The Marriage and Family Therapy Practice Research Network (MFT‐PRN): Creating a More Perfect Union Between Practice and Research

This article describes the Marriage and Family Therapy Practice Research Network (MFT‐PRN). The MFT‐PRN is designed to build a professional community based on practice‐informed research and research‐informed practice, increase the diversity of participants in MFT research, and unify researchers and clinicians. Clinics choose measures from a list that best represent their clinic needs. Clients' outcomes are assessed regularly, and therapists receive immediate graphical feedback on how clients are progressing or digressing. Data are pooled to create a large and diverse database, while improving client outcomes. We will discuss advantages of the MFT‐PRN for researchers, therapists, clients, and agencies, and provide one model that we hope will inform other collaborative clinical‐research models in the field of marriage and family therapy. Video Abstract is found in the online version of the article .     

Targeting Threats to the Therapeutic Alliance: A Primer for Marriage and Family Therapy Training

Although theory and research highlight the importance of the client–therapist relationship, marriage and family therapy (MFT) training has historically centered on specific models, consisting of proprietary language and techniques, instead of common factors like the therapeutic alliance. In this article, we begin by making an argument for explicitly focusing on the therapeutic alliance in MFT training programs. Next, we highlight common alliance threats experienced by both faculty members and student therapists. We then integrate research‐informed principles with clinical wisdom to outline specific recommendations and concrete skill‐building exercises for MFT educators and supervisors to use with their students to address these threats and advance training on the therapeutic alliance.     

Integrating research and clinical training in marriage and family therapy training programs

The future of the profession and practice of marriage and family therapy (MFT) rests with those who promote the integration of research and clinical practice. The Boulder scientist-practitioner model is useful in conceptualizing MFT training, but it is not the perfect solution. Four MFT programs (two master's and two doctoral) are featured in this article for their work in integrating research and practice. Helpful strategies presented include: Encouraging students to question the therapy process; integrating research in the curriculum and supervision; discussing the positives and negatives of empirically supported treatments; focusing on change; and developing creative classroom experiences to use within the scientist-practitioner model.     

Bridging the Clinician/Researcher Gap with Systemic Research: The Case for Process Research,Dyadic, and Sequential Analysis

In Marriage and Family Therapy (MFT), as in many clinical disciplines, concern surfaces about the clinician/researcher gap. This gap includes a lack of accessible, practical research for clinicians. MFT clinical research often borrows from the medical tradition of randomized control trials, which typically use linear methods, or follow procedures distanced from “real‐world” therapy. We review traditional research methods and their use in MFT and propose increased use of methods that are more systemic in nature and more applicable to MFTs: process research, dyadic data analysis, and sequential analysis. We will review current research employing these methods, as well as suggestions and directions for further research.     

The Research-Informed Clinician: A Guide to Training the Next-Generation MFT

The gap between clinical research and practice is a major challenge facing marriage and family therapy (MFT) training programs. Until now, the answer to bridge this gap has primarily been the Boulder Scientist-Practitioner Model. Although realistic for doctoral students, it may not be a good fit for MFT master’s students who have primarily clinical career ambitions—which we believe is a legitimate and positive career choice. The following article articulates a “research informed” perspective as opposed to the scientist-practitioner framework as a research-training model for clinically oriented MFT master’s programs. After articulating the similarities and differences between these two approaches, the authors outline 10 practical ideas to integrate research into programs that desire to remain clinical in focus, but also research informed.     

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.     

Internships for Future Faculty: Meeting the Career Goals of the Next Generation of Educators in Marriage and Family Therapy

A key component of a doctoral education in marriage and family therapy (MFT) is the completion of an internship. Virtually all MFT doctoral internships are focused on advanced clinical practice and often are located in agencies unconnected with an academic setting. This article describes an MFT doctoral internship specifically designed to foster the skills needed as a faculty member. The primary purpose of this "future faculty" internship is to expose doctoral interns to faculty life, including participation in graduate teaching, clinical supervision, research, and faculty service—while still meeting typical clinical requirements. Results of semistructured qualitative interviews with five doctoral interns associated with the site are reported. Guidelines for the development of other doctoral internships designed for future MFT faculty members are discussed.     

Integrity of the Marriage and Family Therapy Research Literature: Perceptions and Recommendations

Reports of falsification, fabrication, plagiarism, and other violations of research integrity across the sciences are on the increase. Joining with other disciplines to actively protect the integrity of the marriage and family therapy (MFT) research literature is of utmost importance to both the discipline and the future of the profession. To inform the issues raised, results are presented of an informal survey among MFT clinical members on their perceptions about the literature together with their preferences for how best to protect its integrity. This article initiates an important discussion about the honesty of MFT research.     

The Doctoral Education of Professional Marriage and Family Therapists

The professional practice of marriage and family therapy (MFT) scholarship is regulated at the master’s level in the United States. Consequently, contemporary curricular issues have largely been focused on what is to be achieved within the master’s degree, with an emphasis on clinical practice. We consider here what value may and should be added through the doctoral degree in marriage and family therapy. Doctoral programs are the developmental stage wherein we should seek to transmit the specialized knowledge and skills germane to MFT scholarship and practice in diverse settings, e.g., clinical and research intensive university, family law, health care, child development and education, child welfare, juvenile justice, faith based, and business. However, underlying this specialty education are three transcendental goals: sophistication of family systems scholarship, socialization into the profession of MFT, and cultivation of professional maturity.     

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.     

Marriage and Family Therapy Trainees' Reports of Explicit Weight Bias

Discrimination based on an individual's weight has been observed in health care, education, retail, and other public sectors (Puhl & Huer, Obesity, 17, 941, 2007). Such inequity, known as “weight bias,” generates negative short‐term and long‐term consequences for the individuals that experience it (Puhl & Brownell, Weight bias in health care settings, 2007). Past research has shown that healthcare trainees exhibit weight bias (Phelan et al., Obesity, 22, 1201, 2014; Wigton & McGaghie, Journal of General Internal Medicine, 16, 262, 2001), yet little focus is given to weight bias in marriage and family therapy (MFT) education. The purpose of this study was to survey MFT students (N = 162) to explore weight bias and how contextual factors associate with weight bias. Participants in MFT programs reported explicit weight bias, with specific contextual factors associating with more bias. Female participants reported more fear of gaining weight, and individuals who identified as overweight had higher rates of explicit weight bias. Contextual differences and implications for training programs are discussed.     

Integrative module-based family therapy: a model for training and treatment in a multidisciplinary mental health setting

Thirty years ago, leaders in psychiatry expressed hope for more interdisciplinary collaboration with family therapy. Since then marriage and family therapy (MFT) has entered the mainstream of clinical practice in psychiatry and psychology. It is mandated for training in psychiatry and psychology. We propose a model for collaboration, training, and treatment in interdisciplinary mental health settings that strives to integrate empirical bodies of knowledge in MFT, psychiatry, and psychology and to provide a usable and testable clinical approach to treatment. It can be taught to trainees with various or limited training in MFT This model delineates nine critical domains that guide treatment. Flexibility is central to this model, focusing on techniques and clinical methods based on empirically supported treatments, when available, and best-practice standards.     

THE EFFICACY AND EFFECTIVENESS OF MARITAL AND FAMILY THERAPY: A PERSPECTIVE FROM META-ANALYSIS

This article reviews the major findings from a multiproject meta-analysis of the effects of marital and family therapy (MFT). Across 163 randomized trials, MFT demonstrates moderate, statistically significant, and often clinically significant effects. No orientation is yet demonstrably superior to any other, nor is MFT superior to individual therapy. Cost effectiveness information is scant in these 163 studies, but supportive. Randomized experiments yield very different answers from nonrandomized experimental studies of the effects of MFT, calling into question whether we should mix the two in reviews. We have also found several new differences in the ways that marital therapy (MT) and family therapy (FT) studies are conducted, making them harder to compare. Finally, important questions still exist about whether any psychotherapy, including MFT, yet has sufficient information about how well research generalizes to everyday clinical practice.     

Effectiveness research in marriage and family therapy: introduction

The papers in this volume offer compelling evidence that MFT is making significant progress toward becoming an evidenced based discipline. Nonetheless, a large gap persists between research and practice, which perpetuates a false dichotomy between the art and science of treatment and has other deleterious consequences for the field. The methodological strengths of the investigations reported, which focus on clinical trials, are discussed along with concerns raised about this type of research. Several important challenges facing MFT research in the decades ahead are described. Finally, MFT education must be changed substantially to give more emphasis to the science of the discipline.     

Competency-Based Training: Objective Structured Clinical Exercises (OSCE) in Marriage and Family Therapy

The field of marriage and family therapy (MFT) has recently engaged in the process of defining core competencies for the profession. Many MFT training programs are adapting their curriculum to develop more competency-based training strategies. The Objective Structured Clinical Examination (OSCE) is widely used in the medical profession to assess clinical competence. These examinations involve using simulated clinical situations as a tool in conducting summative evaluations of trainee competence. This article describes an adaptation of the OSCE procedures for competency-based training of MFT students. Instead of using the procedures as a summative examination as is typical in medical education, this article proposes how to use them as formative exercises in the development of student competence. The development of the OSCE is discussed, including “blueprinting,” focused competencies, procedures, and feedback protocols. The article concludes with suggestions of how to continue the development of the OSCE for evaluation in MFT education.     

The scientist-practitioner model in marriage and family therapy doctoral programs: current status

We discuss the status of the scientist-practitioner model in marriage and family therapy (MFT) doctoral programs. Issues discussed include a lack of faculty research role models in doctoral programs, "farming out" the majority of research courses to other disciplines, problems with curriculum, and how the culture of MFT does not support research. We also present suggestions for improving doctoral research training. The goal is to improve the quality of research training in doctoral programs. We hope that this will help change the culture of MFT to include research as one of its primary goals and greatest assets.     

Purposes,Diversities, and Futures in MFT Doctoral Education

Doctoral education in marital and family therapy (MFT) plays a crucial role in the future of the field. In this article, I write about the purposes, diversities, and futures of MFT doctoral education from the perspective of having hired 18 full-time MFT faculty over the last 13 years. I argue that the field needs well-rounded doctoral-level academics and clinicians who have a solid understanding of the foundations of the field and have mastery around theory, clinical practice, and scholarship in order to advance the profession of Marriage and Family Therapy.     

Multiple Family Therapy Systems

This paper investigates multiple family therapy (MFT), a treatment method which includes several families in a series of sessions with the therapist(s). A brief historical development of MFT is included as well as reports of multiple family therapy groups found in the literature. The characteristics of this treatment method are delineated with special attention to the elements of change attributed to MFT and the stages of development in MFT groups. The role of the therapist and special problems in MFT are also explored. Some implications for research are outlined, indicating that MFT is lacking adequate validation as a treatment modality. Possible advantages inherent in multiple family therapy systems, which have been suggested by therapists' clinical findings, are also reported.     

Nurturing Nature: Exploring Ecological Self‐of‐the‐Therapist Issues

Much has been written about the systemic effects of families and culture on individual well‐being. Seldom discussed, however, are the systemic effects of our relationship with the larger ecological system in which all families and cultures are embedded. A case is made for the importance of nature in family therapy. Furthermore, before therapists can effectively address ecological issues in therapy, they need to address various ecological self‐of‐the‐therapist issues that will influence their clinical practice. A series of questions are asked to help guide therapists in this exploration, and practical suggestions for incorporating nature into MFT clinical practice, training, and research are made.