Transitions to Systemic Practice for a Clinical Psychology Trainee

This article provides an individual perspective on encounters with systemic and family therapy ideas during the transition from university training to professional practice as a Clinical Psychology Registrar. Clinical psychology training provides a solid grounding in individually focussed, cognitive and behavioural models of psychotherapy. What may be less developed on entry to practice are the knowledge, procedural skills and reflective competencies needed to understand and respond to challenges in family‐based therapy and in working within complex caregiving systems. Systemic ideas can provide important resources for facilitating these transitions. Trainees may need support not only in gaining knowledge of family therapy models, but also in making a challenging ‘epistemological shift’ (Cullin, 2014) from internalised models of psychopathology to systemic ways of thinking about problems and change. Systemic concepts and support in developing a position of ‘hospitality’ (Larner, 2003) towards competing therapeutic models can also help the trainee be more effective in complex caregiving environments. This article provides examples from my learning as well as reflections on what may help trainees make the transition to professional practice and make use of systemic ideas.     

Human Sexuality Education in Marriage and Family Therapy Graduate Programs

Given the likelihood that marriage and family therapists will encounter clients with sexual concerns, it is important to know how graduate training programs are preparing future clinicians to work with this domain of life. Sixty‐nine marriage and family therapy (MFT) program directors completed an online survey to examine how sexual health education is integrated into graduate training programs. Findings indicate that while the majority of program directors value sexuality curriculum, and most programs require at least one course in this area, there are barriers to privileging sex topics in MFT graduate programs. Barriers include few MFT faculties with expertise in human sexuality and marginalized sexual health topics. Implications for training MFT graduate students and their work with future clients are discussed.     

Most and Least Meaningful Learning Experiences in Marriage and Family Therapy Education

Marriage and family therapy educators increasingly emphasize training competencies. What we know less about is what makes family therapy education meaningful to marriage and family therapy (MFT) graduate students and what does not. In this study, through an Internet survey, we explored the most and least meaningful learning experiences of 68 MFT graduate students and recent graduates of Commission on Accreditation for Marriage and Family Therapy Education—accredited programs. We used thematic analysis to identify and illustrate resulting themes, which included the importance of experiential and personal components to learning, the professor‐student alliance, tying theory to practice, and the experiences of students with their clients, among others. We discuss the implications of these findings to support family therapy education and offer tentative suggestions for formative discussions both within and across programs. Video Abstract is found in the online version of the article .     

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.     

Measuring the Effect of Sexual Health Education Training in Professionals: Structure of the Sexual Health Education for Professionals Scale (SHEPS) Among Marriage and Family Therapy Graduate Students

Marriage and family therapists and sexual health therapists are likely to receive training in graduate school that prepares them to encounter sexual concerns among clients, but there are few standard ways to assess the efficacy of this training. The Sexual Health Education for Professionals Scale (SHEPS) was developed to address this deficit. In this preliminary study, 163 marriage and family therapy graduate students completed the SHEPS prior to starting a graduate course in assessing and treating sexual concerns. Exploratory factor analyses indicate that the SHEPS subscales have good psychometric properties. The Skills and Knowledge subscales have factors labeled Typical Clients, Special Clients, Conservative Clients, and Ethically Complicated Clients. The Attitudes subscale had factors called General Sexual Attitudes, Valuing Sexual Health Training, Open to Providing Sexual Help, and Conservatism. This new instrument may be used to assess education and training of sexual health and marriage and family therapists. Larger sample sizes and longitudinal studies are needed in future.     

Creating Synergy in Practice: Promoting Complementarity Between Evidence-Based and Postmodern Approaches

Postmodern and evidence-based practice (EBP) are compared and contrasted with the primary aim of adapting evidence-based practice with a more flexible epistemological lens. We begin by reviewing the epistemological underpinnings of postmodern and EBP within the field of marriage and family therapy (MFT). We next discuss how these contrasting philosophies inform therapists’ traits and practice in the context of translational research and practice-based evidence. Finally, we point toward some promising directions for a flexible adaptation of evidence-based practice in which both modern and postmodern clinicians can practice, and ways to incorporate some of these more flexible principles into the clinical training of MFT students.     

Social Work Student Learning Experiences of Family Therapy: Improving Competency in Pedagogy Through Qualitative Research

The purpose of this qualitative study is to evaluate graduate social work student experiences of pedagogy intended to improve competency in family therapy practice. Students from two classes (N = 37) completed open‐ended surveys assessing: perceptions of most helpful pedagogical practices; understanding of needed competencies; and perceived opportunities offered to them during their graduate training for learning about work with couples and families. Results, analysed using grounded theory methodology, revealed that students: (1) believed that experiential activities were especially critical for learning how to do clinical practice with couples and families; (2) understood important competencies related to professional development, therapeutic engagement with the family, and how to approach family practice; and (3) believed they were ‘somewhat prepared’ for practice. Implications include improving understanding of abstract skills in practice with couples and families, and emphasising relationship dynamics more in graduate social work education and training.     

A FAMILY THERAPY INTERNSHIP IN A MULTIDISCIPLINARY HEALTHCARE SETTING: TRAINEES' AND SUPERVISOR'S REFLECTIONS

Family therapy doctoral students from American Association for Marriage and Family Therapy-accredited programs are required to complete a full-time clinical internship. The literature provides little information about these internship experiences. Two doctoral-level marriage and family therapists summarize their professional and personal experiences in their internships located within a multidisciplinary healthcare setting. In addition, their supervisor reports on her experiences working with marriage and family therapy doctoral interns. We hope that this case report will stimulate all interns and their supervisors to provide feedback to their internship sites and graduate programs about their clinical training and the extent to which the programs prepared them for their marriage and family therapy careers in the larger health and mental health community.     

Social Class in Family Therapy Education: Experiences of Low SES Students

In this article, we report the results of a national survey of students in COAMFTE‐accredited family therapy programs who self‐identify as coming from lower‐ or working‐class backgrounds. Results of the study reveal opportunity and tension relative to family, friends, and community because of social mobility associated with graduate education. Participants describe family therapy education as middle‐class centered, pointing to lack of attention to social class, marginalization, classism, and unacknowledged class barriers as salient experiences in their graduate programs. Finally, participants share a number of suggestions for program improvement.     

Top 10 reasons to take your graduate program in psychiatric nursing online

1. Removing barriers to graduate psychiatric nursing education is possible by delivering courses via the Internet. 2. The Internet is full of valuable resources for graduate psychiatric nursing education. 3. Successful online learning environments involve a paradigm shift on the part of faculty from traditional teaching to facilitating the learning of adult students. 4. Increasing the number of advanced practice psychiatric nurses through Web-based education will transform the delivery of mental health care.     

The Digital Divide: Couple and Family Therapy Programs’ Integration of Teletherapy Training and Education

The mental health field is increasingly integrating and growing a teletherapy presence, and couple and family therapists are uniquely situated to offer these services based on our history of innovative approaches to therapeutic services. To do so successfully, careful consideration of training and education must occur. To evaluate current teletherapy training and education opportunities of COAMFTE accredited couple, marriage, and family therapy programs, an inductive qualitative content analysis was conducted on the responses of 95 faculty at COAMFTE accredited programs. Findings indicate that more than two thirds of the participants were in favor of teletherapy integration in training programs; however, most programs currently do not offer such opportunities. Barriers that prevent such integration were highlighted as well as existing concerns to training graduate students in teletherapy. Implications for training programs, policies, and regulations are discussed.     

CURRICULUM CHANGES TO MEET CHALLENGES: PREPARING MFT STUDENTS FOR MANAGED CARE SETTINGS

Fledgling therapists who graduate from family therapy traning programs will have to navigate the world of managed care. In this article, faculty of University of San Diego share changes in its accredited training program that prepare students for practice in an increasingly multidisciplinary world where health maintenence organizations and other versions of managed care predominate. The paper touches on contextual issues, provides a detailed outline of coursework presenting basic knowledge and skills involved in clinical pracice in a managed care environment, and comments on clinical placements and the challenge of helping the next generation of clinicans "fit" into the future of health care delivery while maintaining their unique identity as family therapists.     

Transformative learning through international immersion: building multicultural competence in family therapy and counseling

This study explores the experiences of graduate students who completed one of two international courses facilitated by family therapy faculty in a U.S. master's-level counseling psychology department. Participants reported that international courses were personally and professionally transformative. Spending time in a foreign country gave them opportunities to learn from cultural differences, ultimately increasing the social and global awareness required for multicultural sensitivity. Experiential learning, reflection, and dialogue resulted in raised critical consciousness among participants. In this article, we discuss the transformational learning processes embedded in international courses and the potential benefits of these experiences on the development of multicultural sensitivity in family therapists and counselors in training.     

BUCKLEY'S SCHEME OF SCHEMES AS A FOUNDATION FOR TEACHING FAMILY SYSTEMS THEORY

In recent training literature, a consistent recommendation emerges concerning the need for an emphasis on the development of a strong system theory base upon which future practitioners and researchers can build. This paper advocates the use of Buckley's hierarchical scheme as a teaching tool to provide an understandable, yet broadly applicable, theory base for graduate students in an introductory family therapy course. A method of teaching Buckley's scheme is outlined that not only incorporates the recommendations of the literature, but also provides an umbrella model of systems for future application and theory building.     

A qualitative study of intimate partner violence universal screening by family therapy interns: implications for practice, research, training, and supervision

Although a few family therapy researchers and clinicians have urged universal screening for intimate partner violence (IPV), how screening is implemented-and, in particular, client and therapist response to screening-is vaguely defined and largely untested. This qualitative study examined the dilemmas experienced by couples and family therapy interns when implementing universal screening for IPV in an outpatient clinic setting. Twenty-two graduate students in a COAMFTE-accredited program were interviewed using qualitative research methods grounded in phenomenology. Three domains, 7 main themes, and 26 subthemes were identified. The three domains that emerged in this study include (a) therapist practice of universal screening, (b) client response to universal screening, and (c) therapist response to universal screening. Implications for practice, research, training, and supervision are discussed.     

Factors influencing student selection of marriage and family therapy graduate programs

To understand which factors students consider most important in choosing a marriage and family therapy (MFT) graduate program and how programs met or did not meet these expectations of students over the course of graduate study, we conducted an online mixed-method investigation. One hundred twelve graduate students in Commission on Accreditation for Marriage and Family Therapy Education-accredited programs responded to an online survey assessing what factors led them to select a specific graduate program in MFT. In the quantitative portion, students ranked each factor (personal fit, faculty, funding, research, clinical work, and teaching) as well as characteristics of each factor in relation to its importance in their selection of an MFT program. Additionally, students indicated to what level their programs meet their expectations. In the qualitative portion, students described how they believed their chosen program was or was not meeting their expectations. Both doctoral and master's students ranked personal fit as the top factor affecting their choice of graduate program in MFT, but they differed on the characteristics of each of these factors and their importance in selecting an MFT program. Implications for this research include program evaluation and program advertising, and are consistent with the scientist-practitioner model.     

Transforming an MFT program: a model for enhancing diversity

Marriage and family therapy programs need to go beyond the typical practices of recruiting and retaining students of color. Marriage and family therapy educators must assume positions of leadership by transforming graduate programs to reflect a deep, active, systemic commitment to both diversity and social justice. In this article, we argue that it is through this type of transformation that programs become truly ready to support students of color and to prepare all therapists to advocate for equity in a diverse, often unfair society. This article offers a model that addresses readiness, recruitment, retention, assessment, and professional development from this perspective.     

Sociology as a vocation: Reputations and group cultures in graduate school

Graduate training in sociology involves more than meeting organizationally imposed demands such as satisfying departmental requirements, taking exams, and completing a dissertation. More central is the development of identity through institutional and interactional forces. We examine the experience of graduate students as tied to the social psychological processes associated with professional training. We consider the faculty-student relationship, identifying how student identities as future sociologists are negotiated and constructed within a reputation market linked to status politics. Through this process, graduate students construct frames of interpretation that make sense of a status system in which criteria for evaluation are often variable, uncertain, or undisclosed. To recognize how graduate students fit into their occupational routines, we build upon three core disciplinary constructs: identity, reputation, and group culture. This perspective permits graduate education to be grounded in sociological understandings, underlining the role of a sociological imagination. We propose strategies that sociology departments might follow to facilitate the professional socialization of graduate students, emphasizing the establishment of group culture and presentational norms. In the absence of these changes, we offer advice to graduate students on navigating their current programs.