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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]

The aim of this paper is to provide a description of a significant process which takes place during a first psychiatric hospitalization and to shed some light on its context. This process involves a transformation of an individual considered mentally disturbed into a psychiatric patient which affects the person's identity. The ‘person’ becomes a ‘psychiatric patient’. Although it is self-evident that a patient never stops being a person, the context of the first hospitalization merits attention as it is the time when the patient is in most danger of being objectified and depersonalized. The paper describes a study of forty-six patients hospitalized for the first time on a psychiatric ward and their seventy-five parents. Their narratives from the beginning and the end of stay in hospital were compared and the language used during the introductory consultation and discharge consultation analysed. In this process an important role is played by patients' parents. The parents' narratives are seen to change in a direction of acceptance but at the same time a process of stigmatization is apparent. [ABSTRACT FROM AUTHOR]

Randomized clinical trial (RCT) research has come to dominate the research landscape of marriage and family therapy (MFT). Despite becoming the ‘gold standard’ for evaluating clinical research and clinical practices, there is a growing debate regarding the reliance on RCTs as the primary basis for evaluating clinical intervention in MFT. Given the natural diversity of clients, settings and clinical problems faced by practitioners and the relational and recursive interactional process of MFT, one of the major challenges for the field of MFT will be to come to grips with the research–practice gap by moving beyond a single methodological standard through adopting a ‘levels of evidence’ approach as a framework that promotes diverse research methods, different methodological criteria (depending on the method), and evaluation based on the accumulated type of evidence needed to answer a specific policy, clinical practice choice, or within a model clinical decision. [ABSTRACT FROM AUTHOR]

A review of the place of the therapeutic relationship within systemic approaches to therapy is provided. This serves to contextualize the findings of a research study that subjects therapy sessions to a discursive analysis. The purpose of the analysis is to learn more about the therapeutic relationship through an examination of what actually takes place in sessions. Moments in therapy where therapeutic engagement is stronger and moments when it is weaker are identified and analysed. The discursive contours of a robust therapeutic relationship are highlighted. A theoretical account of the constituents of a stronger therapeutic relationship is constructed from this analysis. [ABSTRACT FROM AUTHOR]