Multifamily Group Therapy Research Articles

A terapia multifamiliar no tratamento da dependência química: um estudo retrospectivo de seis anos

INTRODUÇÃO: A inclusão de intervenções focadas na família, através da terapia unifamiliar, ou da terapia multifamiliar (TGMF) vem crescendo como uma forma de enfrentar um problema tão grave e complexo como é a dependência química. OBJETIVOS: Investigar e avaliar fatores associados à adesão ao tratamento multifamiliar no tratamento de dependentes químicos hospitalizados. MÉTODO: A pesquisa é um estudo transversal retrospectivo, com uma amostra de 672 famílias participantes da TGMF durante o período de seis anos (de março 1997 a julho de 2003). Foi realizado um estudo dos fatores sociodemográficos como idade, sexo, tempo de uso da substância e quanto ao tipo de droga mais prevalente e investigada a associação entre o grau de parentesco do familiar participante do programa e a adesão ao tratamento multifamiliar. Foram pesquisados 672 prontuários de sujeitos que estiveram internados e ingressaram no programa de tratamento multifamiliar e os relatos das sessões descritos pelo terapeuta coordenador do grupo. RESULTADOS: Há associação entre a participação da família e adesão ao tratamento. A participação de dois ou mais familiares repercute na adesão. DISCUSSÃO: Os resultados sugerem que inclusão de um número maior de familiares poderá repercutir em uma maior adesão ao tratamento.

Preventing recurrence of bipolar I mood episodes and hospitalizations: family psychotherapy plus pharmacotherapy versus pharmacotherapy alone

This study compared the efficacy of three treatment conditions in preventing recurrence of bipolar I mood episodes and hospitalization for such episodes: individual family therapy plus pharmacotherapy, multifamily group therapy plus pharmacotherapy, and pharmacotherapy alone. Patients with bipolar I disorder were enrolled if they met criteria for an active mood episode and were living with or in regular contact with relatives or significant others. Subjects were randomly assigned to individual family therapy plus pharmacotherapy, multifamily group therapy plus pharmacotherapy, or pharmacotherapy alone, which were provided on an outpatient basis. Individual family therapy involved one therapist meeting with a single patient and the patient's family members, with the content of each session and number of sessions determined by the therapist and family. Multifamily group psychotherapy involved two therapists meeting together for six sessions with multiple patients and their respective family members, with the content of each session preset. All subjects were prescribed a mood stabilizer, and other medications were used as needed. Subjects were assessed monthly for up to 28 months. Following recovery from the index mood episode, subjects were assessed for recurrence of a mood episode and for hospitalization for such episodes. Of a total of 92 subjects that were enrolled in the study, 53 (58%) recovered from their intake mood episode. The analyses in this report focus upon these 53 subjects, 42 (79%) of whom entered the study during an episode of mania. Of the 53 subjects who recovered from their intake mood episode, the proportion of subjects within each treatment group who suffered a recurrence by month 28 did not differ significantly between the three treatment conditions. However, only 5% of the subjects receiving adjunctive multifamily group therapy required hospitalization, compared to 31% of the subjects receiving adjunctive individual family therapy and 38% of those receiving pharmacotherapy alone, a significant difference. Time to recurrence and time to hospitalization did not differ significantly between the three treatment groups. For patients with bipolar I disorder, adjunctive multifamily group therapy may confer significant advantages in preventing hospitalization for a mood episode.

Psychotherapy as a Rite of Passage

Some psychotherapies may work because they resemble rites of passage. To explore this idea, this article describes an "individual" case of depression in which drug, cognitive, and narrative approaches fell short of effectiveness, and change occurred in a series of experiences that resemble a rite of passage. This resemblance is illuminated by examining two apparently quite different healing processes--Alcoholics Anonymous and multifamily group therapy in schizophrenia--to explore the elements they have in common with the case described: the acceptance of what Victor Turner called a liminal experience, and the importance of witnesses to the ritual support for that acceptance. The discussion contributes to a loosening of the distinctions between the processes of individual, family, group, and other social therapies and leads to questions about the expert knowledge the therapist provides.

A relational approach to eating disorders multifamily therapy group: Moving from difference and disconnection to mutual connection.

A relational approach to eating disorders multifamily therapy group: Moving from difference and disconnection to mutual connection.

Parent-Adolescent Relationships: The Influence of Multi-Family Therapy Group on Communication and Closeness

This article examines perceived change in communication and closeness between adolescents and parents after four weeks in adolescent residential chemical dependency treatment. Adolescents completed perception of parent-adolescent communication, closeness, and open-ended questionnaires before (n = 18) and after (n = 10) treatment and perceived changes in relationships after treatment. T-tests compared (a) those completing the post-test with those not, (b) pre- and post-test responses, and (c) pre- and post-test responses based on parents' attendance at multi-family therapy groups (MFTG). Positive change occurred after four weeks, especially when parents attended MFTG. The critical role of parent involvement in adolescent treatment needs recognition by funding and referral sources.

Multi-Family Group Therapy for Sexually Abusive Youth

SUMMARY Although Multi-Family Group Therapy (MFGT) has been a researched intervention for nearly 40 years, clinicians working with sexually abusive youth and their families have only more recently begun to utilize the intervention. We believe MFGT for a sexual offense-specific treatment population is a sophisticated and powerful clinical intervention with unique advantages including economical use of clinician resources, family-to-family transfer of knowledge and mentoring, community-based resourcefulness, and accelerated catalyzing of emotions. This article will provide direction on establishing the MFGT format as well as discuss its goals, curriculum, facilitation priorities, and strategies.

Coping with infertility: a body-mind group intervention programme for infertile couples.

The recognition of the distressing character of infertility diagnosis and treatment has led to the development of several psychosocial interventions for infertile couples. At the Leuven University Fertility Centre, a body-mind marital group intervention was developed to help infertile couples cope with the distress related to infertility. This treatment programme was originally adapted from a mind-body approach, but integrated concepts and techniques from body-oriented therapy, art therapy and multi-family group therapy. In this paper, the therapeutic foundations, treatment goals and practical implications of the mind-body marital group intervention are outlined. Further, the treatment procedure is explained in detail and illustrated by clinical vignettes. Although the first clinical impressions about the usefulness of the body-mind group programme in fertility clinics seem promising, further research is needed to assess its effectiveness.

Treating Chronic and Severe Mental Disorders: Handbook of Empirically Supported Interventions

Treating Chronic and Severe Mental Disorders: Handbook of Empirically Supported Interventions

Families helping families: implementing a multifamily therapy group with substance-abusing adolescents.

The professional literature identifies a variety of risk factors that indicate whether an adolescent is at risk of substance use (Hawkins, Catalano, & Miller, 1992). Many of these risk factors revolve around family composition and dynamics such as family drug use, family interaction patterns, and boundaries (Smith & Springer, 1998). Therefore, in treating a substance-abusing adolescent, the family is a key target of intervention. Multifamily therapy groups (MFTGs) have been used to involve families in treatment and have been found to be effective with a variety of populations across many settings (Meezan & O'Keefe, 1998; O'Shea & Phelps, 1985). We developed an MFTG model that was used in conjunction with individual and family therapy with substance-abusing adolescents. This article provides a theoretical overview of the MFTG model and describes and illustrates the implementation of the model with substance-abusing adolescents and their families. STRUCTURE OF THE MFTG Our MFTG model was a treatment component of a therapeutic milieu for substance-abusing adolescents. As part of the program, adolescents and their families voluntarily attended weekly individual family therapy sessions and a multifamily therapy The average size of the MFTGs was four to five families, for a total of from 12 to 15 clients. (MFTGs much larger than this are not recommended because they can become overwhelming for all involved.) Each group session lasted 1 1/2 hours. The average age of the adolescent group members was 15 years. Most of the adolescents were polysubstance abusers, using primarily alcohol and marijuana, and had coexisting mental health diagnoses such as depressive and anxiety disorders, oppositional defiant disorder, and attention-deficit hyperactivity disorder. The MFTG was an open Membership changed each week, so each group session began with introductions and a brief review of the group rules, such as What we say in group stays in group. Adolescent members introduced themselves and the rest of their family. Sometimes, the group leaders began the sessions with a brief 10-to 15-minute presentation of psycho educational material. However, some group leaders began sessions simply by inviting families to share how their week had gone and what type of progress they were making on their goals. Very often, this approach led to intense groups marked by member-to-member interaction. OVERVIEW OF THE MFTG MODEL The proposed MFTG model integrates techniques and interventions primarily from four modalities: solution-focused and structural family therapy, and an interactional and mutual aid approach. Solution-Focused Therapy Solution-focused therapy (SFT) (Berg & de Shazer, 1991; de Shazer, 1985; Selekman, 1997) underscores the positive attributes that clients bring with them to treatment. It is a strength-based approach. Using SFT, clients are encouraged to develop future-oriented, positively worded goals. Practitioners are encouraged to work in partnership with clients and to foster collaborative relationships with resources that may benefit the client. We used two techniques from SFT: (1) the scaling question and (2) the miracle question (Berg & de Shazer, 1991; de Shazer, 1994). The scaling question provides a direct and nonthreatening way to monitor client functioning on goals over time. Consider the following illustration. Johnny's primary goal was to get along better with his parents. Using the scaling question, the group leaders asked Johnny to rate, on a scale from 1 to 10, how well he got along with his parents during the preceding week, with 1 indicating that he did not get along with them at all and 10 indicating that he got along with them great. Suppose Johnny gave a rating of 6. The leaders would then ask Johnny what he and his parents could do over the next week to make it from a 6 to a 7. …

Multi-Family Group Therapy for Families of Incarcerated Felons

Abstract This manual presents a comprehensive treatment protocol for families of felons incarcerated for either first or second-degree murder. Literature searches for interventions designed to meet the multi-faceted clinical needs of these unique families have yielded no extant programs for this challenging population. The treatment program illustrated in this manual is based on the multi-family group therapy approach, which is a modality derived from the family systems and group therapy traditions. Due to the complexities of addressing the identified pathological states, which accompany exposure to a family member being incarcerated for murder, an eclectic, integrative therapy approach is recommended. Further, a prescriptive model is deemed best suited to address the multi-system pathologies presented by these families with validated, well-researched interventions. A session-by-session treatment overview is provided with explanations of the specific treatment components employed and case illustrations.

Psicoterapia de grupo de apoio multifamiliar (PGA) em hospital-dia (HD) psiquiátrico

INTRODUÇÃO: O familiar é a ponte, entre o ambiente da casa do paciente e o ambiente terapêutico do hospital-dia (HD), onde o paciente permanece das 7h30 às 15h30, de segunda a sexta-feira. A complexidade para a integração do exercício dessa tarefa e suas conseqüências para o tratamento em HD, levou-nos a criar a Psicoterapia de Grupo de Apoio multifamiliar (PGA) para facilitar o exame das vissicitudes desta via de duas mãos entre a residência e o HD. OBJETIVOS: As características, liderança e fatores terapêuticos de Yalom nessa PGA serão objetos do presente trabalho MÉTODO: A PGA é um grupo aberto com 1 h e 15 minutos de duração, de freqüência semanal e com coordenação, em coterapia, de um psicoterapeuta de grupo e de uma enfermeira psiquiátrica. RESULTADOS E DISCUSSÃO: Os resultados foram obtidos pelo exame de 20 grupos sucessivos, tanto após cada sessão, pelos coterapeutas e observador mudo, durante 20-30 min, como pela análise de conteúdo de 20 sessões transcritas. A presença sempre foi maior que 80% dos familiares esperados, com predomínio de mulheres, especialmente mães de pacientes. A estrutura oferecida pela liderança apressou a obtenção de resultados no curto prazo, entre 4 a 6 sessões. A Coesão Grupal de Yalom apareceu em situações comuns e criou um senso de união entre todos. CONCLUSÃO: A adesão de familiares à PGA facilita e abrevia a terapia em HD. Questiona-se quanto, no futuro, a família orientada assumirá na condução do tratamento dos seus pacientes.

Evaluating the Effectiveness of Multifamily Group Therapy in Child Abuse and Neglect

This article compares the effectiveness of multifamily group therapy (MFGT) with traditional family therapy in the treatment of abusing and neglectingfamilies. Eighty-one families were ran domly assigned to the MFGT group or a comparison group where they received traditional fam ily therapy. Comparison of group means was conducted at pretest and at the close of service on child abuse potential and numerous measures of family functioning. Within-group changes were also examined between pretest and posttest. At posttest, families receiving MFGT reported sig nificantly lower child abuse potential scores and significantly better social support scores than families in the comparison group. Additionally, within-group comparisons show that the MFGT group significantly improved in a larger number of areas of family functioning than the comparison group. The findings argue for the expanded use of MFGT with maltreating families and its adoption of a greater number of family service agencies dealing with this population.

Multifamily Group Therapy: Impact on Family Functioning and Child Behavior

The authors compare the effectiveness of multifamily group therapy (MFGT) with traditional family therapy with abusive and neglectful caregivers and their children. Positive changes in the family functioning of the MFGT group occurred in areas critical to the reduction of child abuse and neglect, whereas changes in the family functioning of those in traditional family therapy occurred only in the area of parental support. The MFGT group children became significantly more assertive and less submissive according to their self-report and, according to their caregivers, showed significantly fewer overall behavior problems and greater social competence at the end of treatment. Changes in the children in the comparison group were not self-reported and did not occur in the area of social competence. These positive findings argue that agencies should consider adopting this modality in the treatment of this population and that it should be included as a treatment option in family-centered child welfare services.

The Role of Multifamily Therapy in Promoting Retention in Treatment of Alcohol and Cocaine Dependence

The authors present a model for incorporating multifamily therapy in the treatment of chemical dependency and investigate the association of family participation in multifamily therapy group with treatment retention in a sample of 164 alcohol- and/or cocaine-dependent outpatients. Results indicate that level of family attendance at a multifamily group strongly predicted completion of short-term and long-term out-patient treatment. Effects were greater for cocaine-dependent than for alcohol-dependent subjects in analyses of short-term treatment retention. Multifamily therapy may be a powerful method to engage patients families in treatment and promote treatment retention, especially in the early, intensive phases of treatment for cocaine dependency.

Multi-Family Psychoeducation Groups For Childhood Mood Disorders: A Program Description And Preliminary Efficacy Data

Existing literature suggests family-based psychoeducation effectively reduces relapse rates, thereby lowering costs and improving quality of life for adults with schizophrenia and major mood disorders. However, similar programs for families with impaired children are lacking. This paper reports on efforts to develop, implement, and test the efficacy of a six-session, manual-driven multi-family psy-choeducation group therapy program for families of children or adolescents with a mood disorder. In this paper we provide a clinical description of the program along with pilot data, which suggest consumer satisfaction as well as improvement in family climate following participation in this multifamily psychoeducation program.

A Model of Multi-Family Group Therapy for Abusive and Neglectful Parents and Their Children

ABSTRACT This article describes one agency's application of multi-family group therapy to a client sample of families in which abuse and/or neglect was confirmed. A description of the treatment protocol, the families served by the program, issues in program implementation, and suggestive evaluation findings are presented. The authors cautiously advocate for the expansion of such programs within the child welfare field as a way of expanding the service continuum to families at-risk of placement.

Multi-family group therapy with dually diagnosed adolescents

This paper describes the use of multi-family group therapy with dually diagnosed adolescents. It includes a brief review of the concept of dual diagnosis, and describes the authors' experience in working with multi-family group therapy in a dual diagnosis day treatment program.

Multi-Family Group Therapy in Social Work Practice

An approach to multi-family group therapy for utilization in social work practice is outlined. Professional help is combined with peer and non peer help within and across families to attain the goal of altered interaction patterns within families. Consideration also is given to the development of the multi-family therapy group as an entity. The patterns of interaction in the multi-family therapy group, were investigated. A case study of a closed time-limited group was developed with a practitioner-researcher design. The data collection utilized structured observation and audio-tape recordings. The data were analyzed qualitatively. The approach to multi-family group therapy described in this paper was developed through the writer's experience as a practitioner in nonresidential multi-family therapy groups located in mental health and in pediatric settings. A child or an adolescent was the identified client. The writer also has used the knowledge gained from the empirical research which she conducted into this modality.

The Multi-Family Therapy Group

No abstract available for this article.

The loyalty bind and sacrifice of the self: Family treatment of adolescent schizophrenia and schizophreniform disorder from a psychodynamic-systemic perspective

This article reviews treatment of families with a schizophrenically functioning adolescent from a psychodynamic systemic perspective. Systemic and psychoanalytic conceptions of family binding and the sacrificial nature of schizophrenic dysfunction, both on an intrapsychic and interpersonal level, provide the theoretical foundation for a multi-dimensional approach to treatment. This treatment approach is predicated on reframing of the adolescent's behavior, a co-therapy model of reparenting and multi-family group therapy to resolve the separation-individuation impasse characteristic of such families. The case of a 16 year old boy and his family is used to illustrate the concepts discussed.