Parent and Child Therapy: An Attachment‐Based Intervention for Children With Challenging Problems

Parent and Child Therapy (PACT) is an attachment‐based intervention for children aged between 4 and 12 years old experiencing emotional and behavioural problems. It is appropriate for distressed parent—child relationships which have not responded to systemic family therapy. PACT seeks to reframe parent—child relationship distress using narrative techniques and experiential tasks based on the concept of supported looking. Therapy occurs in parallel for parent and child using a one‐way screen. PACT improves parents' reflective capacity and sensitivity, and for the child's sense of security in her primary attachment relationship. An outline of the four stages of PACT is presented along with a case study to illustrate the course of PACT. Finally, we discuss the dissemination of PACT within a busy child and adolescent mental health service and outline our plans for future outcome evaluation.     

Family Therapy Retention: An Observation of First‐Session Communication

This study examined the relationship between communication patterns and retention among families (n = 18) receiving family therapy. Those that attended 12 sessions were labeled completers (n = 6), 4–8 sessions were middle dropouts (n = 6), and 1–3 sessions were early dropouts (n = 6). Audiotape recordings of the first therapy session were transcribed. The content (positive or negative) and total percentage of communications by the parent, adolescent, and therapist were coded. Completer and middle dropout parents (but not adolescents) showed higher talk time proportions than parents in the early dropout group. Completer families had higher percentages of therapist‐to‐parent communications, while early dropout families had higher percentages of therapist‐to‐adolescent communications. There were no significant differences between middle dropouts and completers in either content or total communications. These findings demonstrate the potential utility of examining within‐session communication patterns and suggest that within‐session processes may determine therapy retention.     

Training family therapists to work with children and families: a modified Delphi study

This study examined child inclusion issues and training marriage and family therapists (MFTs) to treat children. This modified Delphi study utilized a panel of experts, and gathered data through questionnaires and qualitative interviews. Panelists believe children should participate in family therapy sessions for both child and adult problems, except when parents are discussing sex or sensitive issues. Child-focused courses should emphasize developmental issues, engaging techniques, theoretical issues, play therapy theory, MFT treatment for child disorders, and specific child/family problems. Panelists suggest numerous child-focused references, but reached consensus for only one. Key therapist attributes and skills were identified. Deductive and inductive training methods and the role of supervision were highlighted. Although therapist playfulness and creativity were emphasized, few play techniques were included in the final profile.     

Beyond Behaviour — The Importance of Communication and Connection in Parenting ‘Defiant’ Children: Pilot Study and Program

Parents of children with defiant behaviour are frequently encouraged to establish clear behavioural expectations and consistency. Yet parental exhaustion, the constancy of the child's demands, and the child's push for control may compromise the success of the behavioural approach, leaving the family and therapist to search for other methods. This paper introduces parenting strategies developed as part of the ‘C Plus C — K Program’ for parents of primary school aged children (age range 5–12 years) with major behavioural problems. The program encourages parents to utilise relationship‐building parenting strategies. It is anticipated that over time, the child will develop self‐regulatory ability in situations of stress, leading to a reduction in problem behaviour. Preliminary data suggests that the program may be effective in achieving this aim. C Plus C strategies are illustrated with a fictional vignette based on common parenting situations.     

No Small Change: Process‐Oriented Play Therapy For Children of Separating Parents

This article looks at a process‐oriented play therapy for children adversely affected by parental separation. Process‐oriented play therapy is a therapeutic method that involves the therapist directly entering the ‘world of play’ with the child, by amplifying various modes of expression and helping underlying meaning to emerge, in order to help children access aspects of their life they feel they have no say in. One particular case has been used as an example, involving ‘Jim’ (pseudonym) and his mother, who attended the play therapy session.     

We Don't Need Your Help,But Will You Please Fix Our Children

A Bowen Family Systems therapist employs concepts of triangles and the family projection process to view a child's symptoms as embedded in the broader family patterns. This article will examine the dynamics of two family therapy cases where parents anxiously asked for their children's symptoms to be fixed. These cases will be used to explore the common presentation in child and adolescent mental health, where the parents are concerned for their children but are also keen not to open their own ‘can of worms’. The presenting problem in the first case was violent hostility between adolescent sisters and in the second case was an adolescent's anorexia. Drawing on client feedback, I reflect on the therapy process behind the divergent outcomes. In case one, the parents were willing to address their own troubled relationship and family of origin, while in case two, the parents discontinued therapy when family of origin dynamics began to be explored. The article suggests how the therapist can evoke parents' curiosity about their role in anxious family patterns, without them feeling blamed.     

Harnessing the Power of Play in Emotionally Focused Family Therapy With Preschool Children

Emotionally focused family therapy (EFFT) is an attachment‐based therapy model that has been used with older children and adolescents. More recently, it has been suggested for use with young children. EFFT holds promise as a clinical treatment for young children coping with attachment problems, but more detailed guidelines are needed for implementing the model with this age‐group. Whereas preschool and kindergarten age children are less able to participate in talk therapy than older children, accommodations need to be made to this approach when the identified patient is a young child. This article offers a variety of play therapy activities that may be incorporated within an EFFT framework to strengthen the emotional bonds in families with children ages four to six.     

Studying Circular Questioning “In Situ”: Discourse Analysis of A First Systemic Family Therapy Session

The present article focuses on the study of circular questioning “in situ,” that is, in the context of the discursive arena of an actual first systemic family therapy session. Two typical circular questions are selected, and discourse analysis heavily drawing from the discursive action model is deployed with the aim to highlight their function in the context of therapist and family members' problem talk. The analysis demonstrates the gradual building of two respective patterns, which both exhibit signs of shifts toward the instillment of a systemic epistemology in relation to problem talk: a shift from homogeneity to heterogeneity in family members' voices, which legitimizes the existence of different viewpoints within a system, and a shift from the construction of an accusation toward its deconstruction, which challenges the linear perception of causality underlying the accusation, thus introducing a more circular perspective. Implications are discussed in relation to contemporary, constructionist systemic family therapy practice, and reference is made to the methodological “promises” and challenges of the deployment of discourse analysis for the scrutiny of systemic family therapy therapeutic techniques and tools under a discursively informed light.     

Parenting Practices,Child Adjustment,and Family Diversity

The authors used data from Waves 1 and 2 of the National Survey of Families and Households (NSFH) to test the generality of the links between parenting practices and child outcomes for children in two age groups: 5–11 and 12–18. Parents' reports of support, monitoring, and harsh punishment were associated in the expected direction with parents' reports of children's adjustment, school grades, and behavior problems in Wave 1 and with children's reports of self‐esteem, grades, and deviance in Wave 2. With a few exceptions, parenting practices did not interact with parents' race, ethnicity, family structure, education, income, or gender in predicting child outcomes. A core of common parenting practices appears to be linked with positive outcomes for children across diverse family contexts.     

Running Away from Out‐of‐Home Care: A Multilevel Analysis

Previous research suggests that the likelihood of runaway episodes among children in out‐of‐home care varies across different communities/regions. However, the potential regional variation has rarely been reflected in attempts to understand runaway episodes in out‐of‐home care systems. The current study examines the effects of child characteristics, family characteristics and child welfare system‐related characteristics on the likelihood of runaway episodes among children in out‐of‐home care, while accounting for county‐level variations in the risk of runaway behaviours. The authors employed multilevel analyses using data on children aged 12–17 from the 2009 AFCARS database. Results demonstrate that the likelihood of runaway episodes varied across counties. Accounting for county variation, children's ages, gender, diagnosed clinical conditions, family structures, number of removals, number of placements, removal manner, and case plan goals significantly predicted runaway status. Implications are discussed.     

Commentary on Studying Circular Questioning “In Situ”

In their discursive study of circular questioning in a systemic family therapy session, the authors raise some interesting perspectives on the original Milan therapy team's guidelines for the therapist as the conductor of therapy. By emphasizing circularity from a discourse point of view, they suggest these guidelines can be used to help family members hypothesize about their own perspectives on themselves and the other family members in circular terms, and, drawing upon Cecchin's notion of neutrality, by creating a state of curiosity in their talk and maybe in their minds. Their emphasis on circularity also helps us to become more sensitive to ways in which the natural recursion in language can help us to appreciate the new guiding lines circular questions can suggest with previously spoken elements. If we follow this line of argument, then circular questions can be seen as a critical part of a therapy we can call recursive family therapy in which we use the recursive element of all natural living languages to help our clients to recursively change their language and lives naturally.     

Social Relations Model Analyses of Perceived Self‐Control and Trust in Families

How do people know which family member is trustworthy? In this study, the authors tested the hypothesis that people use their perception of a family member's self‐control as an indicator of his or her trustworthiness. Eighty‐four Dutch families consisting of 2 parents and 2 children completed questionnaires assessing each family member's trust in and perceived self‐control of the other 3 family members. This full‐family design enabled the authors to examine their hypothesis in horizontal relationships, between family members of equal status (i.e., parent–parent and sibling–sibling relationships), and vertical relationships, in which partners have unequal status (i.e., parent–child and child–parent relationships). Consistent with the hypothesis, Social Relations Model analyses showed that being perceived as having higher self‐control is related to greater trustworthiness among adults and children in the large majority of horizontal and vertical relationships (10 out of 12). These findings highlight that perceived self‐control is an important factor by which to gauge trustworthiness in families.     

Children's talk and social competence

This article reviews research on the organisation of children's talk. It outlines the range of disciplinary concerns that contribute to the study of children's talk, and focuses on a range of work which foregrounds linkages between children's talk, social interaction and wider social processes. Paying particular attention to studies in conversation analysis, the emphasis is on how talk in peer‐group and in child‐adult interaction contributes to various theoretical and practical interests in children and society.     

Towards intensive parenting? Changes in the composition and determinants of mothers' and fathers' time with children 1992–2006

Contemporary expectations of good parenting hold that focused, intensive parental attention is essential to children's development. Parental input is viewed as a key determinant in children's social, psychological and educational outcomes, with the early years particularly crucial. However, increased rates of maternal employment mean that more parents are juggling work and family commitments and have less non‐work time available to devote to children. Yet studies find that parental childcare time has increased over recent decades. In this paper, we explore the detail of this trend using data from the Australian Bureau of Statistics (ABS) Time Use Survey (TUS), 1992 and 2006. To investigate whether discourses on intensive parenting are reflected in behaviour, we examine a greater range of parent–child activities than has been undertaken to date, looking at trends in active childcare time (disaggregated into talk‐based, physical and accompanying care activities); time in childcare as a secondary activity; time spent in the company of children in leisure activities; and time spent in the company of children in total. We also investigate whether the influence of factors known to predict parental time with children (gender, education, employment status and the age of children) have changed over time. We contextualize our analyses within social and economic trends in Australia and find a compositional change in parental time, with more active childcare occurring within less overall time, which suggests more intensive, child‐centred parenting. Fathers' parent–child time, particularly in physical care, increased more than mothers' (from a much lower base), and tertiary education no longer predicts significantly higher childcare time.     

Socioeconomic Resource Environments in Biological and Alternative Family Care and Children's Cognitive Performance*

We examined social and economic resources in the environments of children involved with child protective services and their associations with children's cognitive performance. We used a national dataset of child protection investigations (children aged 6–16 at Wave 1). Using latent class analysis, we constructed profiles of the financial resources, parental education and employment, and family structure and size. We then examined within‐ and across‐time associations between resource environment profiles and children's math and reading scores and tested whether associations differed by family care type. Our latent class analysis identified four distinct family resource environments: educated middle class, single earner, large working class, and severely disadvantaged. Family resource environment profiles predicted current cognitive performance and changes in performance over time, but associations were more consistent for children in biological family care. Children who remain in home following maltreatment allegations may benefit from services that target social as well as economic resources.     

Theory and Practice of Systemic‐Dialogical Therapy

Systemic‐dialogical therapy originates from an evolution of Milan systemic therapy, through a reflection on Bakhtinian dialogue and on power and knowledge dynamics in therapeutic sessions. The model considers both emergent patterns in human interaction and the dialogical nature of human exchanges in which emotions play a relevant part. Such theoretical considerations prompted the creation of specific practices, such as emotional micro‐hypothesising, considering heteroglossia in the session, dialogue with the context, finding one's place in the relational network, and fostering relational responsibility in both therapist and clients. The practice of systemic‐dialogical therapy is illustrated by a clinical case study.     

The futility of child therapy

Summary If one takes into consideration modern communication and family systems theory, it is apparent that the therapist's effectiveness may be greatly hampered in situations where she works with the child alone in a play therapy situation. Seeing a child alone in play therapy often tends to play into the already existing double bind situations in a family. The family aims at rejecting new behavior patterns which emerge because it has adapted to the problem behavior. By seeing the child and related family members, an open therapeutic contract can be established aimed at educating and preparing the family to be more receptive to new behaviors via new means of communication. The therapist becomes the active intervening agent in the system, available to all of the members. With the therapist serving as the nurturer which the family lacked, its members learn how to be available to each other in a new way. Once nurturance occurs, the family members feel strengthened to maturate and respond differently to each other.