Family Therapy Research Articles

Progress of systematic psychological interventions in elderly patients with femoral fractures: A comprehensive review

This review aims to gain a deeper understanding of the psychological state of elderly patients with femoral fractures and provide more theoretical and practical support for clinical treatment and care. Through a literature analysis, we found that elderly patients with femoral fractures face various psychological issues such as anxiety, depression, sleep disorders, and social isolation. The application of systematic nursing interventions in clinical practice, including cognitive-behavioral therapy, mindfulness therapy, family therapy, art therapy, interpersonal therapy, emotion-focused therapy, and relaxation training, has yielded significant results. Systematic psychological interventions can improve the psychological state and quality of life of elderly patients with femoral fractures. Therefore, promoting the application and practice of systematic psychological interventions in the clinical care of elderly patients with fractures will provide more effective psychological services to a wider group of patients with fractures in the future.

Will the Intervention Benefit My Client? Helping Social Workers to Answer the Question Using Indicators of Clinically Meaningful Change

AbstractSocial workers strive to provide the best support to each client, making it crucial to consider not just group-level effects of interventions but also individual outcomes. While empirical evidence often stems from group-based analyses, these offer limited insights into individual change, which is key for tailoring interventions. The aim of this study is to highlight the importance of individual-level analyses, an underexplored area in social work, using four indicators of “clinically meaningful change” (CMC). We compare these analyses with group-level analyses using a dataset of 146 Swedish families undergoing Functional Family Therapy (FFT), an intervention with strong empirical support. While group-level analyses confirmed FFT’s general effectiveness in reducing adolescent psychosocial symptoms, individual-level analyses revealed a more nuanced picture, showing variations in outcomes—positive, negative, and neutral. The study thus demonstrates the value of CMC indicators for generating individual-level information that social workers can harness to find optimal solutions for their individual clients.

Systemic Psychotherapy: An Introduction to Its Theoretical Foundations and Clinical Practice.

Systemic therapy (ST) was approved as a further psychotherapy approach in line with the German Psychotherapy Directive's requirements in 2020 for adults and in 2024 for children and adolescents, and is thus covered by statutory health insurance. Selective literature review on the theoretical foundations and clinical practice of ST, including recent meta-analyses of its efficacy. The theoretical foundations of ST include systems and communication theory, moderate constructivism, the multigenerational perspective, and, in some manuals, the attachment perspective. Structural-strategic family therapy and the solution-focused therapy approach are key elements of its clinical practice. ST is mostly provided in individual or multi-person settings. Important interventions include solution-focused and circular questions, positive reframing, genograms, sculptures, tasks, and prescriptions. Several disorder-specific ST manuals have been developed. The efficacy of ST has been evaluated in 7 recent meta-analyses: ST has been found effective against various disorders, both in adults (affective disorders, anxiety/obsessive-compulsive disorders, substance use disorders, eating disorders, schizophrenia/psychotic disorders) and in children and adolescents (anxiety/obsessive-compulsive disorders, hyperkinetic disorders, substance use disorders, eating disorders, and mixed disorders). For example, in the treatment of depression in adults, ST was shown to be superior to no add-on treatment (Hedges g: 1.09, 95% confidence interval [0.78; 1.40]). ST broadens the scope of treatment options for mental disorders, with a specific focus on their social context.

Evaluating attachment-based family therapy in residential treatment in the United States: does adolescents' increased attachment security to caregivers lead to decreases in depressive symptoms?

The inclusion of family therapy in residential treatment centers (RTCs) has increased over time. However, there is little data on whether empirically-supported family therapies (ESFTs) are being adopted and if they contribute to treatment effectiveness. This study aimed to test whether Attachment-Based Family Therapy (ABFT), an ESFT integrated into a large residential psychiatric system, would improve perceived attachment insecurity (anxiety and avoidance) and contribute to decreases in depression for adolescents. ABFT was integrated into the clinical program of a large, residential psychiatric system. All family therapists were trained to a level of certification. Improvement was measured by changes in adolescent's perceived attachment to caregivers and reduction in depressive symptoms. The sample included 4786 patients. Attachment insecurity and depressive symptoms were measured at intake, week 3, and week 5. A random-intercept, cross-lagged panel model was used to examine the relationships between attachment and depression over time. The results generally supported hypotheses. Attachment insecurity and depressive symptoms improved over the five weeks of treatment. Improvements in attachment avoidance preceded improvements in depressive symptoms within subjects, over time. Simultaneously, improvements in depressive symptoms preceded those in both dimensions of attachment. Thus, improvement in perceived attachment was associated with a reduction in depressive symptoms. RTCs that can generate improvements in attachment insecurity and depressive symptoms, via ABFT or other ESFTs, might improve treatment outcomes, and ideally, adolescents' successful transition back home to families. More research is needed to disentangle the contribution of ABFT and other treatment elements in a multimodal, residential treatment program. The study supports the call for increased incorporation of families into the RTC treatment process.

The Impact of Social Networking Sites on the Family Cohesion of Algerian Society: Risks and Pros

Objective: Therefore, the aim of this study is to assess the impact of SNS on family closeness in the Algerian culture while looking at the benefits in addition to the drawbacks of using the technology. Theoretical Framework: Applying Social Capital Theory, Family Systems Theory, and Uses and Gratifications Theory allows the research to explain the connection between SNS and family cohesion and give a coherent concept of how the media affects family bonds. Method: A cross-sectional survey and qualitative interviews were used as main data collection tools from the families of different SES in Algeria; social networking usage patterns were also quantitatively measured by coded questionnaires and a qualitative approach was employed to explore the family dynamics and modes of communication. Results & Discussion: This study revealed bi-directional relationship between SNS and family connectedness ; and, the following are the majority observation : Nevertheless, some families had lesser amounts of direct confrontation and roadside fights. The findings are elaborated in regard to theoretical frameworks. Research Implications: This research emphasizes on family therapy, counseling and education, and use of internet by families. It prescribes SNS usage as a means for a healthy functioning of families. Originality/Value: This work aims at giving a cultural angle to the effects of social networking sites (SNS) on family integration in Algeria while serving to substantiate the prior research on digitisation counterpoint in the area of relationship communication.

The unspoken experiences of systemic supervisors of color: A modified Delphi study.

Despite collective conversations about the need for more racial diversity, the field of couple/marriage and family therapy (C/MFT) continues to be occupied predominantly by White individuals. Within the C/MFT literature, several scholar-practitioners have highlighted what the lack of racial representation means for our profession and, more importantly, our clients. C/MFT scholars have also shed light on the distinctive experiences of racially minoritized students and therapists traversing a racially homogeneous discipline. However, a smaller, and often overlooked, demographic in these conversations is supervisors of color. This modified Delphi study enlisted the expert perspectives of eight supervisors of color who each have at least a decade of supervisory experience. Consensus among the panelists emphasized the unique, but often inadequate training needs for supervisors of color and the sociocultural factors that often affect the supervisory relationship. This study provides implications that are critical to fostering the professional development of systemic supervisors of color.

A comprehensive narrative review on psychotherapies for patients with autism spectrum disorders

Autism spectrum disorders (ASD) are complex neurodevelopmental conditions characterized by challenges in social interaction, communication, and repetitive behaviors. Psychotherapeutic interventions must tailor to meet the specific needs of individuals with ASD, given their diverse presentation of symptoms and functioning levels. This narrative review explores the range of psychotherapies available for individuals with ASD, examining their methodologies, effectiveness, and suitability. By using targeted search terms such as “autism,” “autistic disorder,” “autism spectrum disorders,” “psychotherapy,” “psychological intervention,” and “psychosocial intervention,” an extensive review of publications in English from 2000 to 2024 was conducted. This review covered several databases, including Embase, PubMed, Web of Science, Scopus, Cochrane Library, and Google Scholar. The review identified ten major psychological interventions for the treatment of individuals with ASD: behavioral therapies, developmental therapies, cognitive behavioral therapy, social skills training, speech-language therapy, occupational therapy, family therapy, mindfulness-based interventions, parent-mediated interventions, and dance movement psychotherapy. The main text elaborates on the effects of each intervention on various aspects of ASD. By providing this comprehensive overview, clinicians can select appropriate therapeutic strategies that cater to the individual profiles of those with ASD, ultimately enhancing therapeutic outcomes and quality of life for this population.

OSTEOARTHRITIS AND METABOLIC SYNDROME: KEY ASPECTS OF PATIENT MANAGEMENT

Introduction: Osteoarthritis is a major health concern, and along with coronary heart disease and arterial hypertension, forms a triad of the most common diseases among the adult population. Osteoarthritis significantly reduces the quality of life, leads to disability, and increases mortality rates. Globally, nearly 240 million people suffer from osteoarthritis (about 10% of men and 18% of women over the age of 60). In terms of disease burden, osteoarthritis ranks: first in complications of the musculoskeletal system, second in the number of visits to family doctors, and third in cases of disability. Patients with osteoarthritis, particularly those with comorbid conditions and metabolic syndrome, face a high prevalence of cardiovascular diseases and an increased risk of premature death. Goal: to elucidate modern insights into the pathogenetic links between osteoarthritis and metabolic syndrome, and to justify new approaches to improving treatment for patients with this pathology. Materials and Methods: A literature search was conducted using scientific databases, employing methods of analysis, comparison, and generalization of information about the relationship between osteoarthritis and metabolic syndrome. The study was carried out at the Department of Family Medicine and Therapy at Poltava State Medical University, based in the Regional Rheumatology Center of M. V. Sklifosovskiy Poltava Regional. The study involved 40 patients, both outpatients and inpatients, including 26 women (65%) and 14 men (35%), aged 54-69 years, with primary osteoarthritis of X-ray stages I-II according to the Kellgren-Lawrence scale, in combination with metabolic syndrome. The control group consisted of 20 individuals. Results. A 12-month monitoring of this group of patient was conducted, revealing mild to moderate manifestations of metabolic syndrome along with polymorbid conditions such as chronic obstructive lung diseases and genitourinary system disorders. Most frequently, one, and rarely two, comorbid conditions were detected, along with one or two diseases unrelated to osteoarthritis. The most common progressive conditions observed were arterial hypertension, ischemic heart disease, heart failure, obesity, type 2 diabetes, and digestive system diseases. The primary goal in managing patients with osteoarthritis and metabolic syndrome is to significantly reduce cardiovascular risk and mortality. This involves developing a comprehensive concept of metabolic syndrome and osteoarthritis, identifying patients at high cardiovascular risk, and implementing preventive measures, including lifestyle modifications and the use of appropriate medications. Conclusions. The study revealed a significant clinical effect from the use of therapy that included coxibs in 78% of patients in the main group with osteoarthritis combined with metabolic syndrome. A positive outcome was observed in terms of pain reduction, a reduction in inpatient treatment duration by 2-3 days, and extended remission periods. For this category of patients, primary prevention should focus on weight loss, increased physical activity, and normalization of metabolic disorders.

A PATIENT WITH OSTEOARTHRITIS AND HYPERTENSION IN GENERAL MEDICAL PRACTICE

Osteoarthritis is one of the most common diseases in Ukraine and worldwide, often leading to early disability in people of working age, making it both a medical and social concern. According to the European Society for Clinical and Economic Aspects of Osteoporosis, Osteoarthritis, and Musculoskeletal Diseases, as well as the International Society for the Study of Osteoarthritis, it is known that a middle-aged patient with osteoarthritis typically has four accompanying pathologies. In elderly patients, in addition to osteoarthritis, up to eight other chronic conditions are often diagnosed. Comorbidity is frequently observed in middle-aged patients with osteoarthritis. Understanding the pathogenetic links between osteoarthritis and comorbid conditions plays an important role in the timely diagnosis and treatment of these diseases, helping to maintain a high quality of life for patients. Objevtive: the study of the pathogenesis of osteoarthritis and arterial hypertension, along with the proposed therapy for treating comorbidities in patients with both osteoarthritis and arterial hypertension, aims to enhance the treatment outcomes. Materials and methods. Analytical and bibliosemantic methods were used in this study. During the scientific search, 38 modern literature sources were reviewed and analyzed concerning the pathogenetic impact on the development of osteoarthritis and arterial hypertension, as well as their shared mechanisms in the development and progression of both conditions. The study was carried out at the Department of Family Medicine and Therapy of the Regional Rheumatology Center, M. V. Sklifosovsky Poltava Regional Hospital. A total of 50 people were examined; the main group consisted of 35 individuals with stage II hypertension, grade 2, combined with stage II knee osteoarthritis (according to the Kellgren-Lawrence scale), with joint dysfunction of stages 1-2. These patients were aged 40-65 years (mean age 51.8±2.14 years). The duration of hypertension was 10.07±1.24 years, and the duration of manifested osteoarthritis was 8.56±1.03 years. The comparison group consisted of 20 individuals with stage II, grade 2 hypertension (mean age 52.5±2.38 years), with a mean hypertension duration of 11.31±1.17 years. The clinical diagnosis of osteoarthritis was established according to the recommendations of the European Alliance of Associations for Rheumatology (2018). The diagnoses of comorbid conditions were confirmed in accordance with relevant orders from the Ministry of Health of Ukraine, with verification by specialized experts. Patients with osteoarthritis received standard treatment, and, when necessary, additional treatment for comorbid conditions was prescribed (a hypotensive combination of an ACE inhibitor and long-acting calcium. Results: The presence of osteoarthritis exerts an additional negative impact on heart rate variability in patients with hypertension. The reduction of the Low Frequency/High Frequency (LF/HF) index due to the use of this therapy (a combination of an ACE inhibitor and a long-acting calcium antagonist in doses of 4/5 mg, 4/10 mg, 8/5 mg, 8/10 mg) in the treatment of patients with comorbidity of hypertension and osteoarthritis contributes to the activation of the sympathetic nervous system, reduction of patient mortality, balancing of the nervous system by inhibiting sympathetic nervous tone, and lowering high blood pressure. Conclusions: The proposed combination therapy for patients with osteoarthritis and hypertension contributes to prolong remission of both the primary disease and comorbid conditions, reduces the frequency of hospitalizations, and shortens inpatient treatment by 3-4 days.

Telehealth delivery of GenerationPMTO in the public mental health system: A pragmatic, noninferiority study.

Telehealth is a promising means for expanding access to mental health treatment. Yet, more research is needed to ensure that telehealth service delivery is no less effective than in-person treatment in real-world service delivery contexts. In the current study, we compared telehealth delivery of the GenerationPMTO parenting intervention to in-person delivery in the context of the public mental health system. Using a noninferiority approach with a sample of n = 1452 caregivers, we found telehealth delivery to be noninferior to in-person delivery on all caregiver outcomes: parenting practices, parenting confidence, and caregiver depressive symptoms. We were unable to conclude that telehealth delivery was noninferior to in-person delivery for child behavior problems. Our findings add to the literature suggesting the utility of using telehealth to provide services to families-particularly for delivering evidence-based parenting interventions to enhance caregiver outcomes. Implications for couple and family therapy are discussed.

Family Therapy in Improving the Psychological Dynamics of Fishermen's Families in Kampung Bahari Nusantara

In the daily lives of fishermen, their livelihoods come from natural resources, namely the sea, which makes them have to adjust to the natural situations and conditions. When natural conditions are uncertain, it can cause the mental or psychological condition of fishermen’s families to decline so that it requires an intervention. The goal is to improve the psychological condition of fishing families, located in Kampung Bahari Nusantara on the South Coast of Malang Regency, by providing guidance through therapy. The therapy carried out is a family therapy to reduce the signs or symptoms that can threaten family welfare in families with problems or disorders. Activities were carried out on July 5 – 7, 2023, to conduct data collection interviews and on October 31, 2023, to carry out the family therapy interventions. The methods used were interviews and observations in collecting data, lectures, and group guidance in conducting family therapy interventions. The results of the therapy carried out have a positive impact on the participants to be more open to other family members, understand the differences in the nature of family members, share anxiety still, and can make the family more harmonious. Keywords: psychological dynamics, family therapy, fisherman

Family therapy and systemic interventions for child‐focussed problems: The evidence base

AbstractThis 25th anniversary review updates previous similar papers published in JFT in 2000, 2009, 2014 and 2019. It presents evidence from meta‐analyses and systematic reviews for the effectiveness of systemic interventions for families of young people with common mental and physical health problems and other difficulties where children are the primary focus of concern. In this context, systemic interventions include both family therapy and other family‐based approaches such as parent training, or parent‐implemented interventions. There is now a substantial evidence base supporting the effectiveness of systemic interventions either alone or as part of multimodal programmes for infant mental health and sleep and feeding problems in infancy; recovery from child abuse and neglect; externalising and internalising problems; eating disorders; somatic problems; and psychosis.

Family Resilience in Care Coordination Technologies: Designing for Families as Adaptive Systems

When a child is admitted to the hospital with a critical illness, their family must adapt and manage care and stress. CSCW researchers have shown the potential for collaborative technologies to support and augment care collaboration between patients and caregivers. However, as a field CSCW lacks a holistic, theory-driven understanding of how collaborative technologies might best augment and support the family caregiving circle as a socio-technical system. In this paper, we report findings from interviews with 14 parents of children with cancer admitted for extended hospitalizations. We use the resilience-based Family Adaptive Systems framework from family therapy as a lens to characterize their challenges and practices across four key subsystems: Emotion, Control, Meaning, and Maintenance. Then, we introduce a fifth system-the Information system-and draw on our empirical findings to suggest theory-driven opportunities for designing future collaborative technology to augment collaborative caregiving and enhance family resilience.

The change process questionnaire (CPQ): A psychometric validation.

Tracking therapeutic processes and outcomes session to session, known as feedback-informed treatment (FIT), has shown many significant benefits for systemic family therapists. However, more clinically useful FIT measures are needed in our field. In response, we conceptualize core dimensions of the therapeutic change process and propose a measure-the Change Process Questionnaire (CPQ)-based on some of those dimensions to provide a clinically useful FIT measure. Developed as a 25-item measure, this study evaluated the measure's psychometric properties, resulting in a refined version with 18 items organized into four subscales (client relationships, client well-being, therapist regard, and therapeutic effect) that demonstrate some alignment with core dimensions of the change process. In this article, we provide a preliminary overview of the CPQ's psychometric validity and potential to contribute to the therapeutic change process and its accompanying scholarly literature.

A Qualitative Service Evaluation of the Introduction of Single Session Therapy for Families in a Child and Adolescent Mental Health Service in England, United Kingdom.

This service evaluation details the process of introducing Single Session Therapy (SST) with families to a Child and Adolescent Mental Health Service in the United Kingdom. SST is a model of short-term psychotherapy intervention which can be applied to family contexts to provide timely mental health support. This service evaluation had two objectives: (1) Review the existing evidence base and literature for SST. (2) Evaluate the implementation of a new SST treatment pathway in CAMHS, including patient experiences and satisfaction with the service. SQUIRE Guidelines are used to report on this new knowledge of healthcare. This evaluation used qualitative methods to evaluate the impact of the new service. The team also used existing frameworks within the Trust, namely discharge data, which is collected routinely as part of service evaluation. This evaluation suggests positive support for this model, and that many families appreciate and value the opportunity to build on strengths and work toward their goals as families. This project outcome appears to support some of Talmon's (1990) findings that the most commonly attended number of sessions is one, and that of those who attended only one session, many perceived the session as useful. Waiting times for our service are extremely long. The pace and structure around goals and solutions could feel both galvanising, as some reported, but others felt it was an insufficient response to the severity of their difficulties. More high-quality research is needed before judgments can be made around the cost-effectiveness or efficacy of SST over existing approaches in the United Kingdom. While implementing SST should not be used to justify reduction in existing interventions, it offers a positive additional service for young people experiencing mental health difficulties and their families.

Diagnosis of Bulimia Nervosa Based on Dsm V

The purpose of this study was to analyze the diagnosis of bulimia nervosa based on DSM V. The method used in this study was qualitative with a library research approach. This study concludes that bulimia nervosa is a form of an intense fear of gaining weight or refusing to maintain body weight at or above average body weight, at least according to age and height, and experiencing disturbances in how to view one's own weight or body shape. So, it causes various severe complications and can even cause death. Therefore, people with bulimia nervosa need comprehensive medical and psychological treatment, namely hospitalization if necessary and individual and family therapy.

Linguistic sensitivity in family therapy: A review of language adaptation strategies for enhancing therapeutic engagement

Language plays a pivotal role in family therapy, shaping the therapeutic process and influencing client engagement and outcomes. This review explores the significance of linguistic sensitivity in family therapy and examines various language adaptation strategies aimed at enhancing therapeutic engagement. Drawing upon existing literature, this paper synthesizes key findings and offers insights into effective approaches for addressing linguistic diversity within therapeutic contexts. Understanding the cultural and linguistic backgrounds of clients is essential for promoting inclusivity and facilitating effective communication in family therapy. Cultural competence encompasses not only an awareness of diverse cultural norms and values but also proficiency in navigating linguistic nuances. By recognizing the impact of language on therapeutic interactions, therapists can foster a more inclusive and empowering therapeutic environment. The review identifies several language adaptation strategies that therapists can employ to enhance therapeutic engagement with diverse client populations. These strategies include linguistic matching, which involves adjusting language patterns and communication styles to resonate with clients' linguistic preferences. Additionally, the use of culturally relevant metaphors, idioms, and storytelling techniques can facilitate deeper rapport and understanding between therapists and clients. Furthermore, the review discusses the importance of employing interpreters and bilingual therapists to bridge language barriers effectively. It emphasizes the need for clear communication protocols and the importance of training therapists in language adaptation techniques to ensure ethical and effective practice. Moreover, the review highlights the role of technology in language adaptation, such as the use of translation software and teletherapy platforms with multilingual capabilities. Leveraging technology can broaden access to therapy and support linguistic diversity in therapeutic settings. Linguistic sensitivity is fundamental to promoting inclusivity and effectiveness in family therapy. By adopting language adaptation strategies and embracing linguistic diversity, therapists can cultivate a more responsive and culturally competent approach to working with diverse families. This review underscores the importance of ongoing research and training initiatives to further enhance linguistic sensitivity within the field of family therapy.

Adolescent, caregivers, and therapists’ experiences of youth and family suicide intervention: A qualitative study

Objective This study explores the experience of an individual and family therapy youth suicide intervention from the perspectives of seven psychotherapy triads (young people aged 12–18, their parents/caregivers and therapists). Method Data were collected through semi-structured individual interviews and analyzed using consensual qualitative research methods. Results Four domains were identified: Focusing on the youth-parent relationship, individual therapy for young people and their parents, conjoint therapy, and public service structures and systemic practice that facilitated tailored treatment. All participant groups valued intervention that improved the youth-parent relationship; however, they held different views about its influence on suicidality and recovery. Separate youth and parent therapy was crucial for facilitating the tailoring of treatment and enhancing the reparative potential of conjoint therapy. Barriers to productive intervention included inaccessible, fragmented, and siloed treatment that excluded parents, stigmatizing clinician responses, and acute care that was not attuned to need or developmental context. Helpful intervention was systemically and attachment-informed, multi-disciplinary, individually tailored, and integrated freely available specialist therapy with crisis and inpatient care. Conclusion A relational, nuanced, and flexible approach is needed to tailor youth suicide treatment in the context of the complexity of youth-parent relationships.

SFT for ASD: A systemic intervention for neurodiverse families

AbstractTo increase the number of family‐based interventions and deal directly with the family dynamic that creates maladaptive manners of coping and connection, structural family therapy (SFT) for autism spectrum disorder (ASD) was developed. The model slowly supports families in being more flexible in their relationships and dynamics while imparting interpersonal skills which enhance communication particularly between the children with ASD and their parents by reforming and supporting an appropriate family structure and family dynamic.

Couples therapy and the challenges of building trust, fairness, and justice.

The cornerstone of the contextual family therapy model is predicated on the belief that all family members benefit from trustworthy relationships, which result from (a) acknowledging the contributions of deserving family members, (b) engaging in responsible interactions, and (c) ensuring a fair distribution of relational burdens and benefits. Nonetheless, conflicts may arise when one partner asserts a claim to relational resources based on need, while the other believes they are entitled to such resources based on merit. Based on relational ethics and the development of trust, this paper focuses on the therapist's role in facilitating the conflict-resolution process to assist couples in reestablishing individual responsibility and accountability within the systemic framework of couple therapy. It elucidates several clinical strategies, including (a) cultivating trust through fairness and focusing on the importance of reciprocity and equitable give-and-take, (b) detecting destructive entitlement, and (c) marital relationships and ethics of care. Several clinical examples are discussed, as well as common couple relational issues associated with horizontal and vertical relationships, partnership, and fusion, and the impact of gender and power dynamics and trustworthiness based on the feminist lens.