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.     

“Being a Therapist Doesn't Exclude You From Real Life”: Family Therapists’ Beliefs and Barriers to Political Action

A crucial and overlooked facet of social justice in family therapy is political and policy advocacy. Family therapists have unique insight into how social policies and political discourse shapes clients’ lives and the life of our profession. Such knowledge can inform policymakers and political debate, yet few family therapists are trained to engage in political action. In this randomized, national survey of licensed family therapists’ (N = 174), we explore beliefs about and barriers to engagement in political and policy processes. The findings suggest that there are significant barriers and uncertainties surrounding family therapists’ engagement, including time, feelings of efficacy, and interest. Given these barriers we discuss practical suggestions for clinicians and family therapy training programs.     

Depression,the Family,and Family Therapy

The potential contribution of family therapists to the treatment of depression remains underdeveloped. Family therapists need to articulate how changes in family functioning might benefit depressed persons, as well as how other problems in the families of depressed persons tend to go unrecognised. Furthermore, family therapists need to be alert to how undetected depression in adults and children may interfere with their ability to meet their goals with families who seek therapy for other persons. This article provides family therapists with (1) an overview of the nature and experience of depression; (2) an introduction to antidepressant medication; (3) a summary of research findings relating depression to its family context and (4) a brief overview of developments in the marital and family treatment of depression.     

Transforming an MFT program: a model for enhancing diversity

Marriage and family therapy programs need to go beyond the typical practices of recruiting and retaining students of color. Marriage and family therapy educators must assume positions of leadership by transforming graduate programs to reflect a deep, active, systemic commitment to both diversity and social justice. In this article, we argue that it is through this type of transformation that programs become truly ready to support students of color and to prepare all therapists to advocate for equity in a diverse, often unfair society. This article offers a model that addresses readiness, recruitment, retention, assessment, and professional development from this perspective.     

Cultural Issues in Therapy: On the Fringe

This paper argues that issues of culture have occupied a fringe position in the thinking and practice of most Australian family therapists. Starting with a definition of culture as epistemology, it examines factors pertaining to government policy, demography and the experience of migration to argue the relevance of a cultural perspective in mainstream family therapy discourse. The paper then looks at two central consequences for family therapy and training — cultural oppression and maintaining the status quo — if a cultural perspective continues to be neglected. It then proposes ways that therapists can introduce a cultural perspective in their thinking and clinical work. The paper concludes with a case vignette which illustrates some of the ideas.     

SYSTEMIC TREATMENT OF SUBSTANCE ABUSE: A GRADUATE COURSE

Today, family therapists should have an understanding of the development and maintenance of substance abusing patterns in families. In this paper, the authors describe a graduate course for teaching therapists about the contributions that have been made to the understanding and treatment of substance abuse by family researchers, theorists and clinicians. Course purpose, student selection, instructional methods and course content are delineated.     

Family Law and Family Systems: Multidisciplinary Training for Professionals

The Family Court in New Zealand has become the crucible for the mixing of legal and mental health professionals. Low key workshops convened by family therapists for multidisciplinary groups have made successful use of family therapy models and expertise to provide a base for the conciliation and mediation alternative to the adversary system so common in law and in earlier family litigation. Enhanced cross-disciplinary understanding and morale appear to have accompanied the more formal learnings in family therapy, and the programme as detailed is included as one possible structure on which such experiences might be offered by other therapists in other places.     

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.     

Expanding Systems Thinking: Incorporating Tools from Medical Sociology into MFT Education and Research

The field of marriage and family therapy has historically focused on dynamics within family systems, and at times the role of social and cultural factors external to the family. To date, however, little scholarship has examined how therapists themselves are embedded within a mental healthcare system. The purpose of this article is to demonstrate how structural components of the mental healthcare system shape the practice of therapy. We draw from the field of medical sociology to illustrate how three dominant structures—managed care, diagnosis, and evidence‐based models—are intertwining and mutually reinforcing systems that have significant and long‐term implications for systemic therapists and researchers. We recommend incorporating a sociological understanding of such structures into MFT education and research.     

A perfect fit: connecting family therapy skills to family business needs

The purpose of this article is to encourage family therapists to become more interested in family business practice. It does so in three ways: (a) highlighting the number of therapists already involved in family business issues; (b) showing the parallels between family business and family therapy by applying family business research findings to couples therapy; (c) discussing how family therapists already have the practice wisdom to be effective in working with family business clients. Limitations of this practice are also discussed along with suggestions for overcoming them.     

WHAT IF FAMILY THERAPY WERE A KIND OF PSYCHOTHERAPY? A READING OF THE HANDBOOK OF PSYCHOTHERAPY AND BEHAVIOR CHANGE*

Editor's Note. This piece by Grunebaum is not an “original article,” although his approach to presenting Garfield and Bergin's Handbook to a family therapy audience is certainly original; it does not meet the usual requirements as apiece for the “Connections” section of the Journal, although it certainly does forge such connections with the mental health world beyond family therapy; and it is not a typical “book review,” and thus, is appropriately described in its subtitle as a “reading,” rather than a review. It is a most creative demonstration of the fact that family therapists can learn a good deal of practical value from their colleagues who are “outside” our field.     

Attachment-based family therapy: adherence and differentiation

This study examined the fidelity of attachment-based family therapy (ABFT) for depressed adolescents. Trained observers used the therapist behavior rating scale (3rd version) to code therapist behaviors in 45 sessions of ABFT and 45 sessions each from two empirically based treatments for adolescent substance abusers: multidimensional family therapy (MDFT) and cognitive-behavioral therapy (CBT). Results indicate that ABFT therapists employed essential ABFT interventions, such as focusing on vulnerable affect, highlighting attachment-related themes, and promoting adolescent-parent reattachment through in-session enactments. In accordance with the sequential nature of the treatment, these interventions were used more extensively during the early stage of treatment, when there is a greater focus on reattachment. ABFT was perfectly discriminable from CBT, with ABFT therapists using more restructuring and reattachment interventions and CBT therapists using more signature CBT interventions, such as cognitive monitoring and homework. ABFT was also discriminable from MDFT, with ABFT therapists placing a greater emphasis on reattachment. These results suggest that ABFT is a viable and differentiated treatment. Together with prior findings supporting its efficacy, ABFT should be considered a promising new approach for working with depressed adolescents and their families.     

Systemic alliance in individual therapy: factor analysis of the ITAS-SF and the relationship with therapy outcomes and termination status

Clients providing systematic feedback to therapists via self-report measures of psychological distress and working alliance have been shown to increase therapy outcomes. However, there are few systemic-based measures that are feasible for therapists to use. Recently, Pinsof et al. (Family Process, 2008, 47, 281) developed a brief systemic alliance measure (ITAS-SF) for individual therapy. The current study tested the factor structure of this measure and examined whether the subscales related to clients' therapy outcomes and termination status (N = 570). The results demonstrated supported a 3-factor model for the ITAS-SF (as compared to the seven factors proposed by Pinsof et al.). In the first factor, content combined the goals for therapy, the tasks or methods to reach those goals and bond between the client and therapist. The second factor reflected how clients perceive the relationship with the therapist (i.e., interpersonal dimension-self/therapist), and the third factor reflected how clients perceive the alliance between their social network and the therapist (i.e., interpersonal dimension others/therapist). The two interpersonal factors were related to therapy outcome and termination status.     

Using the Therapist's Inner Conversation in Teamwork with Novice Therapists

Peter Rober's work (2005a) on the therapist’s inner conversation (TIC) has been a significant contribution to understanding the therapist's 'here and now' experience that focuses on the emergence of different voices responding to what is said in the therapy session. Frediani and Rober (2016) conducted an investigation into the experience and TIC of novice therapists concerning emotions aroused and how they deal with them during family therapy. Their research prompted us to ask how this methodology could work with recent graduates and those in the last year of their undergraduate training. This was addressed in the adolescent psychotherapy team that is part of the Equipo de Trabajo y Asesoría Sistémica (Systemic Counselling and Teamwork) (eQtasis) of the Psychology Department of the University of Chile. An important characteristic has been developing an ethics for clinical practice and generating a collaborative reflexive approach as a central aspect of the clinical training. The paper aims to promote the legitimacy of the experience of novice therapists who despite limited professional experience have many stories that connect with what is said in therapy.     

The theory,structure, and techniques for the inclusion of children in family therapy: a literature review

Many barriers prevent therapists from including young children in family therapy, despite the theoretical belief that every family member should be present. Although there is a wealth of literature describing how to include children, the information has not been compiled in a way that is easily accessible to therapists. In this article, we report the findings of an exhaustive and systematic literature review of 64 publications, published between 1972 and 1999, related to including children in family therapy. The purpose of this article is to offer therapists a succinct compilation of theoretical, structural, and practical aspects as well as a comprehensive listing of specific techniques for including children in family therapy.     

Are the Children Playing Quietly? Integrating Child Psychotherapy and Family Therapy

Over many years, family therapy training programs have not included the engagement of children under seven. John Byng-Hall wrote in 1986 that family therapists could learn about understanding young children from child psychotherapists. It has long been my practice to include young children when working with families. This article describe ways of working that include young children's play as relevant information. I hope to encourage other child psychotherapists and family therapists to find better ways of integrating skills.     

South Australia's First Family Therapist — Jeff Gerrard Remembers: An Interview

Jeff Gerrard can claim the distinction of being the first family therapist in South Australia. Early on in his career as a psychiatrist he explored the growing field of psychotherapy overseas and observed, studied, and trained with some of the historical greats in the area. When he returned to South Australia in the early 70s, it seems to have been a natural step for him to begin practising family therapy and training other health professionals in the theory and practice of family therapy. The early training that Jeff led at the South Australian Children's Hospital enabled a cooperation between a number of early family therapists, such as Michael White and Anne Sved Williams, to train the first cohort of people who would later go on to become significant contributors to the family therapy field in Australia. In this interview, Lorraine Read invites Jeff to explore his early contributions to the field and to discuss the training and supervision experiences which were/are important in his development as a family therapist.     

Family Therapy for Child and Youth Mental Health: A Scoping Literature Review

Early intervention in childhood years is an important part of successful therapies for children and adolescents living with or at risk of mental illness. Family therapy acknowledges the role of family relationships, interactions, and family systems in child and youth mental health. To explore the effectiveness and delivery of family therapy in order to inform current family therapy practice in Australian public mental health services, a scoping literature review mapped key concepts of the past 11 years of family therapy research. Current gaps were noted within the following key concepts: family therapy settings and definitions, the influence of family factors on outcomes, transparency of intervention methods, and the training of family therapists. Further research could be undertaken to address current gaps in the literature, specifically: assessment and intervention processes; typical length of time for a series of family sessions; frequency of sessions; and theoretical foundations linked with most effective outcomes, as identified by clinicians, children, and their families. This research would provide a better understanding of best practice and evidence‐based family therapy practices that work for children and their families to inform family therapy practice in Australia and beyond. This scoping literature review identified that there is a noteworthy variation in the way brief family therapy is provided, both in terms of the duration and frequency of sessions, as well as the theoretical underpinnings employed. Further research is warranted to explore different service contexts and brief versions of family therapy delivery and the outcomes for the children and their families.     

Responsive Persistence Part I: Therapist Influence in Postmodern Practice

Feminist and social constructionist developments in family therapy highlighted the importance of attending to therapist–client power relations and incorporating clients' understandings and preferences as a part of therapy. Significantly, less attention has been given to how postmodern therapists do use their power and influence. This is an important topic because it is therapists who have the major responsibility for guiding the interaction with clients and persisting in this so that change is facilitated. Therapist persistence in various forms and across dimensions of therapy process is examined to expand understanding of therapist influence in postmodern and collaborative work. An analysis of responsive persistence in a session with Karl Tomm as the therapist is presented to illustrate this conceptual framing.