Family Therapy Model Research Articles

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.

The essence of contextual therapy, its place in the field of family therapy, and its role in the future.

This article aims to present the basic tenets of contextual therapy and its treatment goals, methodology, and theory of change. It provides an orientation for readers who are new to the approach and should serve as an updated frame of reference for readers already familiar with it. An important contribution of this article is that it clarifies the place of contextual therapy in the vast field of family therapy and dispels some common misunderstandings about the path of its founder, Ivan Boszormenyi-Nagy (1920-2007). Additionally, it demonstrates why contextual therapy should be counted among the postmodern, collaborative approaches to family therapy, which contradicts the usual view that it belongs to the earlier modern models of family therapy. Furthermore, it shows that contextual therapy is well-equipped to incorporate the current and future contributions of human sciences and offers unique therapeutic resources to address the individual and relational consequences of injustices that should remain relevant for the foreseeable future.

Emotion regulation as affective neoliberal governmentality.

Emotion regulation is central in many therapy models, including couple and family therapy models. This article draws on poststructuralist governmentality studies and processual affect theory to offer insight into how the therapeutic concept of emotion regulation may reflect and support neoliberal affective forms of self-governance. We suggest that couple and family therapy-through using professional discourses and affect-oriented techniques or interventions-may be another site wherein neoliberal governmentality is implemented and extended in contemporary westernized neoliberalized societies. In facilitating emotion regulation, we argue that there is a risk that therapists may implicitly promote a neoliberal worldview that encourages clients to mobilize neoliberal techniques to become self-improving, entrepreneurial subjects, responsible for their happiness and well-being. Conditions of precarity associated with individualist, neoliberal capitalist ideologies and policies (e.g., unemployment, job insecurity, forced migration, wealth inequalities, mass incarceration, social isolation) generate emotional burdens for people to manage that professional techniques or interventions may normalize as clients' self-management tasks. We theorize emotion regulation as an affective governmentality tactic of power and suggest that couple and family therapy can offer points of resistance to individualization and responsibilization and opportunities for creating or affirming alternative subjectivities and affectivities.

Increasing Transgender Acceptance in Religious Families: A Pilot Study of Manualized Strategic Family Therapy

ABSTRACT This pilot study explores strategies to increase transgender acceptance within religious families by applying a brief, manualized treatment approach. The research uniquely integrates Haley’s Model for Effective Family Therapy with principles of cultural humility to address the specific challenges associated with transgender identity in a conservative Baptist context. Employing a clinical case study approach, this research combines qualitative and quantitative methods to evaluate the implementation of manualized therapeutic strategies. The study focuses on adapting Haley’s model to enhance family dynamics and promote acceptance while respecting the family’s cultural and religious context. Quantitative data show significant improvements across both the Closeness Scale and the Brief COPE Scale. Family cohesion, overall coping, problem-focused coping, and emotional regulation strategies substantial increased. Qualitative findings further validated these improvements, highlighting enhanced family dynamics and transgender acceptance. These effects were sustained for at least three months post-intervention, indicating lasting positive impacts on family dynamics and coping. This pilot study provides novel contributions by demonstrating how Haley’s Model, adapted with cultural humility, can effectively enhance transgender acceptance within a religiously conservative family system. It underscores the value of culturally respectful and systematic approaches in therapy and highlights the need for further research to explore the long-term effects and broader applicability of these interventions in diverse contexts.

Effectiveness of Integrative Structural Family Therapy and Double ABCX Model on Marital Adjustment and Parenting Stress Among Parents of Children with Autism: Randomized Controlled Trial

Marital adjustment is an important predictor of coping with stress among parents of children with autism spectrum disorder (ASD). A randomized controlled trial conducted on 60 parents of children with ASD showed that integrative SFT and double ABCX therapy, conducted over ten sessions of multiple family therapy in group counseling for five weeks and a one-month follow-up at special needs children’s centers in Jordan, resulted in a 48% increase in marital adjustment and a 34% reduction in parenting stress. These therapies significantly improved the well-being of parents of children with autism, while the control group did not.

Power dynamics in couple relationships: A review and applications for systemic family therapists.

Power dynamics, generally defined as the patterns of partners enacting or resisting influence, are inherent in all relationships. Power structures and processes play a role in people's perceptions of themselves and others, their feelings and emotions, and both their implicit and explicit behaviors. As such, understanding power dynamics is crucial for fully conceptualizing and intervening within relationships. Although power was not always given high priority in many of the early systemic family therapy models, that has changed over the years, with scholars working to address how power is manifested in relationships, how power imbalances affect relationships, and how power can be addressed more explicitly in treatment. Nonetheless, there is much additional work needed to ensure that systemic therapists have an appropriate depth of understanding regarding power dynamics to fully recognize their manifestations in relationships and then intervene appropriately. To help in these efforts, this paper aims to synthesize relational power research into a more complete description of what power is and how it is enacted in couple relationships. To do this, we introduce relevant perspectives of power not fully integrated with family therapy theories. Overall, we provide a brief history of power-oriented research in the fields of family therapy, outline couple research regarding the sources of power that can inform therapeutic case conceptualizations and interventions, describe how power is addressed in specific couple therapy models, and highlight some important clinical applications that can help systemic therapists more fully address power.

Deepening Understanding of Browning’s Strategy: Emergence of an Integrative Strategic Model for Family Therapy

Deepening Understanding of Browning’s Strategy: Emergence of an Integrative Strategic Model for Family Therapy

An integrative treatment model of EMDR and family therapy for children with severe symptomatology after child abuse and neglect: A SCED study

BackgroundChildren who endured child abuse and neglect (CAN) may develop a spectrum of symptoms that goes beyond the development of posttraumatic stress symptoms (PTSS) alone. This can pose unique challenges within the treatment context that may hamper the application of direct trauma-focused treatments. A new treatment model, which focuses on more than PTSS alone, has been developed. Through preparatory work, it aims to engage children in trauma processing. ObjectiveThis study aimed to examine if this integrative treatment model can diminish attachment problems, PTSS, behavior difficulties, and emotional control difficulties in children with a history of CAN who currently reside in permanent placement. Participants & SettingsWe included 15 children between the ages of four and twelve who experienced CAN in the past and who were referred to specialized youth mental health care and their caregivers. MethodsWe conducted a non-concurrent multiple baseline single-case experimental design study with weekly measurements on attachment problems, PTSS, behavior difficulties, and emotional control difficulties through questionnaires. ResultsEight cases were fit to analyze of which all but one participant showed improvement on one or more of the four outcome measures. On group level, we found evidence for functional relationships between the intervention and change in attachment problems, behavioral difficulties, and emotional control difficulties. ConclusionsThis integrative treatment model appears to be a suitable treatment for children with a complex combination of psychiatric problems after CAN and therefore provides promising results for a complex population for whom limited treatment options are available.

Family Counseling With The Spiritually-Directed Satir Model: A Case Report

The number of studies conducted on the family, which has great importance in the life of the individual and society, is increasing. The need for studies on the establishment, continuity, and protection of the family has increased with the rapid change in family structure and the increasing divorce rates in recent years. Family therapy helps family members to deal with and solve their problems with a holistic perspective. The present study aimed to uncover the effectiveness of Spiritually-directed Family Counseling in complex family problems. Developed by Kılınçer, the “Family Therapy Model Using Satir Transformational Systemic Therapy with the Focus on Spiritual Practices of Islam” is a semi-structured model created by integrating the spiritual-religious sources in Islam with Satir transformational systemic therapy. The study was conducted in 11 sessions with a nuclear family with one child who applied with complex problems such as infidelity, bipolar disorder, cancer, childhood traumas, relationship problems, porn addiction, violence, and suicide attempt. As a result of the therapy, it was found that spirituality-directed family counseling can lead to changes in the family at the first level (less fighting, less anger, calmness, etc.) and at the second level (for the couple to forgive and understand each other internally, opening up more space for each other’s feelings, expectations and longings, etc.).

Exploring the Main Models of Family Therapy

Aiming at the improvement of children's behavior and mental health problems, this paper uses a review method to sort out and analyze the current mainstream marriage and family therapy methods with the viewpoints and examples of six different therapies. Cognitive behavioral therapy believes that people's behavior will affect people's thinking and emotions, and improve mental illness through behavior. Narrative therapy believes that personal experiences are fundamentally ambiguous and can only be revealed through multiple interpretations, therefore, they believe that problems exist in language, and therefore problems can also be resolved in dialogue through storytelling. Strategic family therapy believes that people exchange multiple levels of information that define their relationship with each other and that for problematic family rules, we need to change not only the specific behavior of family members but also the family rules. Structural family therapy believes that the goal of therapy is to remove structures that hinder the functioning of the family and replace them with more robust structures that allow the family to function as a whole. Systemic family therapy emphasizes the feelings of the whole family, it tries to identify problems in the family dynamics, as well as the thoughts and attitudes of the whole family to reveal what may be going on in the whole family. Relationship counseling specializes in helping people build the relationships they want with their intimate partners, family, and themselves. Summarizing these modalities will facilitate the integration of all modalities for marriage and family therapy and the selection of the appropriate method.

Internet of Things-Based Home Education Interactive System and Parent-Teacher Relationship Cultivation

In today’s society, young parents have no time to take care of their children under the pressure of life and leave their children to their own parents, resulting in less and less interaction between parents and children. At present, the main problem with family education is that the education method is unscientific. The family education interactive system refers to building a platform for parents and children through the Internet to solve communication problems, improve parents’ educational concepts, and improve the overall level of family education. The level of tacit understanding between parents and teachers has a profound impact on children’s learning. Parents and teachers keep the same educational ideas and form a joint force, which makes students’ subjective learning willingness stronger and effectively avoids negative psychology such as confusion and weariness. Compared with the traditional education model, the new education model is more information-based and digital. The Internet of Things is the product of the expansion and extension of the Internet, which refers to the connection of various information-sensing devices with the Internet to form a broader network system. This study takes parents, students, and teachers as the research objects, mainly applies the embedded system technology in the Internet of Things, and aims to solve some problems in family education and poor communication between parents and teachers. This not only improves the original interactive system of family education but also effectively improves the communication efficiency between parents and teachers by using the Internet of Things technology. Overall satisfaction with the improved home education system increased by 19 percent, and communication efficiency between parents and teachers increased by 8 percent. It has practical reference significance for the research on the Internet of Things in family education. At the same time, the structural family therapy model is used to expand the family’s construction of the problem, obtain a family interaction model to maintain symptoms, and explore the influence of family members’ past on the present and the related changes in family members. In the process of implementation, explore and evaluate the structure of the family, create a situation that changes the family structure, and transform the family system.

22.3 Attachment-Based Family Therapy for Youth at Risk for Suicide: The Next Evolution

Attachment-based family therapy (ABFT) is a manualized, empirically supported family therapy model designed to target family and individual processes that might cause or reinforce adolescent suicide and depression. It is a trust-based, emotion-focused, brief psychotherapy that aims to repair attachment ruptures and rebuild an emotionally protective, secure-based parent-child relationship. ABFT has received 15 years of outcome and process research (Diamond et al, 2022). The model is now well-established and used extensively nationally and internationally.

Multi-family therapy for bulimia nervosa: a qualitative pilot study of adolescent and family members’ experiences

BackgroundMulti-family therapy (MFT-BN) is a new treatment for adolescent bulimia nervosa with emerging empirical support. It extends the bulimia nervosa focussed family therapy model, by offering treatment in a group setting. Up to nine families work together with a team of clinicians over the course of 20 weeks. No qualitative study to date has investigated the experience of MFT-BN. This study aimed to explore this from the adolescent and parent/caregiver perspective.MethodsParticipants from two consecutive MFT-BN groups facilitated at the Maudsley Hospital in London, UK, were invited to participate in either a focus group or individual qualitative interview about the experience of MFT-BN. Of the 19 eligible participants (from 9 families), 15 (8 parents, 1 older sibling, 6 adolescents) consented and participated. Audio-recordings of interviews and focus groups were transcribed verbatim and analysed using reflexive thematic analysis.ResultsThree main themes were identified; (1) seeing and being seen, (2) holistic shift, (3) the unspoken. Participants reported overall shifts in cognitions, emotions, behaviours, and relationships both individually and within the family as a result of attending MFT-BN. Meeting other families with similar struggles and sharing experiences, skills and learning helped reduce isolation and promote change. There was also a sense from participants that some things did not, or could not, be spoken about in the group context and that more direct and challenging conversations might have been helpful at times.DiscussionThe current study identifies some of the perceived benefits and challenges of MFT-BN. The three themes demonstrate the holistic nature of change that can occur across the treatment, as well as the power and limits of the group therapy setting and process. Further research is needed to explore the experience of MFT-BN and its outcomes across a more diverse range of participants and treatment settings.

A Culturally Informed Trauma Therapy Approach for Muslim Refugee Families

Refugees arriving in western countries from predominantly Muslim countries, who have already been exposed to severe traumatic experiences in their country of origin, experience further stress during the resettlement process in the host country. Although the number of Muslim refugees is increasing in the U.S. and Europe, the existing literature is not yet adequate to determine which treatments are effective for traumatized Muslim refugee families. Since inappropriate treatment approaches for this population may result cause ineffective or even negative therapy outcomes, this study aimed to develop a culturally responsive treatment model. Specifically, it offers an integrated family-based therapy approach for refugee families, which is influenced by narrative, art, and narrative exposure approaches. This integrated family therapy model consists of 12 weekly sessions in four phases: a) diagnostic interview; b) narration of the life story; c) exposure to the trauma; and d) re-narration and reprocessing of the traumatic events. Future studies should test the feasibility and effectiveness of this integrated model with randomized controlled trials as the implementation of such treatment models is essential for developing a culturally sensitive treatment model for Muslim refugees.

Tracking Emotional Process in Relationship Interactions Using Sequences

This paper will explore the clinical application of tracking sequences in family therapy with a particular focus on Bowen family systems theory. It considers how sequences can be used to track the emotional process occurring in relationship interactions, and the similarities and differences of a Bowen theory‐informed approach compared with dialectical behaviour therapy and both classic and contemporary family therapy models. Case examples are utilised from the author's clinical practice to raise ideas about the therapist joining the client as a co‐researcher in this exercise and facilitating a process that helps assist the client develop their own self‐awareness and problem‐solving resources in the context of their relationships.

A reflective evaluation of a feeding clinic intervention—Parents as a reflecting team

Accessible summary Children with disabilities can present with eating difficulties that can be a significant stressor on families and the health care teams trying to support them. Integrating behavioural and family therapy models offers a novel way to work with families in this context. Parents working as a reflecting team can facilitate sharing and comparing of ideas and learning over time. Supporting families to move from consumers of health care to co‐producers enables them to not only learn new techniques but also, and more importantly, to critically think about the techniques being offered and how to adapt these to their family preferences, culture, and context.

Effective family interventions for people with schizophrenia

It is encouraging to read a research paper with findings ready for immediate translation to clinical practice. In The Lancet Psychiatry, Alessandro Rodolico, Irene Bighelli and colleagues 1 Rodolico A Bighelli I Avanzato C et al. Family interventions for relapse prevention in schizophrenia: a systematic review and network meta-analysis. Lancet Psychiatry. 2022; (published online Jan 27.)https://doi.org/10.1016/S2215-0366(21)00437-5 Google Scholar report the findings of a thorough systematic review and network meta-analysis of family interventions for relapse prevention in schizophrenia. The authors evaluated 90 randomised controlled trials, with more than 10 000 participants, and identified 11 different models of family therapy. Sometimes simple is best. Family psychoeducation alone reduced the relapse rate significantly when compared with treatment as usual, and to a larger extent than more complex interventions. The findings showed that informing the family about the illness, symptoms, and treatment options had a protective role in the prevention of relapse: about 10% of patients involved in family psychoeducation relapsed compared with 37% among patients who received treatment as usual. Family interventions for relapse prevention in schizophrenia: a systematic review and network meta-analysisAlmost all family intervention models were efficacious in preventing relapse in schizophrenia. Family psychoeducation alone, without behavioural or skills training, was superior to the more complex models. Our results suggest that in contexts where there are financial constraints, family psychoeducation alone should be implemented. Full-Text PDF

Integrating Buddhist-Informed Interventions Into Narrative Family Therapy

Culturally responsive couples and family therapy requires incorporating spirituality into clinical practice at the clients’ request. Researchers led a focus group with Buddhist practitioners who work in clinical care settings to better understand the degree of fit between Buddhist practices and narrative family therapy interventions. Compatible practices included mindfulness, externalization, and self of therapist work. While narrative family therapy's model of change has points of divergence from Buddhism, there are ways to incorporate Buddhist beliefs into narrative practices.

A pilot study of the impact of an integrated individual- and family therapy model for self-harming adolescents on overall healthcare consumption

BackgroundSelf-harming behaviors in adolescents cause great suffering and can lead to considerable costs to the healthcare system. The aim of the current study was to investigate the cost of an integrated individual and family therapy (Intensive Contextual Treatment: ICT) and to compare the adolescent’s healthcare consumption 1 year before and 1 year after treatment.MethodThe study had a within group design with repeated measures. The clinical outcomes and the cost of ICT treatment are based on a sample of 49 participants who were previously enrolled in an intervention trial. Participants with significantly improved clinical outcomes (self-harm behavior, or general mental health symptoms) were defined as treatment responders. Calculation of changes in healthcare consumption is based on 25 participants who gave their consent to participate in a retrospective collection of healthcare data from medical records, including inpatient and outpatient care, and prescribed medication.ResultsThe average estimated cost of ICT per person was €5293. There were no significant differences between the cost of healthcare consumption 1 year before and after ICT, but the results suggested that the adolescents consumed less inpatient and specialized care after treatment. There was a significantly higher cost of psychotropic medication after treatment explained by a higher consumption of central stimulants. Treatment responders (general mental health problems) reduced their consumption of healthcare resources significantly more than non-responders, especially regarding hospital visits and total health care costs.ConclusionsGood response to the ICT in terms of improved general mental health symptoms seems to be associated with reduced healthcare consumption during the post-treatment period. However, controlled studies with larger sample sizes are needed to draw causal conclusions. The results of this study should be interpreted with caution as it is based on a small sample and attrition rate was high.Trial registrationThis study has been registered with the ISRCTN: 15885573.

Treating incarcerated lesbian couples with the Tadros Theory of Change

Incarceration is a major systemic issue in the United States. Many couples undergo multifaceted, complex changes in their relationship due to incarceration. The purpose of this paper is to explore the usage of the Tadros theory of change, an integrative approach to couple and family therapy, to treat incarcerated lesbian couples. A case application is provided utilizing this integrated family therapy model with a lesbian couple experiencing sexual and relational issues as well as offering clinical implications for future usage. This case emphasized how client’s narratives change over time, how the systems in their lives change simultaneously, and the impact of LGBTQ + stigma on couple functioning as they navigate the criminal justice system aids in the exploration of a client’s story. Thus, gaining an in-depth understanding of the intersection between complex issues. This paper advocates for the usage of this theory with lesbian couples within the incarcerated context to better treat this underserved population.