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Complex trauma generally refers to a child's exposure to multiple traumatic events often within the context of an interpersonal relationship. Childhood traumatic events are commonplace and can have significant implications for physical and mental health. However, traumatic events are often not assessed by clinicians involved in their care. This paper outlines an approach to assessing complex trauma in young children in clinical settings. This approach involves an initial interview, an assessment of traumatic events and trauma symptoms in the child, an assessment of the parent–child interaction, an understanding of the child's functioning in multiple settings, and an assessment of parental trauma where relevant. Complex trauma takes time to assess and is dependent on the parent's ability to recognise and acknowledge the effect trauma has had. The paper concludes with some of the challenges when assessing complex trauma in young children in clinical settings. [ABSTRACT FROM AUTHOR]

Many Australians are requiring mental health care, including families, leading to long wait times in order to access support. Walk‐in therapy reduces barriers to mental health support services by providing support at the time that families seek help. This paper presents a proof‐of‐concept study investigating the acceptability and short‐term effectiveness of an online walk‐in family therapy service, Walk‐in Together (WIT). Part 1 of the paper describes the experiences of 44 family members from 22 families who presented to a public family therapy clinic for a virtual walk‐in family therapy session. The session was conducted by a team of three experienced family therapists. Family members' experiences were sought pre‐session, post‐session, and at 6 weeks follow‐up via survey and interview. Part 2 of the paper explores therapist perceptions (n = 7) of the WIT approach, through thematic analysis of semi‐structured interview data. Post‐session feedback showed 85% of family members found WIT to be helpful and 50% were optimistic about their future as a family after their WIT session. Six weeks post‐session it was revealed that WIT supported planning for families in equipping them to move forward with 88% of family members reporting that they knew what to do after the session. All therapists uniformly experienced the model as offering a timely and beneficial service, suitable for diverse presentations and constellations of families. These preliminary results suggest the significant utility of this WIT intervention as a well‐received and helpful service for families, who valued the easy access and rapid therapeutic response afforded by the online, walk‐in delivery model. This proof‐of‐concept paper suggests the potential for further development and growth of WIT, as well as other mental health support services using a walk‐in, telehealth model to meet the rising demand for therapeutic support for families in distress. [ABSTRACT FROM AUTHOR]

Family reunification is an area of high policy importance for child protection systems. The safe return of children from out‐of‐home care to their biological parents or relatives and long‐term family preservation can potentially mitigate the subsequent detrimental effects of separating children from their families. In this paper we describe one type of family for whom reunification was considered; namely, families who have been affected by intergenerational trauma. To assist families affected by intergenerational trauma and abuse requires an understanding of the mechanisms and processes that maintain intergenerational trauma and how these might inform therapeutic approaches for working with children and their families. This paper utilises case studies to illustrate the use of the Adult Exploration of Attachment Interview (AEAI) as part of a broader therapeutic reunification program in an Australian state. The AEAI focuses on supporting parents to become aware of the impact of previous experiences in their childhood; the mitigation of feelings of shame, self‐blame, and inadequacy by helping the parent confront the negative experiences of the past. The aim is to assist the parent to recognise the significance of the past, to consolidate their strengths, and to develop more nurturing relationships with their children. Case illustrations demonstrate that this therapy was a component in addressing the causes of behaviour and psychological distress that had been barriers to reunification from care in two families. This was achieved through a process of reflection and self‐awareness, rather than one focused on guilt or shame, with the therapist there to help verbalise and articulate what otherwise might have been hidden or implicit processes. In both cases, this awareness was used to help reframe the parent–child relationship and led to observable behavioural changes in parenting practices. [ABSTRACT FROM AUTHOR]

The paper builds on ethnographic, qualitative research that explores the 'No Kids in the Middle' program for high‐conflict divorce families, as practiced in the Agder region of South Norway. Parent education programs targeting parents in divorce are generally found to be 'effective' in the sense that parents learn about the pitfalls of conflict and become socialised into less negative patterns of co‐parenting. However, a narrow understanding of the potential of such programs as vehicles for the transfer of knowledge fails to attend to the relational sides of both education and therapy, and the existential sides of parenthood. Drawing on Gert Biesta's articulation of education as a process working along three dimensions of purpose, the paper approaches the 'No Kids in the Middle' program as an educational practice. It aims to explore whether the educational ambitions of the 'No Kids in the Middle' program should be understood primarily in the general terms of qualification (i.e., parents acquiring knowledge and skills) and socialisation (i.e., parents gaining a specific orientation toward a set of norms and values), or if there were practices or elements that seemed directed at subjectification or bringing the 'I' of each parent into play. Analysing field notes from participant observation in a 'No Kids in the Middle' multi‐family group and interviews with parents, therapists, judges, and child welfare caseworkers, the paper concludes that programs like 'No Kids in the Middle' provide a broad spectrum of educational opportunities. While some of these might be intended to instruct along pre‐defined normative paths toward understanding and behaviour, such practices can also be seen as addressing parents in a different, more existential, way. In the particular local practice studied, the dimension of subjectification was perhaps most clearly in play in the informal settings surrounding the program itself. [ABSTRACT FROM AUTHOR]

Studies show that there are strong links between parental conflict and children's psychosocial problems. The program 'No Kids in the Middle' is a group‐based, time‐limited, multi‐family intervention for children aged between four and 16, living with parents in prolonged conflict after divorce. The program is based on a dialogical framework and the purpose is to create a therapeutic and dialogical space where the parents are invited to see, empathise, and connect with their children and act with their child in mind. This paper presents a qualitative study based on interviews with parents who participated in the program. The analysis of the material led to three main themes: ambivalence – doubt, shame and hope; painful new experiences; and progress and new discoveries. We discuss the findings in relation to the therapists' role and the program's aim of creating a free space for interaction, which seems to be important to the parents' progress. [ABSTRACT FROM AUTHOR]

There is a large body of work focusing on the well-being and relationships of couples facing late-stage cancer. The systemic study underpinning this paper explored a less researched topic: How do people caring for a partner with terminal cancer construct their experience and relationships through personal and couple narratives? This UK-based study drew upon dialogical approaches to narrative analysis to focus on six caring partners and their care relationships. Following individual case analysis, two methods of cross-narrative analysis were developed, and an analysis of narrative themes and a typology of archetypal narratives were drawn from the data. This paper focuses on the typology. The clinical implications of the study are considered, focusing on the contribution of a typology to this and future studies. [ABSTRACT FROM AUTHOR]

Gay men and lesbian women have a long history of jointly creating families and co‐parenting their children together. This qualitative study aims to explore the experiences of separation and post‐separation parenting within same‐sex parented families. This involved semi‐structured in‐depth interviews with 22 separated same‐sex parents in Adelaide, Melbourne, Sydney, Brisbane, and regional Victoria. An adaptive theory approach was used for the collection and analysis of the data. The paper explores data from a cohort of six participants who came from three different multi‐parent families who had experienced a separation – either their own, or that of other parents in their parenting group. The term 'co‐parenting families' was found to be confusing due to the different connotations within separation/divorce and same‐sex parent literature. Consequently, the term 'guild parented families' was created to describe these families. Participants from these multi‐parent families had very different experiences of family formation and separation compared to others within the wider separated same‐sex parent study. Separation of one or more of the parent couples within these families complicated their original plans and kinship ideals. Each of the families resolved this differently in their post‐separation arrangements. After separation, whole family narratives and/or the role of individual parents, were either questioned or revised as a way of resolving the complexity of their new kinship situation. Following separation, parents often relied on Western kinship norms that privilege biological kinship and the dual‐parent family to construct their post‐separation kinship arrangements. More awareness of families that begin with more than two parents is needed within separation research and amongst separation services and service providers. [ABSTRACT FROM AUTHOR]

The needs of refugees are of crucial concern internationally. Relational trauma is an area that is particularly under‐emphasised and under‐researched. The Strength to Strength program (STS) was a relationship and family counselling service for recently arrived refugees in Sydney, Australia. The service model built on post‐Milan systemic family therapy principles to include cultural and trauma‐informed aspects of care. This study explored the design and impact of the program, through qualitative accounts provided by service users. This paper focuses on the experiences of staff of the program, and the ways in which more traditional, Western‐informed modes of family therapy were transformed by refugee client needs. The specific study aim was to identify and describe transformations to the delivery of relationship and family counselling with refugees that enabled care, from the perspective of STS staff. A thematic analysis of interviews with STS service staff (bicultural workers, family therapists, managers; n = 10) was undertaken, guided by an interpretive description framework. Findings revealed that acceptable and useful clinical innovations to standard care included the use of community groups, the unique role of the bicultural worker, and increased reliance on more directive and practical modes of family therapy rather than insight‐oriented post‐Milan techniques. The role of community‐based intervention to enrich existing Western‐informed models of care for use with refugees was vital. STS was an example of staff‐driven innovation to the therapeutic care of refugee families resettling in a Western country and took into account their unique and complex set of cultural, practical, and psychological client needs. Future service delivery is best guided by the incorporation of multi‐faceted approaches to care that allow for phasing of treatment in line with client culture, needs, and readiness. [ABSTRACT FROM AUTHOR]

Better Beginnings, Better Futures is an evidence‐based early childhood initiative that promotes the healthy development of children and families in economically disadvantaged communities. The Better Beginnings model involves the development of community‐driven programs through resident involvement that are integrated with existing services, universally accessible to all children and families in a community, focused on prevention, and ecological in nature. In this paper, we describe a pan‐Canadian knowledge transfer strategy involving attendance at workshops designed to build the capacity of participants to develop Better Beginnings initiatives in their own communities, and the impacts of the workshops on participants. Process evaluation data were obtained from participants in each Canadian province and territory immediately following the workshops (k = 12, N = 271). In addition, a smaller sample (n = 54) completed a follow‐up telephone interview 3 months later. All components of the knowledge transfer strategy were well‐received and rated highly by participants. Workshop participants indicated increased knowledge of the Better Beginnings model and high levels of satisfaction with the workshop. In the follow‐up evaluation, participants indicated strong intentions to use the information they had learned about Better Beginnings to advance the well‐being of children and families in their community. We discuss the lessons learned from the knowledge transfer initiative and provide recommendations for advancing knowledge transfer of programs for children and families in context. [ABSTRACT FROM AUTHOR]

The Time to Think Experiment researches the experience of clinicians, consumers, and families of an intersession break, which has been used historically in various models of family therapy training. This qualitative pilot study explores the experiences of 21 clinicians, 19 consumers, and six family members using this break for reflection, across the domains of family and couple therapy, individual therapy, group work, and supervision in a mental health service covering the whole age range. Using a phenomenological design, the analysis included narrative, thematic, content, and comparative techniques. The paper considers the impact of privileging reflection in the therapy process, in a climate where models, work cultures, and general lifestyles may not encourage it. Using the intersession break to create space to 'be' in the therapy process is one way to integrate mindful and family therapy practice. The emerging themes of an intersession break to promote a richer and deeper therapy experience, and the apparent shift of responsibility for change from clinicians to consumers is discussed. [ABSTRACT FROM AUTHOR]

This research concerns itself with the experiences of couple and family therapists ( CFTs) learning about and using an evidence-based practice (EBP). The engagement with EBP is growing across many aspects of the mental health and health care systems. The EBP model is now being applied in a broad range of health and human service systems, including mental and behavioural health care, social work, education, and criminal justice (Hunsley, 2007). The dialogue about the role of evidence-based approaches in the practice of CFT and research literature is also evolving (Sexton et al., 2011; Sprenkle ). Interestingly, while the research delves into what are the best approaches with different populations and presenting issues, little research has explored the experience of CFTs themselves, particularly while learning an EBP. Using a phenomenological approach called interpretive phenomenological analysis (Smith, Flowers & Larkin, 2009), this research explores the experiences of CFTs learning and using an EBP. The paper reports on key issues, challenges, and areas for CFTs, educators, and supervisors. As researchers, educators, administrators, policy makers, and CFTs struggle with what works best with which populations and how best to allocate resources, this research contributes to dialogues about how best to educate and support CFTs, and the complexity of doing research in real-life settings. [ABSTRACT FROM AUTHOR]

The advent of COVID‐19 as a global public health crisis in 2020 was quickly followed by predictions regarding likely increases in occurrences of domestic and family violence (DFV). The aim of this study was to understand the impact of the pandemic on practitioner experiences of DFV in one service organisation in New South Wales, Australia. Qualitative focus group interviews were performed with senior practitioners at Relationships Australia (NSW), and a grounded theory approach was employed in formulation of a perspective which highlighted social isolation under public health management social distancing measures as that which distinguished practitioner experiences of DFV during COVID‐19. Social isolation was conceived as the overarching factor across categorisations of practitioner responses, including: (a) situations of client domestic relations; (b) client general life circumstances; (c) emerging client self‐awareness; (d) organisational and social systems changes; and (e) necessary work practice changes. Organisational and workplace recommendations address the relative difference of pandemic management measures from natural disaster occurrences, with respect to supporting people experiencing DFV. [ABSTRACT FROM AUTHOR]

This article explores professionals' understanding and experiences of parental high conflicts in Norwegian family counsellor and child welfare services. The data were analysed using reflexive thematic analysis, examining four focus group interviews with a total of 24 professionals. We used tame and wicked problems as a theoretical frame of reference in order to discuss how high conflict cases can be understood. The analysis shows that the complexity and experiences of high conflicts challenge professionals in their assessments and development of solutions. Our conclusion is that the nature of the complexity, unpredictability, and instability of high conflicts fits within the framework of wicked problems. [ABSTRACT FROM AUTHOR]

Youth with conduct disorder and their families are difficult to treat and remarkably unresponsive to therapy. A main challenge is treatment engagement. This study's aim was to explore the family's evaluation of active ingredients in family therapy for conduct disorder and discover if those ingredients correspond with the research literature. The intention was to gain more insight into currently known active ingredients and identify any not yet recognised to promote treatment improvement. The study was a qualitative design, using semi‐structured interviews with parents/caregivers, to explore the experiences of families. Four families who had successfully completed Family Centred‐Feedback Informed Therapy, a therapy for youth with conduct disorder, in a regional area of Queensland were involved. A six‐step‐framework thematic analysis was applied whereby the data were analysed and interpreted through the lens of current research (and foundational models and theory). The parents/caregivers who participated in this study endorsed the six known active ingredients of successful family therapy for conduct disorder: therapist adherence, therapeutic alliance, creating a family focus, improved family communication, parenting skills, and delivery in the home. Additional parent/caregiver key ingredients were: putting the problem into words, recognising and adjusting expectations, responding with sensitivity, and youth sees parent/family commitment. Considering a main challenge to successful treatment of conduct disorder is the early engagement of youth and their families, these findings are important. Eliciting parent/caregiver views can add to a more complete investigation of change processes to help obtain maximum gains for families and youth. With this knowledge program developers and therapists may recognise and target specific client factors, including relational factors and beliefs to optimise engagement and change across treatment. The current study results support qualitative research methods in further treatment development including cultural adaptations to programs. [ABSTRACT FROM AUTHOR]

In response to COVID‐19 hygiene and physical distancing restrictions, our service rapidly shifted to delivering Circle of Security‐Parenting™ (COS‐P) groups via telehealth. In this article we report the perspectives and experiences of the group facilitator and the parents who received the intervention during the COVID‐19 pandemic. We use semi‐structured, qualitative interviews to explore the advantages, challenges, and positive impacts of the online parenting group from the perspectives of the group leader and the five group participants. Participants' narrative reflections show that they were satisfied with the convenient and engaging online delivery of the program and would recommend it to other parents. Parents reported significant improvements in their parenting and greater awareness of their strengths and struggles. The online delivery of COS‐P resulted in more efficient service delivery, greater attendance rates, and adherence to the model. The stressors on the experienced facilitator, due to the abrupt transition and multiple technical and communication challenges, may have been mitigated by supervisor and collegial support, as well as careful preparation for herself and the participants. Future research should investigate the effectiveness of online versus face‐to‐face delivery of the intervention, including what works for whom. [ABSTRACT FROM AUTHOR]

Reflecting teams (RTs) represent both an epistemological stance and a therapeutic technique. Most commonly associated with narrative and systemic approaches to therapy, RTs offer an outsider perspective that can bring hope and alternative narratives and perspectives for therapists and clients to explore. Relational hope is a little researched concept in the field of couple therapy research. This study explores the experience of RTs in couple relationships and the aspects of the experience that couples describe as connected to a sense of hope for their relationship. The study also considers whether difference in attachment style shows any relationship with hope in couple relationships before and after the clients' session with a reflecting team. Couples completed questionnaires about their attachment style, demographics, and relational hope and were given the option to complete an interview about their experience with the reflecting team within 1 month of their therapy session. Our findings suggest that RTs contribute positively to hope in couple relationships particularly for clients who present with an anxious attachment style. This direction for research is important because there is very little research about hope in couple relationships despite its importance (Merolla, 2014; Snyder, 2002) and there is no research about what aspects of a reflecting team contribute to hope in couple relationships. Analysis of interviews indicates a number of features of the reflecting team feedback that were valued by clients. [ABSTRACT FROM AUTHOR]

There are many parenting programs delivered in Australia and Parents Building Solutions (PBS) is one of these. Collaboratively designed by Parentzone staff of Anglicare Victoria, it has a twenty year history of building the evidence base. PBS stands apart from other programs because parents actively co‐design the sessions and content with skilled facilitators. Understanding the drivers, processes and practices that make the co‐design methodology work, is fundamental to the implementation science that underpins the program.This study aimed to examine the way co‐design was used in the delivery of PBS, specifically looking at program implementation and outcomes. Focus groups and interviews were conducted with Parentzone staff (team leaders and facilitators) and parents who had recently completed a program. Ethics approval was provided and analysis was conducted using NVivo software with co‐design as the unit of analysis. Three major themes about co‐design were present across team leaders, facilitators and parents: 1) responsiveness and flexibility are central to the functionality of co‐design within PBS; 2) facilitators implement the co‐design methodology using a suite of knowledge and skills; and 3) parents report tangible results from participating in a co‐designed parenting program. There was an overwhelming appreciation from both facilitators and parents about the co‐designed implementation style. Facilitators and team leaders highly valued the flexibility of the program which enabled their ability to respond to parent's needs. Furthermore, parents believed they achieved tangible outcomes derived from strategies and support delivered in the program. The co‐design methodology used in PBS was evident for all stakeholders and was a driver of program implementation and its outcomes. The methodology described in this has practice implications for family therapists and others who work directly parents and families. [ABSTRACT FROM AUTHOR]

Children and youth who have shown serious difficulties or if it is surmised that parents over time will not be able to care for the child or youth, could be placed in a child protection institution. The therapeutic work in such institutions is often described as milieu therapy. There has been little focus on the milieu therapist's relational work in child protection institutions. The research question for this study was: What factors are described by milieu therapists as significant for relational work with youth placed in institutions? To answer this question, we collected data from qualitative semi‐structured interviews with four milieu therapists working in child protection institutions. Interpretative phenomenological analysis helped us identify three overarching categories: (1) structural and personal factors as a basis for relational work; (2) various forms of communication in relational work; and (3) relational work with a starting point in everyday events. [ABSTRACT FROM AUTHOR]

The study demonstrates how motherhood gender‐related discourse is intertwined with the ways in which the systemic techniques and systemic thinking are realised in the session. This research explores the consequences of gender‐related discourse commonly co‐constructed by participants in couple therapy and not recognised or challenged by the therapist. Video‐recorded data from a couple therapy session containing unrecognised gender‐related discourse were subjected to conversation analysis (CA). The interview (Interpersonal Process Recall) transcript was analysed according to the rules of dialogical analysis. Gender assumptions held unchallenged by a therapist can be manifested through: placing one spouse in the position of the person accountable for the gender‐related choices, the therapist's mirroring of one participant's lexical choices only, sharing normative expectation of one person. Unrecognised gender discourse create difficulty in introducing circular thinking. The obstacles on the therapist's side can render power issues connected with gender invisible and thus unavailable for introduction into the therapeutic conversation. [ABSTRACT FROM AUTHOR]

Levels of father participation in parenting interventions are often very low, yet little is known about the factors which influence father engagement. We aimed to qualitatively explore perceived barriers to, and preferences for, parenting interventions in a community sample of fathers. Forty‐one fathers across nine focus groups were interviewed using a semi‐structured interview. Data were analysed using inductive thematic analysis. Key barriers to father participation identified included: the perception that interventions are mother‐focused; beliefs about gender roles regarding parenting and help‐seeking; mothers’ role as ‘gatekeeper’; lack of knowledge and awareness of parenting interventions; and lack of relevance of interventions. Fathers reported preferences for specific content and intervention features, facilitator characteristics, practical factors, and highlighted the need for father‐targeted recruitment and advertising. Many of the barriers and preferences identified are consistent with previous research; however, fathers’ beliefs and attitudes around gender roles and help‐seeking, as well as the perception that interventions are predominantly mother‐focused, may be key barriers for community fathers. Strategies to overcome these barriers and better meet the needs of fathers in promoting and delivering parenting interventions are discussed. [ABSTRACT FROM AUTHOR]

Since it was first introduced in the 1980s, Wraparound has been defined as ‘a philosophy,’ ‘an approach,’ and ‘a service’ which is designed to work with youth and families with high and complex needs. Wraparound is most commonly understood as an intensive, individualised care planning process. It aims to achieve positive outcomes through a structured, creative, and individualised team planning process, which results in effective and more relevant plans for the youth and family. The purpose of this qualitative study was to explore the experiences of Wraparound facilitators, caregivers, youths, and team members to gain a multi‐perspective insight into the process. Sixteen families and Wraparound teams participated in the study which resulted in 56 semi‐structured interviews being conducted involving 16 Wraparound facilitators (some facilitators were interviewed more than once because they served multiple families who participated in the study), 16 caregivers, eight youth, and 16 team members (one person from the team, i.e., teacher, social worker, or mentor). Thematic analysis gave seven themes organised into three broad domains: (1) key elements of the Wraparound process including the Wraparound facilitator, Wraparound's philosophies and principles, and the supportive nature of the process; (2) the outcomes achieved throughout the process including family empowerment and hope, improved family dynamics and relationships as well as individual parent and youth change; and (3) the challenges and feedback respondents identified through the process, which included personal and systemic challenges, improved transition, and continuity of care, role clarity, and accessibility of the service. Overall, the findings from this study support Wraparound as an effective process for youth and their families, identify the importance of key aspects of the process, and suggest some improvements to increase the efficacy of and accessibility to the process. [ABSTRACT FROM AUTHOR]

Circle of Security is an attachment-based parenting intervention that aims to promote secure parent-child attachment relationships. The current study explored whether the Circle of Security intensive intervention resulted in increased attachment security (assessed before and after completing the intervention) for caregiver-child dyads with Autism Spectrum Disorder. The current study also explored caregivers' acceptance of the intervention by seeking client feedback and measured each caregiver's perceived sense of parenting competence. Two mothers each with a child under the age of 5 years diagnosed with Autistic Spectrum Disorder participated in the intervention. Results found one dyad shifted from avoidant to secure whilst the other dyad remained secure across time with some changes in behavioural dimensions. Each mother endorsed the intervention as highly valuable to her needs. Perceived parenting competence also increased post-intervention for both mothers. Replication is recommended in order to generalise the results. [ABSTRACT FROM AUTHOR]

Children and adolescents with functional somatic symptoms are challenging to understand and to treat. The challenges begin at the very outset of the intervention - with the neurological and psychiatric assessments. Patients presenting with functional somatic symptoms, as well as their families, frequently deny any emotional or family problem, and parents are often genuinely baffled as to why a child has suddenly become so ill and why no medical explanation is forthcoming. Families can be unwilling to engage in family assessment and therapy, and therapists may find that standard approaches to family therapy simply can end up alienating these families - the door to therapy is slammed shut. This article is the story of my struggle to understand somatising children and their families and to find a common language to enable us to co-construct formulations, to agree to a treatment plan, and to work together towards a pathway to health. It is also about the role of research and how knowledge from different system levels - and most specifically about the body - may need to be integrated into the therapy to help bring about change. [ABSTRACT FROM AUTHOR]

Research about the experience and position of stepfathers in stepfamilies is scarce. Using data from semi-structured interviews with eight stepfathers, we aim to explore how stepfathers experience family life and their relationships with their (step)children and extended family members (biological father and grandparents), as well as how they describe their position within the stepfamily. Interpretative phenomenological analysis revealed three main themes: most participants saw themselves 'like a parent and a friend.' While none of them considered themselves as 'the father' - this position being assigned to the biological father - they described acting like a parent or a father figure in their relationships with the children. Secondly, despite some difficulties in the initial stages of formation of their new families, most participants described a positive evolution over time and were satisfied with their current family situation. Thirdly, the stepfather's positioning towards non-cohabiting family members such as the biological father and grandparents added complexity but was managed well. Research findings are discussed in light of the current family therapy literature on working with stepfamilies. [ABSTRACT FROM AUTHOR]

Child Protection Unit (CPU) therapists work with the family system, providing support, counselling, and facilitating change. At the same time the counsellor is part of the wider child protection system, its legislation, organisation, and practices, and the justice system. Social workers must act in accordance with the law and organisational directives, and are encouraged to critically reflect on ethical decisions while observing professional values. When these directives conflict with perceived moral obligations, and complex systems intersect in a way that is at times unhelpful and at the worst re-traumatising for children and families, CPU counsellors may find themselves in a state of 'ethics anxiety'; attempting to juggle the systemic imperatives, the needs of the child and the family, ethics, and the law. While our experience arises from the CPU context, the themes we will discuss are relevant for anyone working with people whose presenting problem relates to a court process such as in matters of domestic violence and adult sexual assault. [ABSTRACT FROM AUTHOR]

Little information exists on the specific reflective processes that precede therapists' choice of including or not including a structured feedback procedure in their established practice. In the present study, we aim to describe and explore experienced couple and family therapists' expectations for how the comprehensive therapy feedback procedure Systemic Therapy Inventory of Change might influence their practices. Through a thematic analysis of six focus group interviews, two main themes were elicited. The first main theme involved values embedded in current practice, with the following subthemes: (1) balance between the therapist's expert knowledge and the client's experience-based knowledge; and (2) making time to build alliances. The second main theme concerned the presumed influence on current practice, with the following subthemes: (1) 'Systemic Therapy Inventory of Change will disturb the therapist's capacity to stay present'; (2) 'Systemic Therapy Inventory of Change will shape conversations'; and (3) 'Systemic Therapy Inventory of Change will contribute to increased qualitative depth'. We discuss these results in relation to the notion of Systemic Therapy Invention of Change as a 'third party in the room'. We also discuss the results in relation to implications for collaborative practices, and for client and therapist autonomy. [ABSTRACT FROM AUTHOR]

Child abuse and neglect often occur within the context of multiple risk factors, in particular parental mental health (MH) and/or drug and alcohol (D&A) problems. Interventions aimed at improving parental MH and D&A issues can have a positive impact on children now, as well as in the future. However, implementing sustainable service models that facilitate positive change for families with multiple risk factors is challenging. The purpose of the present study was to gain feedback from key stakeholders on a service model targeted at families where there are parental D&A, MH and child protection concerns to identify possible strengths and limitations of the model. This identified possible strategies for service improvement from the perspective of discharged clients and clinical staff. Gaining feedback from key stakeholders on service models is increasingly recognised as central to service evaluation and development. Ten interviews were conducted with clinical staff and twenty interviews with discharged clients of a pilot service that works with families where the child or children are at risk of significant harm in the context of parental MH and/or D&A issues. The interviews with clinicians highlighted difficulties working with this complex client group and its impact on staff burnout. Clinicians suggested how the model could be changed to better support clinical staff from burnout. Interviews with discharged clients highlighted the importance of the relationship with the worker in establishing client engagement and facilitating change. The way in which these recommendations informed the design of the service model is discussed. [ABSTRACT FROM AUTHOR]