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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]

Background: Partners and family can play a key role in encouraging military service and ex-service personnel to seek help for their mental health. Community Reinforcement Approach and Family Training (CRAFT) was developed to equip concerned significant others (CSOs) of those experiencing substance use disorders with skills to encourage their loved one to enter treatment and improve their own well-being. It was adapted in the US for CSOs of ex-service personnel with post-traumatic stress disorder (PTSD) (VA-CRAFT). Objective: This study aimed to evaluate an adaptation of VA-CRAFT for use with CSOs of serving and ex-service personnel experiencing PTSD and Common Mental Disorders in the UK (UKV-CRAFT). Method: Acceptability of UKV-CRAFT was assessed with interviews with experts, namely key stakeholders (n = 15) working in support provision for serving and ex-service personnel. In addition, individuals who took part in a small-scale demonstrative trial of UKV-CRAFT (three CSOs and three facilitators who delivered UKV-CRAFT) provided feedback. Results: UKV-CRAFT was viewed positively, with interviewees highlighting that programmes like UKV-CRAFT filled a gap in provision for UK Armed Forces families as most services were only available to the serving or ex-service personnel. Interviewees praised how UKV-CRAFT enhanced CSO well-being and communication with their loved one. Concerns over the confidentiality of taking part in UKV-CRAFT were raised due to the perceived negative effects of highlighting a loved one's mental ill health, especially for CSOs of serving personnel. Ideas for improvement included broadening access to all CSOs regardless of whether their loved one was seeking treatment. Conclusion: Interviewees regarded UKV-CRAFT as a potentially useful intervention suggesting it could be proactively offered universally to support timely help-seeking if required. We recommend further evaluation of UKV-CRAFT on a wider scale, incorporating our recommendations, to assess its effectiveness accurately. Community Reinforcement And Family Therapy (CRAFT), a programme for the concerned significant others (CSOs) of people experiencing Substance Abuse Disorders (SUDs), was adapted for the CSOs of UK Armed Forces serving and ex-service personnel (UKV-CRAFT). UKV-CRAFT aimed to equip CSOs with the skills to encourage their Armed Forces loved ones to seek mental health treatment; it was evaluated by post-trial interviews with UKV-CRAFT facilitators, recipients, and Armed Forces stakeholders. UKV-CRAFT was found to be a useful intervention for CSOs but would benefit from further evaluation on a wider scale. Evaluation of Community Reinforcement And Family Therapy in the UK military community. [ABSTRACT FROM AUTHOR]

Poorer social networks predict more coercive pathways to care and other adverse outcomes in people with psychosis. People from Black African and Caribbean backgrounds have more negative experiences within UK mental health care systems and family relationships often breakdown. This study aimed to examine the social network characteristics of Black African and Caribbean people experiencing psychosis and associations between network characteristics and severity of psychosis, negative symptoms, and general psychopathology. Fifty-one participants completed social network mapping interviews (a gold standard approach to assessing social network composition) and the Positive and Negative Syndrome Scale. This is the first study to explicitly measure social network size amongst Black people with psychosis living within the UK and results showed that participants' social network size (mean = 12) was comparable to that of other psychosis samples. Networks were of moderate density and comprised disproportionately more relatives than other relationship types. Poor network quality was related to more severe psychosis symptoms suggesting that social network quality may be an important factor in influencing the severity of psychosis. Findings highlight the need for community-based interventions and family therapies to mobilise sources of social support for Black people with psychosis within the UK. [ABSTRACT FROM AUTHOR]

Background: Young people with refugee or asylum‐seeker status (R/AS) often present with complex mental health needs, in the context of traumatic life experiences. Generic mental health services in the United Kingdom (UK) may be ill‐equipped to manage the unique experiences of these young people. Culturally adapted interventions (CAI) could provide a culturally sensitive approach to mental health support for refugee children experiencing difficult symptoms. A systematic review was conducted to determine the different types of cultural adaptation in the included studies, and to determine the efficacy of CAIs in comparison to generic treatment. Methods: Systematic searches of eleven databases were completed in December 2020. Any psychosocial interventions conducted in the United Kingdom aimed at providing mental health support for refugee young people and families were included. This was to ensure the potential inclusion of all studies regardless of their adherence to the traditional framework of assessment and intervention in high‐income countries, for example randomised control trials. Results: Eleven studies of varying methodology, participant group, intervention type and outcome measures were included in this review. Studies used a variety of cultural adaptations including surface‐level and deep‐level adaptations. Studies showed some support for the use of CAIs with young people with R/AS, with varying degrees of symptom reduction. It was not possible to compare the effectiveness of CAIs against 'treatment‐as‐usual', nor to determine the effectiveness of different CAI components. Conclusions: Whilst there is evidence for the use of CAIs with R/AS young people, the heterogeneity between studies limits the generalisability of these results. The available research is not sufficient to provide conclusive evidence of the use of CAIs over 'treatment‐as‐usual'. Research and clinical implications are highlighted. Future research could examine the most effective components of CAIs and aim to increase the evidence base of interventions for young people and families with R/AS. [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.

This phenomenological study explored experiences of asexual identified persons within the context of relationships. Thirty-five asexual spectrum identified participants took part in semi-structured interviews that focused on how they viewed themselves and their uniquenesses within relationship dynamics. Queer theory guided the research design and analysis. Findings include a movement towards understanding and experiencing relationships that extend beyond heteronormativity. Themes included: (a) evolving asexual identity development, (b) conscious adapting and communication within relationships, (c) reconsidering amatonormativity, and (d) therapeutic recommendations. Participants identified that their relationships were distinctly different from social expectations; however, overall, partners adapted successfully to these differences with communication and understanding. Findings contribute to a greater competency in asexual identities. [ABSTRACT FROM AUTHOR]

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]

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]

As COVID-19 changed daily lives, early intervention therapists in the US and UK continued to provide services to children. This report illustrates the anxiety that therapists and families experienced and the opportunities and challenges of teletherapy. Temporary approval of video intervention sessions provided ways to meet child and family needs while preventing the spread of COVID-19, reaching remote areas, and accommodating those who had been on the waiting list for services. This report provides strategies, recommendations, and reflections advocating the choice of teletherapy services in early intervention. [ABSTRACT FROM AUTHOR]

Objectives: In the UK, people of African‐Caribbean background have the highest rates of psychosis and greatest inequity in mental health services of all ethnicities. National policies have highlighted the lack of evidence‐based psychological interventions for this group. The aim of this study was to examine the acceptability of a novel Culturally adapted Family Intervention (CaFI) for African‐Caribbean individuals diagnosed with non‐affective psychosis and their relatives. Design: A qualitative design. Methods: Semi‐structured interviews conducted with 22 service users and 12 family members following participation in CaFI. The interview topic guide included perceptions of the needs and benefits of CaFI; usefulness, cultural specificity and accessibility of CaFI therapy and supporting materials; content and delivering of CaFI sessions; views and experiences of working with CaFI therapists; and perceived barriers and facilitators to implementation. Results: Deductive framework analysis identified three main themes for service users: perceived benefits, barriers and limitations, and delivery of the therapy. Four themes were identified for family members: perceived benefits, perceptions of therapists, delivery of therapy, and accessibility of therapy content, supporting materials, and cultural appropriateness. Conclusions: CaFI was found to be an acceptable intervention for African‐Caribbean service users with psychosis and their relatives. Family interventions considering the needs of ethnic and cultural groups have the potential to improve the mental health care and experiences of service users and their families. Practitioner points: The Culturally adapted Family Intervention (CaFI) was viewed as acceptable to African‐Caribbean service users with psychosis and their families.Through adapting interventions to be more culturally sensitive, it is possible to enhance the care of those who typically have poor engagement with mental health services.In‐keeping with their ethos of individualized care delivery, mental health services should place more emphasis on being able to offer appropriate, culturally adapted interventions to their service users. [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]

Complex trauma can have a significant negative impact on the developing brain and occupational performance of children and adolescents. This study explored current practice in occupational therapy in complex trauma utilizing interviews and interpretive descriptive analysis. Nine experienced occupational therapists identified functional concerns that were mapped onto the International Classification of Functioning, Disability and Health framework. Findings indicated the importance of caregiver involvement in treatment, interventions to address bottom-up processes, advanced training, and being connected with other therapists who serve this population. Given the range of interventions with this complex population, occupational therapists have a unique opportunity to contribute to this emerging area of practice. [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.

The author discusses issues related to family therapy and the mental health professions around the world as of June 2019. Topics discussed include a workshop by members of the Association for Family Therapy and Systemic Practice about the practice of couple and family therapy in Great Britain, debates on what constitutes family therapy, and presence of most mental health professions in the U.S. before the emergence of family therapy.

This paper details the findings and reflections of family therapy treatment outcomes for a British‐Chinese family using SCORE‐15, a reliable and valid systemic outcome measure developed in the UK. It aims to examine the clinical usefulness of SCORE‐15 through its application to a single case study. The two culture‐specific treatments were conducted at the Marlborough Cultural Therapy Centre (MCTC), which was part of the Marlborough Family Service in London. MCTC was a mental health specialist service for ethnic minorities in their preferred languages that operated for 18 years within the mainstream mental health setting of the National Health Service (NHS). The overall family functioning was found to have improved and problem severity decreased, apart from some aspects rated by the mother. Reflections and discussions with the family with regard to the SCORE‐15 findings facilitated understanding and feedback about clinical changes in the systemic intervention. [ABSTRACT FROM AUTHOR]

The author discusses several studies that show the impact of several couple therapies under the best conditions such as emotionally-focused psychotherapy, cognitive-behavioral couple therapy, and integrative-behavioral couple therapy. Topics mentioned include the impact of treatments under the conditions of typical health care service delivery, multisystemic therapy in out-of-home placement outcomes, and cognitive behavioral couple therapy for depression.

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]

Children placed for adoption often face unique challenges and are at higher risk of mental health problems compared to the general population. Yet despite some important clinical developments, there is still a lack of evidence related to effective therapeutic interventions for this population. This study reports on the preliminary evaluation of a mentalization-based family therapy service, Adopting Minds, offered as part of a post-adoption support service. Thirty-six families who had adopted 42 children were referred to the service between September 2015 and December 2016. Demographic information was collected and assessments undertaken on the families at baseline and at the end of therapy, using a range of validated measures. Five families who had completed therapy were also interviewed about their experience of the approach. For those families on which data were available, positive outcomes in mental health and parental self-efficacy were identified, and adoptive parents reported high levels of satisfaction with the mentalization-based family therapy service. Analysis of the interviews revealed that the families found it a containing space that was supportive and non-judgemental. They felt able to express their fears and worries to a therapist who was friendly and knowledgeable and reported that the service helped them to deal with and link struggles they were facing to their own as well as their child's past experiences. However, some adoptive families felt that this short-term, six-session service alone was not enough to address all the difficulties that had brought the family to seek help, and would have preferred a longer-term intervention or therapy in combination with other types of support. [ABSTRACT FROM AUTHOR]

This study seeks to contribute to our understanding of the lived experiences of family members and friends of individuals with traumatic brain injury (TBI). The study employed an interpretative phenomenological approach, enabling family members and friends to identify and reflect upon the factors they themselves considered most significant about the impact of TBI on someone close to them, and how this experience has affected their own lives and their relationship with the TBI survivor. Eleven participants, two males and nine females aged 22–79, were from the United Kingdom. Several strong and interconnected themes emerged from the interviews, clustering into four superordinate themes: “continuity and discontinuity”; “damage, loss, and grief”; “roles and responsibility”; and “coping and not coping.” The study findings identify the importance of support and information provision for family members and friends of those with TBI to help them manage the long-term impact of TBI. [ABSTRACT FROM AUTHOR]

Background Youth offending and antisocial behavior ( ASB) are associated with low quality mental health and relationships and usually lead to poor adult functioning; they are very costly for society. Family interventions are effective in children but there are few reliably effective and inexpensive interventions for adolescents. Functional Family Therapy ( FFT) is an evidence-based intervention but seldom tested outside the United States. Methods One hundred and eleven adolescents (10-17 years of age, M = 15.0, SD = 1.63) and their families were randomized to FFT + Management As Usual ( MAU) ( n = 65) or to MAU ( n = 46). Assessments were made at baseline 6, and 18 months after randomization and included interviews and questionnaires of parenting behaviors, conduct disorders (CDs) and offending. Parent-child interaction was directly observed and police records obtained. Trial registration: ISRCTN27650478. Results Eighty-nine (80%) were followed-up. In both groups, there were large reductions over time in all measures of offending and antisocial behavior (e.g. primary outcome p < 0.001), but no significant changes over time in parenting behavior or the parent-child relationship. However, there were no differences between intervention and control groups at 6 or 18 months on self-reported delinquency, police records of offending, symptoms or diagnoses of CDs, parental monitoring or supervision, directly observed child negative behavior, or parental positive or negative behavior. Against predictions, the intervention group showed lower levels of directly observed child positive behavior at 18 months compared to controls. Conclusions In contrast to most previous trials of FFT, FFT+ MAU did not lead to greater reductions in youth ASB and offending compared to MAU alone, and did not lead to improvements in parenting or the parent-child relationship. This may be because the trial was more rigorously conducted than prior studies; equally, the possibility that MAU was effective requires further research. [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]

For many family therapists, exploring religion and spirituality with clients can be challenging. Despite notable contributions to the systemic literature over the last 30 years, family therapy continues to tell the story that this is risky territory. In this article I share the personal and professional stories of a number of family therapists brought together in focus groups to discuss personal and professional beliefs and practices in relation to religion and spirituality. The range of perspectives and issues explored renders these encounters a rich resource for family therapists wishing to develop their practice. Connections are made between themes from the discussions and the literature, and ideas proposed to support the development of positive dialogue between family therapists across the faith/secular spectrum. [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]

Parental mental illness (PMI) can negatively affect the lives of all family members, and there is acknowledged need to work with family and social contexts to promote recovery. However, programmes undertaking such work remain rare and knowledge concerning mechanisms through which PMI impacts families and through which recovery might be achieved is underdeveloped. This paper outlines a new family intervention programme and presents evidence from focus groups with 16 professionals into their experiences of work with families with PMI. Evidence suggests that interactional effects of PMI, family communication and family relationships are key to understanding its impacts, but professionals are liable to struggle to engage with these due to concerns over stigma, lack of skills and low confidence. Positive impacts on practice were achieved through raising awareness of the whole‐family context in relation to PMI, building confidence to raise and engage with PMI and the provision of structured tools for use with families. Positive impacts on the lives of family members were then achieved by professionals in relation to symptoms for the ill parent, the burden on children and overall family well‐being, strongly mediated through improved family communication, understanding and relationships. Implications for policy and practice are considered. [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]

The article discusses several social work approaches for children and families within Children's Services and Children's Social Care in Great Britain. The issues considered related to the context, application, and evaluation of these methods are explored. The benefits of adopting specific models or one formal approach are also examined.

It is well evidenced that childhood bereavement has a negative impact upon a range of psychological and educational outcomes. This article describes a service evaluation of the national child bereavement charity, Winston's Wish SWITCH programme. SWITCH is a community outreach bereavement programme targeted at children that are at risk of antisocial and self-destructive behaviour. A preliminary evaluation of baseline to follow up of parent (n=31) and young person (n=96) Strength and Difficulties (SDQ) data suggests that the programme contributes to a positive impact upon emotional distress, relationships, and concentration. Further, more robust evaluation needs to be conducted to understand the long-term implications of the programme on vulnerable young people. [ABSTRACT FROM AUTHOR]

For patients experiencing psychosis, family work is an effective and important intervention and it is recognised that two co-workers are needed for interventions to be successful. While the co-working relationship is identified as an essential factor in the effectiveness of family work, there is less detail available about developing and maintaining the co-working partnership, and the work required to do so. This article examines the co-working partnership, and discusses how to choose a co-worker and develop the relationship. It also explains how the principles of co-working can be used in other areas, such as early intervention teams. [ABSTRACT FROM AUTHOR]

There are almost 90,000 young people in care in the UK. M any over the age of eleven years entercare due to anti-social behaviour, acute stress and family dysfunction. The short-term and long-term costs at an individual, family and societal level of going into care are high. There are a number of preventative interventions available for this vulnerable group in common use but not all have a strong evidence base. Multisystemictherapy (MST) is a community intervention which targets the systems around the young person including the family, school, peer and community. Some barriers of the intervention are that it does not target every young person at risk of care, nor is it available in every local authority and there is a low annual capacity. Some of the strengths of MST include the robust evidence base, the cost savings and the strong emphasis on implementation fidelity. It is argued that all young people at risk of care or entering custody need to have access to evidence-based treatments which aim to enable them to remain safely at home. The implications for commissioners and social care practitioners in changing current practice are discussed. [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]

Longitudinal costly evaluations will always be important in order to understand the factors that impact on child, family and community well-being over the long and medium term. However, in a policy era that accords major importance to the achievement of outcomes, e.g. payment by results, 'outcome theology' can pose threats to service access and professional morale in family support. It is essential therefore, to ascertain the short-term outcomes of services in order to capture the trajectory of progress by families under stress. This paper critiques the concept of 'the outcome'. It traces the development of this trend in policy and describes an alternative but complementary approach, which is based on capturing interim outcomes in family support services. [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]

Aims Family counselling, with its preventative and supportive focus, could offer an important addition to higher intensity family therapy services, improving functioning for families in need. However, a basic question is whether families presenting to such services are, as assumed, less distressed than those presenting to National Health Service ( NHS) services. This study therefore examined the levels of distress (child and family functioning) of families seeking help at a national voluntary sector family counselling service (Relate). In addition, the study explored how parents and children describe their families and understand the difficulties that brought them into family counselling. Method A total of 54 families (60 adults and 15 children) from one local Relate centre completed the 'Systemic Clinical Outcome and Routine Evaluation' Scale ( SCORE-15), the 'Family Adaptability and Cohesion Evaluation Scale III' ( FACES- III) and the 'Strengths and Difficulties Questionnaire' ( SDQ) before counselling. The answers to three open SCORE questions (family and problem description) were analysed with a combination of thematic and content analysis. Results The quantitative results indicate moderate to high levels of distress reported by families when seeking Relate family counselling, comparable with NHS secondary service Child and Adolescent Mental Health contexts. The qualitative data show a broad range of problems at different levels (child-related issues, family conflicts, marital break-down and external pressure). Discussion The results indicate a potential mismatch between the preventative and low-intensive focus of this kind of intervention and the levels of distress and problem severity in the help-seeking population. Possible implications from these results for further research and therapeutic practice are explored. [ABSTRACT FROM AUTHOR]

Family therapists from 10 different countries (China, India, Israel including Palestinian citizens, Japan, Mexico, Peru, Spain, Turkey, Uganda, and the United Kingdom)[The sectio] describe systemic therapy in their contexts and current innovative work and challenges. They highlight the importance of family therapy continuing to cut across disciplines, the power of systems ideas in widely diverse settings and institutions (such as courts, HIV projects, working with people forced into exile), extensive new mental health initiatives (such as in Turkey and India), as well as the range of family therapy journals available (four alone in Spain). Many family therapy groups are collaborating across organizations (especially in Asia) and the article presents other ideas for connections such as a clearing house to inexpensively translate family therapy articles into other languages. [ABSTRACT FROM AUTHOR]

Accessible summary Sometimes people with learning disabilities and their families get upset and want to talk about their problems. They might see a therapist who talks to them and their family together. This is sometimes called family therapy. The therapist might use a team of other therapists to give the family other ideas. This is called the reflecting team., We wanted to know what it was like for the person with learning disabilities when this happened., We showed five adults with learning disabilities a DVD of the reflecting team in their family therapy and asked what it was like for them., They told us interesting things about what was helpful and what was not helpful in their therapy., This will help us give a better service to adults with learning disabilities who have family therapy., Summary This research aimed to illuminate the experiences of adults with learning disabilities of the reflecting team, in the context of their systemic family therapy. Five adults with learning disabilities were recruited from one community learning disability team. A qualitative design using interpretative phenomenological analysis ( IPA) was appropriate to gather participants' views using semi-structured interviews. The interviews used DVD-assisted recall of the reflecting team. Various validation strategies were employed, including respondent feedback and a focus group with the therapists. Insights were gained in the areas of 'therapists' focus on strengths and difficulties', 'differences in metacognition', 'finding a voice in therapy', 'frustration with the outcome of therapy' and 'managing an unusual experience'. The research has indicated some important factors to consider in the successful inclusion of adults with learning disabilities in systemic family therapy. [ABSTRACT FROM AUTHOR]

Tackling the day-to-day challenges of family therapy can prove difficult for professionals. A particular issue arising in family therapy is the notion of what is appropriate for children. Families report events from their social world, out-there to the therapy in-here. There are occasions where the content is 'adult' in nature and this has to be managed in front of the children. On some occasions family members use derogatory or negative descriptions of their children while their children are present. Drawing upon naturally occurring family therapy sessions, we present a discourse analysis of how this is managed through a range of discursive resources. We show that adult family members construct what is inappropriate for children to be exposed to by positioning blame with others. This has implications for how family therapists deal with inappropriateness when children are present while maintaining the equilibrium of therapeutic alliances. [ABSTRACT FROM AUTHOR]

This paper briefly describes narrative and open dialogue approaches before exploring their shared values, ways of working, their differences and the possibilities for integration. Both authors have extensive experience in using a narrative therapy approach, while Val Jackson, a family and systemic psychotherapist, also uses an open dialogue approach in her work in an early intervention in psychosis service in Yorkshire, UK. [ABSTRACT FROM AUTHOR]

Over the last decade, inspired by systemic family therapy and narrative approaches, Glenda Fredman's team in the UK has found ways to bring families, practitioners and communities together to respond to medical, mental health and social care crises. This work has taken place with children, adolescents, older people and people affected by intellectual disability and their families. This paper shares an inspiring story of this work and describes ways of 'conducting' and 'weaving' networks of hope. [ABSTRACT FROM AUTHOR]

Over the last decade, inspired by systemic family therapy and narrative approaches, Glenda and her teams in the UK have found ways to bring families, practitioners and communities together to respond to medical, mental health and social care crises. This work has taken place with children, adolescents, older people and people affected by intellectual disability and their families. This paper shares an inspiring story of this work and describes ways of 'conducting' and 'weaving' networks of hope. [ABSTRACT FROM AUTHOR]

Jaakko Seikkula (2008) has pointed towards the importance of practitioners working in the present moment in dialogical therapy. Extrapolating from Seikkula's work, this article considers the significance of the qualities of therapist attentiveness, generosity and negative capability in dialogical family meetings for psychosis. It is proposed that these qualities are of particular importance when family meetings occur in crisis situations, as when under pressure practitioners can easily be drawn into prematurely interventionist stances that may unintentionally promote chronicity for the person experiencing psychosis. The value of co-working arrangements in enabling practitioners to maintain attentiveness and negative capability in this work is also considered. [ABSTRACT FROM AUTHOR]

Research on individual therapy suggests that the ability to build effective therapeutic alliances with clients is related to the therapist's adult attachment style. This paper reports an on-line survey of the attachment styles of registered family therapists in the UK which investigated associations between therapist's attachment style, prior profession, gender and preference for a model of therapy. All 443 UK registered family therapists were surveyed and 82 (19 percent) replied. The survey included two standardised self-report measures: the Relationship Questionnaire (RQ) (Bartholomew and Horowitz in Pers Soc Psychol 61:226-244, ) and the Experiences in Close Relationships Questionnaire (ECR) (Brennan et al. in Attachment theory and close relationship. The Guilford Press, New York, ). The RQ invites respondents to rate the extent to which descriptions of secure, preoccupied, dismissing and fearful attachment styles applied to themselves. The ECR is a more conventional measure similar to a personality inventory. Responses to the two measures were discrepant. On the RQ 61 self-reported as having a 'secure' attachment style, nine 'preoccupied', six 'dismissing' and six were 'fearful'. Responses to the ECR indicated that 24 were 'secure', 16 'preoccupied', 15 'dismissing' and 27 'fearful'. Attachment style, as measured by the ECR, was not associated with therapists' prior profession, gender and preference for a model of therapy. The discrepancy between measures may be attributable to the more transparent RQ measure. Participants' responses may have been based on how they wanted others to view them or how they viewed themselves. These responses are challenged by the findings from the ECR which revealed apparently less desirable adult attachment styles in this sample. [ABSTRACT FROM AUTHOR]

Children's engagement and disengagement, adherence and non-adherence, compliance and non-compliance in healthcare have important implications for services. In family therapy mere attendance to the appointments is no guarantee of engaging in the treatment process and as children are not the main initiators of attendance engaging them through the process can be a complex activity for professionals. Through a conversation analysis of naturally occurring family therapy sessions we explore the main discursive strategies that children employ in this context to passively and actively disengage from the therapeutic process and investigate how the therapists manage and attend to this. We note that children competently remove themselves from therapy through passive resistance, active disengagement, and by expressing their autonomy. Analysis reveals that siblings of the constructed 'problem' child are given greater liberty in involvement. We conclude by demonstrating how therapists manage the delicate endeavour of including all family members in the process and how engagement and re-engagement are essential for meeting goals and discuss broader implications for healthcare and other settings where children may disengage. [ABSTRACT FROM AUTHOR]

Assessments of children and young people who display harmful sexual behaviours need to consider - at a broad level - the safety of other children at home, in the community and in the wider family. To date, issues of victim selection have been marginalised in the relevant literature. Drawing on our experience of working with this client group, this article uses four composite case studies that reflect the heterogeneity of children and young people who sexually abuse and applies recent research findings about intra- and extra-familial sexual abuse to make suggestions for good practice in assessment and intervention with young people who display harmful sexual behaviours in different settings. Copyright © 2013 John Wiley & Sons, Ltd. Key Practitioner Messages Young people with harmful sexual behaviour are a heterogeneous group who may be more likely than adults to vary victim type., A formulation approach to risk assessment allows us to move beyond merely the likelihood of future risk, to consider more dynamically issues of victim selection and circumstances in which risks may present., Assessments of family relationships, in particular sibling relationships, can help sharpen our approach to risk assessment and the potential for family-community crossover. [ABSTRACT FROM AUTHOR]