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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]

Objective: Parent-only cognitive-behavioural therapy (CBT) interventions have promise for youth with anxiety disorders. Fear-Less Triple P (FLTP) is one such intervention that has been found comparable to child-focused CBT. Although traditionally administered in six sessions, a one-day workshop format of FLTP was developed to improve accessibility. The current study compared the effectiveness of the six-session and one-day workshop formats. Method: Seventy-three youth (mean age, 8.4 years; 74% male) were randomized to traditional FLTP (6-week group) or the one-day workshop format. Anxiety diagnostic status, self- and parent-reported anxiety symptoms scores, independent evaluator-rated improvement, treatment satisfaction, and measures of family functioning were included to assess treatment outcome. Data were collected prior to treatment, and 1-week, 6-months, and 12-months following treatment. Results: Both conditions resulted in significant improvement in child anxiety symptom scores per parent report (on both questionnaire and diagnostic interview measures). Furthermore, significant decreases in sibling anxiety were observed in both treatment conditions. There were no statistically significant differences between conditions on any outcome measure. Conclusions: Results of this study add to the growing evidence that brief, low-intensity, parent-only interventions can effectively target child psychopathology. These brief interventions are ideal for families for whom the resources and time required to commit to a standard multi-week intervention are prohibitive. Registration of Clinical Trials: This trial was registered with the Australian and New Zealand Clinical Trials Registry (ACTRN 12615001284550). [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 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]

The Consolidated Framework for Implementation Research (CFIR) is a well-established framework for systematically identifying key factors influencing the implementation of programs. To enhance the classification of existing CFIR definitions, as well as its +2/-2 scoring system, this study incorporated the views of relevant experts to: i) improve how themes are scored; and ii) utilise more information regarding the frequency with which themes are identified. This structured, frequency-based approach to the CFIR's scoring process has been trialled as the CFIR-frequency (CFIR-f). Researchers thematically analysed semi-structured interview data from four groups of policy and program experts (N = 24) delivering two family-based therapies in New South Wales (NSW), Australia. Themes identified by less than 50% were excluded from further analysis. Themes identified by 50% or more of expert participants in the four groups were classified as enablers or barriers using clearly defined criteria. Each theme was allocated a score according to how many experts identified it as an enabler or barrier, and then mapped back onto the latest adaptation of the CFIR comprising 67 constructs. The CFIR-f successfully determined three enablers of, and six barriers to, implementation. Enablers included the family-based therapy programs, therapist training and participant monitoring systems. Barriers included referral, data collection and staffing difficulties, NSW adaptation issues and the suitability and safety of the programs for Aboriginal families. The same enablers and barriers were identified using both the CFIR-f and the original scoring approach, and the identified themes were successfully mapped to almost all CFIR constructs (65/67). This paper proposes a more frequency-based approach to CFIR's scoring process (the CFIR-f). By specifically utilising the frequency with which these barriers and enablers are identified, the CFIR-f engenders a list of ranked themes that service providers and policymakers can use to inform their decisions about program modification and implementation. [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]

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]

Families affected by another's substance use, including methamphetamine, experience harms to their mental and physical health. Yet, research has paid little attention to support and service needs of this population. This pilot study examines the feasibility and outcomes of SMART Family and Friends, a video-conference-delivered mutual-support group targeting families affected by another's methamphetamine use. Recruitment for this study occurred between March–October 2021 via the SMART Recovery Australia website. Participants were English-speaking Australian residents, ≥18 years, affected by another's methamphetamine use, interested in participating in a manualised eight-module group delivered via video-conferencing. Feasibility was evaluated by attendance rates, participant satisfaction, fidelity ratings, and semi-structured interviews. Measures of distress, quality of life, and family functioning assessed outcomes at baseline and one-month post-treatment conclusion. Forty-three participants commenced SMART Family and Friends groups. 84 % (n = 36) completed ≥4 modules, 67 % (n = 29) completed ≥6, and 42 % (n = 18) completed all 8 modules. Participant satisfaction (M = 4.32, SD = 0.66, out of 5) and facilitator fidelity (>94 % for all modules) were high. A within-group analysis, without comparison condition demonstrated significant improvements in psychological distress (d = 0.38), family impact (d = 0.64), family strain symptoms (d = 0.48), and total family burden (d = 0.69) post-treatment. Qualitative findings illustrated the benefits and challenges of the video-conference-delivered group, as well as recommendations for improvement. Results provide initial support for the feasibility and positive outcomes of the SMART Family and Friends program. These findings demonstrate the successful provision of a mutual-support group for affected families delivered via video-conferencing, and merit further sufficiently powered randomised-control-trials to evaluate efficacy. • Limited evidence-based treatments exist for families affected by methamphetamine. • Families report high satisfaction with the program and video-conference delivery. • The mutual-support component reduces feelings of isolation among families. • One-way design analyses show positive outcomes following SMART Family and Friends. [ABSTRACT FROM AUTHOR]

In designing this study, we aimed to obtain a rich, phenomenological understanding of the experiences of couple and family therapists who transitioned their practice to telehealth due to the COVID-19 pandemic. Twelve experienced therapists from the U.S., Spain and Australia were interviewed in depth about their experiences of this transition, particularly how they developed and maintained therapeutic alliances in a virtual context with couples and families suffering pandemic-related hardships. The qualitative analysis identified 40 themes reflecting participants' initial impressions of telehealth and their positive and negative reactions and adjustments to practicing remotely. Upon overcoming some initial wariness about providing services virtually, many participants described advantages to this way of working with families. Indeed, participants were creative in adjusting to this novel therapy modality, finding new ways to connect emotionally with their clients, to work meaningfully with children, to assess in-session dynamics, and to ensure their clients' privacy and safety. Notably, several participants commented on the relatively slower development of alliances with new cases and the challenge of repairing split alliances between family members. Many of these difficulties were described as due to having minimal access to their clients' raw emotions and the inability to use typical systemic interventions, such as moving family members around physically. Participants also reflected on being a "participant observer" to the upheaval caused by the pandemic, a distressing experience they shared with the families in their care. [ABSTRACT FROM AUTHOR]

This paper will explore the clinical application of tracking sequences in family therapy with a particular focus on Bowen family systems theory. It considers how sequences can be used to track the emotional process occurring in relationship interactions, and the similarities and differences of a Bowen theory‐informed approach compared with dialectical behaviour therapy and both classic and contemporary family therapy models. Case examples are utilised from the author's clinical practice to raise ideas about the therapist joining the client as a co‐researcher in this exercise and facilitating a process that helps assist the client develop their own self‐awareness and problem‐solving resources in the context of their relationships. [ABSTRACT FROM AUTHOR]

This study aimed to explore the most prevalent causes and consequences of maladaptive parent-adolescent conflict from the perspectives of Australian psychologists and other family clinicians. We also queried whether these professionals have observed events or times that exacerbate parent-adolescent conflict. A cross-sectional survey was used to collect data from one hundred and thirty-seven clinicians working in Australia with parents and adolescents. Data were collected via an author-developed, online survey and frequencies were reported. Daily issues of family life (e.g., chores) and relationship readjustment were reported as the most prevalent themes causing parent-adolescent conflict, with problems at school reported as a theme resulting from conflict. Mental health issues in parents and adolescents were reported to (a) be common causes of conflict and (b) worsen after conflict. Trauma and domestic and family violence were identified as additional causes not well represented in existing research. Respondents reported Christmas as a time when conflict was exacerbated. Increased awareness amongst clinicians of the likelihood of encountering these issues in their work with families will support competent risk assessment, crisis management and service delivery. Implications of findings for future research on parent-adolescent conflict during specific years of adolescence, training of clinicians and risk management in clinical practice are discussed. KEY POINTS What is already known on this topic: Conflict with parents increases during the adolescent years. Parent-adolescent conflict can be caused by a wide range of factors, and have a range of adaptive and maladaptive consequences. Parents and adolescents experiencing maladaptive conflicts often seek support from family clinicians. What this topic adds: A current exploration of the causes and consequences of parent-adolescent conflict that are most prevalent. The perspectives of the family clinicians who support conflicted parents and adolescents, but have been underrepresented in existing research. Inform early-career clinicians who support families of the most prevalent factors they may encounter in their work, improving risk assessment and crisis management following a conflict. [ABSTRACT FROM AUTHOR]

There are no published studies investigating the effectiveness of relationship counselling (RC) where only one individual attends (individual relationship counselling (IRC)), in improving client psychological distress (PD). This is important to investigate considering the high prevalence of PD in this client group and the potential for its negative effects to cascade into other domains of an individual's life. The current study aims to address this gap by investigating the short‐term effectiveness of IRC on PD. This study further builds on previous research by investigating variables that may explain changes in counselling outcomes, including client demographics, interpersonal factors, and therapeutic factors. Data were collected from a national sample of 273 individuals presenting for RC at an Australian not‐for‐profit organisation. Results from multilevel modelling showed a significant reduction in PD over time with moderate effect size. Further, relationship status, family functioning, and the Task subscale of the Working Alliance Inventory emerged as significant predictors of PD. The results of this study have important implications for routine practice in informing opportunities to target these key variables as an avenue to increasing the effectiveness of IRC. [ABSTRACT FROM AUTHOR]

The abuse of older people, often perpetrated by family and friends, is a complex multidimensional social problem. In most Australian jurisdictions, responses are currently limited to either primary-level (information, education and referral) or tertiary-level statutory responses. Outside of Australia, Family Group Conferencing has partially addressed this secondary-level service gap by inviting the older person and their wider family system to identify and establish a family-led plan to address potential or actual risk of abuse. This paper presents the core processes of Family Group Conferencing, including the quality of the established evidence base for its use with older people. The limitations and caveats associated with this approach are explored, and a way forward is proposed to explore the utility and suitability of Family Group Conferencing for adults in Australia in response to some types and severities of abuse and mistreatment. The abuse of older people is complex and under-reported, and many older people choose to take no action as a large proportion of perpetrators are family members. Limited Australian responses focus on either primary prevention or tertiary-level statutory responses. Family Group Conferencing may enhance secondary-level service responses to abuse, mobilising the older person's protective networks, and reducing the risk of abuse. [ABSTRACT FROM AUTHOR]

To date, limited research has been undertaken regarding the interplay between differentiation of self (DoS), parental involvement, and the prevalence of psychological symptoms in emerging adults (EA) aged between 18 and 25 years in Australia. The current study aims to assess whether there is an association between mental health symptoms, perceptions of parental warmth, involvement, and autonomy support and indicators of DoS, including self‐regulation capacity and emotional reactivity. In a study of 129 undergraduate students aged between 18 and 30 years, greater DoS, involving both lower emotional reactivity and the ability to take an 'I position' in relation to others, was found to be associated with fewer depressive and anxiety symptoms in EA. In addition, EA who demonstrated lower levels of emotional reactivity (higher DoS) had lower scores in depressive and anxiety symptoms. Parenting variables of caregiver warmth and autonomy granting were also found to be related to lower depressive and anxiety symptoms as well as greater DoS in EA. Regression models show that there were main effects for DoS on depressive symptoms; however, parenting behaviours were not found to moderate this relationship. Overall, this research is important as it supports Bowen's (1978) theorising in relation to the relationship between DoS and mental health, and consideration of the contribution of parenting variables to indicators of well‐being in EA. In this, family therapy has a role in educating both young adults and their parents in how best to promote independence and autonomy for improved psychological health. Further research should focus on the complexity of parenting controlling behaviours on mental health symptoms in EA. [ABSTRACT FROM AUTHOR]

This study explored how psychologists and psychiatrists working in Australian youth mental health services constructed their professional identity, and whether and how implementing Open Dialogue transformed this. Nine clinicians (psychologists, clinical psychologists and psychiatrists) were interviewed after completing Open Dialogue training. Interviews were subjected to discourse analysis. First, two general pre‐existing discursive professional identity positions were constructed: (i) psychiatrists rhetorically distancing themselves from the medical model as 'fixers' of mental illness; and (ii) psychologists and psychiatrists rhetorically embracing their personal identity. Second, participants' responses about implementing Open Dialogue revealed opportunities and discomforts, including: (i) dialogical approaches offering psychiatrists an alternative identity to 'fixers'; and (ii) dialogical approaches generating discomfort at the risk of exposing participants' own vulnerability. Participants' professional identities comprised contrasting positions. Practitioner points: Clinicians' professional identities comprised contrasting positionsClinicians constructed their professional identities by othering themselves from perceived dominant professional paradigmsClinicians incorporated dialogical approaches into existing clinical work after being exposed to Open DialogueClinicians identified Open Dialogue as offering opportunities to construct alternative professional identitiesClinicians appeared uncomfortable with dialogical approaches in situations of high risk within risk‐averse settings [ABSTRACT FROM AUTHOR]

• Multisystemic Therapy for Child Abuse and Neglect has been adapted in Australia. • The program's analytic, training and fidelity systems have enabled implementation. • Referral, data, recruitment and adaptation processes remain persistent challenges. • Overcoming these challenges will streamline its implementation in Australia. Multisystemic Therapy for Child Abuse and Neglect (MST-CAN) aims to reduce the likelihood of child maltreatment and out-of-home care (OOHC) entry for high-risk children aged between six and 17 years. To identify the key enablers and barriers to implementing MST-CAN into the routine delivery of child protection services. Twenty MST-CAN and policy experts, and 25 service providers, involved in the delivery of MST-CAN in New South Wales (NSW), Australia. Semi-structured interviews with MST-CAN and policy experts were thematically analyzed to identify enablers and barriers to the uptake of MST-CAN. These themes were quantified using a modified Consolidated Framework for Implementation Research (CFIR) scoring approach: −2 for barriers, 0 for neutral, and 2 for enablers. The nominal group technique (NGT) identified and ranked the enablers and barriers to MST-CAN delivery perceived by service providers in two discussion groups. The semi-structured interviews generated 15 themes, of which two enablers and four barriers were identified using CFIR scoring. The two NGTs identified six enablers and six barriers. Key enablers common to both interviews and NGTs were the training and supervision of therapists delivering MST-CAN in NSW, and MST-CAN's analytic approach. Key barriers included referral and adaptation challenges for the NSW context and population (including Aboriginal families), staff recruitment difficulties, and problems with the absence and interpretation of outcome data. Barriers to sustained implementation of MST-CAN may be overcome by revising staff qualification thresholds and data collection procedures, and improved adaptation of MST-CAN in partnership with Aboriginal organizations. [ABSTRACT FROM AUTHOR]

There is growing pressure on health and welfare services to provide more efficient and effective services. For one thing, the world's ageing population is resulting in increased pressure on healthcare costs and the availability of government funding. At the same time, community expectations of quick and easy access to high‐quality client‐centred services is growing. Single session ideas can make a valuable contribution to responding to these somewhat competing factors, by providing a basis for effective, efficient, client‐centred, accessible services. This article begins with a functional definition and description of single session therapy (SST), which is used to inform article sections on the attitudinal, clinical, and organisational implications, and ends with ideas for implementing the approach into services, thus, putting SST to work. [ABSTRACT FROM AUTHOR]

Single session therapy (SST) is grounded in the belief that clients and families can effect change after one therapeutic encounter, using their own resources, with brief support and assistance from therapists. SST has been found to be an effective intervention for children, young people, and their families presenting with a wide range of difficulties. Research in child and adolescent mental health has shown that over 50% of families find one SST encounter is enough with no need for further specialist input. This study aims to explore family member experiences of SST (undertaken as single session family therapy and termed hereafter SSFT) as an initial intervention in a regional child and adolescent mental health service (CAMHS), specifically in terms of worry, confidence, and satisfaction outcomes. An exploratory, mixed methods convergent design was utilised using a combination of open questions and Thurstone scales. All eligible family members were invited to complete questionnaires before and after the SSFT, asking about level of worry, confidence, and overall satisfaction with SSFT. Quantitative and qualitative findings indicated most family members had a positive experience of SSFT, although differences were found between young people, parents, and siblings. Overall, family members' level of worry decreased, while only parental confidence in managing the presenting issue(s) increased. Over half of the families did not require further contact with CAMHS following the SSFT. Our findings support previous research that SSFT is an effective, family‐inclusive, and well received intervention for a variety of mental health issues facing children and young people. SSFT could be considered a beneficial and well received first response for the majority of CAMHS clients, which prioritises a family‐inclusive approach. Future research could focus on attaining a more in‐depth understanding of individual family member experiences with a view to improving SST delivery. [ABSTRACT FROM AUTHOR]

Objective: This paper reports findings from a study that sought to better understand the experiences of parents and their children with emergent mental health challenges following the parent's participation in a nurse-led therapeutic group. Design: This was an explorative qualitative study using semi-structured interviews which were then thematically analysed. Setting: Findings from this single-site study are drawn from regional Australia. Participants: Twenty parents and seven of their children aged between 13 and 24. Interventions: Family systems based therapeutic group intervention delivered to the parents of young people attending headspace. Main outcome measure: In line with qualitative research approaches, the participants lived experience was the outcome measure. Result: Three key themes were found in the data: (a) improved parent-child relationships, (b) understanding and being understood and (c) multi-generational perspectives. Conclusion: Regional and remote regions are challenged with comparatively fewer and less diverse services for youth mental health than in urban centres. Findings from this exploratory study highlight that young people can experience therapeutic gains where their parents are the recipients of the intervention. Recommendations from these findings include pursuing further research on the therapeutic gains of parental family system-based groups. [ABSTRACT FROM AUTHOR]

Early intervention in childhood years is an important part of successful therapies for children and adolescents living with or at risk of mental illness. Family therapy acknowledges the role of family relationships, interactions, and family systems in child and youth mental health. To explore the effectiveness and delivery of family therapy in order to inform current family therapy practice in Australian public mental health services, a scoping literature review mapped key concepts of the past 11 years of family therapy research. Current gaps were noted within the following key concepts: family therapy settings and definitions, the influence of family factors on outcomes, transparency of intervention methods, and the training of family therapists. Further research could be undertaken to address current gaps in the literature, specifically: assessment and intervention processes; typical length of time for a series of family sessions; frequency of sessions; and theoretical foundations linked with most effective outcomes, as identified by clinicians, children, and their families. This research would provide a better understanding of best practice and evidence‐based family therapy practices that work for children and their families to inform family therapy practice in Australia and beyond. This scoping literature review identified that there is a noteworthy variation in the way brief family therapy is provided, both in terms of the duration and frequency of sessions, as well as the theoretical underpinnings employed. Further research is warranted to explore different service contexts and brief versions of family therapy delivery and the outcomes for the children and their families. [ABSTRACT FROM AUTHOR]

Open Dialogue is an approach to working with people and their families experiencing psychosocial distress. Interest in Open Dialogue in Australia has been growing recently, raising questions about its adaption and implementation to local contexts. This article is an attempt to answer some of the frequently asked questions we have encountered in training and discussions about Open Dialogue. We attempt to provide responses to questions of how Open Dialogue is different to what is done already, how it fits with current approaches, how you know if you are doing it, whether it is passive or just about doing reflections, issues about including the social network, and concerns about the evidence base. This article aims to present a variety of viewpoints in relation to these questions and to hopefully further discussions on how Open Dialogue can be implemented and adapted to Australian health care and social care contexts. [ABSTRACT FROM AUTHOR]

The number of referrals for children and young people seeking to affirm their gender has risen exponentially in Australia and elsewhere. Whilst the individual mental health needs and treatment outcomes for this group have been the subject of recent research, considerably less emphasis has been placed on exploring and amalgamating individual family member experiences, particularly siblings, using circular questioning. Yet, gender diversity is known to affect everyone in the family, and research clearly demonstrates that youth who feel validated and supported by individual family members in their gender identities benefit from improved mental health and global outcomes. This study aims to explore current clinical practices, professional viewpoints, use of circular questioning, and whole‐of‐family involvement in specialist youth gender diversity services in Australia. Clinical leads and coordinators of publicly funded youth gender diversity services and individual specialists across Australia were invited to complete an online survey, exploring individual protocols and practices in relation to involving the family, and the rationale underpinning this. All six respondents agreed that adopting a systemic understanding, considering general family functioning, and seeking individual family member opinions, was critical. Nevertheless, all family members were infrequently seen, with resourcing issues and time constraints being cited as the main reasons. The value of adopting a systemic and whole‐of‐family line of enquiry was supported by all respondents. Whilst sibling viewpoints were considered valuable by most professionals, siblings were infrequently seen for a variety of reasons. Further attention could therefore be given to involving siblings during specialist assessments. The findings consistently highlighted the value of a systemic line of enquiry and whole‐of‐family approach for gender diversity services and specialists. However, no current assessment guidelines incorporate this as a recommendation. Therefore, future Australian guidelines could formalise a systemic approach. [ABSTRACT FROM AUTHOR]

Objective: The evolution toward more stringent conceptualizations of remission in family therapy for adolescent anorexia nervosa (AN) has, with time, introduced variability in outcomes across randomized controlled trials (RCTs). An examination of remission across the history of research on family therapy for AN shows that earlier studies adopted lenient definitions and generally yielded higher rates of remission than studies of the past decade that have used stricter definitions of remission. In this study, we investigate the reactivity of remission rates to the application of different definitions of remission used within the family therapy for AN literature, within a single RCT data set. Method: We conducted a secondary analysis of data from a single‐site RCT which compared the relative efficacy of two formats of family therapy in a sample of 106 Australian adolescents with AN. Using end‐of‐treatment data, we compared remission rates using 11 definitions of remission that have been used in studies of family therapy for AN spanning more than three decades. Results: We found wide variability in remission rates (21.7–87.7%; Cochran's Q χ2(10, N = 106) = 303.55, p =.000], depending on which definition of remission was applied. As expected, more lenient criteria produced higher remission rates than more stringent definitions. Discussion: Applying different criteria of remission to a single data set illustrates the impact of changing how remission is defined. Failure to consider the greater stringency of remission criteria in recent studies could result in false inferences concerning the efficacy of family therapy for AN over time. [ABSTRACT FROM AUTHOR]

Objective: This is the first pilot study to examine the Australian adaptation of the Strengthening Families Program (SFP), a manualised family intervention recommended internationally in evidence reviews to improve family functioning and child mental health. The study compared two versions (8 vs. 14‐session) and longitudinally evaluated outcomes for child emotional and behavioural difficulties, and parental psychological distress. Method: Fifty‐eight families from disadvantaged primary schools in regional Victoria with children 8–12 years (80.6% of initially enrolled families, 62 parents and 74 children) completed the program and evaluation measures. Measures were repeated at pre‐, post‐, and 3‐month follow‐up and included the Kessler 6, the Strengths and Difficulties Questionnaire, and subscales adapted from the Longitudinal Study of Australian Children and Communities that Care Youth Survey. Results: The program showed significant reductions in child difficulties and parental psychological distress from pre‐ to post‐measurements that were sustained at follow‐up. Reductions in parental psychological distress were significantly associated with reductions in child difficulties at follow‐up. The 8‐ and 14‐session formats were not found to be significantly different in reducing child difficulties or parental psychological distress. Effect sizes for the Australian version were similar to those reported in previous U.S. trials. Conclusions: Findings support the feasibility and effectiveness of an Australian adaptation of the SFP. The current study is unique in identifying similar outcomes for shorter and longer versions of the intervention. It is recommended that the 8‐session Australian version is examined in a larger randomised controlled trial where children present with behavioural and emotional problems. [ABSTRACT FROM AUTHOR]

Much of the discourse regarding social care practice focuses on the differences between the various professions, practice fields, geographical, and organizational contexts involved in the provision of social care. This study surveyed Australian social care practitioners' (N = 438) perceptions of influence on their practice and what similarities and differences existed in these perceptions. Eighteen influential factors were identified with minimal differences across the participants' profession, practice field, organizational sector, or geographical context. These findings suggest that a common ground of experience exists that can be used as a basis for critical discussions and interdisciplinary practice and, thereby, provide a foundation for more consistent and integrated service delivery and outcomes. [ABSTRACT FROM AUTHOR]

This article outlines client and service data from an early psychosis service in New South Wales (NSW), Australia, and presents a client and service profile, with a focus on the psychiatric, psychosocial, and physical health profile of young people with early psychosis. Implications for practice are discussed. Client and service data were captured through a range of processes and comprise a number of different datasets, specifically client demographical information and service data as routinely collected (N = 601), psychosocial data collected through a file audit (N = 33), and client physical health data maintained by the physical health nurse (N = 39). The service researcher extracted all data from each of the databases and analyzed the data descriptively for client and service profile information. The client profile data indicate early psychosis clients present with a range of psychiatric, psychosocial, and physical health vulnerabilities. The data presented support the need for mental health care to be provided in conjunction with primary health care, vocational and employment support, exercise and dietary interventions, and support with substance use. Furthermore, this article highlights the importance of family inclusive practice and trauma-informed care in early psychosis services. The findings support calls for services to be integrated and young people to be responded to holistically through the integration of psychological, psychosocial, and physical health care. [ABSTRACT FROM AUTHOR]

Domestic and family violence is a key area of concern for all professionals who work with families, with recent years seeing an expansion in the availability of intervention programs for men who perpetrate violence against women and children. This paper considers current approaches to the regulation of professional practice in this area, providing information about the changing context in which interventions are offered. The purpose of the paper is to encourage ongoing discussion about the setting of men's behaviour change program standards of practice in Australasia and to identify some key issues that require consideration. [ABSTRACT FROM AUTHOR]

Abstract Antisocial behaviors are common in adolescence. Family centred school-based interventions are attractive models for assisting adolescent populations. This study evaluated the impact of a universal family intervention implemented in Australian schools, on adolescent antisocial behavior. Year 7 students (57% female; M = 12.3 years, the first year of secondary school) in 12 randomly assigned schools, completed a survey in 2004 and were longitudinally followed in 2005 (n = 2042). Multivariate regression analysis revealed that exposure to the intervention did not significantly predict reductions in antisocial behavior across the whole-school population. However, significantly lower increases were evident for the sub-group of adolescents whose parents attended the parent-education activities. Given that 13% of intervention families attended the parent education events, future research should aim to increase parent attendance in school-based interventions. Highlights • Lower rates of antisocial behavior were predicted by female gender, Poor family management and family conflict. • Being in a school with high disadvantage level had an unexpected protective effect, after controlling for other influences. • Being female was found to be a protective factor in the current study. • The current findings confirm prior research that finds early adolescent behavior highly predictive of later behavior. • Family conflict and poor family management may play an important role in adolescent-onset antisocial behavior. [ABSTRACT FROM AUTHOR]

It is well established that connection and support are associated with supporting recovery from eating disorders whereas isolation and feeling misunderstood can be barriers to change. While the consumer and recovery movements have long advocated for treatments that go beyond symptom reduction alone to include factors such as connection with others, there are few treatments that are designed to target these directly for young people with eating disorders and their families. In 2014 the Sydney Children's Hospital Network Eating Disorder Service at The Children's Hospital at Westmead introduced multi‐family therapy (MFT), the first program of its kind in Australia, with a primary aim being to increase solidarity and support for families in addition to helping promote eating disorder recovery more broadly. Rooted in the principles of family therapy for anorexia nervosa, MFT generally brings together six to eight families for a four‐consecutive day workshop followed by six single follow‐up workshops over the course of six months. This paper reviews the current literature available on MFT, describes its introduction at a specialist tertiary eating disorder service in Australia, explores preliminary feedback from families, and discusses the importance of creating solidarity for families affected by eating disorders. [ABSTRACT FROM AUTHOR]

The cover page of the journal "Australian & New Zealand Journal of Family Therapy," is presented.

The author discusses the ethics of using circular questioning when it comes to family sessions focused on gender diverse young people. Topics mentioned include the phenomenon of gaslighting, how parents of transgender children may use sessions with clinicians to focus on their own distress, and a survey of specialist youth gender diversity services in Australia.

Family psychoeducational interventions including Behavioural Family Therapy have an impressive evidence base in the treatment of schizophrenia. While there are challenges in their implementation including the engagement of families, in the few qualitative studies of Behavioural Family Therapy, families report largely positive experiences. Understanding more about families' experiences of Behavioural Family Therapy could guide changes to practice to improve implementation. This qualitative study involved interviews with twenty clients diagnosed with schizophrenia and twenty relatives who participated in Behavioural Family Therapy in Australia. Participants valued sharing experiences between family members and their relationship with the practitioner. Unlike previous studies they reported discomfort in sessions and disappointment in aspects of Behavioural Family Therapy. Greater emphasis on addressing this discomfort and on therapeutic alliance may help overcome implementation challenges. Practitioner points Practitioners can use their therapeutic alliance with families to promote shared understanding by providing information as well as facilitating information sharing between family members, Practitioners need to recognize and respond to the high levels of discomfort experienced by families and particularly the vulnerability of the person with schizophrenia, An increased focus on engagement and the therapeutic alliance may improve the implementation of BFT in services [ABSTRACT FROM AUTHOR]

Background Anorexia nervosa (AN) is a prevalent, serious mental disorder. We aimed to evaluate the cost-effectiveness of family-based treatment (FBT) compared to adolescent-focused individual therapy (AFT) or no intervention within the Australian healthcare system. Method A Markov model was developed to estimate the cost and disability-adjusted life-year (DALY) averted of FBT relative to comparators over 6 years from the health system perspective. The target population was 11-18 year olds with AN of relatively short duration. Uncertainty and sensitivity analyses were conducted to test model assumptions. Results are reported as incremental cost-effectiveness ratios (ICER) in 2013 Australian dollars per DALY averted. Results FBT was less costly than AFT. Relative to no intervention, the mean ICER of FBT and AFT was $5,089 (95% uncertainty interval (UI): dominant to $16,659) and $51,897 ($21,591 to $1,712,491) per DALY averted. FBT and AFT are 100% and 45% likely to be cost-effective, respectively, at a threshold of AUD$50,000 per DALY averted. Sensitivity analyses indicated that excluding hospital costs led to increases in the ICERs but the conclusion of the study did not change. Conclusion FBT is the most cost-effective among treatment arms, whereas AFT was not cost-effective compared to no intervention. Further research is required to verify this result. [ABSTRACT FROM AUTHOR]

Objective This study aimed to examine the trajectory of symptom remission and affective functioning throughout the course of two family-based treatments for adolescent anorexia nervosa (AN): conjoint family-based treatment (FBT) and parent-focused treatment (PFT). Method Participants were 107 adolescents ( Mage = 15.5 years, SD = 1.5) with a primary diagnosis of AN who participated in a randomized clinical trial comparing FBT ( N = 55) and PFT ( N = 51). Patient weight and self-reported assessments of dietary restraint and positive and negative affect were recorded at regular intervals throughout treatment. Results Multilevel models revealed increases in weight (β = 0.33, p < .001) and positive affect (β = 0.03, p < .001), and decreases in dietary restraint (β = -0.03, p < .001) and negative affect (β = −0.04, p < .001) over the course of treatment. No significant effects emerged by treatment type. Discussion These findings suggest that PFT may bring about comparable trajectories of weight gain and reduced dietary restraint as conjoint FBT, despite adolescents not being directly involved in treatment. These findings also highlight that the exclusively behavioral focus throughout both PFT and FBT is associated with significant increments in positive affect and significant reductions in negative affect. [ABSTRACT FROM AUTHOR]

Background: Early childhood interventions can have both immediate and long-term positive effects on cognitive, behavioural, health and education outcomes. Fathers are underrepresented in interventions focusing on the well-being of children. However, father participation may be critical for intervention effectiveness, especially for parenting interventions for child externalising problems. To date, there has been very little research conducted to understand the low rates of father participation and to facilitate the development of interventions to meet the needs of fathers. This study examined fathers' experiences of, and preferences for, parenting interventions as well as perceptions of barriers to participation. It also examined how these factors were associated with child externalising behaviour problems, and explored the predictors of participation in parenting interventions.Methods: A community sample of 1001 fathers of children aged 2-16 years completed an online survey about experiences with parenting interventions, perceived barriers to participation, the importance of different factors in their decision to attend, and preferred content and delivery methods. They also completed ratings of their child's behaviour using the Strengths and Difficulties Questionnaire.Results: Overall, 15% of fathers had participated in a parenting intervention or treatment for child behaviour, with significantly higher rates of participation for fathers of children with high versus low levels of externalising problems. Fathers rated understanding what is involved in the program and knowing that the facilitator is trained as the two most important factors in their decision to participate. There were several barriers to participation that fathers of children with high-level externalising problems were more likely to endorse, across practical barriers and help-seeking attitudes, compared to fathers of children with low-level externalising problems. Almost two-thirds of fathers of children with high-level externalising behaviour had not participated in a parenting intervention or treatment. The only significant predictors of intervention participation were severity of child externalising behaviour problems and child age.Conclusions: The findings have important implications for services seeking to increase father engagement and highlight a number of strategies to enhance the promotion and delivery of parenting interventions to fathers. These strategies include more public health messaging about parenting programs and the importance of father participation. [ABSTRACT FROM AUTHOR]

Child abuse commonly occurs within the context of multiple risk factors, in particular parental mental health and/or drug and alcohol problems. As no one agency can address all these factors, inter‐agency collaboration is paramount to the protection of vulnerable children, especially in families with a complex array of problems. This paper outlines a range of recommendations to improve collaboration between child protection workers and mental health/drug & alcohol (MH/D&A) clinicians from the perspective of Keep Them Safe‐Whole Family Team (KTS‐WFT) clinicians. Taking referrals from child protection, the KTS‐WFT offers interventions to families with parental MH/D&A problems where there are child protection concerns. As part of a larger evaluation of a KTS‐WFT site, 10 KTS‐WFT clinicians participated in in‐depth interviews. Analysis of the interviews identified collaboration with child protection as a primary theme. Participants reported a number of barriers to effective collaboration; in particular, participants reported challenges with information sharing and confidentiality, inconsistency in terms of the level and style of collaboration, tensions between the different theoretical paradigms that underpin practice for MH/D&A clinicians vs. child protection workers, and insufficient clarity around processes and expectations. Consistent with the identified barriers, primary recommendations to improve collaboration were to improve information sharing, overcome silo ways of thinking, manage risk together more consistently, and develop consistent processes and expectations. [ABSTRACT FROM AUTHOR]

A growing body of research suggests that single session therapy (SST) can offer an efficient and effective service. In order to complement this research a recent exploratory study set out to examine client experiences of participating in a service offering single session family therapy. Telephone interviews were conducted with twenty‐five clients to explore their experience of SST and their satisfaction with the service they had received. Although the study was limited in scope and design, the results suggest that (i) most clients found SST had been helpful and responsive to their needs and (ii) most respondents did not report being discomforted or discouraged at the prospect that their contact with the service might involve one or two contacts. Though a small minority of clients expressed some concerns that SST might indicate a lack of availability of service, these worries were alleviated once they had met the therapist. Practitioner points: SST therapy is a framework for family therapy practice that is generally experienced by clients as helpful and responsive to their needs.Therapists can maximize their potential effectiveness with clients by viewing every contact with families as complete in itself.SST therapy offers opportunities for family therapists to make their services more accessible. 名字代表什么？来访者在单次会面治疗中的经历 越来越多的研究表明, 单次会面治疗能够提供有效且高效的干预。作为这一研究的补充, 近期开展的一项探索性的研究调查了一项单次会面家庭治疗服务中来访者的经历。通过与25位来访者的电话访谈, 该研究探索了他们的治疗经历以及服务满意度。虽然该研究在范围和设计上都有局限性, 但是结果似乎显示（1）绝大多数来访者认为单次会面治疗有用, 能够回应他们的需求, 以及（2）大多数调查对象对于自己跟服务提供者将会有一到两次的接触这一事实并不感到不安或者灰心。虽然有一小部分来访者表示了担心, 认为单次会面治疗可能说明服务的供不应求, 但是他们的疑虑都在见到治疗师之后得到缓解。 对实务工作者的启示: 单次会面治疗作为一种家庭治疗实践的框架, 被来访者普遍认为是有效且回应需求的。为了实现治疗效果的最大化, 治疗师可以把每一次与家庭的接触当成是一次完整的会面。单次会面治疗为家庭治疗师提供了机会, 让他们提供的服务能为更多人所用。 关键词：单次会面治疗；来访者治疗结果；家庭治疗；评估；短期治疗 [ABSTRACT FROM AUTHOR]

This study aims to evaluate the effectiveness of the Multisystemic Therapy ( MST) intervention for Australian families invloved with the Specialist Child and Adolescent Mental Health Service (CAMHS). This program was implemented within the Western Australian Department of Health in 2005, and has continually operated two small clinical teams within the Perth metropolitan area since then. This intervention was specifically chosen to improve service access, engagement, and intervention with vulnerable families having young persons with a history of significant and enduring behavioural problems. The study reports on data collected from July 2007 to July 2013 which includes baseline, post-treatment, 6-month, and 12-month follow-up. There were 153 MST families participating in the research at all time points (71% male; 11% Australian Aboriginal; average youth age was 13.6 years). Caregivers completed a set of questionnaires including Child Behaviour Checklist, Parenting Styles and Dimensions Questionnaire, and Depression, Anxiety and Stress Scale. One-way repeated measure ANOVA were used to measure changes over time. Significant caregiver-reported improvements in all measures were reported at post-treatment, and most improvements were maintained at the follow-up periods of 6 and 12 months post-intervention. These preliminary outcomes demonstrate that the 4-5 month MST intervention significantly reduces behavioural problems and emotional difficulties in young Australians and these improvements are generally maintained by caregivers over time. Primary caregivers reported improved skills and mental health functioning that were also maintained over the follow-up period. A proposed randomised controlled trial of the program will address potential placebo and selection bias effects. [ABSTRACT FROM AUTHOR]

Objective Anorexia nervosa (AN) is often first diagnosed in the adolescent years. The treatment with the greatest evidence during this time is family-based treatment (FBT). In FBT, siblings are expected to attend treatment sessions; however, sibling well-being during this time has not been well researched. This study aimed to explore sibling well-being when the ill child was initially diagnosed with AN and after FBT had been completed. Method Eighty-five parents and 55 siblings of adolescents with AN completed the Strengths and Difficulties Questionnaire at diagnosis. In addition, 88 parents and 46 siblings completed the Strengths and Difficulties Questionnaire after finishing treatment. Results Mothers and fathers reported siblings to have lower levels of conduct problems in comparison with population norms. Mothers also reported lower levels of prosocial behaviours. Siblings reported higher levels of emotional difficulties and hyperactivity in comparison with their peers. There were no differences in reported psychosocial well-being of siblings between diagnosis and following FBT. Conclusions Siblings of adolescents with AN have poorer psychosocial adjustment than their peers, both before and after FBT. Clinicians and parents are encouraged to be aware of sibling difficulties and seek additional support if required. Copyright © 2016 John Wiley & Sons, Ltd and Eating Disorders Association. [ABSTRACT FROM AUTHOR]

The aim of this study was to investigate the rate of relationship dissatisfaction among Australian women during the first year after childbirth and to uncover factors affecting their relationships. Postnatal women who had given birth during the previous 12 months were invited to participate in a cross-sectional online study. A comprehensive, multisection questionnaire, as well as the Relationship Assessment Scale (RAS), Female Sexual Function Index (FSFI), and Patient Health Questionnaire - 8 (PHQ-8), were used to collect data. Responses were analyzed using SPSS for Windows. Results showed that 37.2% of the participants experienced relationship dissatisfaction. Results of the multiple logistic regression revealed that the following were significant risk factors for relationship dissatisfaction during the first postpartum year: annual income of less than AU$50,000, sexual dysfunction, and a clinical diagnosis of depression and having symptoms of depression according to the PHQ-8 scores (p < 0.05). Compared to women in a heterosexual relationship, women who were in a same-sex relationship were less likely to have relationship dissatisfaction. In addition, in the period six to 12 months postpartum, women were less likely to have relationship dissatisfaction compared to the period 5 months or less postpartum (p < 0.05). [ABSTRACT FROM AUTHOR]

Background: Accidental injury represents the most common type of traumatic event experienced by children under the age of 6 years. Around 10-30 % of young injured children will go on to develop post-traumatic stress disorder (PTSD) and other co-morbid conditions. Parents of injured children are also at risk of PTSD, and this is associated with short- and long-term consequences for their children's physical and psychological recovery. Despite the significance of this problem, to date, the mental health needs of injured young children have been neglected. One reason for this is due to the uncertainty and considerable debate around how to best provide early psychological intervention to traumatised children and adults. To address these gaps, researchers and psychologists in Australia and Switzerland have developed the Coping with Accident Reactions (CARE) programme, which is a two-session early intervention designed to prevent persistent PTSD reactions in young injured children screened as 'at risk'. Two separate international studies are being conducted to evaluate the effectiveness and feasibility of this programme.Methods/design: The study design for the two proposed studies will employ a randomised controlled trial design and children (aged 1-6 years) who are screened as at risk for PTSD 1 week after an unintentional injury, and their parents will be randomised to either (1) CARE intervention or (2) treatment as usual. Assessment will be completed at baseline (2 weeks) and 3 and 6 months post-injury.Discussion: This international collaboration provides an excellent opportunity to test the benefit of screening and providing early intervention to young children in two different countries and settings. It is expected that outcomes from this research will lead to significant original contributions to the scientific evidence base and clinical treatment and recovery of very young injured children.Trial Registration: The Australian study was registered with the Australian New Zealand Clinical Trials Registry ( ACTRN12614000325606 ) on 26 March 2014. The Swiss study was registered with ClinicalTrials.gov ( NCT02088814 ) on 12 March 2014. [ABSTRACT FROM AUTHOR]

Suicide is the primary cause of death in Australia for youth between the ages of 15 and 24. This is common worldwide as well. Unfortunately, very few treatments have been developed, tested, and successful for treating this difficult clinical problem. Attachment-Based Family Therapy ( ABFT) is one of the therapies demonstrating a significant decrease in suicide ideation and attempts. The effectiveness of this model may rest on the fact that ABFT targets the clinical context (e.g., family, trauma, etc.) of this problem as well as intrapsychic processes. Based on attachment theory, the model aims to help adolescents recover a more secure attachment relationship with parents so that secure-based parenting can help protect the adolescent from future stress and self-harm. A case study is used to demonstrate how the model unfolds, systemically seeking to repair the attachment relationships while also keeping the adolescent safe from suicidal thoughts and behaviours. [ABSTRACT FROM AUTHOR]

In Australia the movement toward evidence based practice was supported by the first National Mental Health Strategy. For mental health clinicians the shift from evaluating process to outcome measurement also brought greater focus on specific disorders and targeted interventions, raising questions about the efficacy and effectiveness of treatment. The gap between research and practice is well documented, and has engendered much debate particularly in regard to empirically supported treatments ( ESTs) and the technologies to widely disseminate practice whilst supporting treatment adherence. In this paper we first, describe the Attachment Based Family Therapy ( ABFT) model before giving consideration to the criticisms of ESTs, and reviewing the dissemination of ABFT in Australia, and the perspectives of Australian clinicians in respect to the model and its relevance to their practice. Finally, we turn to the mission of this Special Issue which is to increase the awareness of ABFT primarily amongst practicing clinicians as we introduce the selected papers that demonstrate the application of the model to a variety of clinical presentations, and clinical settings. [ABSTRACT FROM AUTHOR]

The article addresses the issue of intimate partner violence (IPV) and its impact to couple and family therapy in Australia. The author's reflection on a number of papers related to IPV is discussed including one by Costello that focuses on the difference between the American and Australian system, another by Alan Jenkins regarding the role of shame in IPV and a paper that presents a program in dealing with individuals around issues of IPV.

ABSTRACT Objective To Identify whether early weight gain in family-based treatment (FBT) predicted greater weight and remission at end of FBT and 12-month follow-up. Method Eighty-two adolescents, with anorexia nervosa, participated in a randomized control trial comparing brief hospitalization for medical stabilization and hospitalization for weight restoration to 90% expected body weight (EBW) (1:1), followed by 20 sessions of FBT. Sixty-nine completed trial protocol. Receiver operating characteristic analyses were conducted investigating whether early weight-gain in FBT predicted outcomes at end of FBT and 12-month follow-up. Participants were analyzed according to their original randomization and as a combined set. Binary logistic regression was used to control for randomization arm effect in combined set analysis. Results Weight gain greater than 1.8 kg at FBT Session 4 predicted greater %EBW (99.18 SD = 6.93 vs. 92.79 SD = 7.74, p < .05) and remission at end of FBT (46% vs. 11%, p < .05) and at 12-month follow-up (64% vs. 36%, p = .05). Binary logistic regression confirmed weight gain greater than 1.8 kg predicted remission ( p < .05) while treatment arm randomization did not add significantly to the model. Discussion Early weight gain has potential to distinguish likely responders in FBT from those who may need more intensive intervention to achieve remission offering the potential to improve outcomes. © 2015 Wiley Periodicals, Inc (Int J Eat Disord 2015; 48:919-922). [ABSTRACT FROM AUTHOR]

Foster parents often despair over the lack of information about the past experience of the children in their care, particularly with children who have experienced infant trauma and neglect. In the context of family therapy these unknowns pose both a challenge and an opportunity. The author proposes that foster children gives clues to their past experiences in therapeutic moments, which the therapist may recognize as a result of her own inner conversation. In conjunction with a sound theoretical knowledge of infant trauma and neglect, these moments have the capacity to open a dialogue in the relationships between therapist, child and foster family. This dialogical process offers an opportunity for the child's past experience of infant trauma and neglect to be expressed in silence, and the foster parent's present experience to be heard in stillness, opening for them a way to go on beyond the family therapy sessions. [ABSTRACT FROM AUTHOR]

This paper describes the development of a family therapy service in a regional Australian public mental health service for children and adolescents, using a service model of therapy in the family home which draws on the 'dialogical' and 'collaborative' principles of Seikkula, Anderson and others. The implementation of this service has incorporated training, peer supervision and reflective practice, which has been congruent with dialogical and collaborative principles. Clinicians from a wide range of backgrounds and levels of experience have had a positive experience of learning to work in a dialogical framework. The 'Mobile Family Therapy Team' consists of around 20 clinicians (nurses, allied health clinicians, consultant psychiatrists and trainee psychiatrists) who work in teams of two or three, and who work with one to four families each. Most therapy is conducted in the family home, and clinicians experience this as rewarding but also challenging. This service model is seen as acceptable and accessible to families. Our experience has been that this form of family therapy has been a useful and effective component of treatment for families with complex, severe and high risk problems who have not benefited from previous interventions. Many of these families would not have accessed traditional clinic-based family therapy. We see supervision and reflective practice as essential to the sustainability of this service. [ABSTRACT FROM AUTHOR]