Commentary: Is it Time for Family-Based Interventions in Pediatric Psychology?

Abstract

Is it time for family-based interventions in pediatric psychology? On the one hand, I am tempted to say that it is not only “time” but past time, particularly given the documented tradition of family systems intervention for children with pediatric illness (Minuchin et al., 1975; Kazak, Rourke, & Crump, 2003). On the other hand, I have a cautionary note to offer: beware of “blind empiricism” in the press for evidence-based intervention. There is a great deal of pressure, led in part by funding priorities, to develop evidence-based interventions (including family interventions for a variety of disorders). The pressure is likely due in part to an appropriate corrective retreat from a previous standard of care that included endless expensive therapies without basis for their effectiveness. It seems to me that this is a very healthy correction. But there is a potential risk in a narrow pragmatic approach to developing effective family-based (or other) interventions. The risk is the tendency to reduce investigation to the level of “blind empiricism,” that is, research that is not framed by well-articulated models. (See Drotar and Lemanek, 2001 for a wellreasoned consideration of various approaches to a clinically relevant science of interventions in pediatric settings.) The articles in this special section take substantial steps in the direction of providing a scientific foundation for the development of targeted evidencebased family interventions for children with pediatric illness. It is exciting to see so many well-articulated studies reported in the same place. What follows below are hopefully useful critiques and suggestions for future investigation and development of a family systems approach within the field of pediatric psychology. Lack of Heuristic Models Guiding Family Intervention Research