Australian and New Zealand Journal of Family Therapy最新文献

The Therapeutic Crisis Intervention for Families (TCI-F) program aims to equip caregivers with the knowledge, skills, and confidence to deal with crisis situations involving their children. Despite the program's global dissemination, its influence on predictors of intervention uptake and caregiver experience is not understood. We therefore sought to investigate the changes in determinants of implementation behaviour from pre- to post-TCI-F. These include knowledge, confidence, and intention to implement new strategies, beliefs about consequences that implementation would be beneficial, beliefs that change was part of one's social role, and a sense of having sufficient resources and support. In addition, we sought to understand the experiences of program participation. Caregivers who participated in TCI-F were invited to complete questionnaires about determinants of implementation behaviour before and after the program. They were also invited to complete a questionnaire about their experiences attending TCI-F. One hundred fifty-five participants completed questionnaires. Significant improvements were found in all determinants of implementation behaviour. Caregivers reported improved knowledge about program strategies, a belief that this was part of their role, confidence and capability in managing crises, beliefs that implementation will be beneficial, intentions to implement learned strategies, and a sense of being provided with sufficient resources and support. Additionally, participants reported high levels of satisfaction, hope for the future, improved coping, and overall well-being following the program. Qualitative responses supported these findings and revealed that many participants expressed a wish that the program was available sooner and that additional maintenance support was available. Findings support the use of TCI-F and indicate that this is a promising intervention for caregivers who are struggling to cope with the crisis behaviours of their children. As this is the first published empirical investigation of TCI-F, avenues for further research are identified.

This participatory research project highlighted the views and experiences of young people who are the brothers and sisters of children and young people who have experienced child sexual abuse. By working with young people who had experienced sexual abuse and their siblings, this practitioner research sought to give these young people a voice. The research involved a group process with young people who have experienced sexual abuse and have siblings, and one-to-one online consultations with the brothers and sisters of young people who have experienced abuse. All the young people spoke of their sibling and family relationships as unique and requiring unique responses to these relationships by services and health-care professionals. Siblings’ needs in the aftermath of a child sexual abuse discovery are often overlooked. This research describes how just as children who have experienced sexual abuse may feel anger, fear, guilt, shame, anxiety, and confusion, so do their siblings. Brothers and sisters of young people who have experienced sexual abuse describe significant relational trauma with intense emotional experiences of isolation, confusion, sadness, and anger. There is a real need to support young people and families to find words and develop capacities to talk about child sexual abuse -- a need to find supportive ways to speak about what has occurred and understand its impact on all. The study clearly demonstrated the significant level of need and impact on brothers and sisters of young people who have experienced sexual abuse.

For this special issue, we sought perspectives on the contributions of the infant to their family's development, including recovery from intergenerational trauma and the contribution of the family to the infant's relational security. This special issue features a series of 12 invited papers from a diverse group of professionals, including infant mental health specialists, Indigenous and non-Indigenous family therapists, academic family therapy teaching staff, and developmental psychology and systemic researchers. The contributions span several methodologies – ranging from curated conversations and qualitative research to conceptual insights, theoretical discussions, intervention reports, and new intergenerational empirical data. Through this editorial, we provide a brief overview of the collective works, spotlighting the invaluable synergistic contributions that infant mental health and family therapy approaches provide, while highlighting the untapped potential at their intersection.

This paper shares a far-ranging set of conversations between professors Jennifer McIntosh, Louise Newman, and Carol George, all child and family practitioners, and infant mental health (IMH) and attachment specialists. They explore the domain of infant–family work with high-risk populations experiencing complex relational and intergenerational trauma. George and McIntosh discuss the intersection between family therapy and IMH from an attachment perspective. They explore what family therapy can offer to supporting coherence in caregiving states of mind, beyond the offerings of traditional dyadic mother–baby models of intervention. They highlight the infant's contribution to family work, and the application of attachment theory in a family therapy context. Newman and McIntosh discuss a sensitive and graded approach to high-risk family work with an infant. Newman reflects on when and whom to invite to a family session and the power of enabling the family to speak the unspeakable in the presence of the baby, supporting a future focused path for trauma integration and recovery. For family therapists who may be new to IMH work, there are some important offerings about integrating these fields, bringing into play the family therapist's deep grasp of curiosity, circularity, and capacity to reconceptualise with an IMH perspective on early relational trauma.

This article examines the unique propositions within the ‘Charter for the Rights of Children yet to be Conceived’ posited by First 1000 Days Australia. It argues that the Charter's pioneering focus on preconception conditions significantly broadens the life-course framework for early childhood, challenging traditional rights frameworks that typically commence at birth. The Charter's tenets, their implications, and their relation to international rights frameworks are also discussed. The Charter for the Rights of Children yet to be Conceived expands the landscape within which family therapists can explore not just cultural inclusivity, but an inclusion of imagining what sort of world, future, and family we want for children yet to be conceived; and what we imagine these children would want from us for this to be achieved.

Chronic insecurities that emerge from adverse experiences in early intimate partner relationships in adolescence and emerging adulthood can have profound impacts on mental health and well-being. Less clear is the extent to which these experiences for parents impact subsequent relationships within and across generations. We examine the extent to which secure, dismissing, pre-occupied, and fearful intimate partner relationships in adolescence and emerging adulthood, well before becoming a parent, are associated with next-generation patterns of attachment between mothers and infant offspring. Data were drawn from a nested study of infant–mother attachment (n = 220) within the Australian Temperament Project Generation 3 Study (N = 1167, est. 1983). Intimate partner relationships in adolescence and young adulthood were assessed by self-report at 23–24 years of age. Over a decade later, infant–mother attachment security was assessed at 12 months post-partum. Young adult intimate partner relationships defined by high levels of fearful, pre-occupied, and dismissing attachment styles were reported in 11%, 17%, and 38% of young mothers, respectively. Increases in fear of intimacy in relationships were associated with an increase in the odds, by around 50%, of infant–mother insecure attachments (vs secure; OR = 1.56, 95% CI = 1.07, 2.28) and disorganised attachments (vs organised; OR = 1.49, 95% CI = 1.00, 2.22). A mother's self-reported history of fear of intimacy within young adult relationships predicts later insecure and disorganised mother–infant attachments. Guidance and greater support for young people navigating their earliest intimate relationships may not only prevent adverse relational experiences at the time but also on becoming a parent. Findings have relevance for family and infant mental health therapies. Translating these findings into supported conversations may help prevent infant–mother attachment difficulties, or later repair them, through validation of the lingering effects of early fear of intimacy and empowerment of parents to prevent next-generation infant experiences of distrust.

This qualitative study explores infant-family mental health experts' perspectives and experiences regarding the inclusion of infants in the family therapy setting. Infant socioemotional development is relational in nature and evolves in the context of both dyadic attachment relationships and broader multi-person co-parenting systems. Given this, we sought to understand why family therapy interventions involving families with infants rarely include the infant in a triangular or family systemic approach. Interviews were completed by clinical and/or research experts whose work integrates tenets of both infant mental health (IMH) and family theory and therapy. All interviewees brought at least 5 years of expertise and were actively engaged in the field. Interviewees expressed consistent beliefs that infants have a rightful and helpful place in family therapy approaches. They maintained that infants' innate social drive and communicative capacities position them to make meaningful and clinically significant contributions within family and systemic psychotherapy contexts. Noting that infants have remained on the periphery of these practices, experts advocated expansion and greater integration between IMH and family therapy, while preserving each field's distinctive identity. Experts reported that the interplay between IMH and family therapy fields has been uni-directional as family systems concepts are embedded within IMH approaches, but few IMH premises are incorporated in mainstream family therapy practices. The disconnect was attributed to multiple factors, including graduate and professional training and theoretical, clinical, research, and sociocultural barriers, which were mutually reinforcing. Experts also identified clinical gains for both infants and family members when infants were meaningfully included in family interventions. Common ground was identified between the disciplines, with a belief that relationally distressed young children and parents are best served by clinical engagement with their network of relationships. Results call for greater collaboration between disciplines to challenge existing traditions and to more fully include infants in mainstream family therapy. Recommendations for integration of family therapy and IMH in clinical, theoretical, research, training, and sociocultural domains are offered.

The last decade has seen an increase in public and academic interest in consensual non-monogamy (CNM). CNM involves sexual and/or romantic relationships between multiple partners, with the consent of all individuals involved. Engagement in CNM is estimated at 5% of the general population, although due to stigma with the strong idealisation of monogamy in many cultures, it is a hidden population. This qualitative study explores the motivations, benefits, and challenges experienced in CNM relationships, an area that has been understudied despite the resurgence of interest in it. While previous research has mainly focused on comparisons between CNM and monogamy or individual types of CNM such as polyamory, this study seeks to provide a broader understanding of CNM relationships. We employ a critical realist framework and thematically analyse semi-structured interviews with eight participants. The results identify three overarching themes: mononormativity and cultural norms; growth and responsibility; and diversity and complexity; each has several subthemes. These findings suggest that CNM provides opportunities for greater diversification of needs and increased community and individual growth. The study also highlights the challenges experienced in CNM relationships and the strategies used to manage them, such as personal responsibility for managing difficult emotions and temporarily closing a relationship at times for relationship security. A novel finding in this study is that some individuals involved in CNM have internalised cultural norms and the idealisation of monogamy and need to unlearn these norms. This study adds to the existing knowledge on CNM and is expected to be of interest to clinicians and researchers seeking to understand its motivations, benefits, and challenges. Relationship therapists will benefit from increased knowledge of how to work with clients interested or engaged in CNM relationships. Overall, this study supports previous findings that CNM is a viable, enjoyable, yet sometimes challenging type of relationship.

This paper considers the role of academic training programs in the integration of family therapy and infant mental health (IMH) curricula. It takes the form of a conversation between senior academic staff of the Bouverie Centre in Australia and the special issue editors. Robyn Elliott and Colleen Cousins are family therapists, trauma specialists, and academics at the Bouverie Centre, La Trobe University. Robyn supervises the development and delivery of the Master of Clinical Family Therapy, accredited by the Australian Association of Family Therapy. Colleen is a psychologist and family therapist and coordinates the Graduate Certificate of Family Therapy program. They are in dialogue here with the special issue co-editors, Jessica Opie and Jennifer McIntosh. We consider the degree to which current family therapy training holds the infant in mind, and approaches to deepening the future training nexus between IMH and family therapy.

Training in infant observation, highly valuable in the infant mental health (IMH) field, has an enormous amount to offer family therapists. These two fields of practice, both hold working with the relational world of their clients as central. As two senior family therapists who are also IMH practitioners, we invite those reading this paper to explore the possibilities inherent in undertaking infant observation training as a pathway to enriching and expanding their practice. We provide an overview of infant observation training, how this approach was conceived, and explore the benefits of honouring the subjectivity of the infant, that of bringing the infant's experience alive in the therapeutic space. We provide direct examples from our own practice. We conclude with how infant observation might be incorporated into family therapy training and practice.