Adult Exploration of Attachment Interview in Family Therapy

The Adult Exploration of Attachment Interview (AEAI) is a therapeutic interview developed by the author to assist adults to understand themselves and their relationships with others, especially with a partner, co‐parent and/or children. It is suitable for individuals and couples struggling to overcome repeated patterns of relating, helping to improve their intimate or parenting relationships through greater self and other understanding. The AEAI explores an adult's early relational learning, especially in regard to attachment needs, in order to allow change. The interview uses specific externalising language to help persons tolerate difficult memories, reduce guilt and shame and integrate their thoughts and feelings. It applies key implications of attachment theory and the approach is illustrated by examples from therapy.     

Integrating Attachment Theory into Family Therapy

Solution‐focused therapies have had only short‐term effectiveness for clients with serious problems stemming from abuse who come to our family counselling centre in Auckland, New Zealand. In seeking long‐lasting change, we have begun integrating attachment theory into the family systems therapy we have been practising. The Adult Attachment Interview (George, Kaplan, & Main, 1985) has been incorporated into a case in order to study the effectiveness of integrating attachment and family systems theories. This case illustrates how information gathered about the mother's attachment pattern can help the therapist comprehend the client's response to the present crisis, and clear a path through what can appear to be an overwhelming labyrinth of presenting issues.     

Dyadic Research in Marriage and Family Therapy: Methodological Considerations

With training that emphasizes relationship systems, marriage and family therapists are uniquely attuned to interpersonal dynamics, interdependence, and the influence of relationships on individuals’ perceptions, beliefs, and attitudes. While recent statistical advances have contributed to a proliferation of resources designed to introduce researchers to dyadic data analysis, guidelines related to the methodological aspects of dyadic research design have received less attention. Given the potential advantages of dyadic designs for examining couple and family relational and therapeutic processes, the purpose of this article is to introduce marriage and family therapy researchers to dyadic research methodology. Using examples from our own research, we discuss methodological considerations and lessons learned related to sampling, measurement, data collection, and ethics. Recommendations for future dyadic research are provided. Video Abstract     

Attachment Perspective on Marital Dissolution and Relational Family Therapy

Divorce or dissolution of a long-term intimate relationship is an event on the continuum of an individual’s experience of attachment injury that is reawakened and played out again in this process. An attachment injury means the experience of rejection and betrayal of trust at a critical time of distress when one is in need of support. By means of the case study method, the article presents a case of a female client dealing with divorce. The history of traumatic relations through a lens of attachment theory is presented, along with divorce as the reawakening of an attachment injury and its processing in a relational family therapy model.     

Some Clinical Applications of Attachment Theory in Adult Psychotherapy

This paper discusses the usefulness of attachment theory in working with adults in psychotherapy. There are four classifications of attachment status in adults: secure attachment, and three types of insecure attachment: dismissing, preoccupied, and disorganized. These categories do not conform to standard diagnostic entities. I discuss examples of the three insecure attachment categories and the likely transference and countertransference configurations that may occur in each category. These categories provide an additional way for therapists to understand and to respond to the needs of their clients.     

Family Therapy with Substance Abusers: Legal Considerations Regarding Confidentiality*

This paper explores various problems in the area of confidentiality often confronted by family therapists working with substance abusers. The scope and intent of the Federal Regulations controlling the release of all alcohol and drug abuse patient records and information are examined. Also, the rules regarding the release of confidential information by family therapists to attorneys, other family members and third-party funding sources are explained. Suggestions regarding the release of information in questionable cases are made. Finally, the growing use of family therapy in treating substance abusers, and its impact on confidentiality law and policy, is noted.     

Overview of Outcome Research in Family Therapy: Methodological Considerations1

This paper recognizes that establishing the effectiveness of therapy is important for practitioners and researchers alike, but that to date, there has generally been a failure in family therapy research to demonstrate efficacy. This is essentially due to the complexity of variables interacting in therapy and the practical realities of implementing research in the field setting which has, in turn, produced studies of poor methodology typically leading to ambiguous results and conclusions. A more rigorous approach to experimentation together with single-case methodology (which currently is under-utilized) can assist in providing clearer demonstrations of therapeutic efficacy.     

Considerations on Research in Family Therapy: An Interview with Rudolf Moos

Rudolf Moos, Professor of Psychiatry, Stanford University School of Medicine and Research Career Scientist at the Palo Alto Veterans Administration Medical Centre, is not well known to Australian and New Zealand therapy circles, yet his research into instruments applicable to research into the family and its dynamics is prolific, his personal energy, integrity and dedication are admirable and his persistence at researching the very difficult areas of social environments is unequalled. This interview was recorded at the Social Ecology Laboratory at Veteran's Administration Medical Centre at Palo Alto, where he is Director of the Laboratory.     

Clinical and Ethical Considerations for Delivering Couple and Family Therapy via Telehealth

Studies have generally supported telehealth as a feasible, effective, and safe alternative to in‐office visits. Telehealth may also be of particular benefit to couples/families interested in relational treatments, as it addresses some of the barriers that may be more prominent for families, such as childcare and scheduling difficulties. Therapists interested in expanding their practice to include telehealth should understand ethical and practical considerations of this modality. This article discusses areas unique to the delivery of telehealth to couples and families. Each broad domain is then elaborated upon with case examples from actual clinical practice and specific recommendations for addressing potential difficulties. Authors recommend further empirical research examining differences in modality outcome, as well as feasibility of the suggestions proposed here.     

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 for Disturbed Children: Some Experimental Results in Special Education*

The assumption that family attitudes play an important role in motivating children to learn is widely held. It is believed that poor family attitudes can offset the effects of the best educational program. This study employed psychotherapy to influence attitudes of families with a child in a school for the emotionally disturbed. The results indicated that family therapy improved the classroom behavior of the children as well as behavior observed by their parents at home.     

Some Constraints in the Learning of Family Therapy

It is the authors' contention that there are identifiable learning constraints for trainee family therapists that influence their rate and range of practice development. These constraints are conceptualised at three levels of abstraction: 1. Dogmas from the stone tablets; 2. Restrictive styles of practice; and 3. Unarticulated presuppositions. The relationship between these constraints is discussed in relation to learning and is presented within a student-directed framework for adult learning.     

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 Context Therapy: A Model for Family Change*

Starting where family group therapy fails, this article breaks new territory in family context therapy. Consolidating the past 14 years of his work, Dr. Bell sets forth a conceptual program and methods to meet problems that earlier forms of family therapy could not reach. Here he provides a model drawn from studies, theories, and personal experience of organizational patterns, interrelations, and change among community institutions that provide settings for family functioning. His new methods are designed to modify the family environment so as to solve family problems and promote beneficial family growth—a framework that may bring together a broad variety of existing family development approaches.     

The Core Competency Movement in Marriage and Family Therapy: Key Considerations From Other Disciplines

There is a growing movement to define competency within the field of marriage and family therapy (MFT), particularly with respect to the training of practitioners and the evaluation of clinical practice. Efforts to define competency, however, transcend the practice of MFT and much can be learned from the experiences of other disciplines. Professions such as education, law, and medicine have made strides toward addressing the complex issue of competency standards in their respective fields. This article describes some ways in which the issue of competency has been approached in other professions, as well as some common dilemmas posed by adopting a competency-based orientation, to shed light on the process of defining competency in MFT. Moreover, this article identifies some of the more useful conceptualizations, modes of pedagogy, and evaluative practices found in other professions.     

Some Implications of Training Psychiatric Nurses in Family Therapy

Psychiatric nurses were included in family therapy training, but few of them applied their new skills in their work settings. A seeming paradox was the lack of support given these trainees by the nursing administration. The situation became understandable when analyzed as a "family" problem; the nurses being members of the larger social system comprising the psychiatry department. Strategies were accordingly adopted to modify aspects of the system, and this facilitated more positive contributions by nurses as family therapists.     

Confronting Anxiety in Couple and Family Therapy Supervision: A Developmental Supervisory Model Based on Attachment Theory

Referencing relevant supervisory literature and attachment theory, this article presents a developmental couple and family therapy supervisory model that emphasises the efficacy of the supervisory relationship. Issues concerning anxiety, cognition and learning theory are addressed and phases in the supervisory process are identified and described. Cognitive, emotional and social development are linked to attachment theory and discussed in the supervisory context.