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.     

BASIC FAMILY THERAPY SKILLS,II: STRUCTURAL FAMILY THERAPY1

The Basic Family Therapy Skills Project has yielded empirically derived skills important for beginning family therapists. This article reports the results of ratings from the 103-member panel of experts who practice and teach Structural Family Therapy. A total of 100 competencies of Structural Family Therapy were rated in terms of importance on a 5-point Likert scale by the panel. Panelists were also given alternative responses such as “appropriate as a generic skill,”“inappropriate for beginning therapists,” and “don't understand what this means.” Rationale for the approach and results are discussed in terms of the importance of empirically based competencies for the practice of Structural Family Therapy.     

Preparing marriage and family therapy students to become employee assistance professionals*

While the number of Employee Assistance Programs (EAPs) has grown tremendously, opportunities for marriage and family therapists in EAP settings have not been adequately described. This paper addresses issues pertinent to training Marriage and Family Therapy (MFT) students to develop the skills needed to become EAP professionals. Qualifications for becoming an EAP professional are described and suggestions are made as to how these skills may be taught within the framework of an academically based MFT training program.     

ETHICAL DILEMMAS IN FAMILY THERAPY

A review of the literature in the area of ethical dilemmas facing family therapists revealed that there were a number of issues facing family therapists which are not included in the Principles for Family Therapists (1984) of the American Association for Marriage and Family Therapy. Seventy-five family therapists from across the nation responded to a questionnaire which asked what ethical dilemmas they face and how helpful the ethical guidelines are with these dilemmas. Results indicate that family therapists are encountering dilemmas which are not included in the Principles, significantly more often than those that are included. The ethical principles were found to be helpful for those ethical dilemmas attended to by the Principles.     

FAMILY THERAPISTS' RESPONSE TO AIDS: AN EXAMINATION OF ATTITUDES,KNOWLEDGE, AND CONTACT*

As the number of individuals and families impacted by AIDS continue to multiply, family therapists will increasingly be asked to become engaged in the challenge of caring for those affected. To date, little has been written in family therpy journals regarding the response of family therapists to this crisis. This paper represents an initial attempt to examine the atitudes of clinical members of the American Association for Marriage and Family Therapy toward AIDS and persons with AIDS. Included in the study are data regarding the therapists' contact with persons with AIDS, gays, and lesbians, and the impact of such contact on attitudes. Implications for future research, training, and treatment of those affected by AIDS are also provided.     

Ethical dilemmas faced by family therapists

This study explores the reactions of 202 randomly selected clinical members of the American Association for Marriage and Family Therapy (AAMFT) to a variety of ethical dilemma situations which examine what family therapists are doing in their work when confronted with these difficult situations. Eight of the issues studied have been discussed in the literature and eight are included in the AAMFT's Ethical Principles for Family Therapists (1984). In addition to showing how clinical members responded to dilemmic vignettes that reflect these dilemmas, results indicated that family therapists are facing these dilemmas, have a high rate of consensus of what they would and would not do in each situation and almost all the situations were seen as being ethically significant by the majority of respondents.     

An Empirical Assessment of the Goals of Family Therapy*

This study is an empirical assessment of the goals of family therapists. A list of goals was developed based on a theoretical clustering of the family therapy literature into the dimensions of communication, cohesion, and adaptability. Three hundred ten clinical members of the American Association for Marriage and Family Therapy (AAMFT) responded to a questionnaire about their use of these goals in family therapy. The findings indicate that the goals employed by this sample seem to reflect ideas from the literature which are not the property of any one “school” of family therapy. The goals that were rated and ranked highest included encouraging family members to relate caringly, responsibly, and creatively in negotiating their differences. Goals that were rated and ranked lowest included the more advanced or technical communication skills and some cohesion goals that may be interpreted as related to institutional aspects of family life.     

AAMFT ETHICAL CODE: "DUAL RELATIONSHIPS"

The current American Association for Marriage and Family Therapy (AAMFT) Code of Ethical Principles prohibits an apparently wide, but vaguely defined, range of nonsexual, and presumably nonromantic dual relationships between therapists and clients, supervisers, employees and students. We suggest that this extension of the dual relationship prohibition is undesirable, for a variety of reasons. The most important of these is that attempting to make relationships simple by legislation, rather than dealing with inevitable complexity, prepares students poorly for the work they must do. Instead, we propose that training and supervision include serious emphasis on relationship complexity, and issues of exploitation and power, within the therapy relationship and within the training program or supervision itself.     

An Interview with Maurizio Andolfi

This interview was completed in Rome, Italy, on June 12, 1986. Maurizio Andolfi has evolved into one of the most creative family therapists regarding the use of self and metaphorical objects in the therapy process. For readers familiar with his interview in the American Journal of Family Therapy, 1981, (9)2, and his book, Family Therapy: Interactional Family Therapy, (1979), New York: Plenum, and Behind the Family Mask, (1983), New York: Brunner/Mazel, this interview reflects some of these changes and should provide interesting reading.     

A Comparison of Seven Family Therapy Approaches

Dimensions which should be part of a family theory are developed by drawing from ‘Integrative Family Therapy’, a theory incorporating the concepts, hypotheses, and techniques of American family therapists. The family theories of seven family therapists (Minuchin, Haley, Zuk, Friedman, Speck, Boszormenyi-Nagy, Rubinstein) are described and compared with one another. Their limitations are shown and thereby the characteristics of approaches of family therapy are indicated. Their contribution to a more encompassing ‘Integrative Family Theory’ is shown.     

Trends in family therapy supervision: the past 25 years and into the future

This investigation repeats a survey of American Association for Marriage and Family Therapy (AAMFT) Approved Supervisors done in 1976 and 1986. Despite negative contemporary contextual influences, the AAMFT Approved Supervisor credential is still attractive to the same percentage of the AAMFT clinical membership as formerly and reflects in general the demographic characteristics of marriage and family therapists (MFTs) in clinical practice. Across the last quarter century there has been a steady increase in female AAMFT Approved Supervisors and those with terminal master's degrees. These and other trends are discussed with a view toward what supervision is becoming and what it needs to become.     

AAMFT Master Series tapes: an analysis of the inclusion of feminist principles into family therapy practice

Content analysis of 23 American Association for Marriage and Family Therapy Master Series tapes was used to determine how well feminist behaviors have been incorporated into "ideal" family therapy practice. Feminist behaviors were infrequent, being evident in fewer than 3% of time blocks in event sampling and 10 of 39 feminist behaviors of the Feminist Family Therapist Behavior Checklist. These eminent therapists most often dealt with empowerment of male clients and management of power differentials in the therapeutic relationship in a relatively feminist manner, but they tended to hold women responsible for family issues, endorsed traditional rather than egalitarian relationships, and overlooked how the social context affects families. Several of the therapists were blatantly sexist in their treatment of female clients, communicating disrespect of and pathologizing them. The few tapes portraying effective incorporation of feminist principles in family therapy indicate that a handful of behaviors are key to this approach.     

Student-faculty perceptions of multicultural training in accredited marriage and family therapy programs in relation to students' self-reported competence

Although the marriage and family therapy field's recent attention to multicultural issues is laudable, there appears to be little clarity on what constitutes an effective multicultural training program and the impact of the effects of such training on trainee multicultural competence. The field continues to be challenged at different levels-training, practice, research, the setting of the standards and the work of the Commission on Accreditation for Marriage and Family Therapy Education, and the goals and strategic plan of the American Association for Marriage and Family Therapy Board. This study focused on assessing the extent of multicultural integration at different levels of training and the relationship between such training and students' perception of their own multicultural competence.     

THE BASIC SKILLS EVALUATION DEVICE

The Commission on Accreditation for Marriage and Family Therapy Education (COAMFTE) requires that accredited programs evaluate trainees' clinical skills at various times during trainees' programs. The Commission does not attempt, however, to describe for programs eigher the nature of the skills nor how they are to be evaluated, leaving this to the programs to create. This paper describes the development and uses of the Basic Skills Evaluation Device (BSED). Using a published list of skills (Figley & Nelson, 1989), data from the literature, and data collected from COAMFTE accredited and candidacy programs, the authors and their colleagues developed a device for supervisors to use in evaluating beginning family therapists. Data regarding the reliability of the device presented, along with limitations and suggestions for various ways of using the device.     

AGING AND FAMILY THERAPY: PREVALENCE OF AGING ISSUES AND LATER FAMILY LIFE CONCERNS IN MARITAL AND FAMILY THERAPY LITERATURE (1986-1993)

To what extent are gerontological issues addressed in the marital and family literature? In answering this question, the authors conducted a content analysis of 873 articles published in the Journal of Marital Family Therapy, Family Process, Family Systems Medicine, and the Journal of Family Psychology during an 8-year period beginning in 1986. Only 3.2% (n = 28) of these articles contained explicit emphasis on aging issues and later life family concerns. Furthermore, there was no significant trend in the number of gerontologically focused articles published during this period. The paper describes the content of the 28 aging-focused articles, including the types of presenting problems mentioned, the relational contexts of these problems, and the types of family therapy theories represented. Included in the content analysis were the proceedings of the annual national conferences of the American Association of Marital and Family Therapy from 1986 to 1993. Only 2.3% (n = 37) of the regular conference sessions had an explicit aging focus, as did 1 of the 29 plenary sessions and 1 of the 40 Master Series® sessions. Used as a gauge of gerontological interest and awareness of late life issues, the implication of these findings is that the family therapy community is still engaged in “comming of age.”     

An Exploration of Family Therapists' Beliefs about the Ethics of Conversion Therapy: The Influence of Negative Beliefs and Clinical Competence With Lesbian,Gay, and Bisexual Clients

The majority of the literature on conversion therapy has focused on clients' experiences and rationales for seeking such therapy. This study sought to explore differences in the beliefs and clinical competence of therapists who practice and believe in the ethics of conversion therapy and those who do not. The sample for this study included 762 family therapists who were members of the American Association of Marriage and Family Therapy. Data were collected using electronic surveys that assessed participants' negative beliefs about and perceived clinical competence with lesbian, gay, and bisexual (LGB) individuals. Results indicate that those who believe in the ethics of and/or practice conversion therapy report statistically higher levels of negative beliefs about LGB individuals and lower levels of clinical competence working with LGB clients. Implications for clinical practice and organizational policy are discussed.     

DOES ACADEMIC TRAINING BACKGROUND MAKE A DIFFERENCE AMONG PRACTICING MARRIAGE AND FAMILY THERAPISTS?

Using a national sample of practicing marriage and family therapists (MFTs) and their clients, this study investigated whether academic training background is associated with differences in pracice patterns and client outcomes. Clinical members of the American Association for Marriage and Family Therapy with academic training in psychology, social work, counseling, and marriage and family therapy were compared on a wide range of clinical practice variables, and their clients were surveyed about thier satisfaction and outcomes. Results showed highly similar practice patterns and client outcomes across all four disciplinary groups. Although the findings showed little evidence for the uniqueness of academic marriage and family therapy training among experienced MFTs, they also refute the notion that therapists trained in MFT degree programs practice in unusual or inferior ways compared to MFTs trained originally in other mental health disciplines.     

Burnout among mental health professionals: special considerations for the marriage and family therapist

Burnout is a syndrome consisting of physical and emotional exhaustion resulting from negative self-concept, negative job attitudes, and loss of concern for clients. This research study explores potential predictors and prevalence of burnout among marriage and family therapists (MFTs). It evaluates the Maslach Burnout Inventory (MBI) to establish its applicability to MFTs. Our sample of 116 Clinical Members of the American Association for Marriage and Family Therapy responded to a mailed questionnaire including demographic information and the MBI. Overall, our sample reported low-to-moderate ranges of burnout. Differences were noted in degrees of burnout across job settings. Predictors of clinician burnout include hours worked per week and job setting. Factor analysis indicates that the MBI is an appropriate assessment tool for measuring burnout among MFTs. Implications for clinical practice are discussed.