Use Of Family Therapy Research Articles

Clinicians' experiences and perceptions of family therapy in the context of autism

AbstractThere is a paradoxical paradigm operating in neurodiverse families with autistic children, indicating increased stress alongside enrichment of family life. An emerging body of research has shown that the use of family therapy can improve family functioning and relationships in neurodiverse families. The current study uses constructivist grounded theory to explore clinicians' experiences and perceptions of utilising family therapy in the context of autism. Study findings suggest that clinicians integrate therapeutic techniques from diverse family therapy approaches to improve family relations by bridging different ways of learning and communicating as well as facilitating multiple perspectives. Integrating therapeutic techniques across diverse approaches further encompasses working with the systems around the individual with autism. To adapt family therapy in the context of autism, it is suggested that clinicians examine their own perspectives and beliefs about autism and keep a curious stance during the process.

Family Therapy for Anorexia Nervosa

Anorexia nervosa has attracted great attention recently because it is a psychological disorder with a high mortality rate. Although it is thought to be common in adolescents, it has begun to pose a significant risk to older age groups as well. Many different psychotherapies have been proposed for anorexia nervosa from the past to the present, but no consensus has been reached in the literature on this issue. This article aims to examine the effect of family therapy on anorexia nervosa by comparing it with individual therapies. In the literature, there are different opinions on the effectiveness of family therapy, which is frequently discussed with anorexia nervosa. As long as the family does not prevent the progress of the treatment, the use of family therapy has been found to be beneficial for anorexia nervosa, both through the study of dysfunctional relationship patterns in the family and in order to support the treatment of the family.

Family systemic therapy in patients with eating disorders

Introduction Eating disorders are a group of pathologies in which negative beliefs about food, body type and weight are associated with conducts that include food restriction, binge eating, excessive exercise, induced vomiting and the use of laxatives. They can be really severe, affecting quality of life and lead to multiple physical and psychiatric complications, even with a deadly fate.ObjectivesPresentation of a patient’s case with an eating disorder and the intervention with her family, as well as, doing a review of the family interventions in these kinds of patients.MethodsPresentation of a patient’s case and review of existing literature, in regards to the use of family therapy in patients with eating disorders and its effects.ResultsAs in the patient’s case, there are a lot of studies that support the evidence of improvement using family therapy in patients with eating disorders. However, the difficulty to isolate the necessary variables in order to do studies about psychological treatments, complicates finding scientific evidence that supports the clinical evidence that we see in our patients day by day with these types of interventions.ConclusionsThere are studies that support the efficacy of these types of family interventions. However, there needs to be a more thorough investigation with the objective of finding the more precise optimal family intervention, and specifically, determining for who and under what conditions, certain types of family interventions would be more effective.Disclosure of InterestNone Declared

Family Therapy as an Intervention for Adults With Aphasia and Other Communication Disabilities After Acquired Brain Injury: A Scoping Review

Acquired brain injury (ABI) affects the whole family unit, significantly shifting family roles and relationships, with communication disabilities associated with ABI further compounding these difficulties. Family therapy is offered in situations where family roles have been disrupted, but research on the application of family therapy to families affected by ABI has not been synthesized. This study systematically maps the research on the use of family therapy in people with ABI, identifying to what extent people with communication disabilities (PWCD) are included in the evidence base. A scoping review of primary research was conducted through a systematic search of five multidisciplinary academic databases. A consultation process, involving a person with aphasia, ran alongside the entire research process. Twenty-four studies were included in the final review with four categories of interventions identified. Twelve studies excluded PWCD, 10 potentially doing so due to the communication demands of the study. Twelve studies included PWCD, five of which included speech and language therapists to support the delivery of family therapy. A small evidence base exists for the use of family therapy within an ABI population. However, PWCD are frequently excluded from this research due to the communication demands of the study designs. More research is needed to guide appropriate intervention for PWCD.

21.3 Use of Family Therapy in Working Toward Family Acceptance With Gender-Diverse Youth

Working with families of gender-diverse youth is a crucial part of their overall treatment plan, particularly when working in the context of a multidisciplinary Gender Clinic team. Attendees will leave with a better understanding of how to incorporate family therapy techniques into daily clinical practice when working with gender-diverse youth.

Pilot Trial of Online Measurement Training and Feedback in Family Therapy for Adolescent Behavior Problems

ABSTRACT Objective Pragmatic procedures for sustaining high-fidelity delivery of evidence-based interventions are needed to support implementation in usual care. This study tested an online therapist training system, featuring observational coder training and self-report fidelity feedback, to promote self-report acumen and routine use of family therapy (FT) techniques for adolescent behavior problems. Method Therapists (N = 84) from nine substance use and mental health treatment sites reported on 185 adolescent clients. Therapists submitted baseline data on FT technique use with clients, completed a workshop introducing the 32-week training system, and were randomly assigned by site to Core Training versus Core Training + Consultation. Core Training included a therapist coder training course (didactic instruction and mock session coding exercises in 13 FT techniques) and fidelity feedback procedures depicting therapist-report data on FT use. Consultation convened therapists and supervisors for one-hour monthly sessions with an external FT expert. During the 32 weeks of training, therapists submitted self-report data on FT use along with companion session audiotapes subsequently coded by observational raters. Results Therapist self-report reliability and accuracy both increased substantially during training. Observers reported no increase over time in FT use; therapists self-reported a decrease in FT use, likely an artifact of their improved self-report accuracy. Consultation did not enhance therapist self-report acumen or increase FT use. Conclusions Online training methods that improve therapist-report reliability and accuracy for FT use may confer important advantages for treatment planning and fidelity monitoring. More intensive and/or different training interventions appear needed to increase routine FT delivery.

What we can learn from families experiences of family therapy in an adolescent mental health day program setting?

ABSTRACTObjective: Over the past 50 years Family Therapy has become a widely used treatment approach for emotional and behavioural problems in children and within families [Sargent, 1997. Family therapy in child and adolescent psychiatry. Child and Adolescent Psychiatric Clinics of North America, 152–171]. Within Child and Adolescent Psychiatry, Family Therapy is recognised as a cornerstone of holistic treatment with meta-analysis showing the general effectiveness of such treatments [Hoagwood, Burns, Kiser, Ringeisen, & Schoenwald, 2001. Evidence-based practice in child and adolescent mental health services. Psychiatric Services, 52, 1179–1189]. However, there is a general paucity of literature about Adolescent Mental Health Day Programs and no recorded evidence of the use of Family Therapy within these settings in child and adolescent psychiatry. This study draws upon the experience of two families to explore the use of Family Therapy within Adolescent Mental Health Day Programs.Method: A mixed methodology was employed using the SCORE-15 and semi-structured interviews.Results: The families considered that participating in Family Therapy contributed positively to individual and family outcomes. The case studies highlight the needs and issues in engaging other family members, the importance of both the Family Therapist and mental health clinicians being involved, and that the family approach was seen overall as a positive satisfying experience for families.Discussion: This study provides limited but valuable support for the application of Family Therapy within an Adolescent Mental Health Day Program setting. The study highlights the value of documenting lived experience, as well as indicating further areas for research, including the clinicians experience of this approach.

Family therapy techniques and one-year clinical outcomes among adolescents in usual care for behavior problems.

This study tested whether use of family therapy (FT) techniques predicted long-term clinical outcomes in usual care for adolescents enrolled in either family-based or non-family-based treatment for conduct and substance use problems. Participants included 70 adolescents (53% female; mean age 15.4 years) from diverse backgrounds (64% Hispanic, 16% African American, 11% multiracial) assessed at baseline and 3-, 6-, and 12-month follow-up. Utilization of FT techniques was assessed for 802 therapy sessions via a therapist-report tool that collected postsession data on delivery of core treatment techniques of the FT approach. Latent growth curve modeling was used to examine individual change over 12-month follow-up. FT technique scores, averaged across treatment sessions, were included as a predictor in latent growth models, controlling for adolescent age, sex, and ethnicity. More extensive use of core FT techniques predicted significant decreases in adolescent-reported delinquency and externalizing behavior and marginal decreases in substance use and parent-reported externalizing for cases in both family and nonfamily treatment. Greater use of FT techniques in routine care was associated with better long-term adolescent outcomes, regardless of whether clients attended services featuring family therapy or an alternative treatment approach. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Trauma-Focused Family Therapy With Children and Their Families

Family life is considered to be a context in which children can safely learn life skills such as managing and directing their cognitive, physical, emotional, and behavioral responses to events as a way to achieve a sense of purpose and mastery in life. Traumatic events such as natural disasters, serious accidents, and violence in our homes, schools, or communities may alter an individual’s ability to manage cognitive, physical, emotional, and behavioral functioning. Trauma can significantly affect children and their families, impacting relationships, interactions, and their context. There is evidence to support the use of family therapy with children who have experienced trauma. Family support can improve interactions and relationships and can assist children in resolving trauma symptomology. Trauma-focused cognitive behavioral therapy (TF-CBT) is professionally recognized as an evidence-based intervention. There are also TF-CBT intervention derivations that have been developed to support children experiencing trauma. TF-CBT and TF-CBT intervention derivations are explored in this article including core components of evidence-based trauma-focused family therapy necessary to support traumatized children and their families. Discussion also includes the importance and evidence-based support for honoring cultural diversity and including optimism and hope into family experiences as both a preventative and interventive measure to manage trauma symptomology.

Novel psychoactive substance use among treatment-seeking opiate users: The role of life events and psychiatric symptoms.

Over the past 5years, a shift to the use of novel psychoactive substances (NPS) has been observed among opioid users. The aim of this study was to assess the potential reasons for NPS use among treatment-seeking patients receiving opiate substitution therapy. A structured questionnaire was filled out by a sample of 198 opiate dependent patients of Hungary's National Institute of Psychiatry and Addiction. This questionnaire assessed demographics, treatment characteristics, lifetime substance use, potential reasons for NPS use, negative life events (Life Events Scale), and psychiatric symptoms (Brief Symptom Inventory). The most frequent reasons for NPS use were curiosity, replacing other drugs, and easy availability. The majority of the respondents used synthetic cathinones and chose practical reasons, not psychopharmacological preferences. A series of binary logistic regressions indicated that lifetime amphetamine use (OR=4.64, 95% CI [2.16, 9.96]) and more severe psychiatric symptoms (OR=1.89, 95% CI [1.18, 3.04]) may predict NPS use. Time spent in treatment was a minor protective factor (OR=0.92, 95% CI [0.86, 0.99]). Synthetic cathinones might still substitute amphetamine-derivatives, although these NPS are no longer legal. There is a need for the regular screening of psychiatric symptoms and the use of family therapy among participants on opioid substitution programs.

Videogames as a Therapeutic Tool in the Context of Narrative Therapy.

Videogames can have a significant impact on a person's life. Researchers have looked at how videogames impact a person's life ranging from their creative, mental, and physical aspects to even their social and political worlds (e.g., Montani et al., 2014; Sil et al., 2014; Alhabash and Wise, 2015; Bloom, 2015; Bock et al., 2015; Chang et al., 2015; Yeh, 2015; Gonzalez et al., 2016; Nebel et al., 2016). Videogames in relation to psychotherapy have also been studied and discussed (e.g., Graham, 2014; Fernandez-Aranda et al., 2015; Franco, 2015; Llorens et al., 2015). Franco (2015) discussed the use of family therapy in treating videogame addiction. Graham (2014), in particular, looked at videogame addiction and how to apply narrative therapy to translate videogame skills from online videogames to clients' offline lives. Rather than using family or narrative therapies to treat videogame addiction, it may serve narrative therapists to adopt videogames as a tool in narrative therapy. Videogames have been used in group therapy to treat individuals with traumatic brain injury (Llorens et al., 2015) and in conjunction with cognitive—behavioral therapy to treat individuals with bulimia nervosa (Fernandez-Aranda et al., 2015). Board games, videos, and art are often used by therapists to enable their clients to address therapeutic concerns. In that same vein, videogames can be integrated into the narrative therapy model as tools that can enable clients to externalize their problems and re-author their experiences.

Commentary: Awareness of Risk Factors for Digital Game Addiction: Interviewing Players and Counselors.

Commentary: Awareness of Risk Factors for Digital Game Addiction: Interviewing Players and Counselors.

Factors Relating to the Use of Family Therapy with Adolescent Marijuana Abusers

This study reported on the results of the use of family therapy by marijuana-abusing adolescents. The investigators used a statewide each admission for state supported services. Data on 38,281 adolescent admissions were reported on their age at first use, age of admission, severity of use, ethnic and racial attributes, gender, place of residence, employment status, insurance coverage, and presence of comorbid conditions. The results showed that adolescents most likely to use family therapy were unemployed, white, less than 13 years of age, living in urban areas, experienced in marijuana use and have been judged to have a comorbid condition. Insurance coverage or gender did not influence the likelihood for adolescents to receive family therapy. The authors make recommendations on reducing the barriers to access to family therapy that were found by this study.

Can We Play Too? Experiential Techniques for Family Therapists to Actively Include Children in Sessions

Family therapists are in a position to provide therapeutic support to each member of a family system. Many family therapists however can feel at a loss as to how to actively include children in a session ensuring they gain the full benefit of the therapeutic interaction. This article provides relevant information on the rationale for actively including children in family sessions and specific experiential child-friendly techniques for use in family therapy.

Review of family therapy and dementia: twenty-five years on.

We reviewed the literature on family therapy and dementia to investigate the following: what is known about the use of family therapy in the context of living with dementia; what are the challenges of working in this context; and what guidelines/models are available to guide family therapists working with families living with dementia. We searched English language literature from 1992 onwards, classified the resulting papers into broad categories of theoretical, expository, or research (descriptive, quantitative, or qualitative), and conducted a narrative review to draw learning points from the identified papers. In total 31 papers were identified: five theoretical, 11 expository; and 15 research papers. Several papers described methodologies; psychotherapeutic interventions applied to family members; or complex intervention packages in which the role of family therapy could not be separately identified, rather than family therapy. A range of outcomes were investigated, often involving the caregiver. Several authors suggest areas in dementia care where family therapy is likely to be beneficial. Although the literature on family therapy and dementia has grown over the past 25 years and suggests potentially useful roles for therapy, a number of challenges exist in terms of context, family, and therapy itself. There is a need for further research, particularly into the following fields: How to evaluate the success of therapy; how to ensure treatment integrity; how to make techniques from family therapy available more widely; and how to train the health and social care workforce in working with families.

Validity of therapist self-report ratings of fidelity to evidence-based practices for adolescent behavior problems: correspondence between therapists and observers.

Developing therapist-report fidelity tools to support quality delivery of evidence-based practices in usual care is a top priority for implementation science. This study tested the reliability and accuracy of two groups of community therapists who reported on their use of family therapy (FT) and motivational interviewing/cognitive-behavioral therapy (MI/CBT) interventions during routine treatment of inner-city adolescents with conduct and substance use problems. Study cases (n=45) were randomized into two conditions: (a) Routine Family Therapy (RFT), consisting of a single site that featured family therapy as its standard of care for behavioral treatment; or (b) Treatment As Usual (TAU), consisting of five sites that featured non-family approaches. Therapists and trained observational raters provided FT and MI/CBT adherence ratings on 157 sessions (104 RFT, 53 TAU). Overall therapist reliability was adequate for averaged FT ratings (ICC=.66) but almost non-existent for MI/CBT (ICC=.06); moreover, both RFT and TAU therapists were more reliable in reporting on FT than on MI/CBT. Both groups of therapists overestimated the extent to which they implemented FT and MI/CBT interventions. Results offer support for the feasibility of using existing therapist-report methods to anchor quality assurance procedures for FT interventions in real-world settings, though not for MI/CBT.

A Conceptual Framework for Differential Use of Mediation and Family Therapy Interventions With Older Adults and Their Families

The purpose of this article is to present a family-centered approach to working with older adults. This framework utilizes a differential use of family therapy and therapeutic mediation theoretical concepts and skills. This provides an effective approach to conceptualizing and intervening with these often complex situations regarding the decision-making processes related to care of older members. Family-centered mediators/clinicians must be skilled in both models to understand and intervene in the challenging issues presented by families. A case example is included in the article to illustrate the framework.

P-547 - Is family therapy the most effective treatment for adolescents with anorexia nervosa?

Introduction Anorexia nervosa is a mental health disorder characterised by deliberate weight loss (through restrictive eating, excessive exercise and/or purging), disordered body image, and intrusive overvalued fears of gaining weight. The National Institute for Clinical Excellence recommends that family interventions that directly address the eating disorder should be offered to children and adolescents with anorexia nervosa. Aims To perform a literature review to assess whether family therapy is a more effective intervention than other treatments in the management of adolescents with anorexia nervosa. Method Search of PubMed, The Cochrane Library and NHS Evidence for randomised controlled trials that compared a family intervention with another treatment for anorexia nervosa in adolescence. Results and discussion This literature search revealed only six randomised controlled trials investigating the use of family therapy in the treatment of adolescents with anorexia nervosa, and these all had small sample sizes. Some, but not all, of these trials suggest that family therapy may be advantageous over individual psychotherapy in terms of physical improvement (weight gain and resumption of menstruation) and reduction of cognitive distortions, particularly in younger patients. Due to the small sample sizes and the significant risk of bias (particularly information bias) in some of the studies the evidence in favour of family therapy over individual therapy is weak. In the future, larger randomised controlled trials with long term follow-up are required to assess whether family therapy is the most effective treatment for anorexia nervosa in adolescence.

A Structural/Strategic Lens in the Treatment of Children With Obesity

Childhood obesity is an issue affecting an increasing number of families in the United States and the international community. In the past, obesity has been treated primarily by medical models that may or may not have included family therapy. It has been found that the use of family therapy in treating childhood obesity is helpful to produce long-term results. The authors suggest that the use of structural/strategic family therapy may also be useful in treating children and families dealing with obesity, as well as other medical issues that are a result of it.

W01-02 - Nice, schizophrenia and the evidence behind the treatments

This talk will describe the methodology used for the development of the new NICE guideline on the treatment of schizophrenia for the UK, paying particular attention to meta-analytic and, where possible, economic methods or considerations used to develop recommendations on the use of Family therapy, CBT and the arts therapies. Some time will also be given to examining the evidence behind the first formal meta-analytic review of early intervention services for people with early schizophrenia, and a suggestion that these services may be beneficial as a result of them including evidence-based treatments rather than such services having a particular approach or service ideology. If time allows, we will also examine the evidence behind the choice of antipsychotic in the schizophrenia guideline, and speculate on the continuing usefulness, if any, of using terms such as ‘typical’, ‘atypical’, ‘first generation’ or ‘second generation’.