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An introduction is presented in which the editor discusses articles in the issue on topics including Bowen family systems theory's focus on family as treatment unit, triangles managing anxiety, and differentiation promoting resilience.

Family violence is becoming increasingly visible in Australia, with many state and federal governments taking on more responsibility to address family violence and its impacts on those affected. Current efforts are focused on practice frameworks, identifying and responding to risk factors, and social justice frameworks including legislating against family violence in a range of jurisdictions and addressing more broadly the structural and cultural forces that perpetuate violence and further oppress those victimised. Family violence is not unique to Australia, with prevalence rates internationally suggesting family violence occurs irrespective of country, race, age, culture, effectiveness of social policies or socioeconomic status. This paper explores relevant foundational concepts of Bowen family systems theory (BFST) as it relates to family violence and explores opportunities to evolve practice in this area. BFST offers a unique contribution towards addressing family violence, particularly in relation to the public health challenge of addressing family polyvictimisation. The paper also explores how BFST conceptualises family violence and the role of the professional in working with the family as a single emotional unit. The unique focus of BFST on observing and defining self within the emotional family unit through observation of the underlying multigenerational emotional patterns of functioning provides unique opportunities to evolve and develop both the capacity of clinicians and responses to families who are navigating the serious and challenging impacts of family violence. [ABSTRACT FROM AUTHOR]

Dr Murray Bowen, developer of Bowen family systems theory (BFST), had this to say to clients about working in family systems: if you get bogged down in one area, move into another (Bowen & Kerr, 1985). This statement, along with the knowledge of BFST, offered an inspiration for thinking about a method of therapy. This article highlights a method of working with an individual through a systemic lens. Two ideas are integral to this focus. One is that a client can move more easily into observing self within the system when they are not just observing self in one context or relationship but rather looking at how they function in different contexts or relationships. And second, by moving into different contexts of the system, the therapist is better able to manage the tendency towards symptom focus and stay centred on the work of differentiation. A therapist can truly have a stadium view of the system when speaking with the client about how they function in different areas of life. This method defined happens in three phases: in phase 1, the client observes themselves in their system in different contexts and looks for patterns in their functioning; in phase 2, the client takes this new self‐recognition and experiments with different ways of being in one context; and in phase 3, the insights gained from experiments in one context are applied in other contexts. Both client and clinician will benefit from less symptom focus and increased ability to observe patterns in relationships, both of which are core tenets of the work of differentiation in BFST. [ABSTRACT FROM AUTHOR]

This paper overviews Bowen family systems theory and its approach to family therapy. It aims to introduce this influential approach and a sample of developments in theory and practice since Bowen's first publications of his research and theory. This paper is the second edition of a 1999 article with the same title (Brown, Australian and New Zealand Journal of Family Therapy, 20, 94 and 1999) and, 25 years later, offers new insights from the original author's ongoing research into the theory. This new edition is in collaboration with a second author and Bowen theory scholar, bringing fresh perspectives on the theory's applicability to family therapy practice. The core concepts are presented briefly, and a case example with a parent and symptomatic adolescent demonstrates how theory informs the role of the therapist and the therapeutic work. Examples of criticisms of Bowen theory are also discussed, including the misinterpretation around the idea of emotion in Bowen theory that is communicated in Gottman's training. Differentiation of self is clarified as the integration of emotion and intellect rather than privileging one over another, which affords the opportunity for individuals to avoid being governed by the invisible strings of sensitivities in relationships and instead be themselves in good emotional contact with the other person. [ABSTRACT FROM AUTHOR]

The concept of differentiation of self and its relationship to the natural capacity of humans and other social animals to adapt underpins clinician and researcher Victoria Harrison's long‐term investigation of the biology of reactivity in relationships. Victoria's early research related to infertility and reproduction demonstrated how reactivity in at least three prior generations can contribute to chronic conditions, such as endometriosis, that are less amenable to intervention. Her most recent project, the 'Observations of Change in Physiology and Family' research, highlights how work on differentiation of self improves functional outcomes in physical and mental health for the family. While an individual may not experience the 'calm mind' that is often the goal of conventional therapeutic intervention, a significant reduction in symptoms and an improvement in overall functioning and relatedness are outcomes. This occurred when participants focused on increasing person‐to‐person contact with extended family members, reducing their emotional reactivity to significant others in the important triangles of their life and family and maintaining intellectual activity, often described as curiosity, even while reacting. [ABSTRACT FROM AUTHOR]

The Ackerman Institute for the Family, established in 1960 by Dr Nathan Ackerman, stands as one of the oldest and most respected family therapy institutes in the United States. Ackerman pioneered the integration of systemic insights into group settings, emphasised the crucial role of family in therapy, and advocated for the advancement and acceptance of family therapy. 'The Ackerman' played a pivotal role in launching Family Process, the first journal dedicated to academic activities in family therapy. Diversity and inclusion have been central tenets of Ackerman philosophy, evident in its programs, training courses, and staff composition. This commitment has produced a veritable cadre of family therapy leaders who have contributed significantly to both the Ackerman Institute and the profession, influencing policy decisions and clinical practices. One of the most esteemed and respected thought leaders and innovators of our field, who played a vital role in the legacy of several institutions, including the Ackerman, is Dr. Evan Imber‐Black. She served as a long‐time faculty member and director of the Ackerman Center for Families and Health. Her expertise encompasses the exploration of family rituals and family secrets, with a focus on the importance of rituals in providing meaning, identity, and connection across diverse cultures and family life cycles. As editor of Family Process for 8 years, she highlights the importance of examining scholarly work in the context of cultures as a requirement – we do not stand outside the culture – we are active participants. This paper is based on a conversation with Dr Evan Imber‐Black, held in June 2023, delving into her personal and professional experiences, her connection to the Ackerman Institute, and her influential work on family rituals and secrets. Through this exploration, the paper sheds light on her commitment to diversity and the lasting impact of Dr Imber‐Black's contributions to family therapy. [ABSTRACT FROM AUTHOR]

Umberta Telfener is a highly respected figure known for her diverse contributions to various facets of family and systemic therapy. Her leadership style has earned her a reputation as somewhat of a 'cultural anthropologist,' reflecting her aptitude for creating connections, establishing relationships, and developing partnerships. Her unique 'Umberta style' is known for boundless energy, active leadership, and fierce commitment to challenging the status quo. Despite being in office for just a year at the European Family Therapy Association (EFTA), Umberta has conceived and developed numerous projects, establishing networks with practitioners, and systemic thinkers across the world. Rooted in classical philosophical training, her pursuit aligns with the systematic study of fundamental questions about existence, reason, knowledge, value, mind, and language. Umberta's role reminds one of a 'Chasqui,' a Quechua term for a 'messenger,' which aptly describes her agile networking skills. She actively communicates and shares vital messages, supporting the international community of systemic practitioners. This paper is based on an in‐person conversation held in July 2023 at Umberta's country home in Tuscany. Our discussion delves into her extensive professional experience, from training at the Philadelphia Child Guidance Clinic, being mentored by Boscolo and Cecchin in Milan, to her leadership role as the current EFTA president. Umberta reflects on early pioneers who influenced her thinking and her impactful work with systems. [ABSTRACT FROM AUTHOR]

Several Euro‐American approaches to couple and family therapy have been instrumental in promoting successful practice of couple and family therapy in continental Africa. This article, however, describes one instance in which an African couple's distress of one‐dimensional fertility could not be resolved by drawing solely from the Euro‐American family therapy tradition. One‐dimensional fertility is defined as a crisis that arises in conditions of sonlessness or daughterlessness in a marriage, that is, in situations where there are only male or female children born to the marriage. The use of medical intervention through the prescription of drugs often worsens rather than enhances the psychological well‐being of couples who suffer from the distress of one‐dimensional fertility. Therefore, it is considered beneficial to encourage the development and recognition of psychological literature that suggests what to be done to control such a distress without recourse to the use of medication or the complicated and sensitive procedure of in vitro fertilisation. The article suggests that the leading intervention package for attending to the challenge of couples with the distress of one‐dimensional fertility entails the exercise of inducting them into the principles and practice of the fertility awareness‐based method of family planning known as the billings ovulation method that is in harmony with the African cultural perspective. [ABSTRACT FROM AUTHOR]

This participatory research project highlighted the views and experiences of young people who are the brothers and sisters of children and young people who have experienced child sexual abuse. By working with young people who had experienced sexual abuse and their siblings, this practitioner research sought to give these young people a voice. The research involved a group process with young people who have experienced sexual abuse and have siblings, and one‐to‐one online consultations with the brothers and sisters of young people who have experienced abuse. All the young people spoke of their sibling and family relationships as unique and requiring unique responses to these relationships by services and health‐care professionals. Siblings' needs in the aftermath of a child sexual abuse discovery are often overlooked. This research describes how just as children who have experienced sexual abuse may feel anger, fear, guilt, shame, anxiety, and confusion, so do their siblings. Brothers and sisters of young people who have experienced sexual abuse describe significant relational trauma with intense emotional experiences of isolation, confusion, sadness, and anger. There is a real need to support young people and families to find words and develop capacities to talk about child sexual abuse ‐‐ a need to find supportive ways to speak about what has occurred and understand its impact on all. The study clearly demonstrated the significant level of need and impact on brothers and sisters of young people who have experienced sexual abuse. [ABSTRACT FROM AUTHOR]

This qualitative study explores infant‐family mental health experts' perspectives and experiences regarding the inclusion of infants in the family therapy setting. Infant socioemotional development is relational in nature and evolves in the context of both dyadic attachment relationships and broader multi‐person co‐parenting systems. Given this, we sought to understand why family therapy interventions involving families with infants rarely include the infant in a triangular or family systemic approach. Interviews were completed by clinical and/or research experts whose work integrates tenets of both infant mental health (IMH) and family theory and therapy. All interviewees brought at least 5 years of expertise and were actively engaged in the field. Interviewees expressed consistent beliefs that infants have a rightful and helpful place in family therapy approaches. They maintained that infants' innate social drive and communicative capacities position them to make meaningful and clinically significant contributions within family and systemic psychotherapy contexts. Noting that infants have remained on the periphery of these practices, experts advocated expansion and greater integration between IMH and family therapy, while preserving each field's distinctive identity. Experts reported that the interplay between IMH and family therapy fields has been uni‐directional as family systems concepts are embedded within IMH approaches, but few IMH premises are incorporated in mainstream family therapy practices. The disconnect was attributed to multiple factors, including graduate and professional training and theoretical, clinical, research, and sociocultural barriers, which were mutually reinforcing. Experts also identified clinical gains for both infants and family members when infants were meaningfully included in family interventions. Common ground was identified between the disciplines, with a belief that relationally distressed young children and parents are best served by clinical engagement with their network of relationships. Results call for greater collaboration between disciplines to challenge existing traditions and to more fully include infants in mainstream family therapy. Recommendations for integration of family therapy and IMH in clinical, theoretical, research, training, and sociocultural domains are offered. [ABSTRACT FROM AUTHOR]

This article examines the unique propositions within the 'Charter for the Rights of Children yet to be Conceived' posited by First 1000 Days Australia. It argues that the Charter's pioneering focus on preconception conditions significantly broadens the life‐course framework for early childhood, challenging traditional rights frameworks that typically commence at birth. The Charter's tenets, their implications, and their relation to international rights frameworks are also discussed. The Charter for the Rights of Children yet to be Conceived expands the landscape within which family therapists can explore not just cultural inclusivity, but an inclusion of imagining what sort of world, future, and family we want for children yet to be conceived; and what we imagine these children would want from us for this to be achieved. [ABSTRACT FROM AUTHOR]

This position paper from a core group of infant mental health academics and clinicians addresses the conspicuous underrepresentation of the infant in mainstream family therapy. Despite infants' social capacities and clear contributions to family dynamics, they remain largely overlooked within this therapeutic context. We suggest that family therapists have moral and professional responsibilities to support the participation, protection, and well‐being of all family members, including the infant. Here, we emphasise the importance of including the infant in the family therapy setting. By highlighting their frequent omission, we aim to amplify infants' often unheard 'voice,' role, and contributions to family development, especially recovery from distress. A shift towards infant inclusion as the rule rather than the exception represents a new frontier of integration. We first highlight the relational nature of infant development with a focus on the infants' psychosocial capacities and vulnerabilities. We then consider reasons why the infant may be overlooked in family and systemic therapies and offer a rationale for inviting the infant into these settings, illustrated through the use of a clinical case vignette. To facilitate infant inclusion, we propose a series of guidelines to meaningfully incorporate infants into family therapy practices. We conclude by encouraging shifts in family therapy research, training, and practice to better incorporate and understand the unique contributions of the infant to family life. [ABSTRACT FROM AUTHOR]

For this special issue, we sought perspectives on the contributions of the infant to their family's development, including recovery from intergenerational trauma and the contribution of the family to the infant's relational security. This special issue features a series of 12 invited papers from a diverse group of professionals, including infant mental health specialists, Indigenous and non‐Indigenous family therapists, academic family therapy teaching staff, and developmental psychology and systemic researchers. The contributions span several methodologies – ranging from curated conversations and qualitative research to conceptual insights, theoretical discussions, intervention reports, and new intergenerational empirical data. Through this editorial, we provide a brief overview of the collective works, spotlighting the invaluable synergistic contributions that infant mental health and family therapy approaches provide, while highlighting the untapped potential at their intersection. [ABSTRACT FROM AUTHOR]

Training in infant observation, highly valuable in the infant mental health (IMH) field, has an enormous amount to offer family therapists. These two fields of practice, both hold working with the relational world of their clients as central. As two senior family therapists who are also IMH practitioners, we invite those reading this paper to explore the possibilities inherent in undertaking infant observation training as a pathway to enriching and expanding their practice. We provide an overview of infant observation training, how this approach was conceived, and explore the benefits of honouring the subjectivity of the infant, that of bringing the infant's experience alive in the therapeutic space. We provide direct examples from our own practice. We conclude with how infant observation might be incorporated into family therapy training and practice. [ABSTRACT FROM AUTHOR]

This paper shares a far‐ranging set of conversations between professors Jennifer McIntosh, Louise Newman, and Carol George, all child and family practitioners, and infant mental health (IMH) and attachment specialists. They explore the domain of infant–family work with high‐risk populations experiencing complex relational and intergenerational trauma. George and McIntosh discuss the intersection between family therapy and IMH from an attachment perspective. They explore what family therapy can offer to supporting coherence in caregiving states of mind, beyond the offerings of traditional dyadic mother–baby models of intervention. They highlight the infant's contribution to family work, and the application of attachment theory in a family therapy context. Newman and McIntosh discuss a sensitive and graded approach to high‐risk family work with an infant. Newman reflects on when and whom to invite to a family session and the power of enabling the family to speak the unspeakable in the presence of the baby, supporting a future focused path for trauma integration and recovery. For family therapists who may be new to IMH work, there are some important offerings about integrating these fields, bringing into play the family therapist's deep grasp of curiosity, circularity, and capacity to reconceptualise with an IMH perspective on early relational trauma. [ABSTRACT FROM AUTHOR]

Developmentalists have demonstrated that the quality of relationships established by infants with their proximal social environment is crucial for lifecourse development. However, studies of parent–infant relationships have mostly centred on the mother–child dyad. Stemming from family systems theory that considers interactions within the whole family as critical for an individual's personal development, a group of family therapists and researchers in Lausanne (Switzerland) tried to bridge the gap between systemic and developmental thinking by stressing the need to establish the mother–father–infant triad as a collective unit of study. In response, they created the Lausanne Trilogue Play (LTP), a method to systematically assess the quality of mother–father–infant interactions. The LTP is an observational situation during which parents are asked to play with their infant in four parts: (i) one parent plays with the infant, while the other parent is 'simply present'; (ii) the parents switch roles; (iii) all three play together; (iv) the parents discuss in front of the infant. The theoretical model underpinning the LTP is the family alliance model, which postulates that the quality of the coordination demonstrated by the triad to achieve this task can be assessed mainly through careful observation of non‐verbal behaviours as indicators of the achievement of four interactive functions (i.e., participation, organisation, focalisation, affect sharing); fulfilment of these functions determines the quality of relational functioning within the system. This article introduces the clinical, theoretical, and empirical foundations of using the LTP method with the family alliance model; its use in clinical and research contexts; and the most recent advances in the field of research on mother–father–infant interactions based on the LTP situation. [ABSTRACT FROM AUTHOR]

This paper considers the role of academic training programs in the integration of family therapy and infant mental health (IMH) curricula. It takes the form of a conversation between senior academic staff of the Bouverie Centre in Australia and the special issue editors. Robyn Elliott and Colleen Cousins are family therapists, trauma specialists, and academics at the Bouverie Centre, La Trobe University. Robyn supervises the development and delivery of the Master of Clinical Family Therapy, accredited by the Australian Association of Family Therapy. Colleen is a psychologist and family therapist and coordinates the Graduate Certificate of Family Therapy program. They are in dialogue here with the special issue co‐editors, Jessica Opie and Jennifer McIntosh. We consider the degree to which current family therapy training holds the infant in mind, and approaches to deepening the future training nexus between IMH and family therapy. [ABSTRACT FROM AUTHOR]

In this study, we explore family and clinician experiences with virtual care delivery of whole family assessment and therapy developed for infant and preschool‐aged children and adapted during the COVID‐19 pandemic. A clinical case study is also presented. Between September and November 2020, semi‐structured interviews were conducted with four clinicians working with families with children in the 0 to 5 population and with four caregivers with children aged 4–6 years (M = 5.3) involved in whole family assessment and intervention (i.e., Lausanne Trilogue Play [LTP]; Reflective Family Play [RFP]) at a community mental health facility. Clinicians represented various mental health disciplines. Qualitative data were analysed using inductive thematic analysis with intercoder reliability established. Analysis of interviews generated nine themes organised within two conceptual frameworks, accessibility and efficacy. Accessibility included the themes: (1) flexibility, (2) privacy, and (3) resources. Efficacy comprised: (4) effects of technology, (5) home environment, (6) feasibility of therapy tasks, (7) parent alliance, (8) clinician fatigue, and (9) overall evaluation. Home environment was further divided into three subthemes: (5.1) disruptions, (5.2) boundaries, and (5.3) naturalistic observation. While participants reported benefits and challenges uniquely related to virtual care, both caregivers and clinicians expressed overall satisfaction with virtual whole family assessment and therapy. This study provides a rich exploration of the perspectives of caregivers and clinicians engaged in virtual whole family mental health care during the COVID‐19 pandemic. With adequate technology and privacy, whole family assessment and therapy, such as the LTP and RFP, provided via video teleconferencing facilitated accessible and effective care for families of young children with moderate to severe mental health challenges. Evidence suggests in‐person and hybrid approaches to whole family assessment and therapy could be further tailored to meet the needs of families with young children and infants. [ABSTRACT FROM AUTHOR]

First Nations child and family practitioners, Alison Elliott and Clarisse Slater, yarn here with Jenn McIntosh about the cultural fit and importance of including infants in family therapy. They bring years of experience from the 'Workin' With the Mob' clinical program at The Bouverie Centre to bear on building safe and respectful engagement with First Nations peoples and families. They share a First Nations view of the call of the infant and their ancestry and their power to join in bringing healing to parent and family systems. They discuss safe engagement in attempting to build safety in the present, especially for new parents who carry childhood wounds. The baby's capacity to help reframe these conversations into opportunity for new hope and healing becomes central to systemic safety, rather than something to be avoided. [ABSTRACT FROM AUTHOR]

Metaphors are valuable tools of expression, which give meaning to situations and allow the spontaneous processing of feelings and emotions. As therapists, we can support clients to develop and create their individual metaphor to explain their own meaning of experiences or communicate their perception of problems. Creativity provides us with a rich landscape to explore, expand, and enrich ourselves as therapists and consequently our clients. As systemic therapists, we are responsible for the co‐creation of a human process, which has at its core safety in allowing expression, connection, and movement. Through a respectful and curious approach, we can develop pathways to tap organically into our 'creative selves' while reaching into our clients' creativity and selves as catalysts for connection and positive change. Creative resources and therapies have been successfully used in psychotherapy to enhance the mental and emotional well‐being of children, particularly children with autism who have limited verbal capacity or who are non‐verbal. These children also wish to be understood in expressing their thoughts and feelings; however, they use other methods of communication – sometimes obvious, sometimes not. Therefore, it is important that a therapist can access diverse ways to support the child through this process. The creative use of animals in therapy neutralises spaces, eliciting calm, safety, and healing. This is particularly the case when working with this group of children. This paper is derived from my conversation with an elder statesman of the family therapy profession, Professor Carmine Saccu. He is a jovial master storyteller who craftfully communicates via metaphors. Through creative means, play, and humour, he has developed a remarkably unique way of working with children, especially non‐verbal children with autism. He uses his canine, co‐therapist Mafalda, as a powerful resource and intervention strategy to safely elicit engagement and connection in the therapeutic space. [ABSTRACT FROM AUTHOR]

This study examines the impact of social media‐based drama therapy and family counselling in reducing symptoms of postpartum depression (PPD) in women aged 18–34. The researchers used a quasi‐experimental design and randomly assigned the participants (n = 303) to the control, drama therapy, and family counselling groups. The key findings of the study are as follows. First, at baseline, women not only showed more symptoms of PPD than their male counterparts, but men also reached the PPD threshold of 12/13. Second, the difference between women and men regarding their PPD scores achieved statistical significance (p = 0.004). However, during the post‐intervention assessment, men who received drama therapy intervention reported a significant drop in their PPD below the threshold of 12/13. Only women whose spouses received family counselling on spousal support reported a significant drop in their PPD. However, those whose partners did not receive family counselling on spousal support still reported PPD scores within the threshold. In both instances, women in the control group still had high PPD scores. Finally, during the 6‐month follow‐up assessment, even men in the control group did not have significant symptoms of PPD as their scores dropped below the threshold. On the contrary, women in the control group still had high PPD, indicating that PPD lasted more in women than in men. Also, women whose husbands received family counselling on spousal support reported PPD scores below the threshold. However, women whose husbands did not receive spousal counselling still had PPD scores at the threshold, even though their scores marginally dropped. [ABSTRACT FROM AUTHOR]

This paper documents the development of a programme component within an alcohol and other drugs residential service. Designed to improve relational competence, this pilot component was designed to have multiple levels of function: from the specific, for example, stimulating residents to formulate and monitor relationally oriented goals, to the more pacific, for example, embedding relationally focused learning as an ongoing rehabilitative concern. Development of the component began with a literature review. After finalising a set of relationship types (friends, siblings, etc.), this review identified three domains: 'values', 'knowledge' and 'skills'. To create an initial draft, these categories were populated by items selected from a multi‐stage inspection of the relevant literature. This draft was then reviewed by multiple stakeholder groups. Feedback from these consultations resulted in substantial modifications to the initial draft. In addition to the component having a broad‐spectrum interventive purpose, the authors propose that this component could play a role in (i) pre‐admission assessment and (ii) programme evaluation insofar as data concerning individual residents are aggregated and analysed. [ABSTRACT FROM AUTHOR]

Child focus is a central construct within Bowen family systems theory (Bowen theory). A clinical implication is that mental health treatment focusing on a child may unwittingly reinforce the operation of child‐focused processes, which undermine rather than enhance child well‐being. The concept of child focus in Bowen theory presents significant implications for professionals working in school settings and in fields such as children's mental health, which are inherently child‐focused. Bowen theory is the guiding theoretical framework for School‐Based Filial Therapy (SBFT). SBFT is a play therapy intervention that was initially established in remote and outer‐regional New South Wales, Australia in response to the low availability of children's mental health services and the significant barriers associated with caregiver engagement in children's mental health treatment. It involves trained school personnel facilitating therapeutic play sessions with children experiencing emotional–behavioural problems. The intervention occurs on school grounds, during school hours, and children's family members do not participate in the intervention. This mixed‐methods study examines the impact of children's participation in SBFT upon family functioning. Interviews with caregivers (n = 10) of children who participated in 10 SBFT sessions were analysed using content analysis. Quantitative data were collected using the Differentiation of Self Inventory – Short Form and Visual Analogue Scale – Family Functioning. A Wilcoxon signed rank test was used to analyse the pre‐ and post‐data. Qualitative outcomes indicated changes in the categories of child functioning, caregiver functioning, and extended family functioning, whilst child‐focused processes remained dominant but changed in intensity and valence following SBFT. [ABSTRACT FROM AUTHOR]

The externalising of problems and implementation of interactive metaphors may improve emotional regulation of those clients presenting with autism spectrum disorder. This paper describes a new eight‐session treatment protocol in terms of using preferred interest metaphors with the strengths and strategies of client and family across the home, school, and community settings of client life. This exploratory treatment intervention uses externalising metaphors therapy as a brief treatment modality, addressing emotional regulation concerns of youth on the autism spectrum. The treatment model concretises affective states and creatively leverages visual strengths to improve this common presenting concern for this population. A case study on family therapy is presented with the protocol overview and illustrations. Further research is needed to address the testable hypotheses and identify the mediators of change resulting from this current model. This research would help to establish best practices in a clinical population for which there is no broadly accepted treatment paradigm. Mr. McGuinty has indicated that there are no conflicts of interest in this manuscript. [ABSTRACT FROM AUTHOR]

The Milan approach, pioneered by Selvini‐Palazzoli, Boscolo, Cecchin, and Prata, has significantly contributed to the field of psychotherapy, particularly in the realm of systemic and family psychotherapy. While rooted in systemic principles and concepts, over time the original Milan group demonstrated differences in their clinical orientations and practices which led to their regrouping into two teams. The paper explores the divergences in their views and directions on family dynamics and the role of symptoms within the system. It delves into the influence of Boscolo and Cecchin, two of the 'Milan Four' on the Centro Padovano di Terapia della Famiglia. Drawing from a conversation with Andrea Mosconi, a mentee and collaborator of Boscolo and Cecchin, the paper examines the reconfiguration of the original 'Milan Four' team and its impact on their clinical approach. Key Milan principles and concepts such as hypothesising, circularity, and neutrality are examined with particular emphasis on the work of Boscolo and Cecchin's systemic work. These principles, intertwined and interconnected, provide a fertile ground for the construction of multiple hypotheses and circular questioning. The paper also highlights the concept of reflexivity, which originates from Bateson's work and plays a crucial role in family relations and communication while explaining the birthplace of paradox taking place when two levels of meaning are 'confused.' The Milan approach continues to be highly regarded, as its early concepts and ideas have evolved and left a lasting impact on the field of family therapy. By reflecting on the distinct contributions of Boscolo and Cecchin, and using examples, Mosconi offers valuable insights into the rich legacy and ongoing relevance of the Milan approach to contemporary therapeutic practice. [ABSTRACT FROM AUTHOR]

Over one in four people in Belgium experience severe physical pain. One in 10 people develop chronic pain every year worldwide. Treatment of chronic pain is based on the biopsychosocial model. Scientific views state, among other things, that pain is a threat to the social self, which is an interesting point of entry for (mental) health‐care providers. Conversations with people with chronic pain are always about more than just their pain; they are interesting and cover a lot of ground. Talking about feelings of being hard done‐by, clarifying the complexity of the situation, examining the body as an autonomous entity, offering psychoeducation as a hypothesis, and a general attitude of not‐knowing form a compass that allows us to attune to the patient and not take up an advisory position. Living with chronic pain requires negotiating with the outside world, being allowed to care for and consider the body, and being allowed to differ from the norm and still fit in enough in a world where the body is just a background figure. An identity transformation and the effects of trauma are described. We meet Eddy and Anne, both dealing with chronic pain, who bring theory alive. The author gives an insight into her personal search and struggles as a psychotherapist introducing systemic psychotherapy in chronic pain patients. [ABSTRACT FROM AUTHOR]

Internationally, while the interdisciplinary field of family therapy and systemic practices is well established and evidence for therapeutic impact is advanced, evaluation of training and measurement of its impact lags behind. This paper addresses this gap, utilising a single case study at the Bouverie Centre, the largest family therapy and workforce development service in Australia. We describe (a) the scope of workforce training and implementation at the Centre, (b) the development of our training research and evaluation framework, and (c) standardised data collection methodology, including a pre‐post training reflective survey. Collectively, this work comprises our current evaluation framework through which we will subsequently examine training impact. Future research and practice recommendations are offered to address challenges to workforce training evaluation and progress efficacy of family therapy training. [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]

This paper explores the common parenting style tension around nurture versus limit‐setting often evident when working with families with a symptomatic child. Firstly it will delve into the parenting 'soft/hard split' with an overview of the literature on parenting styles. Next, it summarises the appearance of this phenomenon in the family therapy literature during its formative days, noting how Bowen, Minuchin, Haley, MRI (Bateson), and the Milan associates respond to this parent presentation in their approaches. Next, the paper outlines recent iterations of these family therapy interventions. An expanded discussion follows on Bowen theory's understanding of the parenting tension triangle. The article then outlines elements of the author's qualitative research study of parents' experience of adolescents' mental health treatment where the 'soft/hard split' emerged as a repeating theme. Finally, a clinical intervention based on Bowen theory, the Parent Hope Project, is outlined for how it addresses the parenting 'soft/hard split.' The goal is to contribute to understanding this phenomenon and its implications for clinical practice. [ABSTRACT FROM AUTHOR]

Trauma affecting youth and families takes a variety of forms, from random one‐time events such as accidents and natural disasters to chronic and highly personal trauma from child abuse or intimate partner violence. Though trauma has received increasing attention in theory and intervention research over the last several decades, the prevailing theories and treatments have limitations due to a linear perspective focused on the trauma problems of the individual. This is particularly concerning given the high dropout rates for trauma‐focused treatments and the complexities of intergenerational trauma that cannot be adequately conceptualised at the level of the individual. To inform and improve family‐based treatment of youth and family trauma, this paper proposes a theoretical framework informed by social constructivism and systems theory. Social constructivism upholds that reality is constructed through communication as an adaptive process for survival, with multiple potential realities possible. Systems theory promotes a non‐linear view of causality within a system, such that the structure and properties of a system determine outcomes more than the inputs that go into the system. Together, the principles of these meta‐theories contradict the orthodox focus on traumatic events causing trauma symptoms, and instead imply that family‐based treatment should focus on helping families shift assumptions and dynamics that sustain the problem in the present. The joint application of a social constructivism–systems theory framework for trauma introduces several new principles to inform family‐based treatment: (a) post‐trauma realities; (b) mutual survival; (c) power–justice balance; and (d) adaptive reorganisation. The implications of these principles for youth and family trauma treatment will be discussed. Future intervention development and research should consider these principles in the ongoing effort to improve family therapy for youth and family trauma. [ABSTRACT FROM AUTHOR]

Adolescent relational violence has significant and pervasive impacts for young people's current and future relationships. It is known that there is a cross‐over between adolescent family violence and other offending behaviour, meaning there is a need for youth justice systems to recognise and respond to these forms of violence. This paper outlines a pilot intervention, the KIND Program, run in Youth Justice South Australia, and aimed at intervening with adolescent family and dating violence. KIND aims to provide tailored systemic intervention to young people and their support network, reducing violence while increasing connection and strength within relationships. The pilot of KIND ran for seven months in 2017, and had eight families participating in the program. Participation in, feedback from, and impact of the program suggest that participation was worthwhile and useful for young people and their families. The KIND Program would benefit from a more extensive pilot period to explore the outcomes of this form of intervention. [ABSTRACT FROM AUTHOR]

An editorial is presented on family therapy, such as interventions for low-needs youth with autism spectrum challenges, assessing complex trauma in young children, and using social media-based drama therapy and family counseling to address postpartum depression. Topics discussed include the relevance and impact of these subjects within the field of family therapy.

The 'Milan Approach' made an enormous contribution to psychotherapy and psychiatry and has been viewed as a bedrock in the family therapy field. Mara Selvini‐Palazzoli made a revolutionary shift in the early 1970's to abandon individual therapy and adopt family therapy to treat anorexia in young women. The goal of the three systemic principles; hypothesising, circularity and neutrality, proposed by the Milan Team is to elicit a useful method to interview families which encourages the production of meaningful information. The Milan group took special care of language. Rather than overly focusing on the label and referring to schizophrenia as a diagnosis, for instance, they used the term 'families in schizophrenic transaction'. This perspective more realistically explored the origin of problems while looking at ways how to effectively generate change. In the early stages of its development, heavily influenced by the work of the MRI, the team adopted a pragmatic and strategic approach, however the focus gradually shifted towards semantics and the story of the system. While the 'systemic identity' was the principal guiding principle, the model was also influenced by social constructionism. This paper is a distillation of a conversation held with Matteo Selvini, son of Mara Selvini Palazzoli. We discussed the four key influential figures who developed the 'Milan approach', Selvini Palazzoli, Boscolo, Cecchin and Prata. The focus of the conversation is on Mara and on her influence shaping the approach, its evolution through the years leading to the creation of the Scuola di Psicoterapia Mara Selvini Palazzoli. Matteo also shares his own influence in the evolution of the school through the intervening years. He explains the adapted version of the Milan approach and the amalgam of the original and emerging therapeutic concepts. His key messages to therapists are the importance of working in teams and client follow‐ups. [ABSTRACT FROM AUTHOR]

This article serves as a conversational and conceptual introduction to this special issue. It is written not in Latin America – as the other articles are – but in Australia and it is written by a Chilean who left Chile due to the ravages that the 16 year long dictatorship had on those lands. Using reflections on my experience – as a citizen and later as a student in psychology and in family therapy – both in that country and since, I touch on post‐colonial issues and on epistemic violence to interrogate 'invisibilities' held in mainstream forms of knowledge in the field, invisibilities that come to us from the Western North. Using references to the work of Edward Said and Gabriel García Márquez, the article invites us to review core assumptions and postures in the conceptual frame of systemic work and proposes a methodology that supports alternative forms of knowledge – knowledges of the South – to forge a voice, a resistance to globalising tendencies that threaten to undermine the work we strive to do. [ABSTRACT FROM AUTHOR]

This article was inspired by a reflection on what unfolded with the COVID‐19 virus, especially how it brought to light the interconnectedness of individual and collective well‐being. This calls for a reassessment of the family therapy approach, which has traditionally focussed on the internal dynamics of the family to explain problems faced by individuals inside the family system without taking into account social, political and historical aspects. This approach, which is referred to in the article as 'familialism,' is challenged using the relational philosophy put forward by Gilles Deleuze and Félix Guattari, and a fresh viewpoint is also given from the concept of the 'outside.' This outside perspective seeks to prevent the family system from closing in on itself, allowing for the creation of open systems. By doing so, it is argued, it is possible to incorporate different elements of the social, political and historical order in therapeutic practice and prevent underestimating the complexity of the human experience. [ABSTRACT FROM AUTHOR]

Our work with children whose rights have been violated, with their families devastated by family violence and where the majority have been left out of the sociocultural systems and experiencing serious economic and educational difficulties, has taken us to our professional limit. The solitary and individual work, in the dim light of the office, left us without tools. As therapists, we can say that it has been necessary to break with our own mental schemes and to take a leap into the territory, the terrain itself. The learned university theories were questioned, forcing us to include a more humanising and less judgmental look at the work. A psychology of the trench was born for us. This paper articulates a work process that required something more than specific training in our subject matter. It summoned us as human beings capable of hosting suffering. From this starting point, and with an open mind and heart to go through its stages, this process is presented as a journey with advances and setbacks in its intervention modalities, systematising programs in permanent construction. Systematising practices is not an easy task. Familias Cuidando (Caring Families) and Adoptar es Posible (To Adopt is Possible) are the developmental spaces of our trench practices, practices that aim to accompany children, adolescents, and their families through the system of promotion and comprehensive protection of their rights. From Vicente López, a district in the province of Buenos Aires, our psycho‐socio‐educational and legal approach tries to be a link within collaborative and supportive practices; establishing ties, networks, and dialogues to strengthen the new paradigm aiming to support listening to the voice of children and adolescents; rescuing their childhoods, resignifying the different family models, and accompanying the construction of a life project for each one, in which we all fit. [ABSTRACT FROM AUTHOR]

This article presents a historical journey through the concepts developed (i.e., worked, modified, and made more complex) over four decades in the existence of one of the first family therapy institutions in Argentina: the CEFYP. This journey travels from its beginnings, in the midst of the military dictatorship, to the present. The concepts will be introduced and discussed taking into account those concepts that emerged and stood out as we worked therapeutically, enriching our clinic in each new paradigm. We will start from the CEFYP's emergence within the socio‐political framework of Argentina in the 1970s, its constitution as differentiated from the prevailing psychoanalytic context within the field of psychotherapies, and its evolution, an evolution that was always attentive to the particular questions that accompanied its relational approach. These questions, which intersected philosophy, anthropology, art, and critical history, will express the position of the CEFYP in relation to change, history, power, dialogue, and the therapist and their place in the process of change. Finally, it will also discuss the CEFYP's way of thinking and developing the teaching and training of relational systemic therapists. This article will also present the most outstanding clinical themes, exemplified with the use of vignettes. Among others, these include our trajectories in the clinic of violence and partner violence, the clinic in destructive divorces, and the clinic with seriously disturbed families. [ABSTRACT FROM AUTHOR]

The article presents the discussion on Creative arts providing with the capacity to communicate the simple and the complex. Topics include family and systemic therapists responsible for the co-creation of a human process having at the core safety in order to allow movement; and having personal evolution, and the influence of creative means, such as jazz, in pursuit of integration.

This study explores an abusive wife's symptoms and risk factors of intimate partner violence (IPV) in a heterosexual relationship. A qualitative approach, using a conceptual cluster network, was used to analyse the family therapy case of a wife abusing her husband. Findings indicate that the wife's IPV‐related symptoms included victim mentality, despair, depression, insomnia, aggression, and the desire to divorce the husband. The wife's risk factors were present at the personal, family‐relational, and sociocultural levels. This study indicates that therapists counselling violent Korean couples may explore couples' communication styles, undifferentiation of self, transference, the culture of filial piety, and the influence of Confucian culture. [ABSTRACT FROM AUTHOR]

The paper presents a model of care focusing on family emotions in the treatment of adolescent obsessive‐compulsive disorder, which is illustrated by a case study. It is concluded that augmenting current treatments by targeting family emotions may enhance adolescent outcomes and improve family functioning. The model is illustrated by a case study, and further systematic research with a larger sample size is recommended. [ABSTRACT FROM AUTHOR]

The article discusses the theoretical concepts such as family homeostasis, family rules, relational quid pro-quo, and the theory of the double bind were collaboratively developed. Topics include the cultural issues in counselling and family therapy and brief intervention models; applicability to current issues impacting families, and ways of living that you have here in China and Southeast Asia, and the decisions in other cultures.

With a focus on 'screen and team' family therapy, we tentatively explore possible practice implications associated with family therapy moving from in‐person to online delivery, with the intention of developing questions for further empirical research. By examining some of the affordances and constraints of the online medium in relation to the use of triadic questioning, we set forth a number of the epistemological and ontological consequences of this move. We argue that online therapy has particular features of a dialogical approach and method. We then examine the concept of joint action, the nature of the conversational processes, and the utterance chains that seem to be more likely to emerge when working online. We posit that a major advantage of the move to online delivery of family therapy is the medium's particular utility for generating more invitational, collaborative, and dialogical practices. [ABSTRACT FROM AUTHOR]

This paper reflects on the nuanced way in which the therapeutic dialogue establishes a safe space for families to address and give meaning to mortality and the different ways in which they hear, understand, and communicate about impending death. Intergenerational patterns of families responding to and navigating a terminal diagnosis are also considered. Language, the therapist's own narrative and experience, familial and intergenerational experiences as well as meanings of life‐threatening illness are explored. The concept of impending death as haunting is introduced and explored. Adding this 'existential' haunting into the formula allows us to consider that impending death offers as an opportunity to 'unblock' communication between and within families and at the same time to identify 'blocked' communication patterns, thus providing a deeper understanding through an elucidation of rifts between family members and/or developing unexpected possibilities for movement and reconciliation. [ABSTRACT FROM AUTHOR]

Genograms are a key technology for family therapists, but in many respects they remain distinctly underexplored. This is especially the case when it comes to the basic structure of the genogram. Other authors have added other lenses on top (e.g., the cultural genogram, the spirituality genogram, and many others), but very few have explored in depth the core assumptions of the circles and squares which make up a genogram. In this article, I engage with the genogram literature to suggest that these shapes lead the genogram session to proceed in a way which privileges gender identity ahead of all other social graces, through the process of deconstruction. I then consider if a model of genogram creation which uses a universal symbol and then refers to gender later through symbology might allow for greater flexibility and curiosity in genogram sessions. This idea is offered with the intention that practitioners will engage with this deconstruction of the genogram in a variety of different ways. [ABSTRACT FROM AUTHOR]

The person of the therapist (POTT) framework is a model of therapist training that can enhance clinicians' attunement and further clinical efficacy. In this autoethnography, two graduate school professors of colour detail their experience of implementing the POTT framework overlaid to academic work. This article presents specific arguments for the use of this model as it furthers therapist accountability and responsiveness. The model's advantages in clinical graduate training are also reviewed. [ABSTRACT FROM AUTHOR]

Despite the importance of Bowen family systems theory in the field of family therapy, there have been few studies examining family unit functioning. To fill this gap, a self‐report instrument, the Family Unit Functioning (FUF) questionnaire has been developed. The FUF questionnaire is a multidimensional measure specifically for adults (aged 25+) about nuclear and family‐of‐origin responses to challenges. Eighty‐six adults who were enrolled in Bowen theory training programs participated in an online questionnaire. The FUF assessment tests five dimensions of family unit functioning developed by Papero (2020). The investigators employed a confirmatory factor analysis, and the following analyses results indicate support for four of the five proposed FUF dimensional constructs: 1. resourcefulness; 2. connectedness and integration; 4. systems thinking; and 5. goal structure. However, the third construct, tension management, requires further validation using a larger data source to generate a more favourable result. The potential contribution of the FUF instrument for testing Bowen theory, use as a family psychotherapy assessment tool, and as an indicator of psychotherapeutic outcomes is discussed. [ABSTRACT FROM AUTHOR]

Successful completion of a doctoral program requires dedication and commitment from the student and their family system. However, previous research pertaining to graduate student relationship satisfaction has sought out the perspective of the student. In this phenomenological research study researchers inquired about the lived experiences of eight partners of graduate students completing a doctoral program with a family therapy focus. Researchers inquired about the lived experiences of the partners of the graduate student, and through thematic analysis identified five essential themes: (1) PhD as a priority; (2) learning to have congruent communication; (3) tension; (4) maintaining appreciation; and (5) differentiation and re‐integration. The researchers join the voices of the participants in calling for changes to the on‐boarding process for new doctoral students, and their partners. Educational institutions can provide realistic expectations of the demands on the doctoral student and their partners, thereby providing informed consent in the process. There is also opportunity for leadership to actively reduce stigma around highly successful individuals in academia accessing mental health services. [ABSTRACT FROM AUTHOR]

Working with transgender, gender diverse, and non‐binary (TGDNB) young people and their families requires a family therapist to hold multiple positions of expert, supporter, cheerleader, coach, and creator of a safe space. Anxiety is often high in family systems following a young person's disclosure of their gender diverse identity. Parents experience a range of emotions while trying to support their child to navigate challenging decisions, heavily influenced by society and untold family rules. The existing literature relating to families of TGDNB young people focuses on parental responses and the impact of an affirming or rejecting position. However, little research has focused on working with families to increase their position of support, which ultimately improves outcomes for TGDNB young people. This case study demonstrates the effectiveness of an integrative family therapy approach to working with TGDNB young people and their families, as a way of navigating this challenging and rewarding area of work. [ABSTRACT FROM AUTHOR]

The practice of integrating various therapeutic disciplines and models in therapy has traditionally been the domain of the experienced practitioner. To encourage the newly trained systemic therapist to embark on their journey in the artistry of integrative practice, this paper addresses the question: 'What guidance and encouragement could be offered to the beginning family therapist to practice in an integrative way?' Central to this paper is the view that the discipline of systemic thinking itself facilitates integration. Based on the notion that complex models of integrative practice may not serve the beginning clinician, three suggestions are offered. First, the overarching theories that support systemic family therapy also provide a platform for moving between schools of family therapy and our professions of origin. Second, the role of common factors is a useful and important guiding principle to practice in an integrative way. And finally, an essential ingredient of integrative practice is the return to therapeutic presence and attunement. [ABSTRACT FROM AUTHOR]

An introduction is presented in which the editor discusses articles in the issue on topics including integrative practice, relationships with integrative practice, and integrative practice in practice.