Australian and New Zealand Journal of Family Therapy最新文献

Working with transgender, gender diverse, and non-binary (TGDNB) young people and their families requires a family therapist to hold multiple positions of expert, supporter, cheerleader, coach, and creator of a safe space. Anxiety is often high in family systems following a young person's disclosure of their gender diverse identity. Parents experience a range of emotions while trying to support their child to navigate challenging decisions, heavily influenced by society and untold family rules. The existing literature relating to families of TGDNB young people focuses on parental responses and the impact of an affirming or rejecting position. However, little research has focused on working with families to increase their position of support, which ultimately improves outcomes for TGDNB young people. This case study demonstrates the effectiveness of an integrative family therapy approach to working with TGDNB young people and their families, as a way of navigating this challenging and rewarding area of work.

The practice of integrating various therapeutic disciplines and models in therapy has traditionally been the domain of the experienced practitioner. To encourage the newly trained systemic therapist to embark on their journey in the artistry of integrative practice, this paper addresses the question: ‘What guidance and encouragement could be offered to the beginning family therapist to practice in an integrative way?’ Central to this paper is the view that the discipline of systemic thinking itself facilitates integration. Based on the notion that complex models of integrative practice may not serve the beginning clinician, three suggestions are offered. First, the overarching theories that support systemic family therapy also provide a platform for moving between schools of family therapy and our professions of origin. Second, the role of common factors is a useful and important guiding principle to practice in an integrative way. And finally, an essential ingredient of integrative practice is the return to therapeutic presence and attunement.

This paper will explore the clinical application of tracking sequences in family therapy with a particular focus on Bowen family systems theory. It considers how sequences can be used to track the emotional process occurring in relationship interactions, and the similarities and differences of a Bowen theory-informed approach compared with dialectical behaviour therapy and both classic and contemporary family therapy models. Case examples are utilised from the author's clinical practice to raise ideas about the therapist joining the client as a co-researcher in this exercise and facilitating a process that helps assist the client develop their own self-awareness and problem-solving resources in the context of their relationships.

The prevalence and complexity of children's mental health concerns is increasing for children living in out-of-home-care settings in Australia and in other Western countries. Therapists face an amplified challenge of finding innovative ways of working with children and their caregivers, often drawing upon multiple therapeutic approaches to respond to such complexity. This article discusses some tensions of integration in practice. A case example is offered to demonstrate a way of enacting integration with Deanne, a six-year girl, and her foster family. These practice reflections illustrate a certain way of doing a ‘both-and’ approach to integration, drawing on narrative therapy and attachment therapeutic lenses. The reflections on practice reveal how a nuanced and reflexive approach to integration is needed to ensure theoretical congruence, to avoid contradictory therapeutic stances of ‘knowing' and ‘not-knowing.'

This paper proposes a culturally safe integrative systemic model for supporting First Nations people with borderline personality disorder (BPD). Firstly, this paper examines BPD from a systemic perspective by observing its impact on family and therapeutic systems. An overview of the empirical evidence for integrative systemic therapy demonstrates its suitability for working with BPD, particularly when combining systemic, psychodynamic, and cognitive-behavioural paradigms. A case example illustrating a client's journey using the proposed model is presented to explain how elements of Bowen family systems therapy, narrative therapy, and dialectical behaviour therapy are blended with cultural components to form a culturally safe integrative systemic approach. An initial evaluation demonstrated positive preliminary therapeutic outcomes, with the main strengths being the cultural additions and the mitigation of power struggles in the treatment and family systems that are reported in the literature as detrimental to BPD interventions. Limitations concerning the practicality of replication in mainstream settings are noted, particularly where full cultural safety may be more difficult to achieve. The paper suggests that integrative systemic approaches combined with cultural elements may be effective when supporting First Nations families living with BPD. Finally, this is currently the only integrative culturally safe therapeutic approach proposed for this cohort, making it unique given the overall paucity of empirical evidence in the field.

The discovery of one's professional and personal epistemology is a crucial component of reflexive practice. The following autoethnography focuses on the development of the author's personal epistemology while completing a three-year Master of Counselling degree. Having worked within the medical model for a decade, the author struggled with choosing between modernism and post-modernism as a personal epistemology while practicing in a counselling and family therapy clinic that privileged post-structural and social constructionist epistemologies. This paper examines that struggle. Data were drawn from journal entries documenting reflections, conversations with supervisors and student colleagues, vignettes from sessions, and current research into the development of epistemological positions. Ultimately, the author concludes that it is not modernism versus post-modernism, but rather the two epistemologies, shaped by personal and professional experiences, that work together to facilitate intentional practice. The importance of examining a personal epistemology has implications for students, educators, supervisors, and practicing professionals.

A shift from orientationism (being committed to a particular therapy approach) to integrationism offers the prospect of a more collaborative, curious, and respectful community of practitioners. Yet our current ways of articulating integrative practice can inadvertently undermine this ambition, and result in confusion or ambiguity about exactly what is being integrated, when, how, and why. Some personal and professional reflections are used to situate this dilemma and to suggest the need to expand our vocabulary for practice. Can we avoid an either/or binary between orientationism and integrationism and find ways to get the best of both worlds? This might involve finding concepts that enable practitioners to maintain a primary therapeutic orientation while integrating, as well as ways to articulate our integrative frameworks that respect both an individual practitioner's unique style and the therapeutic traditions they draw upon. Concepts from both integrationism and pluralism are used to develop these themes and to offer some possible alternatives.

Suicidality is a major global public health issue that couple and family therapists will inevitably encounter in their clinical work. While relational therapies for addressing suicidality are growing, few specifically outline ways to address the influence of systemic oppression on suicidality, reflecting the push to de-politicise suicide research. To address this issue, scholars have proposed integrating narrative approaches with evidence-based practices. This paper therefore delineates the integration of narrative therapy with dialectical behaviour therapy as a material discursive therapy. All main aspects of theory integration are described, including the epistemological framework, approach to the therapeutic relationship, and interventions. Finally, the change process is described using clinical case examples throughout to illustrate the ways in which these models can be integrated to produce a critical, relational approach for addressing suicidality in family therapy.

Couple and family therapy is distinguished from individual therapy due to its focus on the interactional patterns between family members. However, there is plenty of overlap because of the reciprocal relationship between individual psychopathology and its relational contexts. Many clients seeking individual therapy aim to improve their relationships, and couples and families who have relational difficulties often have at least one partner with some type of psychopathology. This article presents integrative systemic therapy (IST) as a method for integrating individual, couple, and family therapy. IST is a multitheoretical and multisystemic perspective that utilises concepts and interventions from a variety of therapies for a broad variety of presenting concerns and populations, including individuals, couples, and families. In IST, a repetitive pattern of interaction is co-occurring at two levels – within an individuals' minds (i.e., intrapsychic) and externally in people's interactions with others in their system (i.e., interpersonal) – and they influence each other. Therefore, IST therapists utilise various interventions from individual and couple and family therapy within a case to disentangle problems occurring at various systemic levels. The paper begins with a summary of the theoretical assumptions of IST and introduces basic terms such as sequences. This is followed by specific descriptions of two critical tools, essence and blueprint, which walk therapists through the steps of how to conduct IST and integrate individual, couple, and family therapy. Finally, two case examples are used to demonstrate this process.

Over the last three decades, family therapy/counselling in South Korea has expanded significantly in both public and private sectors and this paper overviews its development and the status of public infrastructure. Since the establishment of the Korean Association of Family Therapy in 1988, family counselling has developed as a distinct professional area but was mainly carried out in the private sector until the mid-2000s. In 2005, the Healthy Family Act was legislated, the Ministry of Gender Equality and Family was established, and approximately 250 public family support centers (FSCs) are currently in operation with a key responsibility for family counselling. FSCs provide diverse services such as couple and family counselling, family group counselling, family helpline, and divorce counselling with an estimated 73,392 users in 2018 (KIHF, 2019). Furthermore, 63 FSCs are accredited as institutes for divorce counselling where various forms of service for divorcing families are provided. Although South Korea has one of the most advanced public systems for a family counselling service in Asia, some issues need to be resolved for its sustainable development including counsellor qualifications, appropriate fees, and the balance between public and private services.