perceived dyadic adjustment in a sample of 468 Italian participants. The research also explored which aspects of differentiation of self most strongly predicted dyadic adjustment in the total sample and in male and female subsamples. The various components of differentiation of self (emotional reactivity, emotional cut‐off, emotional fusion and I‐position) and dyadic adjustment levels were investigated using the revised differentiation of self inventory — revised, and the dyadic adjustment scale (DAS). The analysis revealed that the emotional cut‐off dimension was the strongest negative predictor of dyadic adjustment. The research focused on the importance of differentiation of self processes to achieving an understanding of couple dynamics in research and clinical practice. Practitioners points Assessment of differentiation of self could be incorporated into the preliminary phase of couple therapy in order to screen for specific maladaptive patterns of differentiation. Information about the differentiation processes could be used during the therapy to increase the I‐position status, or decrease emotional reactivity and emotional cut‐off. Differentiation of self and dyadic adjustment scores can be used to monitor progress in systemic therapy. 伴侣的自体分化是否可以预测婚姻适应度? 本研究以拓展后的Bowen的系统性多世代理论分析了468名意大利被试的个人自体分化的不同发展轨迹如何影响感知婚姻适应度。这一研究也探索了全部样本、男性子样本和女性子样本里, 自体分化的哪些方面最能预测感知婚姻适应度。修订版的自体分化量表(修订版)和婚姻适应度量表(DAS)用于调查自体分化的不同组成部分(情绪反应性, 情绪中断, 情绪融合, 和主体定位)以及婚姻适应度的不同层次。分析结果显示情绪中断这一维度和婚姻适应度存在最强烈的负相关。本研究侧重考察自体分化过程在研究和临床实践中对理解夫妻关系动态的重要性。 对实务工作者的启示 在婚姻治疗初期, 可以对自体分化进行评估, 用于探测自体分化特定的不良适应模式。 在治疗过程中可以使用有关分化过程的数据, 用于增强主体定位或者减少情绪反应性和情绪中断。 自体分化和婚姻适应度得分可以在系统治疗中用于检测进度。 关键词:夫妻关系;代际传递;自体分化;婚姻适应度
    May 04, 2015   doi: 10.1111/1467-6427.12073   open full text
  • Blame, responsibility and systemic neutrality: a discourse analysis methodology to the study of family therapy problem talk.
    Pinelopi Patrika, Eleftheria Tseliou.
    Journal of Family Therapy. March 10, 2015
    In this article we present discourse analysis of initial systemic family therapy sessions, focusing on family members' responses to therapists' attempts to introduce a systemically neutral, relational perspective on their troubles, by means of circular questioning and the final team message. The article draws from a qualitative study of family therapy problem talk with a sample of nine videotaped first and second sessions with six families and four therapists. The sessions were transcribed verbatim and subjected to discourse analysis following the discursive action model. Our analysis indicates that family members may decode the therapists' discursive moves as attributing blame or responsibility to them and engage in further blaming of the identified patient. We conclude by raising the implications of the present research study for the latent attributional work in clinical practice. We also stress the potential of discourse analysis methodology for studying blaming actions and for enhancing reflexivity about our models and practices. Practitioner points Family members may decode therapists' attempts for introducing a systemically neutral perspective as allocating blame to them for the presenting problem(s). Practitioners should be reflexive about their potentially blaming discursive contributions in therapeutic dialogue. Discourse analysis methodology can enhance clinicians' reflexivity about their contributions in therapeutic dialogue. 责备, 责任, 和系统性中立:针对家庭治疗问题谈话研究的话语分析方法 本文针对家庭成员对治疗师在尝试通过循环提问和最后小组信息的方式, 对他们的问题带入一种系统中立、关系性的视角时候的反应进行了话语分析。研究数据来自一项关于家庭治疗问题谈话的质性研究, 样本为来自6个家庭和4个咨询师的9段第一次和第二次会面时的录像。这些录像被逐字转录后根据话语行动模型进行了话语分析。我们的分析显示, 家庭成员可能会把咨询师们的推论性话语译解为对他们的责备或是责任推卸, 并进一步责备指认病人。最后, 我们指出这篇文章对临床实践中潜在归因工作的启示。我们还强调了话语分析方法在研究责备行为和加强对我们的模型和实践的反思中的潜力。 对实务工作者的启示 治疗师引入系统中立视角的尝试可能会被家庭成员理解为治疗师在就问题责备他们。 治疗师应该对治疗性对话中潜在的责备推论归因进行反思。 话语分析法可以加强临床工作者对其在治疗性谈话中所起作用的反思性。 关键词:问题谈话;系统性家庭治疗;系统性中立;责任;责备和责任归因;话语分析。
    March 10, 2015   doi: 10.1111/1467-6427.12076   open full text
  • Family and systemic psychotherapists' experiences of personal therapeutic consultations as a tool for personal and professional development in training.
    Bob Williams, John Carpenter, Jo Timms.
    Journal of Family Therapy. February 16, 2015
    This study investigated family therapists' experiences of personal therapeutic consultations during their training and how this related to personal and professional development (PPD). Interpretive phenomenological analysis was used to analyse one semi‐structured interview with each of four participants. Results: The personal consultations provided a unique and powerful learning opportunity, including learning about the interactional elements of family therapy, therapeutic relationship factors and relational roles. The personal consultations also affected the lives of family members who attended, and in some cases, those who did not. The results raise several ethical considerations including, confusion about the boundary between the personal therapeutic consultations and family therapy, preparedness, and considerations about what we are asking of our families. It is argued that this is a valuable learning, training and PPD opportunity and should be repeated as long as attention is paid to the ethical points highlighted. Practitioner points Trainees' participation in personal therapeutic consultations with members of their own family may have a powerful effect on their learning and subsequent practice. Training institutions and future trainees should be aware of the affect that personal therapeutic consultations can have on relationships. Training institutions should consider personal therapeutic consultations as a tool for PPD as long as attention is paid to the ethical implications highlighted in this study.
    February 16, 2015   doi: 10.1111/1467-6427.12071   open full text
  • Perceptions of family functioning in adolescents who self‐harm.
    Elizabeth Palmer, Patrick Welsh, Paul Alexander Tiffin.
    Journal of Family Therapy. January 15, 2015
    This study compares the self‐reported family functioning of 21 adolescents presenting at four UK medical wards with self‐harming behaviour with those obtained from a sample of adolescents drawn from the local community. Adolescents hospitalized for self‐harm reported that their families were more dysfunctional than healthy controls on the family perceptions scale. However, this difference was not observed when covariates such as emotional and behavioural distress were controlled for. Poor levels of agreement between adolescents and adult family members in relation to family perceptions were also observed. The findings suggest that adolescents who engage in significant self‐harm perceive impairments in their family functioning. These reported impairments may be the result of concurrent emotional and behavioural distress or some form of interaction between family functioning and distress. A comprehensive family assessment to detect absolute changes and disparities in perceived family functioning may therefore help guide family interventions in this context. Practitioner points Adolescents who are hospitalized for self‐harm report significant impairments in family functioning compared with healthy controls. Adolescent and adult family members appear to disagree on the degree of impaired family functioning. A comprehensive family assessment may therefore help guide family interventions in hospitalized adolescents. 自残青少年对家庭功能的理解 本研究对比了来自当英国地社区的21位由四个内科病房报告出的有自残行为的青少年对家庭功能的自我报告。这些因为自残而住院的青少年陈述表明他们的家庭在家庭印象量表上比健康控制下的家庭呈现出更多的 功能不良。 然后, 再控制情绪和行为痛苦这些协变量之后, 这些不同不复存在。针对家庭印象方面, 青少年和成人家庭成员间的理解也被观察到很不统一。这些发现表明存在严重自残行为的青少年认为他们家庭的功能是不可修复的。 这些报告出的不可修复感可能就是同时存在的情绪和行为痛苦的结果或者可以说在家庭功能和痛苦方面存在相互作用。在这样的背景下, 更全面的家庭评估以用于探查再家庭功能认知方面的绝对的改变和差距可能对指导家庭干预有帮助。 对实践者有用的几点建议 因自残行为住院的青少年, 和健康控制下的家庭对比, 报告出更严重的在家庭功能方面的不可修复感。 针对家庭印象方面, 青少年和成人家庭成员间的理解被观察到很不统一。 更全面的家庭评估以用于探查再家庭功能认知方面的绝对的改变和差距可能对指导家庭干预有帮助。 关键词:自残;年轻人;家庭功能;家庭理解;以解决方案为导向的家庭治疗
    January 15, 2015   doi: 10.1111/1467-6427.12069   open full text
  • Developing a model of sustained change following multisystemic therapy: young people's perspectives.
    Daphne Paradisopoulos, Helen Pote, Simone Fox, Pinder Kaur.
    Journal of Family Therapy. January 15, 2015
    Multisystemic therapy (MST) is an empirically validated, family and community‐based intervention for young people presenting with antisocial and offending behaviour. This qualitative study aimed to explore young people's experiences of MST and learn what had helped them to sustain positive outcomes over time. Semi‐structured interviews were conducted with eight young people at an average of 14 months after MST (range: 5–21 months). A constructivist version of grounded theory was employed to analyse the data, leading to the development of a model of sustained change in MST. Themes from the model included therapeutic alliance, increases in systemic awareness, recognizing responsibility, positive peer relationships, acknowledging and celebrating success, continued use of specific strategies (for example, worry boxes) and the identification and creation of a preferred future. This research presents an understanding of how change may be sustained after MST, highlighting systemic, developmental and individual factors in relation to this. Clinical implications and a proposed model of sustained change in MST are discussed. Practitioner points The therapeutic alliance was perceived by young people as central to the process of change and sustained change following MST Young people's contribution to sustaining therapeutic gains at follow up, alongside caregivers, highlighted the importance of actively engaging them in therapy Peer relationships were identified as relevant to sustaining change, particularly in relation to shared values and goals for the future
    January 15, 2015   doi: 10.1111/1467-6427.12070   open full text
  • Differential effects of the working alliance in family therapeutic home‐based treatment of multi‐problem families.
    Egon Bachler, Alexander Frühmann, Herbert Bachler, Benjamin Aas, Guido Strunk, Marius Nickel.
    Journal of Family Therapy. October 27, 2014
    Families with a low socioeconomic status play an increasingly significant role in health services, research and social policy. The present outcome research study is a pre/post naturalistic study of home‐based therapeutic work with multi‐problem families (MPF), as conducted by Therapeutisch Ambulante Familenbetreung, an integrative family therapy with a structure‐related, mentalization‐based, psychoanalytic orientation. With a mean treatment duration of 75.7 weeks, 379 families showed significant psychological improvement on 10 scales concerning patient–therapist collaboration, treatment expectancy and psycho‐social outcome measures with a medium to large effect size for all parameters (range: .35–1.49). About two‐thirds of the sample improved by two SD on individually set treatment goals, further supporting the clinical significance of the therapeutic effect of home‐based family treatment. Improvements in goal‐directed collaboration and treatment expectancy are shown to be related to clinical improvement. Structural family therapy interventions for families with multiple problems thus benefit from individually setting goals and improving their self‐efficacy and problem‐solving by means of improved treatment expectancy. Practitioner's points MPF constitute a significant problem in healthcare and costs (burden of disease). The treatment of MPF is considered relatively difficult. Improvements to the process quality (working alliance, treatment expectancy) increase the quality of the results of home‐based treatment of MPF.
    October 27, 2014   doi: 10.1111/1467-6427.12063   open full text
  • The influence of dyadic coping in relationship education for low‐ income racial and ethnic minority couples.
    Amanda M. Mitchell, Jesse Owen, Jill L. Adelson, Tiffany France, Leslie J. Inch, Carrie Bergen, Amy Lindel.
    Journal of Family Therapy. September 29, 2014
    Financial concerns are stressors experienced by many couples and are negatively associated with relationship outcomes, such as relational satisfaction. Racial and ethnic minority (REM) couples are disproportionately affected by financial stress, as they are overrepresented in the lower socioeconomic bracket. In a sample of 299 low‐income REM couples who participated in a relationship education programme, we explored how financial stress can influence relationship functioning, as well as the mediating relationship of couple coping. The results revealed a good fit between the data and the dyadic model, suggesting that financial stress indicators can influence relationship functioning. Moreover, couples' change in dyadic coping after a relationship education programme mediated the relationship between couple distress at baseline and couple adjustment after the relationship education programme. Implications for the findings and future research are discussed. Practitioner points Dyadic coping is one vehicle through which relationship education programmes enhance relationship functioning in low‐income REM couples experiencing financial stress. Processing dyadic coping reactions and behaviour during psychotherapy may serve as a method to build, improve or enhance the couple identity of two partners.
    September 29, 2014   doi: 10.1111/1467-6427.12057   open full text
  • Working in a family therapy setting with families where a parent has a mental illness: practice dilemmas and strategies.
    Jennifer Power, Rose Cuff, Hanna Jewell, Fiona McIlwaine, Imogen O'Neill, Greg U'Ren.
    Journal of Family Therapy. September 01, 2014
    There is strong evidence supporting the benefits of family work, for both parents and children, in the treatment of parental mental illness. However, there has been only limited research on the implementation of family work in settings outside the mental health sector, such as family therapy or family counselling services, where mental illness may not be the primary presenting issue for a family. This article reports on a qualitative study that explored the experiences of family therapists working with families affected by parental mental illness. The article focuses on dilemmas clinicians faced integrating discussions about parental mental illness into family sessions. The findings support the need for clinicians to have appropriate training in family work related to mental health issues and also to develop the skill set needed to actively introduce, negotiate and explore the topic of mental illness with families. Practitioners points Developing knowledge, language and confidence in talking about mental illness may assist clinicians to raise discussions about parental mental illness in family sessions. Training in evidence‐based interventions for working with children of parents with a mental illness may provide a tool for clinicians in family sessions. Clinicians must be attuned to the ‘emotional readiness’ of parents and children to discuss parental mental illness. Developing readiness may take time.
    September 01, 2014   doi: 10.1111/1467-6427.12052   open full text
  • A pilot investigation of a brief, needs‐led caregiver focused intervention in psychosis.
    Sarah Roddy, Juliana Onwumere, Elizabeth Kuipers.
    Journal of Family Therapy. September 01, 2014
    Caregivers play an important role in the treatment and recovery of people with psychosis but they have different needs from service users and can experience significant distress as part of their role. Responding to caregiver needs is not readily identified as being the primary responsibility of clinical services that have limited resources. A small pilot study sought to evaluate the effect and acceptability of providing a brief, needs‐led intervention to long‐term caregivers of service users with psychosis. A two or three session, interactive and structured intervention, adapted from family work with psychosis, focused on facilitated carer access to reliable information about psychosis, goal setting and adaptive problem‐solving. Measures of affect, coping and care‐giving impact were completed at baseline and post‐intervention. Data for the first four caregivers who attended individual sessions are presented. Post‐intervention scores indicate reductions in levels of carer distress and depressive symptoms. Caregivers reported high levels of acceptability and satisfaction. Further studies are required to evaluate the impact of such interventions on a larger number and wider range of caregivers. Practitioner points To date, it has proved difficult for clinical services to meet the needs of caregivers of service users with psychosis. The caregivers of service users with psychosis have readily identifiable needs that can be met with a brief, structured, individualized and interactive intervention. Offering a time‐limited intervention to carers who would like support with their role has benefits for both the caregivers and the service.
    September 01, 2014   doi: 10.1111/1467-6427.12054   open full text
  • Youth and parental perspectives on the functional family therapy programme.
    Katarzyna Celinska, Chia‐Cherng Cheng, Nikiesha J. Virgil.
    Journal of Family Therapy. July 24, 2014
    Assessing clients' satisfaction with family therapy interventions has important practical and theoretical implications. This article presents findings on client satisfaction after participating in functional family therapy (FFT), which addresses youths at risk of delinquency behaviour and communication problems in the family. Qualitative interviews and quantitative research methods are employed to compare programme perceptions with standardized therapeutic outcomes. The data include a parent or guardian interview, a youth interview, a services tracking form and the initial and discharge strengths and needs assessment (SNA). We observed high levels of satisfaction with FFT, yet satisfaction with family therapy and therapists was higher among parents. Parents uniformly indicated satisfaction on six Likert scale items while the youths were satisfied only on one. We found five significant differences between the parents' and youths' responses. The parents reported greater trust in therapists, more engagement in family therapy and more positive perception of changes in family dynamics following the intervention. The two scales, satisfaction with the programme and satisfaction with the therapists, were correlated only for parents. However, both scales were correlated with some items on our outcome variable: the changes in the SNA, for parents and young people. We assessed predictors of satisfaction and found that satisfaction with therapy was inversely related to the number of sessions for youth. For parents, the only common predictor of both satisfaction with the therapist and satisfaction with the programme were the changes on the caregivers' strengths scale. The answers to the open‐ended questions indicated that, although both parents and adolescents valued the improvements in communication patterns, the youth seemed to be especially attuned to changes in this area. Researchers should continue assessing satisfaction with family therapy and study the relationship between satisfaction and the intervention's outcomes. Our findings suggest also the importance of including youth in assessing satisfaction. Practitioner points Assessing feedback from both, parents and youth, during and after an intervention can assist in providing more effective treatment. Youth might benefit from a shorter therapy and those who are mandated should be given more voice in an intervention. The strengths and needs assessment is a clinical tool that is useful in evaluating the intervention's outcomes. Functional family therapy improves communication skills among family members.
    July 24, 2014   doi: 10.1111/1467-6427.12051   open full text
  • The therapeutic alliance with involuntary clients: how does it work?
    Luciana Sotero, Sofia Major, Valentín Escudero, Ana Paula Relvas.
    Journal of Family Therapy. June 15, 2014
    This study aimed to compare involuntary and voluntary clients in the establishment of the therapeutic alliance in the context of family therapy. The system for observing family therapy alliances was used to rate the alliance in sessions 1 and 4 from videotapes of 40 families seen in brief family therapy. This instrument has four alliance dimensions. In the first session, results showed that the clients who sought therapy voluntarily demonstrated more alliance‐related behaviour than did involuntary clients in all alliance dimensions. In the fourth session, however, only the Engagement dimension showed group differences. Notably, there also were group differences in the evolution of the alliance from the first to the fourth session in the Safety dimension, with the voluntary clients developing this dimension more negatively. The results are discussed in terms of the specific characteristics of involuntary clients, as well as the implications for practice. Practitioner points Be aware of differing motives, motivations, and degrees of readiness for therapy within the family Inquire about the amount of pressure experienced by clients, and the source of that pressure, early in the family therapy Promote and monitor the therapeutic alliance with involuntary clients Promote a safe context, providing structure and guidelines for safety and confidentiality and helping clients to talk truthfully
    June 15, 2014   doi: 10.1111/1467-6427.12046   open full text
  • Reflections on the challenges of understanding racial, cultural and sexual differences in couple relationship research.
    Jacqui Gabb, Reenee Singh.
    Journal of Family Therapy. May 08, 2014
    In the field of systemic psychotherapy there has been much recent interest in the areas of culture and reflexivity, and in working with couples. In this article we reflect on the process of conducting research in these areas. Drawing on findings from a large, national, empirical mixed‐methods study on long‐term relationships, we use two examples from the data to illustrate the complexity of researching across racial, cultural and sexual differences, in terms of research design and sampling, fieldwork and research practice, and making sense of multidimensional data. We point to findings that suggest that notions of coupledom are culturally constructed and thus challenge straightforward ideas of the procreative, sexually active couple dyad, separate from intergenerational extended families. The clinical significance of the findings for both lesbian, gay, bisexual or queer and culturally diverse couples and families are discussed. Practitioner points Cultural or racial matching is not a sufficient condition for engagement and empathy with couples and families. Critical reflexivity about similarity and difference is essential in cross‐cultural systemic practice. ‘The couple’ and its distance from the extended family may be defined differently in different cultures. One research tool used in this project, the emotion map, appears to have utility in clinical practice with couples and families.
    May 08, 2014   doi: 10.1111/1467-6427.12044   open full text
  • Whose illness is it anyway? On facing illness as a couple.
    Jenny Altschuler.
    Journal of Family Therapy. April 21, 2014
    This article explores current trends in research and clinical practice regarding life‐limiting illness and couple relationships; focusing on intimacy, gender, coping strategies and congruence in perceptions. A case example is used to illustrate how systemic ideas and techniques can help couples address the challenges they face and rethink what they want and need from each other. Practitioner points In all clinical work it is important to bear witness to partners' shared and different experiences. It is also important to reflect on resonances with one's own experiences of loss and illness. Where couples are struggling, systemic techniques offer a way of increasing relational awareness, authenticity and mutuality.
    April 21, 2014   doi: 10.1111/1467-6427.12043   open full text
  • Technology in families and the clinical encounter: results of a cross‐national survey.
    Gonzalo Bacigalupe, Maria Camara, Laura E. Buffardi.
    Journal of Family Therapy. April 15, 2014
    Information communication technologies (ICT) are an integral part of contemporary family life, though the existing research about its impact is scarce, less than definitive, and individually based, as well as failing to attend to cross‐cultural and cross‐national dimensions. This study investigates how family clinicians construe the impact of ICT in the clinical context. A survey directed at family clinicians (N = 258) in four countries (Canada, Mexico, Spain and the USA) was designed to gather data on their beliefs about the impact of the emerging ICT on families and on their own clinical practice. The study found differences in the use of ICT across countries and correlation analyses showed there were more positive attitudes about the impact of emerging ICT on family dynamics among the clinicians whose use them the most. Practitioner points A constructive attitude towards emerging technology may enhance the effective use of technology in family therapy. The use of technology for personal and professional purposes by therapists may elicit appreciative conversations with families about its impact on family processes. Emerging digital technologies may enable clinicians to involve family members in virtual exercises and participation.
    April 15, 2014   doi: 10.1111/1467-6427.12042   open full text
  • Special issue on the therapeutic alliance in family therapy.

    Journal of Family Therapy. April 08, 2014
    There is no abstract available for this paper.
    April 08, 2014   doi: 10.1111/1467-6427.12040   open full text
  • Predicting premature termination with alliance at sessions 1 and 3: an exploratory study.
    Hana Yoo, Suzanne Bartle‐Haring, Rashmi Gangamma.
    Journal of Family Therapy. March 11, 2014
    Research has demonstrated that the therapeutic alliance is associated with termination status and treatment outcomes regardless of therapy models and the number of people involved in the treatment. Compared to individual therapy, however, relatively less attention has been paid to the therapeutic alliance as a predictor of premature termination of couple and family therapy. In the current study, videotape recordings of two samples of couples in therapy – one in the first session and the other in the third session – were analysed to examine the association between the therapeutic alliance and termination status. A total of 34 videotapes were analysed in this exploratory study. All the tapes were rated for the therapeutic alliance using the Vanderbilt therapeutic alliance scale, which allowed observers to code behaviour and interactions between couples and their therapist. The results of this study, though preliminary, suggested that the therapeutic alliance measured at the first session was more predictive of premature termination than was the alliance at the third session, which somewhat challenges findings from studies of individual psychotherapy. Practitioner points Assessing the therapeutic alliance in the first couple therapy session may be more important in predicting later premature termination than in the third session. In particular, new therapists in training may need to pay special attention to their alliance with clients from the very beginning of therapy.
    March 11, 2014   doi: 10.1111/1467-6427.12031   open full text
  • Pre‐therapy relationship adjustment, gender and the alliance in couple therapy.
    Tyler C. Halford, Jesse Owen, Barry L. Duncan, Morten G. Anker, Jacqueline A. Sparks.
    Journal of Family Therapy. March 04, 2014
    This study examined gender differences in session one alliances and in the trajectory of the alliance over the course of couple therapy. Additionally, this study examined the association between men and women's pre‐therapy relationship adjustment and alliance at session one and over the course of therapy. A total of 316 couples seeking outpatient couple therapy were given the Locke–Wallace marital adjustment test at pre‐therapy to measure relationship adjustment and the session rating scale after each session to measure alliance with the therapist. The results showed that men had lower alliance ratings after session one than women. Men's pre‐therapy relationship adjustment was positively associated with their own session one alliance as well as their own alliance trajectory over the course of therapy. Men's pre‐therapy relationship adjustment was also positively associated with their partner's session one alliance. Women's pre‐therapy relationship adjustment showed no significant relationship with their own alliance or their partners at session one or the alliance trajectory over the course of therapy. The implications for how these gender differences may impact on the process of couple therapy with heterosexual couples are discussed. Practitioner points Initial alliances may differ for men and women in heterosexual couples and attending to reasons for seeking help may be instrumental. Partners’ pre‐therapy relationship distress can negatively impact on early alliance establishment; thus, more attention to the alliance may be needed for more distressed couples. Therapists may want to monitor the alliances in couple therapy to develop a better understanding of each partner's engagement in the process.
    March 04, 2014   doi: 10.1111/1467-6427.12035   open full text
  • The father's roles in the recovery of young Chinese suffering from anorexia nervosa in two Chinese cities, Hong Kong and Shenzhen.
    Joyce L. C. Ma.
    Journal of Family Therapy. March 04, 2014
    The fathers' role in assisting the recovery of young Chinese diagnosed with anorexia nervosa has seldom been documented in Chinese contexts, namely Hong Kong and Shenzhen. In this article the author argues for the importance of engaging the absent Chinese father in helping in this context, describing the process of family treatment and highlighting the treatment principles and skills in achieving the goal of helping, illustrating it with two clinical cases from two Chinese cities, Hong Kong and Shenzhen. Practitioner points Engaging the absent father in treatment to join hands with his spouse is crucial to assist a young Chinese person with anorexia nervosa to recover. Translation of the young person's symptoms as a developmental challenge is clinically useful to achieve the goal of paternal engagement. Increased paternal involvement to mediate mother–daughter conflicts, raising the father's self‐confidence and improved marital relationships are clinically useful
    March 04, 2014   doi: 10.1111/1467-6427.12037   open full text
  • Positive systemic practice: a controlled trial of family therapy for adolescent emotional and behavioural problems in Ireland.
    Ciara Cassells, Alan Carr, Mary Forrest, Jane Fry, Fidelma Beirne, Tom Casey, Brendan Rooney.
    Journal of Family Therapy. March 04, 2014
    This study aimed to evaluate the effectiveness of positive systemic practice (PSP) in the context of a controlled trial. PSP is a model of family therapy for adolescent emotional and behavioural problems. A series of thirty‐seven consecutive patients assigned to a PSP treatment group and thirty‐five similar patients consecutively assigned to a waiting‐list control group completed this trial. They were assessed at baseline (Time 1) and 16 weeks later (Time 2) using the strengths and difficulties questionnaire (SDQ) that evaluates adolescent emotional and behavioural problems, and the systemic clinical outcomes and routine evaluation (SCORE) that evaluates family functioning. The PSP group was also followed up 6 months later (Time 3). For trial completers, the clinical improvement rate on the SDQ in the treatment group (65%) was significantly greater than that of the control group (20%) at Time 2 and the improvement was maintained at Time 3 (60%). The amelioration in adolescent behaviour problems on the SDQ was correlated with improvement in family adjustment on the SCORE. Treatment completers reported a high level of treatment satisfaction with this model of family therapy. Practitioner points PSP is a promising model of family therapy for adolescent emotional and behavioural problems. A distinctive feature of the model is the provision, by a co‐therapy team, of conjoint family sessions and parallel series of sessions to adolescents and parents. The model is described in a treatment manual.
    March 04, 2014   doi: 10.1111/1467-6427.12038   open full text
  • What clinicians think of manualized psychotherapy interventions: findings from a systematic review.
    Liz Forbat, Lynne Black, Kerem Dulgar.
    Journal of Family Therapy. February 20, 2014
    This article reports a systematic review of the literature examining therapists' views and experiences of utilizing treatment manuals. Key databases were searched and a thematic narrative analysis was conducted. Twelve articles were identified. The literature contains four distinct subthemes: (i) exposure to and use of manuals; (ii) therapists' beliefs about manuals; (iii) therapist characteristics, such as age/gender/training and (iv) characteristics of the work, such as client group. The analysis finds that clinicians who have used manuals appraise them positively, and view them as facilitating flexibility, allowing for therapeutic relationship and keeping therapy on track. The review is a helpful contribution to the literature and is a prompt to practitioners to consider their own views and exposure to manualized treatments and how this relates to generating the ‘hard’ outcome data that governments and service commissioners internationally find credible and persuasive. Practitioner points The positive appraisal of manuals is increased through exposure to them in clinical practice or research settings. Clinicians may wish, therefore, to seek out opportunities to use manuals. Clinicians are rarely exposed to manuals, which presents a potential topic for training courses to address.
    February 20, 2014   doi: 10.1111/1467-6427.12036   open full text
  • The evidence base for family therapy and systemic interventions for child‐focused problems.
    Alan Carr.
    Journal of Family Therapy. January 29, 2014
    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.
    January 29, 2014   doi: 10.1111/1467-6427.12032   open full text
  • The evidence base for couple therapy, family therapy and systemic interventions for adult‐focused problems.
    Alan Carr.
    Journal of Family Therapy. January 29, 2014
    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.
    January 29, 2014   doi: 10.1111/1467-6427.12033   open full text
  • Cultural differences stand to universalities as practice stands to theory: comments on Rober and de Haene.
    Inga‐Britt Krause.
    Journal of Family Therapy. January 28, 2014
    There is no abstract available for this paper.
    January 28, 2014   doi: 10.1111/1467-6427.12034   open full text
  • ‘Which aspects of social GGRRAAACCEEESSS grab you most?’ The social GGRRAAACCEEESSS exercise for a supervision group to promote therapists' self‐reflexivity.
    Yoko Totsuka.
    Journal of Family Therapy. January 05, 2014
    Promoting supervisees' self‐reflexivity is an integral component of systemic family therapy supervision. This includes facilitating thinking about the influences of social differences. The article describes an exercise designed to facilitate exploration of participants' relationships with different aspects of social GGRRAAACCEEESSS (SG). The exercise consists of mapping the influences of different aspects of SG and ascertaining how some of them come to be more privileged than others. It is proposed that the exercise is used in the context of a supervision group, where the supervisees and supervisor share their personal and family of origin stories related to SG. Team members' reflection offers a further opportunity for learning. Feedback from supervisees has been sought on how this exercise impacted on their practice. The potential benefits and caveats are discussed. Practitioner points Promote self‐reflexivity on issues of differences Explore supervisees' relationships with aspects of social GGRRAAACCEEESSS
    January 05, 2014   doi: 10.1111/1467-6427.12026   open full text
  • A philosophy of practice for systemic psychotherapy: the case for critical realism.
    David Pocock.
    Journal of Family Therapy. December 10, 2013
    An argument is made for Bhaskar's critical realism as a more coherent, accountable and enabling philosophy of practice for systemic psychotherapy than the kinds of strong constructionism and pragmatism that are currently powerful in our field. Constructionism is positioned, not as an opponent to realism in the usual way, but – in a moderate version – as a necessary partner to give realism its critical edge. The dimensions of critical realism are sketched and its potential for the coherent support of practice is illustrated with an analysis of a moment of therapeutic change. Practitioner points Critical realism supports the understanding of multiply interacting causal tendencies, from genetics to discourse, providing a new platform for eclecticism and integration and a renewed, though cautious, relationship with science. The growing split between structuralism and poststructuralism is closed by critical realism, giving the potential for systemic family therapy to become a unified field. The covert use of realism by clinicians is made accountable by critical realism.
    December 10, 2013   doi: 10.1111/1467-6427.12027   open full text
  • Supporting families in genetic counselling services: a psychoeducational multifamily discussion group for at‐risk colorectal cancer families.
    Álvaro Mendes, Raquel Chiquelho, Teresa A. Santos, Liliana Sousa.
    Journal of Family Therapy. November 29, 2013
    A non‐experimental exploratory study examining a multifamily discussion group for colorectal at‐risk individuals and their families is described. Four families attended a 90‐minute four‐session psychoeducational programme at a genetics centre of a Portuguese public hospital. A post‐programme focus group interview was performed to assess practical and psychosocial impact, and collect participants' views. Participants reported that the programme responds to the patients' and families' needs, enhancing their adaptation and coping to genetic illness. Results reinforce the need to integrate family‐centred interventions in genetic counselling services and address the holistic experience of hereditary disease. We conclude that the programme provides an integrated healthcare setting to help at‐risk individuals and their families cope with the specific biopsychosocial demands of their increased genetic susceptibility. Practitioner points Multifamily psychoeducational groups have a useful role in genetic counselling services. Family‐based approaches to genetic susceptibility to cancer need to be based on a family life‐cycle model incorporating the stage the cancer is diagnosed. Because of the reproductive implications of susceptibility, wider family members (and possibly adolescents) should be involved in the intervention.
    November 29, 2013   doi: 10.1111/1467-6427.12016   open full text
  • The individual‐system relationship: methodological cues from the stance‐taking process analysis.
    Marina Everri, Laura Fruggeri.
    Journal of Family Therapy. November 25, 2013
    The individual‐system relationship is one of the core, and most controversial, issues that have animated family therapy discussions since their origins. We advance the idea that an important point of departure for addressing this issue is the contamination of family therapy with constructs and methods coming from systemic research into normal family processes, such as the notion of stance‐taking. Relying on empirical data taken from a study conducted with families dealing with adolescents, we introduce and discuss the notion of stance‐taking as an innovative methodological procedure that can illuminate the individual‐system relationship while family interactions unfold. For the purpose of this article, we present and describe three selected family cases that document the potentialities of the stance‐taking process analysis for studying the individual‐system relationship, thus offering cues to systemic research and practice in family therapy. Practitioner points The stance‐taking process analysis allows clinical practitioners to develop systematic and empirically informed hypotheses. Pointing out the different stances taken by each member during family interactions, therapists can make such variability into a resource to promote change. Therapists can be trained to observe how their stances shape the ongoing process, and act in the unfolding conversations to transform the emerging patterns.
    November 25, 2013   doi: 10.1111/1467-6427.12025   open full text
  • A comparison of two systemic family therapy reflecting team interventions.
    Pippa Mitchell, Paul Rhodes, Andrew Wallis, Val Wilson.
    Journal of Family Therapy. September 12, 2013
    This research focused on exploring the experience of fifteen families who attended a first session of systemic family therapy, with reflecting team feedback being delivered in two different formats. In the first the interviewer consulted with the reflecting team alone after the therapy session while the family took a break and then provided feedback directly to the family. In the second the interviewer and family exchanged rooms straight after the session and the reflecting team provided feedback in conversation with each other. Families in both conditions of systemic family therapy described how the presence of a team led to a heightening of their emotion in session, a factor that served to effect a change in family interaction. For families in the first condition the consultation break reduced these intense emotions and provided a unique opportunity to continue independent discussions outside the therapy room. In contrast, those in the second condition reported that their experience was more exciting but it made information retention difficult. For this reason, the use of a therapeutic letter with this group was a crucial aspect of follow‐up intervention. Practitioner Points Families see systemic family therapy reflecting teams as helpful, providing an opportunity for new conversations, perspectives and behaviour to emerge. These benefits can be maximized by providing a detailed descriptions of the process beforehand, minimizing phone calls from the reflecting team to the interviewer and providing a break between interview and feedback. When using Andersen's (1991) model, following‐up sessions with a therapeutic letter can enhance the retention of information.
    September 12, 2013   doi: 10.1111/1467-6427.12018   open full text
  • Action ethics: using action method techniques to facilitate training on ethical practice.
    Kerri Newns, Moli Paul, Kate Creedy.
    Journal of Family Therapy. September 12, 2013
    This article describes how we facilitated a family therapy training day that privileged experiential learning when teaching ethics. Our approach used a range of action methods as learning activities selected from different disciplines. The theoretical basis on which these ideas were taught was drawn from types and categories of rights, balancing rights and parents' and children's rights. The teaching of these ethical frameworks, facilitated through action methods, enabled trainees to apply rights‐related reasoning to link theory to practice. Systemic social constructionist connections with action methods are explored and the term action ethics is used to describe the process of teaching ethical thinking and reasoning in a clinical context. Practitioner Points Clinical ethics in family therapy is best taught using action method techniques to facilitate trainees learning. The application of action method techniques in training creates opportunities for reflexive ethical therapy. Action method techniques applied in family therapy training develops trainees' skills in rights related ethical reasoning and thinking.
    September 12, 2013   doi: 10.1111/1467-6427.12020   open full text
  • Thematic review of Family Therapy Journals 2012.
    Alan Carr.
    Journal of Family Therapy. September 12, 2013
    In this article the contents of the principal English‐language family therapy journals, and key family therapy articles published in other journals in 2012 are reviewed under these headings: therapy processes in the treatment of child‐focused problems, autism, adolescent substance use, human immunodeficiency virus, depression and grief, fragile families, mental health recovery, medical family therapy, family business and systemic practice, couple therapy, intimate partner violence, key issues in theory and practice, research, diversity, international perspectives, interviews, and deaths.
    September 12, 2013   doi: 10.1111/1467-6427.12021   open full text
  • Detecting therapeutic improvement early in therapy: validation of the SCORE‐15 index of family functioning and change.
    Peter Stratton, Judith Lask, Julia Bland, Ewa Nowotny, Chris Evans, Reenee Singh, Emma Janes, Anneka Peppiatt.
    Journal of Family Therapy. September 12, 2013
    The SCORE index of family functioning and change is an established measure, with strong psychometric properties, of the quality of family life. We report the sensitivity to therapeutic change of the short form, the SCORE‐15. Data are reported from 584 participants aged above 11 years, representing 239 families. All couples and families had been referred for systemic couples and family therapy, completing the form at start of the first session and close to the fourth. The SCORE‐15 is shown to be acceptable with strong consistency and reliability. Change over only three sessions was highly statistically significant. Further validation is provided by improvements in quantified scores correlating significantly with independent measures provided by family members and by their therapists. The SCORE‐15 is a proven measure of therapy and of therapeutic change in family functioning. It is therefore a routinely usable tool applicable to service evaluation, quality improvement, and to support clinical practice. Practitioner Points The SCORE provides practitioners with brief descriptions of varied aspects of family interaction that have proven significance for many families who present for therapy. SCORE‐15 can be used with confidence to monitor and report proven indicators of progress in systemic therapy. Because SCORE identifies clinically significant issues of family interaction it has many potential uses in therapy. There are many new possibilities for therapists to undertake collaborative research.
    September 12, 2013   doi: 10.1111/1467-6427.12022   open full text
  • Revealing underlying vulnerable emotion in couple therapy: impact on session and final outcome.
    Jacqueline M. McKinnon, Leslie S. Greenberg.
    Journal of Family Therapy. July 16, 2013
    This study examined how the revealing of underlying vulnerable emotion relates to session and final outcome in the context of emotion‐focused therapy for couples. Segments of videotaped therapy sessions were rated on a measure of underlying vulnerable emotional expression for twenty‐five couples. Results indicated that partners rated sessions in which underlying vulnerable emotion was expressed significantly more positively than control sessions on a measure of session outcome. Moreover, from pre to post, couples who were found to have expressed underlying vulnerable emotion at least once improved significantly more on a measure of trust, and marginally significantly more on a measure of unfinished business, than couples who were not found to have expressed underlying vulnerable emotion. Recommendations for treatment are provided in light of the findings. Practitioner points It is recommended that couple therapists help partners to access and express underlying vulnerable emotion, because this appears to be associated with better session and final outcomes. When an underlying vulnerable emotion begins to emerge, it is recommended that the therapist maintain the focus on this emotion and help to facilitate its full expression.
    July 16, 2013   doi: 10.1111/1467-6427.12015   open full text
  • A component analysis of a brief psycho‐educational couples' workshop: one‐year follow‐up results.
    Julia C. Babcock, John M. Gottman, Kimberly D. Ryan, Julie S. Gottman.
    Journal of Family Therapy. July 16, 2013
    This study tested moderators of treatment outcome of the ‘Art and Science of Love (ASL) Workshop’, a couples' group psycho‐educational intervention with 80 distressed married couples. Couples were randomly assigned to one of four conditions: (1) friendship enhancement alone, (2) conflict management alone, (3) combined friendship enhancement + conflict management or (4) bibliotherapy. Three outcomes were assessed: (1) relationship satisfaction, (2) friendship quality and (3) destructive conflict at pre‐, post‐ and one year following the intervention. All conditions led to increased marital satisfaction and decreased problems with friendship and destructive conflict at one‐year follow‐up. Examining exposure to the components of the ASL workshop in a 2×2 design – friendship enhancement (yes/no) vs. conflict management (yes/no) – revealed differential impact for men's and women's relationship outcomes over time. Results suggest that the combined condition produced the greatest changes in marital satisfaction and the greatest decreases in problems in friendship and conflict, particularly for men. Practitioner points A combination of friendship enhancement and conflict management is recommended to maximize outcomes. Bibliotherapy alone may be effective for significantly distressed couples without co‐morbid problems. Psycho‐education is recommended before a course of more intensive couple therapy. Men and women have different needs and respond to particular aspects of the programme. Women particularly value the component concerning how to deal with conflict constructively and require more than the friendship enhancement component of the programme.
    July 16, 2013   doi: 10.1111/1467-6427.12017   open full text
  • Naming the problem: a membership categorization analysis study of family therapy.
    Katherine O'Neill, Amanda LeCouteur.
    Journal of Family Therapy. May 15, 2013
    Discursive research has examined family therapy as a process of collaboratively negotiating a preferable account of the problem. The present study uses membership categorization analysis to examine how this process occurs in a sequence of family therapy sessions with the family of a 15‐year‐old boy diagnosed with high‐functioning autism and experiencing conflict with his school. The analysis focuses on the deployment of the membership categorization device ‘disability’ in the construction of the problem and the use of the devices ‘family’ and ‘stages‐of‐life’ to construct a new, problem‐dissolving account. Conclusions are drawn about the potential usefulness of recategorization via naturally occurring membership categorization devices in constructing solutions in family therapy. Practitioner points Therapy is the collaborative negotiation of an account of the family situation in which the problem does not exist. Naturally occurring groups of categories (MCDs) supply resources for such renegotiation. Where a problem has been constructed in the MCD ‘disability’ it can be ‘dis‐solved’ using the MCDs ‘family’ and ‘stages‐of‐life’. More generally, the use of higher order and highly naturalized MCDs may be effective in displacing problem‐generating constructions.
    May 15, 2013   doi: 10.1111/1467-6427.12008   open full text
  • Intercultural therapy and the limitations of a cultural competency framework: about cultural differences, universalities and the unresolvable tensions between them.
    Peter Rober, Lucia De Haene.
    Journal of Family Therapy. May 15, 2013
    Working with a family from a cultural background other than one's own is considered to be challenging for the therapist. Influenced by social constructionism, the family therapy field highlights the importance of contingency and cultural differences and therapists are encouraged to develop their cultural competency in order to deal with these differences. In this article, starting from contemporary critiques of notions of Western societies' cultural diversity, we address the way in which the cultural competency framework, by highlighting the importance of cultural differences and the therapist's culture‐specific knowledge, may underestimate the importance of the social dimensions of the issues involved. Furthermore, highlighting cultural differences may obscure the shared humanity present in a transcultural encounter. In this article, as an alternative to the cultural competency framework, we propose a view of intercultural family therapy in which the unresolvable dialectical tension between differences and universalities is central. Practitioner points The article addresses the challenge of working with families from diverse cultural backgrounds. The traditional framework of cultural competence is critically reviewed. Family therapists should not only be open for cultural differences, but also for universalities and especially for the never‐ending tension between differences and universalities.
    May 15, 2013   doi: 10.1111/1467-6427.12009   open full text
  • Protective vigilance: a parental strategy in caring for a child diagnosed with ADHD.
    Gill Goodwillie.
    Journal of Family Therapy. May 15, 2013
    This article describes a key finding that emerged from a small‐scale qualitative study that explored parental views of the impact of having a child diagnosed with attention deficit hyperactivity disorder (ADHD) on family relationships. The term, protective vigilance, describes a strategy used by parents to manage the risk that children can present to themselves and to others with whom they might come in contact, such as their siblings or peers. The term draws attention to the challenges parents face in supervising their children in a manner that others might describe as overprotective or over‐controlling. In this article the parents' voice is heard describing their dilemmas and the article invites professionals working with families, with a child diagnosed with ADHD to consider protective vigilance as an inevitable aspect of the parental role and incorporate this idea into their clinical practice. Practitioner points Explore with parents how concerns for their child's safety might impact on their parenting style Recognize that a child's behaviour shapes and influences parental style in a recursive manner Note that early intervention with a relational focus may improve future outcomes for the child diagnosed with ADHD Adopt a systemic approach based on a ‘both and’ stance to free the practitioner from the polarized discourses that surround the diagnosis of ADHD and help to avoid the dialectics of blame Note that parental aspirations and hopes for a child diagnosed with ADHD may be affected by negative cultural views about the diagnosis Explore practitioners' own prejudices about the diagnosis before they set about helping parents.
    May 15, 2013   doi: 10.1111/1467-6427.12010   open full text
  • ‘We're here to get you sorted’: parental perceptions of the purpose, progression and outcomes of family therapy.
    Michelle O'Reilly.
    Journal of Family Therapy. May 02, 2013
    This article reports research on family therapy interactions. The research uses discourse analysis to explore the ways in which parents construct their reasons for requiring family therapy, the outcomes they desire from it and orientations to their progress. The analysis suggests that parents often position their child as the problem and this is something that is rarely challenged or questioned by the child. Parents express a desired outcome of ‘fixing’ the child and highlight this as what they believe the purpose of family therapy to be. During therapy they emphasize their progression and consider improvements in family functioning. By understanding parental perceptions we can move research forward in understanding engagement in therapy and attrition, and integrate guidelines on service improvements with what parents feel is beneficial. Practitioner points Parents manage their presence in family therapy in many ways and typically position the child as the reason for their attendance. Offering the child some time alone with the therapist has potential to uncover the child's perspectives on goals and outcomes which may be inhibited by parental presence. Anticipating that the child may be described in derogatory or negative ways at the start can help the therapist to reframe the problem in more helpful ways.
    May 02, 2013   doi: 10.1111/1467-6427.12004   open full text
  • Positioning theory and narratives in the organization: teaching MSc students to apply theory to practice.
    Paula Boston.
    Journal of Family Therapy. May 01, 2013
    This short article presents a teaching session on the topic of positioning theory and narratives within the organizational context. The theory is made more accessible to students through playful group experiential learning in which the university assessment process is considered from different discourses and positions. Students could see how, in role, they were positioned and positioned others. Organizational narratives were brought to life. Practitioner points Novelty and playfulness are important in the teaching of theory Using the ‘organization created around learning’ offers a refreshing new arena in which to apply theory Positioning theory is best understood through experiential learning. By using the role play, the student is exposed simultaneously to at least three positions; their own personal perspective, that of the character in the role play and the experience of listening to others
    May 01, 2013   doi: 10.1111/1467-6427.12002   open full text
  • The relationship between family‐of‐origin experiences and sexual satisfaction in married couples.
    James G. Strait, Jonathan G. Sandberg, Jeffry H. Larson, James M. Harper.
    Journal of Family Therapy. May 01, 2013
    This study examined the relationship between perceptions of family‐of‐origin experiences, sexual satisfaction and marital quality. The sample consisted of 3953 married couples who responded to the relationship evaluation. The results showed that more positive overall family‐of‐origin experiences and parent–child relationships were related to higher sexual satisfaction. Overall, family‐of‐origin experiences and parent–child relationships were predictive of higher sexual satisfaction; however, that relationship was significantly mediated by marital quality. There was a strong positive relationship between marital quality and sexual satisfaction. No major gender differences emerged from the findings. The results suggest that family‐of‐origin experiences play a key role in the sexual satisfaction of married couples, especially when mediated by marital quality, and should be considered in treatment, education and research.
    May 01, 2013   doi: 10.1111/1467-6427.12007   open full text
  • Couple communication among problem drinking males and their spouses: a randomized controlled trial.
    Kimberly Walitzer, Kurt Dermen, Kathleen Shyhalla, Audrey Kubiak.
    Journal of Family Therapy. April 09, 2013
    This study evaluated the effects of alcohol‐focused spouse involvement and behavioural couple therapy (BCT) on couple communication in the context of group drinking reduction treatment for male problem drinkers. Sixty‐four male clients and their female partners were randomly assigned to one of three conditions: (i) treatment for problem drinkers only (PDO), (ii) couple alcohol‐focused treatment or (iii) couple alcohol‐focused treatment combined with BCT. Couples whose partners participated in the treatment made fewer negative statements during a couple conflict communication task following treatment than PDO couples. The beneficial effect of spouse involvement on negative couple communication was partially mediated by a reduction in the frequency of clients’ heavy drinking during treatment. There was also evidence that BCT reduced couples’ negative communication and increased problem‐solving communication. Practitioner points Involving the spouse in group drinking reduction treatment for male problem drinkers can improve drinking outcome. Therapists can encourage spouses to decrease counterproductive behaviour and engage in behaviour supportive of drinking reduction. Actively involving the spouse can decrease negative statements during problem‐solving communications. Reduction in negative communication may be a result of, rather than a cause of, the male partner's drinking reduction.
    April 09, 2013   doi: 10.1111/j.1467-6427.2013.00615.x   open full text
  • Support‐seeking, support‐provision and support‐perception in distressed married couples: a multi‐method analysis.
    Lesley LL Verhofstadt, Gilbert MD Lemmens, Ann Buysse.
    Journal of Family Therapy. December 02, 2012
    An emerging consensus argues for the importance of spousal support in our understanding of how relationships succeed or fail. This report covers two studies that examined support seeking, support provision and support perception in distressed married couples. In Study 1 a total of seventy distressed and seventy non‐distressed couples participated in a survey study; in Study 2 twenty distressed and twenty non‐distressed couples participated in an observational study. Global self‐reports were used in both studies to assess spouses’ support behaviour and perceived support. These measures were supplemented in Study 2 with measures of observed support behaviour and interaction‐based perceived support as assessed during specific support interactions. Our self‐report and observational measures consistently indicated that distressed marital couples display lower levels of positive support‐seeking and emotional or instrumental support provision than non‐distressed couples. We also found evidence for higher levels of negative support‐seeking and provision behaviour in distressed couples, as compared to non‐distressed couples. Distressed spouses also reported lower levels of global and interaction‐based perceived support than non‐distressed spouses. Practitioner points Assess and evaluate the different support behaviour in couples Explain the interactional support behaviour cycle Increase support skills within the couple Detect and block negative support behaviour
    December 02, 2012   doi: 10.1111/1467-6427.12001   open full text
  • Patient‐focused research supported practices in an intensive family therapy unit.
    Rolf Sundet.
    Journal of Family Therapy. October 26, 2012
    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.
    October 26, 2012   doi: 10.1111/j.1467-6427.2012.00613.x   open full text
  • The Fit Families pilot study: preliminary findings on how parental health and other family system factors relate to and predict adolescent obesity and depressive symptoms.
    Lisa M. Hooper, Joy J. Burnham, Rachel Richey, Jamie DeCoster, Mitch Shelton, John C. Higginbotham.
    Journal of Family Therapy. October 26, 2012
    This study, undergirded by family systems theory, examined the extent to which parent and family‐level factors correlate with adolescent obesity and depressive symptoms. We also considered whether these variables predict unique variance in adolescent obesity and depressive symptoms. The participants were a convenience sample of 77 racially diverse, predominantly early adolescents (aged 12 to 17) and their parents. Results from a series of linear and logistic regression analyses indicated that three of the study factors (parental weight history, family resources and adolescent weight history) significantly contributed to the variance in adolescents' body mass indexes and only one of the study factors (parental depressive symptomatology) significantly contributed to the variance in adolescents' rates of depressive symptomatology. These preliminary findings clarify how parent and family system factors might inform family and school‐based intervention and treatment efforts for adolescent health outcomes. Practitioner points Family environment (measured in this study as family conflict and cohesion) should continue to be evaluated as a risk factor for obesity and depressive symptoms in racial and ethnic minority and non‐minority families. Family therapists as well as other practitioners (for example, primary care providers) should assess for family conflict when adolescents present with physical and psychological distress and disturbances. Family therapists and other practitioners could be more effective if they established whether adolescent patients and their family members have the resources (for example, knowledge, financial ability and skills) needed to live a healthy lifestyle, as well as the coping strategies for maintaining their physical and psychological health.
    October 26, 2012   doi: 10.1111/j.1467-6427.2012.00616.x   open full text
  • Systemic empathy with adults affected by intellectual disabilities and their families.
    Hilly Webb‐Peploe, Glenda Fredman.
    Journal of Family Therapy. September 12, 2012
    This article explores how we might bring forth and value the voice of the person with intellectual disabilities alongside the voice of their family and carers so that all those present can feel understood and appreciated. We offer a description of systemic empathy as the ability to connect with one person while maintaining the possibility of connecting with other individuals in the system and at the same time tuning in to those people's connections with each other. We share examples from practice that challenge our ability to work empathically when there are several people in the same room holding different or opposing perspectives and who evoke different emotional reactions in us. We offer principles and practices through which we have been able to make empathy systemic with examples from our work with adults with intellectual disabilities and their families. These include empathizing through curiosity and irreverence, co‐creating meanings with more than one person, double listening with ears, eyes and bodies, preparing our own emotional postures, taking the perspectives of others and creating reflecting processes.
    September 12, 2012   doi: 10.1111/j.1467-6427.2012.00605.x   open full text
  • Therapeutic moments are the key: foster children give clues to their past experience of infant trauma and neglect.
    Judith M. Brown.
    Journal of Family Therapy. September 03, 2012
    Foster parents often despair over the lack of information about the past experience of the children in their care, particularly with children who have experienced infant trauma and neglect. In the context of family therapy these unknowns pose both a challenge and an opportunity. The author proposes that foster children gives clues to their past experiences in therapeutic moments, which the therapist may recognize as a result of her own inner conversation. In conjunction with a sound theoretical knowledge of infant trauma and neglect, these moments have the capacity to open a dialogue in the relationships between therapist, child and foster family. This dialogical process offers an opportunity for the child's past experience of infant trauma and neglect to be expressed in silence, and the foster parent's present experience to be heard in stillness, opening for them a way to go on beyond the family therapy sessions.
    September 03, 2012   doi: 10.1111/j.1467-6427.2012.00606.x   open full text
  • Constructions and enactments of whiteness: a discursive analysis.
    Jennifer Wallis, Reenee Singh.
    Journal of Family Therapy. August 24, 2012
    Systemic therapists have argued that it is important to re‐examine issues about white identities if they are to develop cultural competence and cultural sensitivity. Despite this, few studies have explored whiteness in systemic psychotherapy. This small‐scale qualitative study therefore explores how a group of white systemic psychotherapists (trainers and trainees) construct whiteness, how these constructions or discourses facilitate or constrain talk about whiteness and how this influences what therapists do in therapy. The research method used was focus group discussions and an action research approach. The data were analysed using Foucauldian discourse analysis and three main discourses were made apparent: ‘whiteness as an invisible norm’, ‘political correctness’ and ‘systemic therapy discourses’. These discourses are described and the implications, discussed.
    August 24, 2012   doi: 10.1111/j.1467-6427.2012.00602.x   open full text
  • Client crying in the context of family therapy: an exploratory study.
    Loreto Cuevas‐Escorza, Miguel Garrido‐Fernández.
    Journal of Family Therapy. July 10, 2012
    This study explores the crying episodes of twenty‐eight clients treated at a family therapy service in a community centre. The crying episodes were associated with some significant elements: the time of appearance, the content and triggering factor, the interpersonal context of sessions and the emotions clients had for the therapist, as well as the therapy's outcome (end of treatment and the satisfaction of clients). Crying was much more frequent during the first session. It occurred more frequently when there was another family member present. The proportion of clients who cried during the treatment was significantly higher for clients who completed it successfully. Clients who cried perceived the therapist, in all cases, as a kind person who never got annoyed with them. Crying could be considered a type of behaviour that helps the therapist to create a safe context and foster the therapeutic alliance.
    July 10, 2012   doi: 10.1111/j.1467-6427.2012.00596.x   open full text
  • Couple therapy for depression in a naturalistic setting in Finland: a 2‐year randomized trial.
    Jaakko Seikkula, Jukka Aaltonen, Outi Kalla, Pirjo Saarinen, Asko Tolvanen.
    Journal of Family Therapy. June 11, 2012
    The dialogical and narrative processes in couple therapy (CT) for depressions project was conducted to develop therapy for depression and to investigate the effectiveness of CT in everyday clinical practice; thus aiming at high external validity. Patients with moderate or major depression were randomized to a CT group (n = 29) and a control group (n = 22). The CT group needed significantly fewer therapy sessions. There were significant differences in favour of the CT group in terms of general mental health (symptom check list), Hamilton depression rating scale, global assessment of functioning and decreasing alcohol use. As regards depressive symptoms using the Beck depression inventory, 79 per cent of the research group and 70 per cent of the control group showed a clinically significant improvement. CT may be the method of choice in moderate and severe depression if agreement is reached with the couple concerning the form of therapy.
    June 11, 2012   doi: 10.1111/j.1467-6427.2012.00592.x   open full text
  • Meditative dialogue: tuning in to the music of family therapy.
    Susan A. Lord.
    Journal of Family Therapy. June 11, 2012
    Meditative dialogue is a mindfulness method through which families and their therapists are able to access the present moment and develop acceptance, non‐judgmental attitudes and attunement with one another and with the music that is always present in their lives. This process can be used to deepen empathic connections, tap into creative forces and loosen and encourage embodied and flexible interactions that alter patterns and cultivate openness to possibility and to change.
    June 11, 2012   doi: 10.1111/j.1467-6427.2012.00594.x   open full text
  • ‘She needs a smack in the gob’: negotiating what is appropriate talk in front of children in family therapy.
    Michelle O'Reilly, Nicola Parker.
    Journal of Family Therapy. June 11, 2012
    Tackling the day‐to‐day challenges of family therapy can prove difficult for professionals. A particular issue arising in family therapy is the notion of what is appropriate for children. Families report events from their social world, out‐there to the therapy in‐here. There are occasions where the content is ‘adult’ in nature and this has to be managed in front of the children. On some occasions family members use derogatory or negative descriptions of their children while their children are present. Drawing upon naturally occurring family therapy sessions, we present a discourse analysis of how this is managed through a range of discursive resources. We show that adult family members construct what is inappropriate for children to be exposed to by positioning blame with others. This has implications for how family therapists deal with inappropriateness when children are present while maintaining the equilibrium of therapeutic alliances.
    June 11, 2012   doi: 10.1111/j.1467-6427.2012.00595.x   open full text
  • Video games: support for the evolving family therapist.
    Nickolas A. Jordan.
    Journal of Family Therapy. June 07, 2012
    Video games are a growing part of USA and world culture. Gaming may have addictive effects on some gamers and may foster violent thoughts and behaviour in children and adults. Conversely, there are documented positive outcomes from playing video games. Through this growing media, family therapists have a new gateway to better understand the experience of a younger generation of clients. To keep up with a changing client base, family therapists must learn about video games, their contextual impacts, addictive aspects and possible uses in the therapeutic setting while ignoring the myth that all gaming is harmful.
    June 07, 2012   doi: 10.1111/j.1467-6427.2012.00593.x   open full text
  • Towards a relational framework for pathological gambling (Part I): Five circuits.
    Bonnie K. Lee.
    Journal of Family Therapy. April 18, 2012
    Relationship patterns before and after pathological gambling were investigated qualitatively using eight in‐depth clinical case studies in which one partner met Diagnostic and Statistical Manual of Mental Disorders‐IV pathological gambling criteria. Five circuits of couple interactions are described: (i) fault‐lines; (ii) pressure points; (iii) escalation; (iv) relapse and (v) congruence. The exploration of these circuits is developed in two complementary articles. This first article delineates the first four circuits as recursive self‐perpetuating cycles of couple distress in systemic interaction with pathological gambling development and relapse. The second article delineates how a couple can be helped to extricate themselves from these recursive circuits through ‘congruence’. Implications of this relational formulation of pathological gambling for conceptualization, assessment and treatment are discussed.
    April 18, 2012   doi: 10.1111/j.1467-6427.2012.00588.x   open full text
  • Towards a relational framework for pathological gambling (Part II): Congruence.
    Bonnie K. Lee.
    Journal of Family Therapy. April 17, 2012
    In an illustrative clinical case study, congruence is depicted as the fifth circuit in a relational framework to extricate gambler and spouse from pathological gambling and its after‐effects. Congruence couple therapy poses interventions in four dimensions of the couple experience: (i) intra‐psychic; (ii) interpersonal; (iii) intergenerational and (iv) universal‐spiritual. Congruence is operationalized as awareness, attention, acknowledgment and the alignment of the four dimensions. The philosophical underpinnings of this concept‐based model are laid out with clinical vignettes. The couple reported improved relationship quality with a reduction of gambling urges and maintained abstinence. The couple relationship serves as leverage for both gambler and spouse to reconnect with themselves, with each other, with their intrinsic worth and dignity and with their family of origin experiences. As such, congruence couple therapy goes beyond the level of the individual and intra‐psychic to reconstruct key family relationships in both past and present, and to rebuild spiritual resources to fortify the couple's capital for sustained recovery.
    April 17, 2012   doi: 10.1111/j.1467-6427.2012.00591.x   open full text
  • Use of metaphors in Chinese family therapy: a qualitative study.
    Liang Liu, Xudong Zhao, John K. Miller.
    Journal of Family Therapy. February 15, 2012
    The use of metaphors in family therapy has been extensively written about in western literature, yet very few studies on this subject have been conducted in China. The goal of this study was to summarize the metaphors used by Chinese family therapists. Transcriptions from 36 hours of video‐recorded family and couple therapy sessions from eighteen Chinese family patients were qualitatively analysed to identify categories of therapist‐produced metaphors that are applicable to the Chinese context. Two major categories emerged: verbal and non‐verbal metaphors. Verbal metaphors included four subgroups: story, object comparison, sayings and age. Nonverbal metaphors involved two subgroups: gesture and spatialization. The influence of the Chinese culture on the use of metaphor is discussed. This study adds to the greater understanding of how to integrate metaphors in therapy in the Chinese context.
    February 15, 2012   doi: 10.1111/j.1467-6427.2012.00582.x   open full text
  • Therapist attentiveness and negative capability in dialogical family meetings for psychosis.
    Alex Reed.
    Journal of Family Therapy. November 30, 2011
    Jaakko Seikkula () has pointed towards the importance of practitioners working in the present moment in dialogical therapy. Extrapolating from Seikkula's work, this article considers the significance of the qualities of therapist attentiveness, generosity and negative capability in dialogical family meetings for psychosis. It is proposed that these qualities are of particular importance when family meetings occur in crisis situations, as when under pressure practitioners can easily be drawn into prematurely interventionist stances that may unintentionally promote chronicity for the person experiencing psychosis. The value of co‐working arrangements in enabling practitioners to maintain attentiveness and negative capability in this work is also considered.
    November 30, 2011   doi: 10.1111/j.1467-6427.2011.00580.x   open full text
  • Family therapy in Macau: development, challenges and opportunities.
    Simon Tak‐mau Chan.
    Journal of Family Therapy. November 28, 2011
    Family therapy in Macau is in its early stages of development. The Satir model and structural family therapy were the first two therapies introduced. Later on, solution‐focused brief therapy and narrative therapy were also introduced. Macau has been undergoing dramatic socioeconomic changes since the relaxation of the gambling licenses. In sociocultural terms this has led to significant changes: the so‐called ‘dealer's complex’, gambling, drug abuse and youth deviance have become more prevalent. To address complicated family problems, various counselling institutes and training centres were established to conduct family therapy. However, there are still some limitations and challenges that must be addressed in order to have a thriving family therapy profession in Macau.
    November 28, 2011   doi: 10.1111/j.1467-6427.2011.00578.x   open full text
  • Systemic psychotherapy as an intervention for post‐traumatic stress responses: an introduction, theoretical rationale and overview of developments in an emerging field of interest.
    Stephen Coulter.
    Journal of Family Therapy. September 15, 2011
    The purpose of this article is to critically examine the literature to provide a rationale for including systemic family therapy (SFT) in the psycho‐social treatment of people suffering the impact of post‐traumatic stress (PTS). Attention is drawn to the relatively underdeveloped academic literature on PTS and the family. The impact of PTS is conceptualized within a psycho‐social framework and the current evidence base for psycho‐social interventions for PTS responses is described, highlighting the opportunity and need to undergird this area of daily practice. The impact of PTS on the family at multiple levels is identified, emphasizing its recursive nature. The case for SFT is articulated and a range of models of family intervention for PTS briefly reviewed, concluding with an emphasis on Walsh's key processes in family resilience as a framework for practice.
    September 15, 2011   doi: 10.1111/j.1467-6427.2011.00570.x   open full text
  • The application of a domains‐based analysis to family processes: implications for assessment and therapy.
    Jonathan Hill, Bernadette Wren, Jane Alderton, Charlotte Burck, Eilis Kennedy, Rob Senior, Neelo Aslam, Nichaela Broyden.
    Journal of Family Therapy. September 14, 2011
    Social domains are classes of interpersonal processes each with distinct procedural rules underpinning mutual understanding, emotion regulation and action. We describe the features of three domains of family life – safety, attachment and discipline/expectation – and contrast them with exploratory processes in terms of the emotions expressed, the role of certainty versus uncertainty, and the degree of hierarchy in an interaction. We argue that everything that people say and do in family life carries information about the type of interaction they are engaged in – that is, the domain. However, sometimes what they say or how they behave does not make the domain clear, or participants in the social interactions are not in the same domain (there is a domain mismatch). This may result in misunderstandings, irresolvable arguments or distress. We describe how it is possible to identify domains and judge whether they are clear and unclear, and matched and mismatched, in observed family interactions and in accounts of family processes. This then provides a focus for treatment and helps to define criteria for evaluating outcomes.
    September 14, 2011   doi: 10.1111/j.1467-6427.2011.00568.x   open full text
  • Relational consciousness and the conversational practices of Johnella Bird.
    Ottar Ness, Tom Strong.
    Journal of Family Therapy. September 02, 2011
    In this article we review Johnella Bird's notion of relational consciousness, explaining it in terms of an ethnomethodologically informed social constructionist theory. We extend this notion to her conversational practices in therapy, examining first her general practice (and focus) on relational language‐making. We then turn to describing three of her specific conversational practices – negotiating conflicting discursive positions between partners in a relationship, exploring a partner's experience of hurt in a relationship, following unspoken assumptions, and negotiating power relations. We conclude by relating relational consciousness to an attendance to language as it is used by clients and by therapists in dialogue with clients.
    September 02, 2011   doi: 10.1111/j.1467-6427.2011.00567.x   open full text
  • Commentary: a different lens for working with affairs: using social constructionist and attachment theory.
    Janet Reibstein.
    Journal of Family Therapy. July 29, 2011
    A combined social constructivist and attachment theory approach can help in work with affairs. Using past empirical research, a case is made that vulnerability to affairs derives primarily from pressures on partnerships stemming from the dominant discourse of modern partnerships. This discourse exalts sharing and joining, subjugating the more common experience of couples that other meaningful relationships (including non‐sexual ones) augment and fill in gaps. Affairs may be seen as, perhaps misguided, attempts to address untenable goals of the dominant discourse. Concomitantly, attachment theory explains both the need to be in a variety of relationships, normally within a hierarchy (‘multiple attachments’) and also the extreme wounds attendant to the discovery of secret affairs. Using both these perspectives can be useful preceding attempts at forgiveness. It is argued that they help therapists to establish an empathic positioning toward both partners in the couple, rather than the moralistic one too frequently attendant in work with affairs.
    July 29, 2011   doi: 10.1111/j.1467-6427.2011.00562.x   open full text
  • Do primary care psychological therapists ‘think family’? Challenges and opportunities for couple and family therapy in the context of ‘Improving Access to Psychological Therapies’ (IAPT) services.
    Melanie Shepherd.
    Journal of Family Therapy. July 15, 2011
    Very little couple or family work takes place in primary care despite the advantages offered by the context. This pilot study investigated the experiences of primary care adult therapists regarding the place of families in their clinical work. Semi‐structured interviews with seven therapists were analysed using interpretative phenomenological analysis. The findings tentatively suggest that primary care psychological therapists ‘think family’ primarily from the perspective of their main therapeutic model when offering individual therapy. Some study participants questioned the appropriateness of their family/context focus. Family members were extremely rarely seen together. Facilitating factors included supervision and training. Barriers to family work were both external (the work setting) and internal (beliefs about it). The impact of the current dominance of cognitive behavioural therapy in National Health Service adult psychological therapy services and the development of Improving Access to Psychological Therapies (IAPT) services on the provision of couple and family therapy are discussed. Some challenges and opportunities presented by IAPT for couple and family therapy are explored.
    July 15, 2011   doi: 10.1111/j.1467-6427.2011.00559.x   open full text
  • Facilitating forgiveness in the treatment of infidelity: an interpersonal model.
    Stephen T. Fife, Gerald R. Weeks, Jessica Stellberg‐Filbert.
    Journal of Family Therapy. July 15, 2011
    This article presents a unique clinical model of forgiveness developed specifically for use in the treatment of infidelity. The model focuses on forgiveness as a central component of the process of healing for couples who desire relationship reconciliation following an affair. Infidelity causes significant damage for couples and results in a loss of trust and relationship stability. However, couples can become reunified and trust may be restored as couples work through the process of forgiveness. Forgiveness is facilitated as therapists and clients focus on four unifying factors: empathy, humility, commitment and apology. Specific steps are outlined for therapists to help them guide clients through the process of forgiveness. The clinical application of the model is illustrated with a brief case example.
    July 15, 2011   doi: 10.1111/j.1467-6427.2011.00561.x   open full text
  • ‘Seeking permission’: an interviewing stance for finding connection with hard to reach families.
    Percy Aggett, Mary Swainson, Dave Tapsell.
    Journal of Family Therapy. July 13, 2011
    The systemic therapy literature is dominated by clinic‐based accounts of therapy. The work of an outreach, home‐based therapy team is described, in a tradition of systemic therapies which directly seek to challenge service access constraints and social injustice. In paying careful attention to the micro‐interactions of initial contact, seeking permission is suggested as an interviewing stance for connecting with families who are not engaged with services, where there have been histories of partner violence.
    July 13, 2011   doi: 10.1111/j.1467-6427.2011.00558.x   open full text
  • Extreme Traumatization in Chile: the Experience and Treatment of Families.
    Arturo Roizblatt, Niels Biederman, Jac Brown.
    Journal of Family Therapy. June 17, 2011
    Chile entered a period of political turmoil when Dr Salvador Allende, a socialist, won the 1970 presidential election. After he was overthrown, Chile was governed by a military dictatorship that engaged in massive human rights violations. Some 30 years later, this article summarizes the psychological consequences of the traumas that victims experienced and the emotions triggered in these individuals and their families, as well as the very real difficulties they faced. This report focuses on the loss and grief that many families experienced after a family member was imprisoned and tortured or assassinated, or both. Systemic therapeutic implications of the difficulties these families faced are proposed.
    June 17, 2011   doi: 10.1111/j.1467-6427.2011.00555.x   open full text