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.     

Impact of Empowerment Training on the Professional Work of Family Peer Advocates

A pilot study using a prospective design examined the impact of a collaboratively developed training model, called the Parent Empowerment Program (PEP), for professionally-employed family peer advocates who work with caregivers of children with mental health needs. This training used a combination of didactic, practice exercises, and group discussion. It targeted specific mental health knowledge content and collaborative skills to facilitate the work of family peer advocates in empowering caregivers. Co-delivered by a family peer advocate and clinician, the training consisted of a 40-hour face-to-face training, followed by six monthly face-to-face booster sessions. A total of 15 advocates participated in assessments conducted at baseline and post-training. This group of experienced family peer advocates showed no significant increase in knowledge about mental health content, but post-training assessments indicated increased collaborative skills and mental health services self-efficacy. This initial evaluation has implications for expanding training and support for the emergent workforce of professionally-employed family peer advocates in children's mental health.     

Integrative Systemic Therapy: Lessons on Collaboration and Training for the 21st Century

The field of couple, marital, and family therapy (CMFT) is at an important juncture of identity development and synthesis. Integrative Systemic Therapy (IST) is a problem‐centered metaframeworks approach that meets the growing needs of family therapists working with diverse and complex family systems and restores the field to its original focus on collaboration. This paper describes the process by which IST developed featuring anecdotes from live interviews with the founders. We briefly outline IST's theoretical pillars and the essential way IST practitioners deliver treatment including a blueprint for therapy. Finally, we propose that IST is a comprehensive, systemic guide uniquely beneficial to CMFT training and discuss our approach to integrating IST into our training of students in a COAMFTE accredited program.     

Working Therapeutically with Indian Families within a New Zealand Context

This article aims to raise awareness amongst non‐Indian therapists working with Indian people by highlighting some of the important aspects of Indian culture within the New Zealand context. Although there is a great deal of diversity amongst Indians, there are some fundamental issues that would have relevance for most Indians. Specific issues relating to immigrant families are discussed, such as the sacrifices made by families in the hope of providing a better future for their children and the difficulties encountered by new migrants. The cultural clash for young people caught between parental expectations and peer pressure can often lead to significant family conflict. Some of the common pitfalls for non‐Indian therapists working with Indian people are outlined and suggestions made in relation to the process of therapy.     

Evaluating Training to Promote Critical Thinking Skills for Determining Children’s Safety

This study examined changes in training participants’ satisfaction with the instruction, knowledge gain, transfer of new skills, and beliefs about family involvement and engagement in working with families to help ensure children have safety. One hundred and forty-five practitioners participated in the training. Findings revealed shifts in knowledge and use of certain kinds of safety and risk assessment. Qualitative training feedback revealed that caseworkers and supervisors are now talking more about their practice and how they are trying new strategies to help children and families rather than how they complete a list of procedural tasks. The combination of workshop-based training followed by agency-based coaching appears to be a promising approach to professional learning in this practice area of child welfare.     

A RATIONALE FOR FAMILY THERAPY SPECIALIZATION IN EARLY INTERVENTION

Over the past two decades, professionals providing intervention to families with children with disabilities have witnessed a philosophical shift from individually oriented care to family-centered care. Although the relevance of family therapy to these families has been formally acknowledged through the Individuals with Disabilities Education Act (IDEA), the integration of the fields of family therapy and developmental disabilities has not yet occurred to any signigicant degree. Awareness of critical issues associated with developmental disabilities and the potential impact on the family system is vital to the process of family-centered intervention. In this paper we address the need for family specialists to become knowledgeable about early intervention considerations relevant to young children with disabilities and their families.     

Cognitive-Behavioral Family Therapy with a Family in High-Conflict Divorce: A Case Study

Children who live in families with high-conflict divorce situations are increasingly coming to the attention of clinicians. This paper explains the nature of the impasse of high-conflict divorce. It presents a brief theoretical overview of cognitive-behavioral family therapy as an effective approach to treatment for high-conflict divorce families. A case study that successfully utilized a cognitive-behavioral approach to family therapy is presented. Specific techniques such as parent training, communication and empathy skills, problem-solving skills, assertiveness training, role-modeling on the part of the therapist and application of the concept of reciprocal inhibition were included in the cognitive-behavioral family treatment. An N=1 research design is graphically illustrated for evaluation purposes.     

Language as an Exclusive or Inclusive Concept: Reaching beyond the verbal

Language is a primary means by which practices of inclusion and exclusion are determined in our society. As language is also the primary medium of most narrative family therapies, the politics of our practices with regard to inclusion and exclusion require examination, particularly when working with children for whom language is neither a strength nor a preferred processing mode. In this paper, some young people showing language-based learning difficulties will be introduced. Children's experiences with oppression and colonization will then be briefly considered, followed by the particular experiences of children showing language-based learning difficulties. The interrelationship between language, social-emotional development and social competence will be considered and ways to ‘scaffold’ these children during the therapy process to facilitate their inclusion will be addressed. Throughout the discussion, the implications for narrative family therapists will be explored as we consider whether our fascination with language is wielded in inclusive or exclusive ways and whether we can competently reach beyond the verbal in our practice.     

A Child‐inclusive Family Intervention in a Community Adult Mental Health Service

In this paper we describe an intervention that focuses on the needs of children in families where a parent has a mental illness and attends a community adult mental health setting. After a brief outline of the literature, we present a family approach that includes children and young people, their parents and grandparents. Case studies then illustrate the work as a ‘best practice’ for parents who are clients in community adult mental health services.     

Questioning the Suitability of Traditional Self-Report Family Functioning Measures for Single-Parent Families with Young Children

Family functioning is a common interest of social science and health researchers. Most often, well-established self-report instruments are used to measure family functioning. Although these instruments have been used with families of diverse compositions, our experiences using one of the commonly used instruments, the McMaster Family Assessment Device (FAD), suggest that it is not appropriate for single-parent families with young children. In addition to describing the difficulties we encountered with the FAD, we discuss our experiences in relation to current research findings about the processes and effectiveness of family functioning in single-parent families. As well, we examine other frequently used self-report family functioning instruments, the results of which lead us to question the suitability of any of the commonly used self-report family functioning instruments for single-parent families with young children. We conclude by arguing for the development of family functioning instruments that are appropriate for diverse family structures and compositions.     

An Educational Model of Family Consultation*

This approach to working with families under stress recognizes the family as a system interacting via communication patterns among its own members and within a larger context of peers, neighbors, school, work, and community agencies. The goal is to help the family become a support system for all its members, more capable of meeting both adult and child needs for ongoing socialization and personal growth. The model is educational in that the focus is on teaching the family to identify strengths as well as dysfunctional behavior, and to acquire some basic communication and problem-solving skills. Methods are both cognitive and experiential. The approach is useful in short-term therapy with single families or groups of families.     

Emotionally Focused Family Therapy and Play Therapy for Young Children Whose Parents Are Divorced

ABSTRACT

Divorce is common and can pose risks to those involved. Although divorce affects all parts of the family system, young children face extraneous challenges due to their unique developmental stage and limited cognitive ability. Emotionally focused family therapy (EFFT) works to enhance attachment bonds by restructuring a family’s negative interaction cycle and can be useful for repairing relationships between parents and their children who are suffering negative effects of parental divorce. Whereas adults have the skills to express themselves verbally, young children often use imaginary play to convey their emotional experiences and unmet attachment needs. By using play therapy techniques within an EFFT framework, adults and children can better communicate their perspectives concerning difficult life events such as parental divorce.     

A Contextual Therapy Framework for MFT Educators: Facilitating Trustworthy Asymmetrical Training Relationships

This article provides a conceptual framework for asymmetrical relationships between family therapy educators and trainees. Our framework is based on contextual family therapy, and we apply the concepts of trust, entitlement, self‐validation, and loyalty to training relationships. We highlight the value of educators modeling responsible uses of power in addition to teaching trainees clinical concepts and skills. We propose that training can be a process where trainers earn constructive entitlement through their interactions with trainees, who then give to future clients, supervisees, and trainees to continue the cycle of intergenerational trustworthiness. We also provide examples that illustrate the application of contextual therapy skills such as multidirected partiality, I‐Thou relating, acknowledgment, validation, and accountability to family therapy training.     

Family‐Focused Child Therapy in Marital Separation

When marriages and long‐term relationships break down, parents may refer their children and adolescents to therapy for a variety of reasons. While the systemic therapist's preference may be to work with the family system/s, high conflict separation may prohibit such an approach. This article discusses family‐focused child therapy that prioritises the needs of children while seeking to preserve a systemic approach. At a practice level this may involve: (a) individual child therapy, (b) engaging with smaller subsystems including siblings, (c) joint therapeutic work involving child/ren plus parent/s, and (d) any of these combinations; all while continuing to maintain a systemic understanding of the work. The article discusses the challenges of working with children from separated families, where there is restricted or no possibility of engaging with the broader family system.     

HOME-BASED MARITAL THERAPY FOR MULTIPROBLEM FAMILIES*

This paper describes a project designed to reach low-income, multiproblem families, utilizing couples therapy in the home. By targeting a population of young couples under the age of 30 and with children no older than 7 years, the project aimed at prevention of severe family dysfunctioning and child disturbances. The major characteristics noted in the literature on multiproblem families are reviewed here, as are the treatment goals and techniques with such families. Most programs working with multiproblem families have focused primarily on the parental functioning in family therapy, and little has been reported on work with the couple in multiproblem families. The project described here used home visits by a male-female therapist team, including frequent individual and couple sessions. Therapeutic techniques based on modeling, role playing and demonstration were emphasized. In addition, tasks which increased the individual and couple functioning of the spouses were designed and successful completion was reinforced. An attempt was made to integrate the couple into the community and to create a network of support outside of the family, including friends and community services.     

The role of birth/previously adopted children in families choosing to adopt children with special needs.

Engaging birth/previously adopted children during the adoption process is crucial to laying the ground-work for successful placements. When families choose to adopt children with special needs, however, the role their other children will play in the adoption's success is often overlooked. This article presents a practical model that recognizes the dynamics of strength and vulnerability in adoptive families, then applies this model in preparing and supporting the family through the changes that are inevitable in special needs adoption. The model can also be used to assist adoptive parents in identifying and developing the skills they need to manage these shifts within the family.     

Achieving Competent Family Practice with Same-Sex Parents

Abstract

Due to the increasing recognition of same-sex marriage in different jurisdictions and growing numbers of parents raising children in the context of a same-sex relationship, it is becoming ever more important for family therapists to attain clinical competence in working with families headed by same-sex parents. This paper takes as its premise that good intentions and general acceptance of diversity are not sufficient in working with this population of families. Rather, clinical competence rests on experience working with lesbian and gay clients and knowledge of the impact of heterosexism on parenting in the context of same-sex relationships. Equally critical to competent family therapy practice is a theoretical framework that pulls together complementary concepts from different bodies of theory to analyze family structures and functions in the social context of heterosexism. To this end, this paper reviews family systems theory, structural social work, ecological systems theory and queer theory with an eye to culling complementary constructs relevant to working with same-sex parents. Specific aspects of family functioning such as maintenance of boundaries around and within families and role differentiation between parents are then explored using this theoretical framework. Finally, implications for the clinician working with families led by same-sex parents are reviewed.     

Training for frontline workers

This article examines the training needs of people who work directly with children and families–frontline workers. It argues that such people are working with child abuse, whether they have recognized this to be the case or not. The article outlines work that needs to be covered in training of frontline workers, in order that they can respond effectively to abused children and undertake appropriate prevention work. A range of relevant publications which can support this training are discussed.     

FAMILY THERAPY WITH INTELLECTUALLY AND CREATIVELY GIFTED CHILDREN

Few family therapists have expertise in the psychology of giftedness, and little research has been conducted to determine the effectiveness of family therapy with talented children and their families. The purposes of this paper are: (1) to provide family therapists with information on the unique psychosocial stressors associated with giftedness and (2) to stimulate further research and development on the efficacy of family therapy in alleviating distress and actualizing potential in gifted and talented children and their families. The paper provides a critical overview of the existing research literature on gifted children and their families. First, current conceptualizations of giftedness are described. Then the research literature on the characteristics of intellectually and creatively gifted children and their families is reviewed with an emphasis on the endogenous (individual) and exogenous (systemic) factors that can create or exacerbate psychosocial problems. Finally, we suggest an eclectic, eco-systemic approach to three common concerns that bring gifted children and their families to therapy.