Journal of Family Therapy最新文献

This article presents research that explored the ways that systemic and family therapists might approach the support of families living with dementia. A constructivist grounded theory methodology was used to interpret interviews with four systemic family therapists working in the United Kingdom. All participants had professional and/or lived experience of dementia. Transcript analysis and theoretical sampling led to the development of five categories, each related to different aspects of considering systemic therapy in a dementia context. These categories were further developed into a ‘systemically informed dementia orienteering’ conceptual framework, which is presented in this paper as a learning resource. Findings are related to existing literature, and recommendations for future research are made.

A total of 32% of children whose parents have some mental health problems are estimated to be diagnosed with some mental disorder later in life. As a consequence, a need arises to offer preventive psychological interventions aimed at these children. The aims were to investigate whether there are significant changes before and after the KidsTime program. In total, 101 people participated in the program, and pre-intervention and post-intervention data on self-stigma, self-esteem, resilience, parenting practices and strength and difficulties of thirty-three parents with mental illness were obtained. Significant pre-post differences were found in the ‘expression of affection’ subscale of the parenting practices and in self-stigma. In the group of parents with a mental illness, the KidsTime program showed improvement of parents' emotional support for their children and a reduction in their self-stigma as well. Multi-family interventions are key to improving self-stigma and parenting skills, and this can lead to prevention of future mental health problems in their children.

Couples raising a child diagnosed with autism spectrum condition (ASC) experience unique challenges that can affect their relationship. This grounded theory study explores how couples maintain functioning in their relationship despite ongoing stressors related to raising a child on the spectrum. The presented model shows what couples can do to create and maintain their relationship functioning. It utilises four major themes developed from our analysis of interviews with 19 couples in the United States with a child diagnosed with ASC. This study increases understanding of couple functioning when raising a child on the spectrum. The grounded theory defines couple functioning for couples with a child diagnosed with ASC as balancing four mutually influential themes: togetherness, adaptability, resilience and communication. We also discuss clinical implications for systemic therapists to work with couples with a child diagnosed with ASC effectively.

This study presents a mixed-methodology pilot study of a narrative-mantra multi-clinician group, which is an integrative systemic and mindfulness-based intervention, to promote the well-being of mental health clinicians working at a local child and adolescent mental health service in London, UK. The study also served as a nonclinical sample pilot for a narrative-mantra multi-family group trial for adolescents awaiting treatment and their parents. In total, nine clinicians participated in the study: five participants and four controls. Descriptive analyses were conducted on self-reported measures, GHQ-12 and SCORE-15. Slight improvements were found in the clinicians' mental well-being and their significant relationships. Five global themes emerged from the thematic analysis of a focus group discussion, including ‘voices that connect and liberate’ and ‘connecting ingredients for integration’.

Problematic alcohol use (PAU) has been a marginalised subject within the systemic field. The present article brings PAU into focus and discusses the conceptualisation of PAU. Reflected in the dominance of individually orientated treatment approaches, PAU is widely seen as an individual condition with aetiology and maintenance attributed to individual pathology and behaviour. Pathologising and stigmatising dominant discourses surrounding PAU also appear to perpetuate this individual conceptualisation, the implications of which are discussed in this article. The present article maintains PAU is a relational illness, with relational aetiology and maintenance, thus with relational implications for treatment. Implications for the systemic field, including clinical practice, are highlighted.

This article discusses the status and challenges related to the basic perspective of knowledge and science in systemic practice. This article points out that some parts of the field (i.e. collaborative dialogical practice) have a preference for knowledge obtained through qualitative rather than quantitative studies. This is problematised, partly based on methodology and partly on the bias this entails in the provision of knowledge to students and systemic practitioners. The consequences of such a preference may be that systemic practitioners will lack significant knowledge, and that they are not encouraged to conduct or participate in quantitative studies. This issue highlights a stronger focus on the field's basic perspectives, as well as key political, ethical and professional policies. In response, the article presents the theories of interactive constructivism and critical realism and proposes that these become the guiding paradigm for systemic practice.

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.