Uniqueness of family therapists as family business systems consultants: a cross-disciplinary investigation

The purpose of this study is to address how the consulting approaches of family therapists working with family businesses differ from those of business consultants. The logic of analytic induction was used to analyze qualitative data from family business consultants with and without training in family therapy. Consultants were asked to respond to two vignettes: one emphasized primarily family system problems, whereas the other emphasized business problems with influencing issues at the family/business intersection. Both similarities and differences were found in reference to problem assessment, consulting goal orientation, intervention strategy focus, consultant role and function, and consulting setting preference between consultants with and without family therapy training. Results indicate that consultants of each discipline provide a unique perspective and expertise that allow them to successfully address the spectrum of issues that family firms face. Further, findings highlight the unique contribution of family therapists to an interdisciplinary consulting team.     

The wisdom of family therapists

This qualitative research study explored the ways in which family therapists (MSWs) perceive the family treatment process. A purposive sample of eight practicing clinical social workers were selected for face to face interviews which explored the workers' perceptions of the family treatment process. Findings revealed that although certain consistent themes appear to exist among family therapists, family therapy practice may well be much more idiosyncratic than commonly believed.     

The treatment of sexual problems in marital and family therapy

With the proliferation of new research data and clinical practice techniques for dealing with sexual dysfunction, many family and marital therapists whose patients express sexual complaints experience the need to integrate this knowledge into their practice. For many couples and therapists, the rapid treatment approaches to sexual difficulties are inappropriate or ineffectual, yet the current literature addresses itself to either sex therapyper se or marital therapy and rarely deals with an integration of the two. This paper presents guidelines for assessing the sexual difficulties in the context of the relationship and outlines techniques for addressing the sexual difficulties directly while maintaining a more traditional marital therapy approach.     

Ethics and family therapy: the case management of family violence*

All family therapists, and especially Milan-style systemic therapists, have been trained to take a neutral stance regarding family issues, based on a circular causality model of family interaction. Therefore, when therapists deal with family violence, their ability to perceive individual responsibility for unethical behavior is weakened or suppressed. In fact, this ability is the primary tool in developing effective treatment planning in cases of family violence: The actively physically abusive man needs to be in individual and/or group therapy, not conjoint or family therapy. The ethical judgment of the therapist is what determines the limits of family therapy.     

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.     

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.     

Integrative module-based family therapy: application and training

The field of marriage and family therapy is currently at a crossroads. The challenge for contemporary therapists is how to incorporate the wisdom of previous models with the accountability that comes from evidence-based practice. The Integrative Module-Based Family Therapy treatment model provides a formalized series of steps that clinicians can use in their case planning and implementation. It is based on nine clinically relevant modules for assessment and intervention that are consistent with current best practices and empirically supported treatments. It thus meets the need for a structured family therapy practice and training approach that is respectful of the "art" of family therapy while still adhering to the principles of the "science" of evidence-based treatment.     

Maintaining a family focus: Underlying issues and challenges

More therapists respect and support the idea of family therapy than actually practice it. Reasons have been proffered for this state, but none has considered the therapist's personhood as a variable. This paper explores the possible connection between worker's personality and tendency to underuse the family focused treatment modality. A relationship is made between the therapist's developmental experiences as a parentified child and their impact on choices for favoring less populated frameworks of treatment than family focused approaches. Areas of difficulty are identified and suggestions for assisting staff to increase family focused practice are made.     

Can a Family Therapist do Statutory Work?

Despite a clear interest in problems such as child abuse it appears that family therapists could work more extensively and constructively with statutory presentations. This paper proposes three reasons as partial explanation for the difficulty many therapists have in working with statutory cases. These reasons are: (i) a belief that social control is not the business of therapy, (ii) a belief in a particular and restrictive notion of neutrality, and (iii) a practice habit of talking less than directly to clients. The existence and persistence of these constraints to the effective provision of statutory services is related to the historical tradition which largely structures professional/client relationships. It is argued that this pattern is highly implicit in our work and can therefore act to restrict our practice and our ability to envisage alternatives.     

Action-oriented evaluation of an in-home family therapy program for families at risk for foster care placement

The purpose of this study was to conduct an action-oriented evaluation of an in-home family therapy program serving families deemed at risk for the placement of children in foster care. In this study, feedback was solicited from both clients and therapists. Results indicate "duality" associated with several aspects of in-home family therapy, including the opportunity to observe families in their own homes versus the vulnerability some families feel when therapy is conducted in-home; therapists suggesting that sufficient training is required for in-home family therapy to be effective versus clients' opinions that therapists' lived experiences are more relevant; and the importance of the therapeutic alliance versus feelings of abandonment upon termination. Implications for researchers and practitioners are discussed.     

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.     

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.     

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.     

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.     

Integrating gender on multiple levels: a conceptual model for teaching gender issues in family therapy

As the field of family therapy has evolved, there has been growing recognition as to the importance of gender in family therapy. To prepare the next generation of family therapists adequately, it is important that they recognize the many and complex ways in which gender permeates their work. In this article we present an integrative model to help educators teach family therapists about gender issues. The model examines how gender influences clinical work on multiple levels, including contextual levels such as society and the marriage and family therapy field. The model also acknowledges how gender can influence individuals, including clients, therapists, and supervisors. Finally, the model attempts to capture the complexity of how gender can impact the relational dynamics between two or more individuals.     

Re-authoring the stories we work by Situating the narrative approach in the presence of the family of therapists**

This paper evaluates the work of the narrative school of family therapy, as developed by Michael White. This is examined in relation to the field of ideas in family therapy out of which it emerged, highlighting some of the similarities and differences, The lack of acknowledgement by the narrative school of many of the commonalities shared with others is then considered. A second order perspective is taken, situating the therapist's theory in the presence of the family of therapists to examine the development of the narrative approach to theory and practice. Constructionist contributions are considered in relation to the development of an eclectic approach where the therapist adopts a multiverse of theories to draw upon in practice. Development of theory becomes then a dialogue between different lenses rather than the development of any one truth.     

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.     

What about the family in family therapy research?*

Family therapists are frequently criticised for not publishing any substantiation of the effectiveness of their therapeutic interventions. This paper discusses why clinicians do not evaluate their work through examining current recommendations for family therapy evaluation, and the effects of these recommendations on the family under study. We provide some criteria specific to the family which will assist clinicians in selecting measurement instruments to evaluate family therapy. These relate to ethics, parsimony and design features of the study. The complexity of family therapy evaluation must be addressed if more clinicians are to do evaluation.     

Deconstructing heterosexism: becoming an LGB affirmative heterosexual couple and family therapist

The purpose of this article is to propose a three-step model to help heterosexual therapists become more aware of the influence of their own heteronormative assumptions, heterosexual privileges, and heterosexual identities on the therapy process. This article also provides definitions of concepts central to the practice of affirmative therapy with lesbian, gay, and bisexual clients and strategies that therapists and clients can use to deconstruct heterosexism in the context of therapy.