Search

This article presents research that explored the ways that systemic and family therapists might approach the support of families living with dementia. A constructivist grounded theory methodology was used to interpret interviews with four systemic family therapists working in the United Kingdom. All participants had professional and/or lived experience of dementia. Transcript analysis and theoretical sampling led to the development of five categories, each related to different aspects of considering systemic therapy in a dementia context. These categories were further developed into a 'systemically informed dementia orienteering' conceptual framework, which is presented in this paper as a learning resource. Findings are related to existing literature, and recommendations for future research are made. [ABSTRACT FROM AUTHOR]

For this qualitative study, eight family therapists were interviewed about their experiences of practising online during the pandemic. Findings are organised using a framework of problems, possibilities, resources and restraints (PPRR, Neden & Burnham, 2007). Despite variation in therapist confidence in online practice, all participants found new possibilities in this way of working, including connecting family members across distance, increased co‐construction within therapeutic relationships and engaging clients who would not usually attend appointments. Therapeutic alliance was generally possible to establish online, though felt more challenging with whole families than individuals. Problems and restraints included therapist fatigue, risk and safety management, and attuning to nuanced expression of emotion. Implications for practice and future research are proposed. It is suggested that systemic practice has unique qualities to offer the field of online psychotherapy. [ABSTRACT FROM AUTHOR]

Evidence demonstrates the deleterious impact of ongoing and poorly resolved parental conflict on children's wellbeing. 'No Kids in the Middle' (NKM) is a multi‐family programme that aims to help high‐conflict separated parents find new ways of communicating. The aim of this study was to adapt, deliver and evaluate NKM in three UK pilot sites. This paper reports findings from interviews exploring families' experiences of this intervention, and questionnaires which measured change for families over the course of the programme. Parents reported reductions in hostility and conflict when discussing parenting issues. Children reported improved wellbeing with respect to family life, and a reduction in 'avoidance' with respect to talking or thinking about parental conflict. Parents reported reduced internalising symptoms in children. The findings indicate that NKM could be a promising intervention for high‐conflict separated parents and their children, deliverable by frontline practitioners. Practitioner pointsInter‐parental conflict can negatively impact children's wellbeingMulti‐family therapy may be a promising approach for separated parents experiencing co‐parenting conflictAfter the NKM multi‐family programme, parents reported reduced levels of hostility and conflict when discussing parenting issuesAt the end of the NKM programme, children reported improved wellbeing with respect to family life, and a reduction in 'avoidance' with respect to talking or thinking about family conflict. Relatedly, parents reported reduced internalising symptoms in children [ABSTRACT FROM AUTHOR]

The article discusses systemic practice in family therapy, focusing on topics such as multi-family preventative approaches for mental illness, sibling experiences of parental mental distress, and the impact of autism spectrum conditions on couple relationships.

Whilst there is increasing interest in spiritual and religious narratives in the field of family therapy, little has been written regarding how these constructs intersect in training and practice. This study explores the experiences of three Muslim community leaders who completed two years of systemic training as part of an innovative project in an inner‐city area. Semi‐structured interviews were analysed using interpretative phenomenological analysis (IPA), resulting in the emergence of three themes: (i) the self of the systemic practitioner, (ii) experience of systemic training and (iii) application in the community. Participants recognised that most systemic principles and interventions were complementary to religious constructs and could be applied in their community work. Being part of a Muslim cohort, the skilful management of cultural sensitivity by the instructors and opportunities for faith‐based perspectives to be appreciated and engaged with as part of the meaning‐making process all contributed to a positive learning experience. Practitioner pointsMuslim community leaders in this study recognised that most systemic principles and interventions were complementary to religious constructs and could be applied in their community work.Being part of a Muslim cohort, the skilful management of cultural sensitivity by the instructors and opportunities for faith community perspectives to be heard and articulated all contributed to a positive learning experience.They expressed a need for systemic training and knowledge to be disseminated to support community leaders and Imams as well as the communities they serve.Opportunities for the expression of the subjugated discourses held by faith‐based communities are required to help identify gaps in research and training that could lead to the establishment of service provisions that do not denigrate the core beliefs of these populations.The incorporation of faith community understandings of the self, family and society into systemic practice would enable institutions, trainers, supervisors and therapists to be more responsive to the needs of these communities, as well as identify opportunities for the co‐creation of knowledge. [ABSTRACT FROM AUTHOR]

Following the COVID‐19 pandemic, psychological therapies rapidly moved online in mid‐2020. The Association for Family Therapy and Systemic Practice in the UK (AFT) surveyed the attitudes and practices of systemic therapists in the UK in early October 2020, exploring members' views and gathered information about ongoing needs. A sample of 312 people were included in a mixed methods analysis. In total, 65% of respondents felt their overall experience of using online video technology professionally was positive, further reflected in responses to two open‐ended questions. Detailed thematic analysis revealed that many positive comments were related to the practical advantages of online working, whilst many negative comments were related to technique and the therapeutic relationship. Possible respondent biases are discussed, and the implications of this change in practice are explored. It remains to be seen if this marks the beginning of a more permanent shift in our field as we explore the potential of new technologies. Practitioner Points: The vast majority of UK systemic therapists felt that their experience of online video technology was positive.They noted many practical advantages but also identified many challenges regarding therapeutic techniques and the therapeutic relationship.Therapists developed a range of creative solutions to maximise the therapeutic opportunities of online video. [ABSTRACT FROM AUTHOR]

Covid‐19 has led to a shift towards online therapy. This paper focuses on therapists' experiences of translating systemic practice online with families. A range of UK services are represented, including community, inpatient, adult and children services. A social construction theory, coordinated management of meaning, is used to understand online family and systemic therapy. The new context of online therapy influenced all other levels of the therapeutic encounter including content and structure of sessions, therapeutic relationship, therapists' identity and culture of therapy. The relationship between 'doing' online therapy and reflecting on practice has been central in co‐constructing new ways of interacting. There were many similarities across services, where there were differences these were client and context specific. As better ways of engaging emerged, therapists became more confident, creativity in therapy increased and attitudes about online therapy became more positive. Practitioner points: Online systemic therapy is possible across adult and children services at different tiers within community and inpatient settings.CMM provides a framework to understand communication in online therapy.Online therapy requires reconsiderations at all levels of the therapeutic encounter.Increased confidence and competence correlates with positive attitudes about online therapy.Online therapy is impacting on the overall evolving culture of therapy. [ABSTRACT FROM AUTHOR]

This article explores the phenomenon of language switching in clinical practice in the systemic psychotherapy field. I consider multilingual therapists' experiences of switching from use of one language to another in the therapeutic context, the therapists' awareness of this, and the intentions or possible meanings they attribute to these experiences. The interpretative phenomenological approach was used to analyse the experiences of four female family therapists based in London and from a range of cultures and communities. It was found that the therapists construed their multilingual position as both challenging and advantageous. Suggestions are made to explore the language switching phenomenon in supervision and training, as well as to think more widely with monolingual and multilingual colleagues and supervisors about the meaning and the use of language switching in therapeutic practice. Existing research in this area can be developed further to provide a framework that could benefit practitioners in the systemic field. Practitioner points: Language switching was viewed as an invaluable skill by therapists, enabling them to shift between languages and understand their clients' world in a rich wayMultilingual family therapists can address issues of power and voice with families through the practice of language switching [ABSTRACT FROM AUTHOR]

An introduction is presented in which editor discusses articles in the issue on topics including systemic assessment format in a fieldwork team; use of an anticipatory dialogue approach in a social care setting; and how a model developed in a clinical setting for use in child protection services.

Abstract: Engaging black and minority‐ethnic (BME) individuals in therapy and maintaining a positive therapeutic alliance can be a complex task, especially when challenging a family's core belief system. This study examines how therapists working within a specialist cultural service in London, UK were able to question a family's core cultural belief system whilst building and maintaining a strong therapeutic alliance. Video‐assisted semi‐structured interviews were carried out with two family members and their two therapists, and analysed using thematic analysis. The findings suggest that core beliefs can be effectively challenged within the context of a strong therapeutic alliance if topics are approached in a sensitive and respectful manner, by trusted therapists who have a degree of knowledge and awareness of their own cultural positioning, as well as an understanding of their clients’ culture. We propose that engaging with culture in this way can strengthen alliance and facilitate positive change. Practitioner points: Core cultural belief systems can be effectively challenged by therapists within the context of a positive therapeutic alliance Topics need to be approached sensitively with a degree of authenticity, curiosity and respect Respectfully challenging core beliefs while being aware of one's own cultural construction and positioning, can strengthen the therapeutic alliance and promote positive change [ABSTRACT FROM AUTHOR]

Asian Chinese families are experiencing constant changes. While commonly known cultural themes such as 'face', 'hierarchy', 'harmony' and 'filial piety' are useful references and important caveats in clinical settings, they are most useful when the context of larger socio-economic and political developments of recent decades is taken into account. This article is co-authored by seven experienced Asian therapists from China, Hong Kong, Macau, Malaysia, Singapore, Taiwan and the United Kingdom. They share their insights into working with Chinese families in Asia. In addition to considering cultural dimensions, the authors attempt to consolidate the understanding of Asian Chinese families by focusing on the effects of socio-economic and political development. Other than focusing on the unique characteristics and challenges of working with Chinese families in their region, they highlight the most useful therapeutic stances and approaches when working with Asian Chinese families. Practitioner points Be mindful that changing family structures affect family dynamics, childcentric values and work-life balance., Chinese families expect to receive advice and instruction. Therapists need to be direct and authoritative where appropriate to avoid causing dissatisfaction, Chinese families can be helped to negotiate their emerging needs for the differentiation of self, A possible therapeutic option is use of self and the ability to embrace uncertainty [ABSTRACT FROM AUTHOR]

SCORE‐15 is a self‐report measure developed for systemic approaches to therapy. This article describes a pilot study designed to test the reliability and content validity of the original SCORE‐15 for lesbian, gay and bisexual (LGB) adults in the UK. Quantitative data analyses conducted with an LGB sample (n = 59) and a non‐LGB sample (n = 57) found sufficient temporal and internal reliability in the SCORE‐15 but with some exceptions for the communication subscale. The content validity of SCORE‐15 was checked via group discussions with two clinical professionals groups (n = 7) and a gay/bisexual men group (n = 8). An alternative adult version of SCORE‐15 named the relational SCORE‐15 or the R‐SCORE‐15 was constructed and its content validity was checked by the original clinical professionals and an additional professional group (n = 8). The R‐SCORE‐15 has content validity for clinical use with couples and LGB people in relationship therapy. Practitioner points: SCORE‐15 is a systemic self‐report measure reliable for routine clinical use with LGB people and couples in the UK to measure relational changes.The use of the term family affects the content validity of SCORE‐15 for LGB people and couples who may not regard family as their primary relationships.R‐SCORE‐15 is a recommended alternative to SCORE‐15 for couples, LGB people and those who may not define significant relationships via biology or marital ties. 从家庭到关系版SCORE‐15：为伴侣和LGB群体另行设计的成人版系统自我报告量表 SCORE‐15是为系统性治疗方法设计的一份自我报告量表。 本文描述了一项初步研究, 其目的在于测试原版SCORE‐15在英国女同性恋、男同性恋和双性恋（LGB）群体中的信度和内容效度。对一个LGB群体样本（n = 59）和一个非LGB群体样本（n = 57）的数据进行定量分析的结果显示, 除了其中的沟通分量表之外, SCORE‐15具有足够的跨时间信度和内部一致性信度。对SCORE‐15的内容效度的检测是通过与两个专业临床人士小组（n = 57）和一个同性/双性恋男性小组（n = 58）的小组讨论来进行的。在此基础上, 新设计了另一份成人版SCORE‐15, 将其命名为关系版SCORE‐15或者R‐SCORE‐15。在原有的专业临床人士上, 新加了一个专业人士组（n = 8）, 以确定这一新量表的内容效度。R‐SCORE‐15具有足够的内容效度以供关系治疗中的伴侣和LGB人群的临床使用。 对实务工作者的启示: SCORE‐15是一种系统性的自我报告量表, 在测试英国LGB群体和伴侣关系变化的临床用途上具有信度。对于LGB群体和伴侣来说, “家庭” 这个词的使用影响了SCORE‐15的内容效度, 因为他们可能并不把家庭看作他们的首要关系。对于伴侣、LGB群体和不将血缘或婚姻关系当作重要关系的人群, 推荐使用R‐SCORE‐15作为代替。 关键词：LGB；女同性恋；男同性恋和双性恋；SCORE‐15；关系版SCORE‐15；R‐SCORE‐15；常规测量指标；系统性自我报告量表；信度和效度；伴侣治疗；LGB适用的SCORE‐15 [ABSTRACT FROM AUTHOR]

SHIFT has been one of the largest RCTs in the field of systemic family therapy in the UK. The study took place over five years, including three major centres with fifteen Trusts and twenty‐five family therapists who worked with a manualized treatment in CAMHS with adolescents who self‐harmed. While the results are not available at the time of this publication, this paper will briefly describe the pre‐ existing factors which were helpful in developing a successful bid, clinical and managerial elements of ‘real world research’ of complex psychological processes and the construction of the manualized systemic family therapy. It also offers examples of some of the unanticipated events in the life of such a large trial. Practitioner Points: Large trials develop from small studies and clinicians are urged to look for opportunities for research partnershipsInvestment in time for consideration of difficult issues as they arise is essential for effective trial managementThe balance between research rigour and ‘real life’ practice is an inevitable area of tension and requires consideration of both immediate and outcome consequences 尝试和痛苦 – 一种随机对照试验对比下的把干预当作惯常和在实施过程中出现的重要事件上的反思的家庭治疗 人工家庭治疗 摘要: SHIFT目前是英国家庭治疗领域最大的随机对照试验之一。本研究历时5年, 囊括了三个主要的中心在内的15个信托, 25位曾在CAMHS对自残青少年进行人工治疗的家庭治疗师。因为在发表这篇文章的时候, 结果还没有出来, 本文将简短地描述1）有助发展成功bid的已经存在的因素, 2）临床以及管理方面的复杂心理过程的”真实情况研究”元素, 3）以及人工系统家庭治理的建构。本文还提供了生活在这样一种大的的尝试下的一些意想不到事件的例子。 对实践者有用的几点建议: 大的尝试发展自小的研究, 临床工作者急需寻找研究合作者的机会困难事件需要及时解决, 不然就会对有效尝试管理产生重要影响研究活力和”真实生活”实践的平衡是一种不可避免的引起紧张的领域, 这需要对当下和结果的同时考虑 关键词：实证实践, 研究, 儿童和青少年精神健康, 培训 [ABSTRACT FROM AUTHOR]

This article reports research on family therapy interactions. The research uses discourse analysis to explore the ways in which parents construct their reasons for requiring family therapy, the outcomes they desire from it and orientations to their progress. The analysis suggests that parents often position their child as the problem and this is something that is rarely challenged or questioned by the child. Parents express a desired outcome of 'fixing' the child and highlight this as what they believe the purpose of family therapy to be. During therapy they emphasize their progression and consider improvements in family functioning. By understanding parental perceptions we can move research forward in understanding engagement in therapy and attrition, and integrate guidelines on service improvements with what parents feel is beneficial. Practitioner points Parents manage their presence in family therapy in many ways and typically position the child as the reason for their attendance., Offering the child some time alone with the therapist has potential to uncover the child's perspectives on goals and outcomes which may be inhibited by parental presence., Anticipating that the child may be described in derogatory or negative ways at the start can help the therapist to reframe the problem in more helpful ways. [ABSTRACT FROM AUTHOR]

The systemic therapy literature is dominated by clinic-based accounts of therapy. The work of an outreach, home-based therapy team is described, in a tradition of systemic therapies which directly seek to challenge service access constraints and social injustice. In paying careful attention to the micro-interactions of initial contact, seeking permission is suggested as an interviewing stance for connecting with families who are not engaged with services, where there have been histories of partner violence. [ABSTRACT FROM AUTHOR]

An introduction is presented in which the editor discusses articles in the issue on topics including increasing polarisation of views among Great Britain politicians due to Brexit; challenges faced by the abortion in Ireland; and the Brexit challenges in Great Britain.

An introduction is presented in which the editor discusses various articles within the issue on topics including adult mental health, client satisfaction and changes in training and systemic practice of Great Britain which results use of manuals in practice and training.