Gaps in Family Therapy Practice: Discussion of Dr. Langsley’s Paper

Abstract

Dr. Langsley has raised several major training and clinical issues with which I resonate strongly. The training of residents, psychologists, and social workers is very complicated in the diagnostic treatment planning phase with the disturbed child. How do you make the choice of whether to go one of three ways: traditional one-to-one child therapy, family therapy alone, or concurrent individual and family therapy? This depends partly on what population you have in the clinic. You may end up, at least in Rochester where I used to be Head of Child Psychiatry, with something like 40% or more of the cases initially assigned to classical one-to-one therapy. Or, do you go the road of an exploratory initial period with both individual therapy and concurrent family therapy, while you are getting more deeply involved in both the understanding of what is going on here and beginning to make certain initial therapeutic moves? Or, do you see that individual therapy is really not relevant and you should start right out with family therapy alone? Until we conduct more research and follow-up studies, we will not be clear about the appropriateness and effectiveness of various treatment strategies.