Journal of Family Therapy最新文献

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.

Using a combination of macro- and micro-analytic approaches in discourse analysis, this article examines transcripts from three initial sessions of DVD-recorded conjoint couple therapy with an intercultural couple. We analyse the strategies of power employed by therapy participants to promote their preferred construction of the referral problem. Focusing on the intersections of gender, psychopathology and culture, we explore how wider sociocultural discourses play out in the micro-context of participants' discursive exchanges. We also consider how the therapist's interventions privilege and marginalise client discourses in both strategic and unintended ways. This article offers some clinical techniques to address the dilemmas and difficulties identified in our analysis. We conclude by underscoring the value of reviewing recordings and transcripts of therapy dialogues to enhance cultural reflexivity.

The effectiveness of intense specialised multi-family therapy (ISMFT) for 111 multi-stressed families, and the therapeutic alliance as a possible predictor of outcome, were examined. A repeated measures design was used, where changes in all ISMFT phases (preparation, multi-family therapy and follow-up) were assessed and compared for both mothers and fathers. Evidence was found for improved family functioning after the therapy period, which was maintained at 3 months follow-up, although the multi-stressed families still functioned in the problematic range. The therapy did however not decrease parenting stress, or did so only temporarily. Observations of the therapeutic alliance with the System for Observing Family Therapy Alliances (SOFTA) scales indicated that high therapist engagement was related to positive therapy outcomes, both at the start of therapy and later. High family engagement also predicted therapy effectiveness, but only at the start of therapy. The present study shows that solution-focused multi-family therapy at least seems to provide the first step in alleviating problems in multi-stressed families.

A systemic approach to child and adolescent psychiatry involves not only the immediate family but also the wider environment in which the subject lives. Despite growing evidence confirming the effectiveness of systemic family therapy in child and adolescent psychiatry, this approach is not well represented in inpatient services in Greece. We present systemic principles as practiced at a child and adolescent psychiatric inpatient clinic embedded in a general hospital. We consider the competencies and strengths achieved by the team within a systemic epistemology, the difficulties of functioning in a biomedical-oriented environment, and the challenges faced during the 10-year socioeconomic crisis and the COVID-19 pandemic.