What Novice Family Therapists Experience During a Session… A Qualitative Study of Novice Therapists' Inner Conversations During the Session

“What do novice family therapists experience during a session with a couple or family?” This is the central question in this article. A videotape‐assisted recall procedure was used to study novice family therapists’ inner conversations. The therapists' reflections were analyzed using thematic analysis. This resulted in a coding system that distinguishes four main domains: (a) reflections concerning the self; (b) reflections about the therapy process; (c) reflections on emotions about the family members; and (d) managing the session as well as own emotions. The study furthermore revealed that during a session, novice family therapists experience strong emotions, such as self‐criticism and irritation. Both emotions may encompass dangers, as well as opportunities for the therapeutic alliance and the process.     

Clinical and Supervisory Considerations for Transgender Therapists: Implications for Working with Clients

Transgender therapists have unique and valuable perspectives into how gender organizes the therapeutic process. Currently, in the MFT field, there is discussion of the cisgender therapist's experience in the therapy room, but no known articles on the transgender therapist's experience. This article provides insight into the experiences of transgender therapists around issues of self‐disclosure, social locations of both therapist and client, and clinical supervision. Drawing from our clinical experiences as transmen, we highlight special considerations for working with cisgender, queer, and transgender clients. Implications for supervision of transgender therapists are also discussed. As more gender diverse students seek MFT training, there is an urgent need to acknowledge their perspectives. This article is a call for beginning conversations in this direction.     

Personal Reflections of A Family Therapist*

In this informal paper I discuss my personal evolution as a family therapist, developments in the field, the politics of a systems approach in conventional settings, resistances to family and marital therapy by other professionals, some still puzzling aspects of family therapy, whether family or marital therapy works and what do we mean by working, directions my own work has taken, some comments about the nature of family life, the satisfactions and frustrations and stresses of being a family therapist, some hidden agendas of family therapy practices, how one's own personal family relationships affect and are affected by this kind of work, the casualties among family and marital therapists, and, finally, whether family therapists should have family therapy for themselves and their own families.     

Systemic Therapists' Experience of Powerlessness

In this article we explore and discuss the relevance of the concept of powerlessness in systemic practice. The views and concerns of systemic trainees' groups are compared with those of experienced therapists'. We interviewed 12 experienced systemic therapists and investigated what made them feel powerless and how they dealt with it. Extracts from interviews are quoted and summarised in the text. We argue that therapists' powerlessness is a marginalised subject in the systemic approach and that open discussion about the topic would enhance therapists' self‐reflexivity and contribute to a fuller understanding of the part that power and powerlessness play in the therapeutic relationship. We consider the place of gender, culture and wider sociopolitical contexts in the experience of therapists' powerlessness. Finally we discuss the implications of our findings for systemic therapy, training and supervision.     

Factors Influencing the Degree and Pattern of Parental Involvement in Play Therapy for Sexually Abused Children

Although much has been written about the role of therapists in children's recovery from child sexual abuse, relatively little attention has been paid to the role of nonoffending parents. This study investigated the work of a team of therapists who sometimes included such parents in therapy sessions with children. The study sought to understand what factors were influencing the degree and pattern of parental involvement and to understand what effect these patterns of parental involvement were having on the process and outcomes of therapy. The study successfully identified a range of factors influencing the patterns of parental involvement, but more research will be needed to understand the effect on outcomes.     

Art,Science and Curiosity: Research and Research Methodologies in Australian Family Therapy 1979–2000

This article presents an historical analysis of the development of research and research methodologies in an Australian context. The Australian and New Zealand Journal of Family Therapy was chosen as the site of the analysis. The first section of data consists of the articles that represent themselves as ‘research’ in the period from 1979 (the journal's inception) to 2000. These texts have been analysed using bibliometric analysis. The second section of data consists of commentary articles about research in family therapy. This data has been analysed using discourse analysis. Overall, I have been interested in how family therapists have defined ‘research’; how family therapists have chosen to inquire; representations of the researcher in Australian family therapy; associations between theoretical or clinical developments and the methodologies that have been chosen for inquiries. Findings from the study reveal very limited representations of research in the journal for the period under review, and an apparent struggle for family therapists to undertake a discussion about what research actually is. Questions are raised around how this has occurred, and some ideas are presented as to how research knowledges can be included in debates around theory diversity in family therapy.     

Implementation and program evaluation of trauma-informed care training across state child advocacy centers: An exploratory study

Awareness of Trauma-Informed Care (TIC) is essential for all professionals employed at child advocacy centers (CAC). This study evaluated the effectiveness of a training program that utilized a modified version of a TIC curriculum accessible through the National Child Traumatic Stress Network (NCTSN) among CAC workers in Florida. The workers' TIC knowledge level (n = 203) was examined prior to the training, immediately thereafter, and in a 12-month follow-up. Participants in general had similar levels of TIC knowledge before the training although the knowledge level was significantly affected by race/ethnicity, years of working experience, and educational degree. The results also indicated that participants' TIC knowledge significantly increased after training, with an effect size of 0.71. This increase appeared to be universal among participants. Further, the significant increase still maintained in the 12-month follow-up test. The analysis of participants' responses to two open-ended questions suggested that most participants were satisfied with the program. It is suggested that training efforts need to be conducted frequently to ensure that CAC employees get repeated exposure to the information in order to ultimately improve the services they provide to victims.     

Marriage and Family Therapy Students’ Experience with Common Factors Training

With the increased empirical and theoretical support for common factors in the psychotherapy literature, marriage and family therapy (MFT) scholars have begun discussing the inclusion of common factors in MFT training. However, there is very little empirical research on common factors training or how to include common factors in MFT curricula. The purpose of this phenomenological study was to investigate MFT students’ experience with common factors training. Seventeen master's degree students who received training in common factors participated in the study. Data was comprised of participants’ journal reflections and focus group interviews on their experience learning about common factors and how this influenced their work with clients. Participants’ responses to the training were overwhelmingly positive and highlighted the ways in which studying common factors enhanced their confidence, understanding of MFT models, conceptual abilities, and clinical practice. Additional results and discussion about incorporating common factors in MFT training are presented     

SEXISM IN FAMILY THERAPY: DOES TRAINING IN GENDER MAKE A DIFFERENCE?

The purpose of this study was to investigate the clinical decision making of marriage and family therapists who had no training in gender compared to those who had such training, either through a separate course or by having gender issues integrated throughout the curriculum. Specifically, levels of feminism and sexism in the clinical assumptions and interventions of therapists were evaluated using clinical vignettes. Participants for this study included 150 beginning or entry-level therapists from marriage and family therapy training programs in academic settings. Of the 102 participants with some training in gender isues, 64% reported having received gender training from a faeminist perspective. contrary to expectations, a multivariate analyssis of variance revealed that training in gender issues alone did not significantly influence levels of feminism and sexism in clinical decision making. However, the levels of sexism in clinical interventions were significantly lower if therapists had received gender coursework from a feminist perspective, whether in a separate course or integrated throughout the curriculuim. These findings raise a question as to the wtility of teaching gender issues if what is taught and how it is taught are not also considered.     

Substance Use Training Experiences and Needs: Findings From a National Survey of Social Care Professionals in England

For more than 30 years there have been calls in the UK to improve training for social workers in relation to substance use. Yet very little research has explored what training practitioners have received or what their training needs are. This study sought to establish practitioners' experiences of previous training in substance use and identify their current training needs. An online survey was disseminated to 3,164 practitioners in adults' (AS) and children's (CS) social care and 12 vignette-based focus groups were also held. Of the final sample of 597, more than a third of social workers had not received any training and a further fifth only received between one and four hours. Other social care staff fared worse. Overwhelmingly, respondents said that substance use knowledge and skills were very important to their practice but their professional education had not prepared them well. They identified a number of training needs including ‘how to talk to people about substance use’ and ‘the types of intervention and treatment available’. Most social care professionals report not being adequately prepared for working with substance use, particularly basic knowledge and skills which would help them to conduct assessments and signpost people to specialist substance services.     

Producing Family Problems: Organization and Uses of the Family Perspective and Rhetoric in Family Therapy

This article applies and extends literature on the micropolitics of trouble and family rhetoric perspectives by analyzing how therapists in a family therapy agency practicing the brief model used family rhetoric in defining and responding to client problems. Family rhetoric is the use of images of family (the family perspective) to (1) persuade others to one's preferred orientation to issues of mutual concern and (2) attribute identities to one's self and others. The article focuses on how the therapists rhetorically enacted and applied the family perspective in interactions with colleagues and clients to define and remedy client troubles. In general, troubles were defined and remedied by treating them as products of clients' family systems, defined as enduring roles, relationships, and perspectives. The therapists sought to remedy client troubles by initiating changes assessed as appropriate for their troubles and family systems. The article concludes by considering some of the implications of the findings and analysis for the sociological study of human service work.     

‘Riding the Wave’: Working Systemically with Traumatised Families

This paper draws on the authors’ clinical experience as family therapists, working predominantly with families who have experienced trauma such as sexual abuse, physical abuse and neglect, to demonstrate that taking a systemic trauma‐informed approach is a powerful therapeutic modality that can facilitate positive outcomes for all family members. The paper discusses the impact of trauma on relationships, and then outlines a rationale for a trauma‐informed, systemic approach with those traumatised families who are, at times, challenged by excessively heightened behaviour and emotional dysregulation. Drawing from parenting research, it includes a discussion of the place of parent work and how this can be integrated with systemic family work. Key constraints and considerations are highlighted followed by a discussion of key interventions the authors have found useful in building a clinical framework for this work, including what is critical for the therapeutic process. While working with traumatised families is complex and challenging, offering a safe place for families to be in the presence of each other's pain and ‘ride the wave’ of emotions can be a powerful path to recovery.     

Partners in the Spiritual Dance: Learning Clients’ Steps While Minding All Our Toes

We present four case illustrations highlighting the complex interplay of therapists’ and clients’ spirituality in therapy. Complexity, in these cases, results from (a) degrees of similarity and difference, both real and perceived, between clients’ and therapists’ spiritual beliefs and practices; (b) degrees of spiritual disclosure; (c) characteristics of the therapeutic relationship; and (d) geographic and cultural influences. Practicing therapists and therapist training programs can benefit from addressing how therapist and client spirituality intersect and influence therapy, how both similarity and difference present obstacles and opportunities, and how ambiguity and assumptions can contribute to misunderstandings. We believe that both the therapist’s and the client’s spiritualities are key influences in therapy that can contribute to the frustration, and the growth, of clients and therapists alike.     

Strategies Used by Foreign‐Born Family Therapists to Connect Across Cultural Differences: A Thematic Analysis

With the growing diversity in the United States among both clinicians and clients, many therapeutic encounters are cross‐cultural, requiring providers to connect across cultural differences. Foreign‐born therapists have many areas of differences to work through. Thus, exploring how foreign‐born family therapists in the United States connect to their clients can uncover helpful strategies that all therapists can use to establish stronger cross‐cultural therapeutic connections. A thematic analysis was conducted to understand strategies 13 foreign‐born therapists used during therapeutic encounters. Four themes were identified: making therapy a human‐to‐human connection, dealing with stereotypes, what really matters, and flexibility. Findings suggest that developing a deep therapeutic connection using emotional attunement and human‐to‐human engagement is crucial for successful cross‐cultural therapy. Clinical and training implications are provided. Video Abstract     

The Impact of Family Therapists’ Adult Attachment Styles on Their Career Choice and Approach to Therapy: An Interpretive Phenomenological Analysis

Attachment theorists have highlighted the role of the therapist in providing a ‘secure base’ for therapy. This raises the question of how therapists with insecure as well as secure attachment styles manage the integration of their personal experience and their therapeutic work. This study explored the relationship between family therapists’ adult attachment styles, influences on their career choice and their approach to therapy. Participants’ (n = 11) attachment styles were previously assessed using the self-report Experiences in Close Relationship questionnaire. Three participants were assessed as having a ‘secure’ attachment style; three were ‘preoccupied’, three ‘fearful’ and two ‘dismissing’. They were interviewed about their practice and the impact of past or current relationships on their development as therapists. Interpretive Phenomenological Analysis was used to analyse the verbatim accounts into cluster of master themes and subthemes. The analysis identified two master themes: understanding one’s self and the impact of family of origin experiences, and the integration between personal experiences and therapeutic work. There were differences in responses relating to the therapists’ attachment styles. Therapists with ‘secure’ adult attachment styles were aware of their challenges and able to utilise their experiences in their practice and respond sensitively to their clients. Conversely, those with ‘insecure’ styles have difficulties in mentalisation and in using counter-transference responses in their practice. We suggest that family therapists, social workers and others engaged in therapeutic work with families should undertake an exploration of the ‘self’ of the therapist in the context of their own family relationships and adult attachment styles as part of their training and continuing professional development.     

Healing loss, ambiguity, and trauma: a community-based intervention with families of union workers missing after the 9/11 attack in New York City

A team of therapists from Minnesota and New York worked with labor union families of workers gone missing on September 11, 2001, after the attack on the World Trade Center, where they were employed. The clinical team shares what they did, what was learned, the questions raised, and preliminary evaluations about the multiple family meetings that were the major intervention. Because of the vast diversity, training of therapists and interventions for families aimed for cultural competence. The community-based approach, preferred by union families, plus family therapy using the lens of ambiguous loss are proposed as necessary additions to disaster work.