Journal of Family Therapy最新文献

In this study, we investigated the association between clients' initial outcome expectations and their subsequent perceptions of the expanded therapeutic alliance. Romantic partners (N = 252) who received at least four sessions of systemic couple therapy from thirty-one therapists from the Marriage and Family Therapy Practice Research Network (Johnson et al., 2017; www.mft-prn.net) completed an outcome expectation measure before session 1 and a therapeutic alliance measure before session 4. Results showed a strong association between expectations and alliance (r = 0.51). While fourteen per cent of the variability in session 4 alliance scores was uniquely attributable to therapists, 31.6 per cent of the variability in the expectations/alliance association was uniquely attributable to couples, with only 6.1 per cent uniquely attributable to individual clients. Taken together, these results suggest that, while some therapists are better at developing strong alliances, couple and client factors associated with expectations for therapy set the stage for how the expanded alliance develops.

Just as language is political, so too is the way we listen to people. Our listening shapes the way we witness and respond to others and the stories of life that are co-constructed in the process. Co-constructing resiliences includes returning the gaze on the political and social contexts in which harm to people takes place. In the process, we explore listening practices associated with therapeutic activism (D'Arrigo-Patrick et al., 2017) and the generative potential offered by tuning into the meanings people attribute to their responses to violence and how people do resilience in their lives offers. We will demonstrate how our work with a family has led us to think about how we can all be jointly sustained in the work by making moments and practices of resistance and resilience visible. We will explore how these practices can enhance a sense of personal agency and create experiences of vicarious resilience (Hernandez-Wolfe, 2018) that help people access more possibilities in their lives.

Notions of home are deeply rooted in how we understand our interrelational selves and where we fit in to the world around us. This qualitative research explored how young people, their families and staff on a United Kingdom (UK) psychiatric adolescent inpatient unit constructed meaning around the notion of home within the unit. Admissions on such units can range from a few days to many months, and understanding what young people, families and staff consider the unit to be – home, hospital, or something else – has significant clinical implications for both treatment and recovery. Eleven focus groups with staff, young people and families on a general adolescent inpatient unit were conducted and the data scrutinised using a discourse analysis. This research suggests that discourses around role confusion, safety and the embodiment of home, attachment relationships and the contradictory positions of home or hospital were evident for all participants. Theories such as the reciprocal nature of attachment relationships between staff and young people, iatrogenic injury and attachment ruptures between young people and parents all have a profound impact on an inpatient admission and are often unspoken and under-operationalised. Clinical recommendations are made about the need for a paradigm shift in how admissions are understood for young people, how to manage the dilemmas associated with the unit becoming a home and what the subsequent training needs of inpatient staff are.

According to the Family Domains Framework (FDF), family life consists of a movement of parents and children across four domains: exploratory, attachment, discipline/expectation and safety. Each has its own typical behaviours, ways of speaking and pacing, and each serves distinct and equally important functions for the growing child. On admission to an adolescent psychiatric unit, staff become temporary custodians of some of the domains' processes, while also working in partnership with parents. Here we outline the Family Domains Framework and describe its application in a Family-Domains-informed systemic therapy, attending to the roles of unit staff, the family therapist, parent and young person. We outline how the FDF can be used to review everyday challenges involving staff, parents and young people to generate hypotheses and ideas for alternative staff strategies. We also describe how the framework can be used to clarify the roles of unit staff and parents.

This paper describes a multi-family therapy (MFT) group for adult outpatients with obsessive-compulsive disorder and their family members. Since family accommodation (FA) is known to maintain OCD symptoms by preventing exposure and response prevention (ERP), reduction of FA is a major focus of the treatment. Furthermore, psychoeducation, conjoint ERP and (re)discovering resources and strengths of families are also important therapeutic foci of the family group. The organisation of MFT is explained and involvement of family is illustrated with clinical vignettes. Finally, some reflections about MFT are provided. On the basis of initial clinical impressions, MFT seems a promising approach. A clinical trial is currently underway.

Mother–child dyads were invited via Instagram to read 10 children's short stories together over the course of 10 weeks. Stories were read to/with the child on a self-paced, once-weekly basis in the mother's presence, on WhatsApp and Skype. Children were elementary school age, that is, 7–11 years. Analysis of interview transcriptions with mothers indicated three major themes: empathy, improved filial relations and emotion regulation of parent. Mothers emerged more empathic and aware of their emotions 3–4 weeks into the intervention, with a better understanding of and grip on themselves. They also experienced better regulation of emotion and a closer filial connection with their child over this period. Limitations of the study and guidelines for future research are also discussed.

Although attachment seems to be ‘in fashion’ when it comes to discussing mental health issues, there are few evidence-based therapy models treating attachment issues related to psychopathology. In this paper, we will briefly introduce Attachment-Based Family Therapy (ABFT) as an evidence-based intervention for depressed and suicidal adolescents, and its first-time large-scale application and implementation in a young adult inpatient care unit. We present our clinical data showing that 98% of the young adults who were proposed ABFT engage into this therapy. In our discussion we briefly describe accommodations to the young adult (YA) age and the inpatient setting and discuss hypotheses about which characteristics of young adulthood, the ABFT core interventions and the residential setting play a role in this high engagement. We discuss how adopting a shared clinical attachment-based framework as a team might broaden the impact.