The use of theory in family therapy research: a content analysis of family therapy journals

Ninety-five studies from Family Process and Journal of Marital and Family Therapy were evaluated with regard to their use of theory. While a majority of the articles were judged to use theory in either an explicit or an implicit manner, 42% did not appear to draw on theory in either the introductory or discussion sections. Studies that used qualitative methods appeared to use theory more frequently and explicitly than those using quantitative methods alone. Systems theory was found to be the most common conceptual framework, followed by feminism. We conclude that the link between theory and research in family therapy needs strengthening and suggest that the role of theory in family therapy be reexamined.     

The use of color-coded genograms in family therapy

A variable color-coding system has been added to the standard family genogram. Characteristics or issues associated with a particular presenting problem or for a particular family are arbitrarily assigned a color. The family is then asked to mark each family member with the colors that represent characteristics that fit. Advantages of the color-coding are presented, followed by clinical examples of the color-coding as an assessment tool and as a family task during treatment.     

Three perspectives on clients' experiences of the therapeutic alliance: a discovery-oriented investigation

To deepen our understanding of the therapeutic alliance in conjoint treatment, we interviewed clients in four families about their individual, private experience of the alliance after an early session. These qualitative data were triangulated with family members' scores on Pinsof's Family Therapy Alliance Scale-Revised and observational ratings of their behavior on the System for Observing Family Therapy Alliances. This discovery-oriented investigation focused on three interrelated aspects of the alliance: the family's shared sense of purpose about the needs, goals, and value of therapy (i.e., within-system alliance), split alliances with the therapist, and felt sense of safety within the therapeutic context. Results were highly consistent across the three perspectives and congruent with idiographic, therapist-rated outcomes.     

Walk-in Together: A pilot study of a walk-in online family therapy intervention

Many Australians are requiring mental health care, including families, leading to long wait times in order to access support. Walk-in therapy reduces barriers to mental health support services by providing support at the time that families seek help. This paper presents a proof-of-concept study investigating the acceptability and short-term effectiveness of an online walk-in family therapy service, Walk-in Together (WIT). Part 1 of the paper describes the experiences of 44 family members from 22 families who presented to a public family therapy clinic for a virtual walk-in family therapy session. The session was conducted by a team of three experienced family therapists. Family members' experiences were sought pre-session, post-session, and at 6 weeks follow-up via survey and interview. Part 2 of the paper explores therapist perceptions (n = 7) of the WIT approach, through thematic analysis of semi-structured interview data. Post-session feedback showed 85% of family members found WIT to be helpful and 50% were optimistic about their future as a family after their WIT session. Six weeks post-session it was revealed that WIT supported planning for families in equipping them to move forward with 88% of family members reporting that they knew what to do after the session. All therapists uniformly experienced the model as offering a timely and beneficial service, suitable for diverse presentations and constellations of families. These preliminary results suggest the significant utility of this WIT intervention as a well-received and helpful service for families, who valued the easy access and rapid therapeutic response afforded by the online, walk-in delivery model. This proof-of-concept paper suggests the potential for further development and growth of WIT, as well as other mental health support services using a walk-in, telehealth model to meet the rising demand for therapeutic support for families in distress.     

Spiritual issues in family therapy: a graduate-level course

With the advent of the biopsychosocial approach in family therapy, the domain of spiritual issues is increasingly being recognized as important to families. This article will describe a graduate-level seminar on Spiritual Issues in Family Therapy at the University of San Diego that offers family therapy students the opportunity to examine issues of spirituality, religion, and meaning and their place in therapy. One premise of the course is that research has demonstrated that most clients consider their spiritual life to be relevant to personal problems and would prefer a therapist who is comfortable with such topics. The goals of the course include (1) training in opening a dialogue with individuals and families about spiritual issues and discerning when referral may be appropriate; (2) expanding an awareness of wisdom traditions through use of comparative religions material; and (3) identifying from current practice many of the spiritual issues that may arise in the clinical setting.     

Characteristics of effective providers of marital and family therapy in rural mental health settings

Characteristics of effective providers of marital and family therapy (MFT) in rural mental health settings were investigated. The survey sample included 74 members of the National Association for Rural Mental Health who, through a modified Delphi process, created a composite picture of effective MFT providers. The findings yielded six major rank-ordered characteristics of effective MFT providers in rural mental health settings, with effective skills in MFT ranked first. Rural community understanding, appreciation and participation ranked second. Specific competencies contributing to each major characteristic were also identified and are discussed. Recommendations for use of this information are provided.     

The spiritual genogram in family therapy

Spiritual and religious issues often surface during marital and family therapy. In this article, I describe a spiritual genogram that is a multigenerational map of family members' religious and spiritual affiliations, events, and conflicts. Used as a tool in family therapy, the spiritual genogram enables clients to make sense of their families' religious/spiritual heritage and to explore the ways in which their experiences impact present couple or family issues.     

Considering justice: an exploratory study of family therapy with adolescents

Feminist approaches to therapy with adolescents emphasize an empowering focus on the strengths of adolescents while simultaneously insisting that therapists become aware of their own biases toward today's adolescents. However, a review of the family therapy literature finds little mention of feminist approaches for addressing injustices (e.g., family scapegoating, negative societal views of adolescents, and gender oppression) that arise in family therapy with adolescents. Therefore, this study explores clinical approaches and resources suggested by a surveyed group of self-identified feminist family therapists. In addition, we also recommend several approaches and resources that will aid family therapists in creating a more just climate for family therapy with youth.     

Internal family systems therapy for children in family therapy

This article presents a developmentally supported implementation of Internal Family Systems Therapy for school-age children and their families. Relevant developmental characteristics of children are described. Suggestions for working with parents, child-oriented interventions, and a case example are presented.     

The effectiveness of couple therapy in Germany: a replication study

The utility of couple therapy has been investigated in a number of controlled clinical efficacy investigations, demonstrating the superiority of most forms of couple therapy relative to control groups. Despite its widespread use, the effectiveness of couple therapy in field settings is largely unknown. In 1997, Hahlweg and Klann published an effectiveness study of couple therapy as practiced in German and Austrian marital counseling agencies. The purpose of the current investigation was to replicate their earlier findings in a similar setting with identical measures. The findings demonstrate that the results are remarkably similar across the two studies and that couple therapy in these applied settings helps to alleviate relationship distress as well as individuals' depression.     

The Power Equity Guide: attending to gender in family therapy

In the past two decades, feminist scholars have challenged the field of family therapy to incorporate the organizing principle of gender in its theory, practice, and training. In this paper, we introduce a training, research, and therapeutic tool that provides guidance for addressing or observing gender and power differentials in the practice of family therapy. As a training tool, the Power Equity Guide helps trainees to translate their theoretical understanding of feminist principles into specific behaviors in therapy. Researchers and supervisors can use the Power Equity Guide to evaluate the practice of gender-informed family therapy. We also provide specific suggestions for its use by trainers, supervisors, therapists, and researchers.     

Qualitative research in family therapy: a substantive and methodological review

Over the last decade, marriage and family therapy (MFT) researchers have developed a growing interest in qualitative research. In this article, we review substantive and methodological trends in the published qualitative studies within the MFT field. The research is compared and contrasted in the following areas: General topic, epistemological theory, methodological theory, sampling and sample, data collection, data analysis procedure, and approach to reliability and validity. We also provide recommendations for future research.     

Qualitative evaluation of family therapy programs: a participatory approach

In this article, we provide examples of participatory qualitative evaluation methods that can be used within family therapy training programs. These methods can elicit useful feedback to improve programs and, at the same time, empower trainees to become partners in the evaluation process.     

The core variables of symbolic-experiential therapy: a qualitative study

Symbolic-experiential therapists have been criticized for not adequately operationalizing symbolic theory and empirically validating their methods. Although pioneering researchers have noted that the task of studying and evaluating humanistic therapies is complex, we agree that all therapists need to be held accountable for their interventions. In this article we identify the core variables underlying symbolic-experiential therapy that emerged from a research study using grounded theory. The inductively derived conceptual framework for symbolic-experiential therapy included: (a) Generating an interpersonal set; (b) creating a suprasystem; (c) stimulating a symbolic context; (d) activating stress within the system; (e) creating symbolic experience; and (f) moving out of the system.     

Selfobject functions of the family: Implications for family therapy

The application of Self-Psychology theory to family functioning adds to our models of understanding and intervention in family therapy. This article develops a theory of the family as a supraordinate selfobject and explores diverse clinical applications of the theory. The family as a selfobject matrix enhances the self development of the child by the provision of continuity through the maintenance of proximity over time, and by an enhanced quality and quantity of selfobject responsiveness for the individual. This application of Self Psychology theory has wide implications for family therapy with children in foster care, family therapy with elderly couples coping with dementia in one spouse, and family therapy as a component of treatment with suicidal adolescents.