Training Of Family Therapists Research Articles

A commentary on infant mental health knowledge within the training of family therapists

AbstractThis paper considers the role of academic training programs in the integration of family therapy and infant mental health (IMH) curricula. It takes the form of a conversation between senior academic staff of the Bouverie Centre in Australia and the special issue editors. Robyn Elliott and Colleen Cousins are family therapists, trauma specialists, and academics at the Bouverie Centre, La Trobe University. Robyn supervises the development and delivery of the Master of Clinical Family Therapy, accredited by the Australian Association of Family Therapy. Colleen is a psychologist and family therapist and coordinates the Graduate Certificate of Family Therapy program. They are in dialogue here with the special issue co‐editors, Jessica Opie and Jennifer McIntosh. We consider the degree to which current family therapy training holds the infant in mind, and approaches to deepening the future training nexus between IMH and family therapy.

A comparison of classroom-based and online multicultural training course within a marriage and family therapy training program.

This study contributes to an emerging area of research on online learning within marriage and family therapy training programs while responding to the need for research on the effectiveness of multicultural training marriage and family therapists receive. Using 32 students in a marriage and family therapy program and a pretest-posttest design, this study focused on student outcomes across a classroom-based multicultural training course and an online section of the same course. Support was found for the effectiveness of each instructional modality in delivering multicultural training. Findings also indicated that student gains did not significantly differ across students in the two course sections. This is the first study to provide evidence that online learning does not compromise the effectiveness of multicultural training for marriage and family therapists and adds evidence to the claim that the multicultural training marriage and family therapists receive is effective in achieving its aims.

Zooming into Feminist Family Therapy Telesupervision: Experiences of Supervisors during the COVID-19 Pandemic

ABSTRACT The COVID-19 pandemic has altered the way feminist clinical supervisors provide supervision to family therapist trainees. This study explored the experiences of feminist family therapy supervisors who engaged in supervision remotely or had transitioned to virtual supervision. Using thematic analysis, four themes emerged from analysis of eight supervisors’ answers to an online survey: using technology as a collaborative medium, self-of-the-supervisor process, intentional supervisory relationship, and supervisor responsibilities. In telling their stories, the supervisors described how they pivoted to support therapists, attended to parallel processes, and adjusted their own supervision techniques to maintain their feminist focus. The authors discuss implications of supervision adjustments and offer suggestions and considerations for remote feminist supervision and recommendations for future research.

Exploring Our “Deltas”: A Training Tool for Conceptualizing Systemic Theory of Change

Systematically utilizing theory to guide clinical practice is integral to developing and maintaining therapist competency. However, helping Marriage and Family therapist trainees develop their own theory of change can be a challenging training component and more educational guides are needed to help facilitate the learning process. This paper introduces the Delta Model for conceptualizing systemic change as such a tool. The proposed Delta Model is introduced and guidelines for specifically teaching trainees at each level of the Delta are provided. The proposed model will be applied to a case vignette and discussion of additional considerations for applying the Delta Model beyond clinical practice will be reviewed.

MFTs: Confidence, Comfort, and Training to Address Client Financial Concerns

Research is limited regarding the training marriage and family therapists (MFTs) receive in the area of financial problems couples and families experience. We surveyed 293 professional MFTs to gain information about their financial training, level of comfort addressing financial topics with clients, and level of confidence to successfully address financial concerns of clients. Results indicated the majority (61%) of therapists did not receive any financial training but reported feeling comfortable (46.1%) or very comfortable (22.2%) addressing financial issues, and somewhat confident (56.7%) or very confident (23.2%) they could successfully address client financial issues. Therapists who received some type of financial training were more confident and comfortable addressing client concerns than those who did not receive any training. Implications for the field of marriage and family therapy are discussed.

Clinical Supervision of Couple and Family Therapy during COVID‐19

This paper addresses the need for a swift transition from in‐person clinical supervision to telesupervision during the time of the COVID‐19 global pandemic. Five specific areas will be discussed in the effort to enhance the quality of clinical supervision provided to couple and family therapists in training at this time including the following: (1) COVID‐19 and the structural changes and technological adaptation of supervision; (2) culturally and contextually sensitive guidelines for clinical supervision during COVID‐19; (3) the supervisee’s competence and the clinical supervisory process; (4) the new set of boundaries and the supervisory role; (5) and the supervisory alliance and supervisees’ vulnerabilities in the face of COVID‐19.

Remote Care for Caregivers of People With Psychosis: Mixed Methods Pilot Study.

BackgroundA reduced availability of resources has hampered the implementation of family work in psychosis. Web-based support programs have the potential to increase access to high-quality, standardized resources. This pilot study tested the Norwegian version of the Relatives Education and Coping Toolkit (REACT), a web-based United Kingdom National Health Service program in combination with phone-based support by trained family therapists.ObjectiveWe investigated how the program was perceived by its users and identified the facilitators and barriers to its clinical implementation.MethodsRelatives of people with psychosis were offered access to REACT and to weekly family therapist support (with 1 of 2 trained family therapists) for 26 weeks. Level of distress and level of expressed emotion data were collected at baseline and after 26 weeks using the Family Questionnaire and the Relatives Stress Scale. Both family therapists and a subset of the relatives were interviewed about their experiences after completing the program.ResultsDuring the program, relatives (n=19) had a median of 8 (range 4-11) consultations with the family therapists. Postintervention, there was a significant reduction in stress and in expressed emotions in the relatives of people with psychosis. Interviews with the relatives (n=7) and the family therapists (n=2) indicated the following themes as important—the intervention turned knowledge into action; the intervention strengthened the feeling of being involved and taken seriously by the health services; and management support and the ability for self-referral were important, while lack of reimbursement and clinician resistance to technology were barriers to implementation.ConclusionsThe service was found to offer a valued clinical benefit; however, strategies that aim to engage clinicians and increase organizational support toward new technology need to be developed.

Sense of coherence in systemic family therapy trainees in times of change

This study aimed at qualitatively exploring the development of a sense of coherence (SOC) among systemic family therapist trainees (FTT) over a 3-year period. It was conducted in a private family therapy training institute in central Germany. The sample consisted of 66 trainees. The components of SOC and their general health played an important role in the development of FTTs throughout the three training years. Findings show that the SOC component of meaningfulness (motivation) was most frequently mentioned and most important to participants’ personal and professional development, followed by comprehensibility (understanding of self, others and the context) and finally by manageability (coping with challenges based on personal, social and professional resources). The three SOC components fostered a positive self-care approach in FTTs and improved health and well-being over the 3 years. Visions of FTT at the end of the training show that they aim at personal and professional growth and development in the Fourth Industrial Revolution (4IR).

Family Therapy for Child and Youth Mental Health: A Scoping Literature Review

Early intervention in childhood years is an important part of successful therapies for children and adolescents living with or at risk of mental illness. Family therapy acknowledges the role of family relationships, interactions, and family systems in child and youth mental health. To explore the effectiveness and delivery of family therapy in order to inform current family therapy practice in Australian public mental health services, a scoping literature review mapped key concepts of the past 11 years of family therapy research. Current gaps were noted within the following key concepts: family therapy settings and definitions, the influence of family factors on outcomes, transparency of intervention methods, and the training of family therapists. Further research could be undertaken to address current gaps in the literature, specifically: assessment and intervention processes; typical length of time for a series of family sessions; frequency of sessions; and theoretical foundations linked with most effective outcomes, as identified by clinicians, children, and their families. This research would provide a better understanding of best practice and evidence‐based family therapy practices that work for children and their families to inform family therapy practice in Australia and beyond. This scoping literature review identified that there is a noteworthy variation in the way brief family therapy is provided, both in terms of the duration and frequency of sessions, as well as the theoretical underpinnings employed. Further research is warranted to explore different service contexts and brief versions of family therapy delivery and the outcomes for the children and their families.

The Puzzling Metaphor: Teaching General Systems Theory to Marriage and Family Therapy Trainees

This article aims to connect the general systems theory (GST) principle of Holism and structural family therapy (SFT) to highlight commonalities between theories. This article will discuss primary concepts, family development, symptomology, process of change, and techniques of SFT in order to provide a basic overview of the theory. In an effort to provide a means for teaching marriage and family therapist trainees, an innovative strategy using metaphor will be introduced. The Puzzling Metaphor symbolizes the systems concept of holism in a visual representation coupled with SFT’s concepts and techniques to concurrently learn principles of both models.

Developing Value-Orientations in Family Therapy Trainees: A Three-Year Investigation.

Family therapy has advanced as an important therapeutic approach in Europe and, in Germany, future family therapists enter a three-year-training programme every year. Family therapist trainees (FTTs) have hardly been studied in terms of their value-orientations (VOs) and how they see the world. This study aims at researching the value-orientation developments in FTTs during the three-year training period and based on the Schwartz value model. A longitudinal study was carried out over a three-year period. The sample consisted of 65 FTTs. VOs were investigated using open questions in self-developed questionnaires. The findings show that FTTs focus mainly on VOs in the Schwartz value domain of "benevolence", followed by "self-direction" and "universalism". This shows that the well-being of others is in the centre of interest in FTTs. However, VOs which indicate a freedom to make decisions and be self-directed are also extremely important. The least-mentioned value domains include "power" and "stimulation", showing that FTTs are neither focused on status, wealth or richness, nor on excitement or a varied life. With regard to the Schwartz value dimensions, the dimension of "self-transcendence" was the most frequently mentioned, followed by "conservation", "openness to change" and "self-enhancement". Self-transcendence includes the value domains of benevolence and universalism and shows that the preservation and enhancement of welfare of other individuals are highly important, as well as VOs such as understanding, appreciation, tolerance and protection of human beings and the environment. So-called collectivist VOs seem to be more important to German FTTs than individualistic VOs: they focus on the needs of the social group and their VOs show that the systemic view is inherent in their social VOs. Findings further show that FTTs develop their professional identity while consciously strengthening their VOs. This study contradicts previous research which claims that FTs are, to a large extent, unconscious in respect of their VOs. The study shows that FTTs are aware of their VOs and this supports them in facilitating client-centred approaches and develop themselves as FT professionals. Recommendations for future research and practice are provided.

The Development of a Sense of Coherence in Family Therapy Trainees in Germany: A Three-Year Investigation

ABSTRACTResearch on family therapy training and sense of coherence is lacking. Sense of coherence has been proposed as a meta-model for salutogenic family therapy. This study aims to explore the development of sense of coherence among systemic family therapist trainees in Germany over a 3-year period. The sample consisted of 66 trainees (1st year) with 55 and 43 respondents in the 2nd and 3rd years, respectively. Biographical and sense of coherence data were analyzed. Findings indicate an increase in total sense of coherence, particularly for meaningfulness. Certain subgroups developed sense of coherence and subscales more so than others. Conclusions are provided and recommendations for family theory and practice given.

Clinical Training and Practice Patterns of Medical Family Therapists: A National Survey.

Medical family therapy (MedFT) has gained momentum as a framework in healthcare for individuals and families. However, little is known about what background training and clinical experiences Medical Family Therapists (MedFTs) have in everyday practice. This study investigated the clinical training of MedFTs and their practices in a variety of care settings. A survey was completed by 80 participants who use a MedFT framework in practice, with descriptive data on curriculum, clinical training, and treatment characteristics. Results reflect that many MedFTs lack formal coursework in key content areas of their graduate training and work primarily with psychological and relational concerns. Future research is needed to explore how MedFTs practice around specific mental health and chronic health conditions.

The Importance of Training Marital, Couple, and Family Therapists in Sexual Health

Sexual health has been declared a sexual right and part of human rights on health and freedom from discrimination. Over 40 years ago the World Health Organization, and other international organisations since, have called for marital, couple, and family therapists to be trained in working with sexuality in a respectful, positive manner that affirms sexual health and sexual expression. Despite this, there have not been significant strides in helping therapists understand a view of sexual health focused on freedom of expression and pleasure, nor significant advances in requirements for professional training in a broad conceptualisation of sexuality. There is also evidence that practitioner comfort with the topic has not significantly changed over time. In this paper, ethical issues impeding the advancement of sexual health services within mental health professions are explored and recommendations for training curriculums are provided.

Training Family Therapists for Working in the Schools

Historically the schools have not been substantial employers of family therapy professionals. Yet, the issues of school violence and dropout prevention have raised awareness of the need to work with families as pro-social deterrents. Since Marriage and Family Therapists are trained to work systemically and productively with families in many contexts, the next step is to provide new trainees with general and specific skills for working within the schools where they can activate and connect the resources in the family and in the school. The following manuscript describes an overview of how a district-wide MFT program trains inexperienced therapists to work in the schools.

Supporting Couples, Marriage, and Family Therapy Trainees in Need of Performance Improvement

Couples, marriage, and family therapy (CMFT) educators and supervisors are required to differentiate between typical developmental struggles and more severe competency concerns. This process has the potential to become highly subjective and supervisors may differ in their perceptions of severity of trainee concerns, the need for intervention and/or remediation efforts, types of interventions utilized, and when to discontinue remediation efforts after interventions have failed to be effective. Ethical and competency standards, Council on Accreditation of Counseling and Related Educational Programs (CACREP) guidelines, and American Association for Marriage and Family Therapy (AAMFT) core competencies can be utilized in combination with a collaborative supportive approach to identify and encourage remediation of competency concerns for couples, marriage, and family therapists in training (CMFT-ITs). A composite case study is utilized to illustrate the unique demands of CMFT programs, promote early identification of ineffective trainee behaviors, consider ethical and legal mandates, and provide recommendations for intervention and remediation.

Training Marriage and Family Therapists in Formal Assessment: Contributions to Students’ Familiarity, Attitude, and Confidence

Studies suggest that few practicing marriage and family therapists use formal assessments and even fewer use systemic assessments. Given the potential value of formal assessment to both clinicians and clients, we surveyed current marriage and family therapy students (N = 91) about their familiarity, attitude, and confidence in training with assessment. Experience using assessments predicted familiarity. Having a supervisor that valued assessments predicted familiarity and confidence in training. The number of courses taken in assessment was not predictive of familiarity, attitude, or confidence. Implications for training and future research are discussed.

Thinking and working relationally: interviewing and constructing hypotheses to create compassionate understanding.

In the initial interviews of family therapy sessions, the therapist faces the challenge of obtaining and organizing the information that is most relevant toward understanding the essential concerns that families and couples bring to therapy. This article describes the process of clinical interviewing and case conceptualization used in training family therapists at the Ackerman Institute for the Family. This approach helps the therapist bring forward, and organize, specific information into relational hypotheses, or systemic-relational conceptualizations, that allow both family members and the therapist to understand presenting problems within their relational contexts. While always provisional, relational hypotheses help anchor the therapist in a systemic-relational frame and provide a conceptual through-line to guide the ongoing work of the therapy. The process of interviewing and the construction of clear and complex conceptualizations of presenting problems are illustrated through case examples.

Exploring Discourses That Affect Therapists Regarding Single Women

Grounded in the narrative approach, this article describes an innovative, experiential practice for therapists to explore their own stories and interrelations with dominant social discourses concerning singlehood in Israeli Jewish women. As demonstrated, the practice broadens the participants’ awareness of the influences of these discourses on their work. The personal and professional effects of this practice on therapists are discussed, as well as the extended possibilities that are opened up to both the therapists and their clients in the therapy room. Additional ways of using variations of this experiential practice in supervision and in the training of family therapists are suggested.

Is Family Therapy Including Children?

This paper presents a review of recent child therapy and family therapy texts and training courses in Australia. The aim was to determine the extent to which knowledge and information about child development and emotional and psychological problems in children and adolescents is included in the education and training of family therapists. The paper argues this is crucial to prevent the difficulties of young person's being ignored or exacerbated and discusses relevant ethical issues.