BASIC FAMILY THERAPY SKILLS, IV: TRANSGENERATIONAL THEORIES OF FAMILY THERAPY

This pape focuses on the basic skills and compentencies of transgenerational approaches to family therapy, the fourth report of a program of research surveys by the Basic Family Therapy Skills Project. In the first survey, a panel of family therapy educators listed the most critical or basic skills or compentencies of beginning family therapist with a transgenerational orientation. In the third survey, self-selected respondents rated these items according to degree of importance for beginning family therapists. Rankings of the items according to mean scores of the Likert responses indicate that transgenerational family therapy skills are founded in theory and can be identified behaviorally. The most important skills are those that use the self of the therapist to understand and utilize transgenerational family therapy skills for both therapist and client. Also listed are skills that many raters deemed "generic" rather than specifically related to transgenerational family therapy. Other findings and their implications for the future training of family therapists are discusses. Although the paper is intended for family therapy educators interested in their colleagues' ideas about critical skills in trans-generational family therapy, theorists and clinicians may also find it useful.     

Review of outcome research on marital and family therapy in treatment for alcoholism

This review of controlled studies of marital and family therapy (MFT) in alcoholism treatment updates the earlier review by O'Farrell and Fals-Stewart (2003). We conclude that, when the alcoholic is unwilling to seek help, MFT is effective in helping the family cope better and motivating alcoholics to enter treatment. Specifically, both Al-Anon facilitation and referral and spouse coping skills training (based on new findings) help family members cope better, and CRAFT promotes treatment entry and was successfully transported to a community clinic in a new study. Once the alcoholic enters treatment, MFT, particularly behavioral couples therapy (BCT), is clearly more effective than individual treatment at increasing abstinence and improving relationship functioning. New BCT studies showed efficacy with women alcoholics and with gay and lesbian alcoholics, and BCT was successfully transported to a community clinic, a brief BCT version was tested, and BCT was adapted for family members other than spouses. Future studies should evaluate the following: MFT with couples where both members have a current alcohol problem and with minority patients, mechanisms of change, transportability of evidence-based MFT approaches to clinical practice settings, and replication of MFT outcomes of reduced partner violence and improved child functioning.     

A Contextual Therapy Framework for MFT Educators: Facilitating Trustworthy Asymmetrical Training Relationships

This article provides a conceptual framework for asymmetrical relationships between family therapy educators and trainees. Our framework is based on contextual family therapy, and we apply the concepts of trust, entitlement, self‐validation, and loyalty to training relationships. We highlight the value of educators modeling responsible uses of power in addition to teaching trainees clinical concepts and skills. We propose that training can be a process where trainers earn constructive entitlement through their interactions with trainees, who then give to future clients, supervisees, and trainees to continue the cycle of intergenerational trustworthiness. We also provide examples that illustrate the application of contextual therapy skills such as multidirected partiality, I‐Thou relating, acknowledgment, validation, and accountability to family therapy training.     

Developing Family Therapy Skills on a Shoe String Budget: A Peer Supervision and Training Approach

Family therapy skills are an essential tool when working with young children and their families, yet accessing family therapy training and supervision in workplace settings has become more difficult. Skills enhancement may be obtained through formal training in accredited courses, a costly undertaking, in which clinicians most often carry the entire cost for the training. In this paper, we propose that specific family therapy skills relevant to working with families of young children can be developed within a peer group format. The peer training described in this paper is extremely cost effective, easy to set up, specifically tailored to our unique training needs and the characteristics of the population of families we are working with. Further, the training allows us to develop fresh and creative ways of skills acquisition, our own ‘curriculum’, with flexible use of training techniques, depending on our particular needs at a given time. We conclude with some of the disadvantages of the model and propose ideas for future development.     

Integrating Family Therapy Training in a Clinical Psychology Course

Teaching family therapy to clinical psychology trainees is not common practice in Australian clinical psychology training programs. There is sparse discussion in the literature. Family therapy is an evidence based intervention that complements a diversity of established theories and psychotherapies and would complement the intervention skills of trainee clinical psychologists. The aim of this paper is to illustrate how family therapy training may be integrated into a postgraduate clinical psychology course. The literature on core family therapy knowledge, skills and training methods will form the backdrop to a review of specific family therapy training courses for clinical psychology trainees. This will then be mapped against a consideration of accreditation requirements of clinical psychology courses in Australia and suggestions made for integrating family therapy into their training curriculum. Anecdotal feedback from students provides an initial step toward evaluation.     

Cognitive-Behavioral Family Therapy with a Family in High-Conflict Divorce: A Case Study

Children who live in families with high-conflict divorce situations are increasingly coming to the attention of clinicians. This paper explains the nature of the impasse of high-conflict divorce. It presents a brief theoretical overview of cognitive-behavioral family therapy as an effective approach to treatment for high-conflict divorce families. A case study that successfully utilized a cognitive-behavioral approach to family therapy is presented. Specific techniques such as parent training, communication and empathy skills, problem-solving skills, assertiveness training, role-modeling on the part of the therapist and application of the concept of reciprocal inhibition were included in the cognitive-behavioral family treatment. An N=1 research design is graphically illustrated for evaluation purposes.     

Enrichment Role-Playing as a Step in the Training of Family Therapists

In recent years increasing attention has been devoted to the training of family therapists. This paper focuses on the difficulties inherent in such training, and the benefits provided by an alternative model based on enrichment role-playing. This technique provides a much needed step in the systemization of family therapy training. Specific benefits include: (a) an optimal environment for teaching basic relationship skills, (b) security for the student and clarity of perceptions for the supervisor, and (c) an opportunity for the trainee to learn family diagnostics. A brief review of family therapy training, marital and family enrichment, and role-playing precedes discussion of the enrichment role-playing technique. Case material is presented to illustrate the trainee's experience.     

Early-Onset Schizophrenia: A Literature Review of Empirically Based Interventions

Children presenting with early-onset schizophrenia are now diagnosed utilizing the same criteria as adults with schizophrenia. A review of the literature indicates that there is a dearth of intervention studies specific to the treatment of children diagnosed with early-onset schizophrenia, though this form of schizophrenia is considered to be more severe and chronic. Pharmacological studies specific to children are reviewed as are social skills training and family behavioral therapy studies conducted on the adult schizophrenia population which may hold potential for treating children diagnosed with early-onset schizophrenia. Recommendations for practice and research are presented.     

Culture as a barrier to rural women's entrepreneurship: experience from Zimbabwe

This article identifies the important issues addressed by programs and projects that are aimed at promoting women's equality through entrepreneurship and suggests several actions for future focus of gender programs and training. Culture was seen as a barrier to the self-confident and autonomous economic activities of women in Zimbabwe. Likewise, structural barriers such as lack of marketable skills, time and ability to travel, land and assets, education, and position as primary family providers all compounded to the problem of entrepreneurship among women. Establishment of policy approaches for women like vocational skills training augmented by training in business skills and marketing, however, are insufficient since it failed to discuss and transfer behavioral skills necessary to make one an entrepreneur. To conclude, programs must be designed to empower personal skills and self-awareness, as well as address the constraints to entrepreneurship, and macroeconomic policy change.     

Brief Family Therapy: A Critique of Kinston and Bentovim

There has been a growing interest in the use of brief family therapy with children. Despite this increased interest, research into the effectiveness of this approach appears to have lagged behind clinical practice. The present paper critically reviews a study by Kinston and Bentovim (1978) which could be viewed as typical in the area of brief family therapy. Analysis of Kinston and Bentovim's investigation revealed serious methodological deficiencies and raised some important clinical issues in brief family therapy studies. These include the importance of training in family therapy, the use of a consistent theoretical framework, and flexibility in the application of techniques. On the basis of this review, recommendations are made that future investigations of brief family therapy follow the guidelines necessary for valid psychotherapy research.     

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.     

Assessing Competencies in Couples and Family Therapy/Counseling: A Call to the Profession

Psychometrically sound measures of family therapy competencies are necessary to assess the effectiveness of training on student performance. This article critiques the self-report and observer rating measures developed to date to assess the clinical skills of trainees in the individual and in the family therapy fields. Suggestions are made to foster future instrument development specifically designed for the field of couples and family therapy/counseling.     

THE QUESTION CUBE: A MODEL FOR DEVELOPING QUESTION REPERTOIRE IN TRAINING COUPLE AND FAMILY THERAPISTS

This paper presents a three-dimensional model for teaching questioning to those wishing to develop skills in couple and family therapy. The model breaks questions into their component parts of format (the style of the question: open, closed, forced choice, rating, or ranking); orientation (the person who is being inquired about: self or other), and subject (the content of the question: behavior, feelings, beliefs, meaning, or relationship). The model is presented in the context of our post-Milan version of couple and family therapy training. The model is useful in that it allows students gradually to increase their repertoire of questions in a way that offers step-wise learning and integrates with their existing skills.     

TEACHING PROFESSIONAL WRITING TO FAMILY THERAPISTS: THREE APPROACHES

The authors present three educational approaches designed to demystify the writing process and to support better writing skills among family therapists. One framework is an academic course in professional writing, another is a writing seminar for family therapy and physician trainees within a medical school setting, and the third is a 2-hour continuing education writing workshop for family therapists. Each is replicable within a variety of settings.     

A graduate course in marriage and family enrichment

Legislation aimed at decreasing the divorce rate and the resurgence of interest in marriage and family enrichment have propelled educators to consider how well they are training new therapists in the preventive approaches to therapy. In this article, we present a graduate course to educate students about the enrichment movement and skill- and competency-based approaches to family intervention. We provide a general outline for teaching the course as well as specific resources and guidelines that can be of value to all marriage and family therapy practitioners.