Australian and New Zealand Journal of Family Therapy最新文献

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.

This position paper from a core group of infant mental health academics and clinicians addresses the conspicuous underrepresentation of the infant in mainstream family therapy. Despite infants' social capacities and clear contributions to family dynamics, they remain largely overlooked within this therapeutic context. We suggest that family therapists have moral and professional responsibilities to support the participation, protection, and well-being of all family members, including the infant. Here, we emphasise the importance of including the infant in the family therapy setting. By highlighting their frequent omission, we aim to amplify infants' often unheard ‘voice,’ role, and contributions to family development, especially recovery from distress. A shift towards infant inclusion as the rule rather than the exception represents a new frontier of integration. We first highlight the relational nature of infant development with a focus on the infants' psychosocial capacities and vulnerabilities. We then consider reasons why the infant may be overlooked in family and systemic therapies and offer a rationale for inviting the infant into these settings, illustrated through the use of a clinical case vignette. To facilitate infant inclusion, we propose a series of guidelines to meaningfully incorporate infants into family therapy practices. We conclude by encouraging shifts in family therapy research, training, and practice to better incorporate and understand the unique contributions of the infant to family life.

In this study, we explore family and clinician experiences with virtual care delivery of whole family assessment and therapy developed for infant and preschool-aged children and adapted during the COVID-19 pandemic. A clinical case study is also presented. Between September and November 2020, semi-structured interviews were conducted with four clinicians working with families with children in the 0 to 5 population and with four caregivers with children aged 4–6 years (M = 5.3) involved in whole family assessment and intervention (i.e., Lausanne Trilogue Play [LTP]; Reflective Family Play [RFP]) at a community mental health facility. Clinicians represented various mental health disciplines. Qualitative data were analysed using inductive thematic analysis with intercoder reliability established. Analysis of interviews generated nine themes organised within two conceptual frameworks, accessibility and efficacy. Accessibility included the themes: (1) flexibility, (2) privacy, and (3) resources. Efficacy comprised: (4) effects of technology, (5) home environment, (6) feasibility of therapy tasks, (7) parent alliance, (8) clinician fatigue, and (9) overall evaluation. Home environment was further divided into three subthemes: (5.1) disruptions, (5.2) boundaries, and (5.3) naturalistic observation. While participants reported benefits and challenges uniquely related to virtual care, both caregivers and clinicians expressed overall satisfaction with virtual whole family assessment and therapy. This study provides a rich exploration of the perspectives of caregivers and clinicians engaged in virtual whole family mental health care during the COVID-19 pandemic. With adequate technology and privacy, whole family assessment and therapy, such as the LTP and RFP, provided via video teleconferencing facilitated accessible and effective care for families of young children with moderate to severe mental health challenges. Evidence suggests in-person and hybrid approaches to whole family assessment and therapy could be further tailored to meet the needs of families with young children and infants.

Despite the weight of scientific evidence demonstrating the importance of fathers in the social and emotional development and well-being of infants, infant mental health services struggle to engage fathers. Commonly, fathers are assumed to be unavailable, uninterested, unnecessary, or even unsafe in relation to infant mental health work. These outdated perspectives perpetuate the myth that this work pertains exclusively to the infant–mother dyad. This paper aims to explore some of the reasons for and barriers to involving fathers in infant mental health services. We present an imagined conversation between three mental health professionals working in a child and adolescent mental health service. Presented as a script, the various arguments, counterarguments, and reflections made by the three characters aim to bring the subject matter to life and capture something akin to an actual discussion between colleagues working in a child mental health service. A junior clinician notices that an infant case presented at the multidisciplinary team meeting did not mention the child's father. A senior clinician explains that the team's work usually focuses on the infant–mother relationship, as this is considered of primary importance clinically. A psychiatrist, who has only recently joined the team, explores some of the aspects of team culture that might exclude fathers from participating in the service. Several plausible objections to involving fathers are explored as the discussion unfolds between the three professionals. Infant mental health services should consider how their culture and processes influence whether fathers and/or other adult caregivers engage in these services. For clinicians, thinking about the infant's immediate interpersonal context from their unique development perspective can reveal opportunities and resources within the family that may lead to effective systemic treatment approaches.

First Nations child and family practitioners, Alison Elliott and Clarisse Slater, yarn here with Jenn McIntosh about the cultural fit and importance of including infants in family therapy. They bring years of experience from the ‘Workin’ With the Mob' clinical program at The Bouverie Centre to bear on building safe and respectful engagement with First Nations peoples and families. They share a First Nations view of the call of the infant and their ancestry and their power to join in bringing healing to parent and family systems. They discuss safe engagement in attempting to build safety in the present, especially for new parents who carry childhood wounds. The baby's capacity to help reframe these conversations into opportunity for new hope and healing becomes central to systemic safety, rather than something to be avoided.