Family Therapy Clients Research Articles

In-session therapist actions for improving client retention in family therapy: Translating empirical research into clinical practice

ABSTRACTUp to half of clients in psychotherapy do not return after their initial session, and clients in family therapy are more likely than those in individual therapy to terminate after the first session. Recent research has identified six therapist-related conditions in the family therapy session that have influenced client decisions to continue after the first session. This article reports the findings of a review of the professional literature aimed at operationalizing the six therapist-related conditions by identifying specific family therapist actions that can be deliberately applied during initial family therapy sessions to increase the chances that client families will return.

The Effect of Expectations on Intention to Persist in Therapy

ABSTRACTLittle is known about the impact of expectations on persistence in couple and family therapy. A better understanding of the factors that contribute to persistence in therapy is key to understanding therapeutic dropout. We report results of a secondary grounded theory analysis of individual, couple, and family therapy clients' therapy expectations and their intention to persist in therapy. Participants were 19 clients of MFTs. Results indicate that clients carry expectations about the therapist, therapy process, duration, and outcome. Positive disconfirmation (Tambling & Johnson, 2010) of negative expectations contributed to therapy persistence.

Predictors of Health Care Use for Children of Marriage and Family Therapy Clients

The goal of this study was to determine predictors of children's health care use in families that were presenting for couple and family therapy. Participants completed a battery of assessments addressing various aspects of biopsychosocial functioning. Best subsets multiple regressions were used to determine which variables were best suited as predictors of children's health care use. Results suggest that parents’ marital cohesion and life satisfaction were significant predictors of their children's medical use. Specifically, an increase in parents’ marital cohesion was associated with increased use of health care services by children. Also, lower life satisfaction reported by the parent was related to more use of health care services by the child. These two variables accounted for 46% of the variance in the children's health care use. The identified predictors are valuable potential targets for therapeutic intervention in a family and couple therapy setting.

Conversation and psychotherapy: how questioning reveals institutional answers

By analyzing session exchanges and questionnaires administered to family therapy clients, this article examines questioning as conversational practice grounded in institutional goals that are therapist-directed and therapist-conceived. In their manifestation in talk and text, therapeutic questions function to replace client accounts with the nosological accounts of institutional psychiatry. The analysis illuminates three ways in which questioning works in the session and then locates these in therapy's professional and institutional logic. A critical reflection on psychotherapy's questioning practices in a social context concludes the article.

Ethnic background, therapeutic alliance, and treatment retention in functional family therapy with adolescents who abuse substances.

In this study, the authors examined the role of balance between adolescent-therapist and parent-therapist alliances in the retention of functional family therapy clients. Therapeutic alliances of mothers, fathers, and adolescents were assessed from videotapes of the 1st treatment session for 43 Hispanic and 43 Anglo families. Hispanic families who dropped out before completing the requisite number of sessions were found to have greater imbalance in alliance (parent-adolescent) than those who did complete therapy. However, this finding was not replicated with Anglo families. Results are interpreted in terms of previous research on family-level balanced alliance effects.

Differences in Dropout Rates Among Individual, Couple, and Family Therapy Clients

The premature dropout of clients from therapy is an inefficient expenditure of mental health resources. This study examined differences in dropout rates among individual, couple, and family therapy clients. Data came from archived records at a marriage and family therapy clinic at a university in the United States. Results indicated that there were no significant differences in dropout rates, despite the use of multiple measures of dropout. Thus, from a mental health services perspective, administrators and clinicians can expect that dropout rates will remain fairly consistent across treatment modalities.

Fostering Client Creativity in Family Therapy: A Process Research Study

Creativity has been shown to enhance problem solving, and to increase flexibility and adaptability—qualities associated with positive therapeutic outcomes. Literature related to therapist and/or client creativity is primarily anecdotal. Empirical literature addressing how therapists can facilitate the creativity of their clients in family therapy is scarce. In this study, the researchers used process methodology to code the behavior of therapists and clients in 31 videotaped family therapy sessions. Results show a significant positive correlation between interventions that induce positive affect and the creative client behaviors of optimism and playfulness.

Remarried Clients Seeking Marital Therapy as Compared to Those Seeking Family Therapy

This study compared marital and psychological distress in remarried persons entering a university-related clinic for marital (MT) or family therapy (FT). Complete data from the Brief Symptom Inventory (BSI), Dyadic Adjustment Scale (DAS), FACES-III, and number of children in the home were available for 82 remarried women (41 FT) and 62 remarried men (21 FT). A MANOVA indicated that MT clients had higher levels of marital and psychological distress than those seeking FT. Gender differences were limited to a single BSI scale. MANOVA results were unchanged when only those MT and FT clients with children were compared. Within MT clients, there was no effect of the presence of children in the home.

Impact of Home-Based Family Therapy on Maternal and Child Outcomes in Disadvantaged Adolescent Mothers

This study evaluated home-based family therapy. The clients-116 high-risk urban disadvantaged teenage mothers and their children-received case management and supportive counseling or these services plus family therapy. At the 12-month follow-up the family therapy clients were less dependent on welfare and had improved more on all 3 parenting dimensions but at 24 months there were no significant differences between the groups. (authors)

The Rational-Emotive Therapy (RET) Approach to Marriage and Family Therapy

The Rational-Emotive Therapy (RET) approach to family therapy holds that people largely disturb themselves emotionally when they take their socially learned goals, standards, values, and preferences and irrationally reconstruct them into absolutist, inflexible demands on themselves, on others, and on world conditions. Acquiring a philosophy of acceptance would significantly help people's personal, mamrage, andfamily relationships. This philosophy includes accepting human fallibility, demandingness, some degree of responsibility for one's own disturbance, unconditional self-acceptance, and unconditional acceptance of others. A number of cognitive, emotive, and behavioral methods of RET to help mamage and family therapy clients to achieve these kinds of acceptance are presented in this article.

A follow-up analysis of family therapy clients*

A follow-up analysis of family therapy clients*