The Divide Between “Evidenced‐Based” Approaches and Practitioners of Traditional Theories of Family Therapy

Evidenced‐based approaches continue to grow in the field of family therapy. However, practicing family therapists do not always embrace these approaches. In this article, we explore factors contributing to practitioners' concerns with evidence‐based treatments and suggest a broader, more clinically palatable view of evidenced‐based treatment. We also suggest how family therapy researchers, practitioners, and educators might begin to close the researcher–clinician divide in the best interest of all concerned.     

Single Mothers “Do” Family

This paper explores how single mothers both incorporate others into family life (e.g., when they ask others to care for their children) and simultaneously “do families” in a manner that holds out a vision of a “traditional” family structure. Drawing on research with White, rural single mothers, the author explores the manner in which these women both endorse their children’s attachment to other caregivers and maintain boundaries around issues of discipline and attachment vis‐à‐vis these others. The author demonstrates that single mothers are willing to share this protected realm of family life with a new man (a fiancé or cohabiting boyfriend) as they pursue the goal of what has been called the “Standard North American Family.”     

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.     

Non-Sexist “Marital” Therapy*

Certain factors limit marital therapists in dealing with individuals conflicted over and disenchanted about “traditional” marriage: 1) the therapist's gender, 2) the presence of sex-role stereotyped behaviors and expectations, and 3) the therapists own marital experience. Specific helpful experiences (working with a co-therapist of the opposite sex, examining attitudes and biases toward divorce) and therapeutic techniques (working out a schedule for sharing household tasks and childcare, restructuring the marital contract, and dealing with open companionship) are discussed. The general therapeutic goal is working toward an equal sharing of overt power, with social, economic, and political considerations and intrapsychic forces given comparable consideration.     

Child-Focused Family Therapy: Behavioural Family Therapy Versus Brief Family Therapy

We examined the effectiveness of behavioural family therapy (following the treatment agenda outlined in Fleischman, Horne and Arthur, 1983) and brief family therapy (following the procedures outlined in Fisch, Weakland and Segal, 1985), in the treatment of child psychological disorders. The parents of the 49 children referred to the outpatient unit of a children's hospital completed the Child Behavior Checklist (CBCL) (Achenbach and Edelbrock, 1983). Three scales of the CBCL were examined to assess the effectiveness of the two therapeutic approaches pre- to post-treatment. Significant pre- and post-treatment differences were found for behavioural family therapy on the Internalizing, Externalizing, and Sum T scales and for brief family therapy on the Internalizing and Sum T scales. Sum T scales represent the sum of scores across all sub-scales of the CBCL. Neither treatment was found to be more effective than the other.     

Family Therapy and the Family Doctor − 1

The author shows that the family doctor's burden of responsibility in the area of psychological dysfunction in the community is immense. Traditionally he has little training, limited knowledge, and a paucity of skills, in the areas of counselling and psychotherapy. The author argues that structural and strategic family therapy skills may be applicable to family practice and of benefit to the family doctor. A brief introductory course and subsequent feedback are described.     

Family Therapy Process in a Family Therapy Seminar

The interaction between leaders and members in a year-long family therapy seminar is systematically compared to the process that unfolds between therapist and family during the course of family therapy. A five stage developmental process common to both is postulated and described: (1) Battle for Structure, (2) Naive Enthusiasm, (3) Conflictual Frustration, (4) Task Orientation, and (5) Mutuality. The dynamic elements of each stage are analyzed and factors affecting their development are identified. It is concluded that this five stage process occurs in all similar groups, but that the content of each stage may vary widely from group to group.     

Family Therapy for the Trainee in Family Therapy*

The growth and self understanding of the therapist as a person are considered by most training centres to be a significant part of the training process. This article reports on a pilot project which provided marital and family therapy for trainees in a two-year program. Therapy was established on a contract basis and included individual, conjoint, family intergenerational and small group. Interns and family members responded favorably to the program. Supervisors found the experience enabled trainees to maintain an experiential consistency with a general systems model utilized as the core theory of the training program.     

“Family Matters”: A Systematic Review of the Evidence For Family Psychoeducation For Major Depressive Disorder

The first aim of this systematic review was to evaluate the evidence for family psychoeducation (FPE) interventions for major depressive disorder (MDD). A second aim was to compare the efficacy of different modes of delivering face‐to‐face FPE interventions. Ten studies (based on nine distinct samples) were identified comprising four single‐family studies, four multifamily studies, one single versus multifamily comparative study, and one peer‐led, mixed‐diagnosis study. Seven studies measured patient functioning and six reported positive outcomes. Six studies measured carer's well‐being and four reported positive outcomes. Results provide preliminary evidence that FPE leads to improved outcomes for patient functioning and family–carer's well‐being for persons with depression. The implications for future development and delivery of FPE interventions for MDD are discussed.     

Family Therapy for Chronic Childhood Asthma†

Family therapy has been increasingly advocated in the management of chronic severe childhood asthma. At the Adelaide Children's Hospital we are currently engaged in a trial of family therapy in chronic childhood asthma. Effectiveness of family therapy is judged with a twelve-month follow-up on reduction of symptoms, drug use, emergency physician visits and hospital admissions and on improvement in school attendance and social and family functioning compared to the previous two years experience of the treated patients and compared to a cohort of untreated patients Of similar severity. We are particularly interested in studying different patterns of conflict detouring (child centredness, triangulation and fixed coalition) and the different therapeutic strategies required.     

Case‐Based Research in Family Therapy

Traditionally, case‐based research has not been considered as scientific by many in the field due to the lack of controlled conditions and objectivity. However, case‐study material may be more effective than once believed in educating family therapists. Future implications of the role of case studies in family therapy research are considered, including the manner in which case studies might be designed to be more rigorous so that they can serve as the basis for drawing causal inferences in clinical cases, and at the same time, provide family therapists with useful information to improve their skills. A discussion section highlights the future direction of case‐based research in the family therapy literature and how it may be used as an effective learning tool.     

Getting “Bi” in the Family: Bisexual People's Disclosure Experiences

There are many similarities in gay, lesbian, and bisexual individuals' coming out experiences, but bisexual people face unique challenges. Despite this, an explicit focus on bisexual people is missing from family research. Using family systems and cultural sociological perspectives, the authors analyzed how social and cultural factors shape disclosure processes for bisexuals as they come out to multiple family members. After analyzing qualitative data from a diverse group of 45 individuals, they found that bisexual people navigate monosexist and heterosexist expectations in their family relationships. Cultural constructions of bisexuality shape the ways that bisexual people disclose their identities, including how they use language to influence family members' responses in desirable ways. Relationship status also influences bisexual people's disclosure strategies, as a romantic partner's gender is meaningful to family members' understandings of their sexual orientation. The findings highlight the importance of addressing cultural and social contexts in understanding sexual minority people's coming out processes.     

Getting Comfortable as “Fish Out of Water”: Using Qualitative Research Methods Training to Enhance the Technical Capacity of Family Therapy Trainees

This article describes a qualitative research methods training project undertaken in a COAMFTE‐accredited family therapy master’s‐level program. Graduate students were trained to collect research data for a qualitative study on the resilience of families displaced to the United States because of war and politically motivated violence in their country of origin. By involving trainees in a research project with refugees, the project was intended to address a gap in clinicians’ training, specific to the refugee population (Miller, Muzurovic, Worthington, Tipping, and Goldman, American Journal of Orthopsychiatry 2002; 72 : 341). However, the training process was also a way to increase the students’ skills at interviewing in complex situations, develop their cultural sensitivity beyond awareness, enhance their capacity for routine self‐reflection, and introduce them to basic practices of qualitative research methodology. In this article, we focus on the students’ experience of the training and discuss the potential implications of their feedback for family therapy training.     

“Beating the Odds” Versus “Changing the Odds”: Poverty,Resilience, and Family Policy

Mixed in with national data on declining poverty rates are other signs that poverty, economic hardship, and inequality continue unabated. This essay examines: (a) the scope of poverty and the growing disparity in income and wealth; (b) the consequences of poverty of adults and children; and (c) strategies for improving their resilience. It is suggested that resiliency will be enhanced more by keen attention to national economic policies than by focusing upon individual personality characteristics, family attributes, or even unique community features. Drawing on a public health analogy, a focus on prevention (through sound economic redistribution policies) could significantly strengthen families and improve their well‐being.     

Teaching Family Therapy

Family therapy is a distinctive treatment modality, differing in techniques, objectives, and problem definitions from other modalities. Integrating it into a social work curriculum poses several difficulties because of this fact. In this paper several themes in the training literature are isolated and problems associated with assisting learners to shift their practice orientation from individuals to families are discussed