Change In Family Therapy Research Articles

The development of a reliable change index and cutoff score for the SCORE-15.

The Systemic Clinical Outcome and Routine Evaluation version 15 (SCORE-15) is a measure used to assess family-level change in family therapy. The SCORE-15 has been demonstrated to be a reliable and valid measure, with high clinical utility; however, the SCORE-15 lacks the ability to determine whether the change in family functioning during the course of therapy is clinically significant. This study aimed to establish a reliable change index (RCI) and clinical cutoff score so that researchers and clinicians can determine clinically significant change in family therapy. USsamples of 71 clinical participants and 244 community participants completed the SCORE-15. Results indicated a cutoff score of 40.37 and an RCI of 9.52. Consequently, family members who improve their SCORE-15 score during the course of therapy by at least 9 points and who cross the threshold of 40 during the course of therapy are considered to have experienced clinically significant change.

Illustrating systemic change in family therapy: How therapists’ and clients’ alliance perceptions codevelop over time

Research showing that caregivers’, adolescents’ and therapists’ perceptions of the therapeutic alliance become more similar over time has not examined conceptual models, like emotional contagion and interdependence, that are theorized to account for this convergence. Objective: We modeled codevelopment in systemic family therapy to examine mutual influence and shared environment processes among the alliance perceptions of youth, caregivers, and therapists. Method: The self-report version of the System for Observing Family Therapy Alliances (SOFTA-s) was administered after sessions 3, 6 and 9–156 Spanish maltreating families and 20 therapists. Results: Using a triadic version of the repeated measures actor-partner interdependence analysis, a random intercepts cross-lagged panel model, we found significant effects of the shared environment and mutual influence in caregivers’ and therapists’ alliance scores over time, reflecting emotional contagion. Additionally, (i) therapists’ alliance scores at session 6 significantly predicted youth alliance scores at session 9, and (ii) therapist alliance at session 6 significantly mediated the relationship between caregiver alliance at session 3 and youth alliance at session 9, suggesting that therapists bridge the caregiver’s and youth’s perceptions of the alliance. In successful (compared to unsuccessful) cases, therapists’ alliance perceptions at session 6 positively influenced caregivers’ alliance perceptions at session 9. Conclusion: Therapist’s perceptions of the alliance can bridge differences in alliance perceptions of caregivers and adolescents resulting in greater similarity in alliance perceptions over time.

Change in Family Therapy

A fundamental theoretical premise in Structural Family Therapy (SFT) is that changes in individual members and improvements in intra-familial relations are realized by repairing the family structure. Dysfunctional families are conceptualized in terms of individuals taking on inappropriate roles (e.g., children acting as if they were parents) and the boundaries between parental executive levels and the children/sibling level are unclear, too rigid, or highly permeable. The therapist’s role is to temporarily engage (join) with family members in a way that generates in-session interactions that exemplify the desirable family structure. While the theory supporting these interventions are well developed, there has been little work done on explicating how such tasks may be interactively accomplished in clinical practice. Drawing from the methods of conversation analysis, our aim for this paper is to show how a master therapist in SFT accomplishes some of these transformations during a single therapy session. We focus on the discursive resources through which the therapist is able to readjust the role relationships between a mother and her daughter (i.e., in such a way that the mother can adopt a more agentive position vis-a-vis her children) and how the therapist’s actions indexed core SFT principles of restructuring the family.

Harnessing the Power of Family Dinners to Create Change in Family Therapy

Family dinner and family therapy confer many similar benefits to family members and they are both settings in which families can connect and interact as a group, in a designated space and time. Over the last 20 years, a large body of research documents the physical, academic, and mental health benefits of family dinners. Research links regular family meals with healthier eating habits and lower obesity rates, lower rates of substance abuse, teen pregnancy, depression, stress, and anxiety, as well as stronger self‐esteem, parent‐child connectedness, resilience, and even better vocabularies. Family therapists can harness these benefits in four ways. First, by asking screening questions of families to determine whether and how often they are sharing meals and then discussing solutions to overcoming common obstacles. Second, by asking about or enacting a family dinner to obtain a snapshot of a family's organisation and functioning, in terms of their gender roles, division of labour, expression of affect and conflict, capacity to have fun, and tolerance of difference. Third, by playing non‐competitive games in therapy that promote conversation, games that can also be played at the dinner table. Fourth, using family dinner as an annex to therapy as a place to experiment with new roles, behaviours, and patterns of communication, which can be enacted on a nightly basis after being discussed in therapy. Two case examples are presented to illustrate the ways that dinner can be a place for change, begun in therapy, and implemented at home.

Perceived Process of Change in Family Therapy for Eating Disorders in Shenzhen, China: A Qualitative Study

In this article the author reports the results of a qualitative study in Shenzhen, China, drawing on the subjective experiences of five Chinese parents and young persons who have recovered from an eating disorder family treatment, and explores the linkage between the changes in the family context and changes of individual experiences and behaviors, as well as the roles of family members and of the therapist in facilitating the healing. The symptomatic cycle of interaction of the families was discerned from treatment at the initial stage of helping. Two emerging themes in relation to the perceived changes were identified: (1) the perceived contextual changes, including the involvement of the previously disengaged father in the care of the young person suffering from an eating disorder to disrupt the symptomatic cycle in the family, and the change in the parenting methods, and (2) the different roles played by the emaciated young person, the parents, and the therapist in healing.

Momentos marcantes na construção da mudança em terapia familiar

Assumindo as contribuições construcionistas sociais, esse estudo visa compreender o processo de produção de sentidos sobre a mudança em terapia familiar. Para isso, analisamos o processo terapêutico de uma família a partir da transcrição integral das sessões vídeo-gravadas. Baseado no método da poética social, buscamos identificar momentos marcantes do processo terapêutico vividos pelos terapeutas e familiares. Nossa análise apontou que a construção conversacional da mudança terapêutica foi marcada pelo deslocamento do discurso do problema individual para o da responsabilidade compartilhada, em que a definição do problema como algo individual foi desconstruída, passando o mesmo a ser considerado relacionalmente. Concluímos que o investimento dos terapeutas na construção de uma atmosfera dialógica e não-avaliativa foi fundamental para a emergência desses sentidos de mudança.

Transcending a Differend: Studying Therapeutic Processes Conversationally

Studies of actual conversational behaviours used to generate positive change in family therapy are relatively rare. In this study such conversational details were examined as they occurred in a single session of family therapy. With passages identified by family members as helpful, discursive methods of analysis (conversation analysis and critical discourse analysis) were used to examine an actual conversation between a renowned family therapist (Karl Tomm) and a family formerly at a conversational impasse. Conversational practices and sequences in talk used by the therapist and family members to bridge these differences in their ways of relating are discussed.

Creating ?Maneuvering Room?: A Grounded Theory of Language and Influence in Marriage and Family Therapy

Influence in psychotherapy has been described as a characteristic of the therapist, a characteristic of the therapeutic relationship, and a negotiated process. This study combines grounded theory and task analysis to explore language patterns in facilitating change in family therapy. Thirty-one episodes of therapy were analyzed, resulting in the emergent concept of creating “maneuvering room.” Therapists introduce uncertainty into clients’ beliefs about problems then offer new ways of defining problems by speaking from three dimensions: therapist as expert or non-expert, therapist as participant or observer, or family members’ experiences as similar or different. The findings of this study support a possible common factor in family therapy.

Evaluating problem and systems change in family therapy: A multiple tracking design

A model using single-case designs for evaluating problem and systems change in family therapy is presented and illustrated. The model demonstrates methods of simultaneously investigating (a) the contribution of family-systems processes to problem maintenance and change and (b) the role of treatment in affecting both family processes and problems.

Therapeutic Change and Anorexia Nervosa: Views of a Family and a Therapist

Answers to the question ‘Why do people change in family therapy?’ remain somewhat elusive and may to some extent always remain partial. However, the perceptions of important participants in the therapeutic system, namely family members themselves, seem somewhat under‐utilised. A regular examination and integration of the families' views may lead to enrichment of our understanding of this complex area.In this paper the therapist's (and therapy team's) views of the possible catalysts of change in therapy are compared with one family's ideas twelve months after termination of treatment. The family had attended for family therapy because the middle daughter had been suffering from anorexia nervosa.

Application of behavioral principles within family systems therapy: A conceptual framework for the treatment of alcoholism

Although family systems therapy has been successfully used in the treatment of various clinical problems, there has been little research regarding the process variables that contribute to successful outcomes in family therapy. We propose that the integration of behavioral (learning theory) principles with the family systems framework would allow researchers to establish clear operational definitions and reliable measures of family therapy processes. This paper presents a description of several core concepts in family therapy from the perspective of learning theory. We also present alcoholism within the family as an example of how behavioral principles can help to define and measure family process concepts. Finally, we discuss several of the proposed mechanisms of change in family therapy of the alcoholic through an integration of behavioral principles.

Non‐Equilibrium, Chance and Change in Family Therapy

The model of the systemic approach that we commonly use in family therapy is mainly an homeostatic model insisting essentially on negative feedback and allowing little room for amplification phenomena and for abrupt changes that may occur. Our approach, called “systemic,” is related principally to models applying in cases of processes occurring at thermodynamic equilibrium or at stationary states close to equilibrium. In those instances, stability is maintained no matter what external or internal perturbations are exerted on the system.But our practice shows that a modification limited to one part of the family system extends quickly to the whole system. How are those changes brought about? How is an open system, such as the family in which feedback loops exist, pulled away from a stationary state? It was partly to answer such questions that we started to give attention to organizational forms likely to appear away from thermodynamic equilibrium and particularly to the work done in this field by the team ofllya Prigogine. Starting with a few examples of “dissipative structures” some concepts will be introduced which seem likely to be fruitful in our field.

The use of family assessment and feedback in ongoing family therapy

Abstract The Family Environment Scale (FES) is being used clinically to facilitate assessment, intervention and evaluation of change in family therapy. This paper illustrates the use of the scale by providing case descriptions of two typical families. Discussion of each family member's real and ideal family environment serves to identify key areas of agreement and disagreement about actual and desired aspects of family functioning. This semi-structured procedure can focus each therapy session on specific interpersonal issues and encourage each family member to take an active part in discussing problems and formulating goals.

Child Psychiatry and Family Therapy

Abstract The polarization which has characterized the relationship between child psychiatry and family therapy no longer dominates the interrelationship between the two fields as it once did. Increasingly child psychiatrists are employing family therapy in their clinical work and discovering the valuable contribution the two fields can make to each other. This paper attempts to explore this fruitful interrelationship by reviewing the usefulness of family therapy in relation to diagnosis, treatment, and crisis intervention and by discussing the role of children and the value of dynamic and developmental concepts in understanding core clinical issues and therapeutic change in family therapy.

Processes of change in family therapy

(1976). Processes of change in family therapy. Journal of Family Counseling: Vol. 4, No. 1, pp. 14-22.

Prompting change in family therapy.

ONE reason I think families change in therapy is because, in wishing the good regard of the therapist, they follow his direction. Thus it is important that the therapist seek to guard and enhance his prestige when he can in order that families will have the greatest desire for his approval and be amenable to his direction. Families, however, tend to oppose any direction of the therapist that raises the specter of change in the status quo. Thus, paradoxically, while wishing to please the therapist and follow his direction, families will balk when his direction involves what they perceive as a clear-cut threat to the status quo. One of the great problems for the therapist is to find means to bypass this resistive tendency of families. From the perspective of the family therapist, I find that a useful definition of family status quo may be