Australian and New Zealand Journal of Family Therapy最新文献

Non-judgemental care is a widely acknowledged aspect of therapeutic work with children and families. There is limited literature that defines current practices of non-judgemental family care and assesses its implementation within mental health settings. Clinicians who encounter and work with childhood maltreatment and abuse may make moral judgements and potentially ascribe culpability to a child's parents, carers or support network. This is despite understanding that adverse childhood experiences (ACEs) are associated with the complex interplay of sociocultural factors and wider determinants of health. This pilot narrative review explores facilitators and barriers to provision of non-judgemental care in the modern literature from clinician, as well as lived and survivor, perspectives. A detailed search of the literature was conducted using PubMed, Cochrane Library, Ovid, Embase and PsycINFO databases, with focus on childhood maltreatment, intergenerational trauma and ACEs between 2014 and 2024 and published in English language. Title and abstract screening, then full-text screening, was completed by the primary author and results were identified via informal analysis of themes. Eight studies of clinician perspectives identified facilitating themes of professionals' responsiveness, positive personal attributes and utilisation of strength-based approaches. Clinician-identified challenges included maintaining curiosity in the context of uncertainty and complexity, power differences and unconscious processes. Nine lived experience studies were included, identifying listening and attunement as facilitators. Shame, barriers and inadequate acknowledgement of historical traumas hindered therapeutic engagement. Shame was found to be a key barrier to the experience of non-judgemental care and postulated to influence how clinician interventions are received. The author concludes that non-judgemental care is incompletely understood in practice, with clinician judgements being ubiquitous and diffuse in therapeutic impacts. Future research is required to understand intersubjective therapeutic perspectives and elucidate existent gaps between delivery and perception of non-judgemental care.

Many innovations in clinical care are never reported in academic literature, because skilled and creative practitioners are often unaccustomed to academic writing. This means that important insights that could influence practice may not come to the attention of researchers who can generate the evidence that is needed for an intervention to gain wide acceptance. Heather Chambers is one of those gifted clinicians whose insights have often been revolutionary for the practitioners who have worked with her, but whose work still requires formal evaluation. Parallel Parent and Child Narrative (PPCN) is one of the interventions that Heather Chambers developed. It is a dyadic form of therapeutic storytelling, in which moving beyond any moral condemnation and towards therapeutic care is deeply embedded. PPCN focuses on revealing and proving the good intentions at the heart of everything that parents and children do, to counter feelings of hurt, blame and shame. PPCN has been utilised in both New Zealand and Australia, in small geographical pockets, since the early 2000s. There is accumulated anecdotal evidence from its use in private practice: Infant, Child and Family Services (ICAFS) in the Hutt Valley and Wellington, New Zealand; and Child and Adolescent Mental Health Services (CAMHS) and reunification services (restoring children to their birth families, after removal by child protection services) in South Australia. The use of PPCN over many years and in a variety of settings suggests that clinicians who are familiar with PPCN find it useful and rewarding and that families are able to engage with the process. This conversation with Heather Chambers has been included in this special issue with the hope of introducing PPCN to the wider family therapy community and stimulating interest in this approach.

The article derives from an interview with Corin Morgan-Armstrong, the architect of Invisible Walls, an innovative model of whole-family support for people in prison, their children and families/significant others in the community. This groundbreaking approach not only aims to improve reintegration outcomes for the person leaving prison, but expands the focus to include all family members as equal beneficiaries of support to improve family relationships, their quality of life, and disrupt the intergenerational cycles of disadvantage and trauma in which many of these families are entrenched. The reader is provided with insight into Corin's journey to see beyond the person in prison, recognising him in his role as a father and inspiring a holistic approach which involves family, children and community to support lasting change and improve ‘whole family’ outcomes beyond simply reducing reoffending.

Informed by participatory action research methodology, this article adopts a unique collaborative co-writing process providing a means for practitioners of diverse cultural and professional backgrounds to share and reflect on family work, including but not limited to family therapy, happening across a specialist torture and trauma recovery service. Through exploring historical and contemporary ways of working with families at the Queensland Program of Assistance to Survivors of Torture and Trauma, an agency providing support to people from refugee backgrounds, some common practice principles were identified as well as key theories and frameworks underpinning collective family work. Guiding principles identified include: the need for a systemic lens, flexibility in service delivery, building safety and trusting relationships, cultural humility and valuing lived experience, recognising complexity and avoiding assumptions, and listening and responding to client and community needs. In moving away from moral condemnation, the article underscores the value of thinking systemically and abiding by recognising each family's unique story and the need for culturally sensitive interventions. Ongoing opportunities to connect over practice are considered valuable for practitioners engaged in different types of family work.

This paper provides an outline of a novel approach to explain the complexity of human relationships. A map of relational possibilities was developed by the first author to explain complex theoretical concepts to their clients in a private practice. It describes the process of what an infant will do to manage relationally traumatic situations where their caregivers have failed to consistently scaffold the infant's fear management system or meet the requirements to ensure a robust sense of self develops. The map also describes the nature of relationships between individuals with differentiated selves. This paper then discusses how the map manages to bridge the research–practice gap in a unique way using everyday language to describe processes that are familiar to every human in managing complex relational dynamics.

Mothers who experience DFV are often at risk of being epistemically harmed by professional discourses that are mother-blaming because professionals often overburden them with unrealistic expectations of protecting their children. In addition, children and young people who experience DFV are frequently at risk of being subjected to epistemic injustice by professional discourses that negate them as knowledge generators. Added to this tangle of epistemic misplacement is the wedge that perpetrators drive between mothers and children so they both cannot see each other survivance wisdom and connection to each other. Family-inclusive/lead therapy that epistemically privileges mothers' and children's survivance wisdom can repair the damage done to them as knowledge generators and to their relationships. This article describes an example of nondeliberative work that highlights family-inclusive/lead therapy has a place in family intervention post-DFV.

The aim of this reflective piece is to explore the under-recognised contribution of shame to disorganising attachment–caregiving relationships. The first hypothesis is that ‘shame without solution’ is a part of a core and enduring emotional wound central to relational trauma in infancy and associated attachment disorganisation. The second is that dominance and submission hierarchies, order and control are potent defensive adaptations employed to stabilise ‘shame without solution’. Children exhibiting profoundly disturbed behaviours, stemming from intergenerational cycles of trauma and distress, are disproportionately represented in child protection, intensive family support and child mental health services. Despite being set up to support these children and their families, the most distressed mothers too often disengage, feeling blamed even by compassionate therapists who work hard not to alienate them. If the mothers disengage, the mothers and their children are left without professional support. Arising out of this theoretical work are recommendations that support constructive and effective working relationships with these families, originally articulated in Parallel Parent and Child Therapy (P-PACT; Chambers et al., 2006). The first recommendation is to provide mothers with the support that we want the mother to give the child. This means meticulously avoiding reinforcing the negative self-view typical of these mothers. The second recommendation is to prioritise empathy for the mother and the mother–child relationship early in treatment. For many practitioners, this second recommendation will conflict with their natural desire to prioritise empathy for the child, especially when the mother's capacity to do so is compromised. Experience and theory support the adoption of these recommendations to avoid perceived blame of the mother (and all members of the family), a critical shift to establishing engagement.

Foster care is a key element of Australia's child protection system. If a child's safety is threatened, they are removed from their families and placed under the guardianship of the chief executive in a care setting (guardianship order). In South Australia, the rate of children and young people entering the ‘In Care’ system has been increasing. As of 31 May 2024, the South Australian Department for Child Protection (DCP) reported that 4874 (0.4% increase from 2023) children and young people were on guardianship orders. In addition to the increase, there continues to be an overrepresentation of Aboriginal children and young people in care (37.4%) due to the ongoing impacts of intergenerational trauma because of colonisation and the Stolen Generation. The increase in children in care has placed immense pressure on the child protection system. Research indicates the best place for children to be is with their families. Centacare Foster Care, while supporting all care types, has a specialist reunification model (SRM). This model, the topic of this paper, incorporates a care team approach, informed by Centacare's stabilising trauma in everyday practice (STEP) framework. The SRM which starts from recruitment has been key in ensuring children and young people maintain positive connection with their family and return home safely, resulting in the successful reunifications. This model has seen a 67% success rate in reunifications, well above the 48% success rate nationally. Importantly, this model has seen a 65.5% success rate in reunifications of Aboriginal children between the years 2022 and 2024, which is well above the national reunification rate of 7.6%. This paper, written by Centacare's specialist reunification foster care team, outlines some of the key features of the model and broader program, from recruitment to reunification.

Trauma is a central theme in child protection. Responding to and preventing traumatic harm to children is a key function of statutory child protection agencies and systems in Australia. Parents who encounter these systems are also known to be a highly traumatised cohort, often experiencing trauma throughout their own early development and into their adult lives. Despite these being broadly accepted principles amongst practitioners, there are limited pathways for parents to undertake trauma-processing therapy as an integrated part of current child protection practice. Narrative exposure therapy (NET) is a manualised therapy model that has been used successfully to support individuals with life-threatening trauma to process these experiences and take agency over their lives. The successful use of this model by non-traditional therapists such as community health workers, in brief timeframes, has made it a valuable approach in settings with a high need for therapeutic support and low resources, such as refugee accommodation. Although these themes also have synergy with the child protection setting, there is relatively little research on the use of NET in this setting. This paper is written by practitioners and for practitioners and examines the real-world application of NET with parents involved with a non-statutory reunification service in the South Australian child protection system, grounded in a trauma-informed model of practice. As such, the paper considers extending the possible value of NET into an area of limited previous use. The paper highlights observational findings suggesting that NET has the potential to be an effective tool for bringing focus to the trauma experiences of the parent, so that they may process these and develop greater capacity to parent safely as well as engage more productively with the demands of the child protection system.

Digital technology profoundly impacts family dynamics, posing challenges for therapists. This article explores how excessive technology use affects family interactions, illustrated through three case studies. The aim is to highlight the implications of overuse rather than the inherent properties of technology. Using Bowen family systems therapy and socioculturally attuned family therapy, a blending of these systemic approaches, the therapist designed targeted interventions to address excessive technology use within diverse family systems. Interventions shifted pre-intervention attitudes and technology-related beliefs, where family members viewed technology as either a source of conflict or an integral part of daily life. Six 90-minute family therapy sessions were conducted where families, with varied pre-intervention perspectives on technology, transitioned towards technology moderation, fostering digital mindfulness and offline family activities. Understanding and addressing the interplay between technology and family dynamics are crucial. Cultural considerations and sensitivity towards generational, ethnic and technological cultural differences were emphasised. An immigrant family and their first-generation American children exemplify the intersection of cultural identity, generational technology gap and technology integration, advocating for socioculturally attuned therapeutic approaches.