Australian and New Zealand Journal of Family Therapy最新文献

Despite the importance of Bowen family systems theory in the field of family therapy, there have been few studies examining family unit functioning. To fill this gap, a self-report instrument, the Family Unit Functioning (FUF) questionnaire has been developed. The FUF questionnaire is a multidimensional measure specifically for adults (aged 25+) about nuclear and family-of-origin responses to challenges. Eighty-six adults who were enrolled in Bowen theory training programs participated in an online questionnaire. The FUF assessment tests five dimensions of family unit functioning developed by Papero (2020). The investigators employed a confirmatory factor analysis, and the following analyses results indicate support for four of the five proposed FUF dimensional constructs: 1. resourcefulness; 2. connectedness and integration; 4. systems thinking; and 5. goal structure. However, the third construct, tension management, requires further validation using a larger data source to generate a more favourable result. The potential contribution of the FUF instrument for testing Bowen theory, use as a family psychotherapy assessment tool, and as an indicator of psychotherapeutic outcomes is discussed.

In March of 2020, during the global COVID-19 pandemic, therapists quickly transitioned to telehealth platforms to provide their services. Teletherapy, while subject to some constraints, presents unique opportunities to work creatively with couples, particularly during these uncertain times. This paper offers a case study of work with a couple using systemic, developmental attachment, dialogical, and somatic trauma theories. Action techniques, including doubling, ideal futures creation, and a foam roller trust exercise are employed to facilitate change processes as couples face the chaos and unknowns of the pandemic and the difficulties that have become triggered between them. These exercises help to open perspective, increase awareness, and lower resistance to change. Couples are able to physically enact and metabolise alternative realities while discharging excess energies in familiar surroundings.

Like many family therapists today my approach to therapy can be described as integrative; it utilises various therapy frameworks and models and combines individual and family therapy approaches in response to the needs of clients and the nature of the work. This paper begins with a brief professional retrospective that illustrates the integrative therapy challenge. It then describes integrative therapy as systemic in the sense of bringing together multiple conversations about therapy based on the idea of an ethic of hospitality. Integration as an ethics of practice is grounded in a finely honed attunement between therapist and client as well as an openness to considering multiple perspectives and frameworks of therapy. This is discussed in relation to the contemporary family therapy literature and illustrated by a practice example.

Integrative psychotherapeutic practice is the process of creating a broad, overarching framework as a guide to selecting and combining concepts and interventions. Attracting attention over the past 20 years, it has been identified as the dominant trend in family therapy moving into the 21st century. It is no surprise that clinicians necessarily combine several theories, techniques, and factors in their work given the multidimensional nature of work with clients and families. Integrative practice has evolved over time with different models and frameworks proposed, and yet in the field, there are concerns that it is not widely taught despite many identifying as eclectic or integrative. The purpose of this paper is twofold. Firstly, it reviews the topic of integrative practice, its history, evolution, strengths and pitfalls, and models. Secondly, a systemic meta-framework is proposed as a guide to clinical practice and teaching. The review found a move from eclecticism to integrative practice, with the evolution of integration leading to five primary methods. The proposed QIFT Systemic Meta-Framework for Integrative Practice both fits within and extends these methods, with the following key elements: way of being, therapeutic alliance with a focus on neurobiology, systemic assessment and formulation, and decision-making highlighting theory of change.

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.