[Together in the face of extreme violence: accompanying families after a traumatic event]. / Accompagner les familles après un événement traumatique.

After a traumatic event, families can also be impacted at different levels and require post-immediate or longer-term care. The adaptation of these family care procedures carried out following the attacks of 2015-2016 in France, based on existing clinical arrangements, in a child psychiatry service associated with a medical-psychological emergency unit, is discussed via two clinical examples. These different modalities of follow-up, a family debriefing and a situation of mourning associated with a trauma insist on the necessity to consider the temporality of the follow-up, the use of different theoretical tools, as well as the importance given to rituals and family skills hard hit by the traumatic event.

Ethical issues, family systems and analytical training.

This paper proposes a relationship between family problems and the issues of an analytical training group from the point of view of systems theory and analytical psychology. It also explores some ethical problems that are common to families and to training groups.

Cet article établit une relation entre les problèmes familiaux et les questions survenant dans les groupes de formation analytique, du point de vue de la théorie systémique et de la psychologie analytique. Il explore également quelques problèmes éthiques qui sont communs aux familles et aux groupes de formations.

El presente trabajo establece una relación entre problemas familiares y cuestiones grupales en la formación analítica, desde la perspectiva de la psicología analítica y de la teoría en sistemas familiares. También explora algunos problemas éticos que son comunes a las familias y a los grupos de formación.

Este artigo faz uma relação entre problemas familiares e questões de grupo de treinamento analítico, do ponto de vista da teoria dos sistemas e da psicologia analítica. Também explora alguns problemas éticos que são comuns às famílias e aos grupos de treinamento.

[Adolescence and definition of family, the complexity of new family configurations]. / Adolescence et définition de la famille, la complexité des nouvelles configurations familiales.

When a family is recomposed or reconstituted, this brings new developmental tasks into play. The period of entry into puberty for adolescents is the beginning of a new family life cycle that challenges the tasks and roles of each individual. Family therapy can help to assemble individual fantasies into collective fantasies and allows for the rewriting of a family narrative that is meaningful to all members.

[Systemic Treatment of Eating Disorders]. / Systemische Therapien bei Jugendlichen und Erwachsenen mit Essstörungen.

Systemic Treatment of Eating Disorders Abstract. Eating disorders (EDs) are deleterious illnesses that are associated with significant psychiatric and medical morbidity and mortality, considerable distress and impairment, marked caregiver burden, and high treatment costs. Because EDs commonly onset in adolescence and young adulthood, and with consistent evidence that early intervention results in the most promising treatment outcomes, an increasing amount of research has been devoted to the treatment of adolescent EDs. Although still less researched in adult presentations of EDs, the historical record of research on adolescent ED treatment over the last half-century principally supports family therapy. Current published clinical guidelines recommend an ED-specific family therapy as the first-line treatment of adolescents with anorexia nervosa (AN) and as a recommended treatment of adolescents with bulimia nervosa (BN). The number of treatment trials for adolescent AN has slowly grown over the last few decades and, more recently, family interventions include protocols extending to new populations and diagnoses, including BN. This narrative review summarizes existing family-based approaches to the treatment of adolescent EDs, integrating recent research findings. This article also includes discussion of methods, both current and proposed, that expand and adapt current family-based approaches in efforts to improve the breadth and scope of ED treatment in adolescence and young adulthood.

[The family therapeutic alliance]. / L'alliance thérapeutique familiale.

The therapeutic alliance should be sought between the family and the therapist. Over time, it has experienced a significant evolution from the Freudian concept of the early 20th century to that of "potential competence" nowadays. Families now play an active role in the care of their hospitalised relatives.

[Multidimensional family therapy: which influences, which specificities?]. / La thérapie familiale multidimensionnelle (MDFT) : quelles influences, quelles spécificités ?

BACKGROUND: Among illegal psycho-active drugs, cannabis is the most consumed by French adolescents. Multidimensional family therapy (MDFT) is a family-based outpatient therapy which has been developed for adolescents with drug and behavioral problems. MDFT has shown its effectiveness in adolescents with substance abuse disorders (notably cannabis abuse) not only in the United States but also in Europe (International Cannabis Need of Treatment project). MDFT is a multidisciplinary approach and an evidence-based treatment, at the crossroads of developmental psychology, ecological theories and family therapy. Its psychotherapeutic techniques find its roots in a variety of approaches which include systemic family therapy and cognitive therapy. OBJECTIVE: The aims of this paper are: to describe all the backgrounds of MDFT by highlighting its characteristics; to explain how structural and strategy therapies have influenced this approach; to explore the links between MDFT, brief strategic family therapy and multi systemic family therapy; and to underline the specificities of this family therapy method. DISCUSSION: The multidimensional family therapy was created on the bases of 1) the integration of multiple therapeutic techniques stemming from various family therapy theories; and 2) studies which have shown family therapy efficiency. Several trials have shown a better efficiency of MDFT compared to group treatment, cognitive-behavioral therapy and home-based treatment. Studies have also highlighted that MDFT led to superior treatment outcomes, especially among young people with severe drug use and psychiatric co-morbidities. In the field of systemic family therapies, MDFT was influenced by: 1) the structural family therapy (S. Minuchin), 2) the strategic family theory (J. Haley), and 3) the intergenerational family therapy (Bowen and Boszormenyi-Nagy). MDFT has specific aspects: MDFT therapists think in a multidimensional perspective (because an adolescent's drug abuse is a multidimensional disorder), they work with the system and the subsystem, focusing on the emotional expression and the parental and adolescent enactment (a principle of change and intervention). MDFT includes four modules (adolescent, parent, family interaction, and extra-familial systems) in three steps (1) build the foundation, (2) prompt action and change by working the themes, and (3) seal the changes and exit). The supervision philosophy and methodology is also based on the principle of multidimensionality. Indeed, many different supervision methods are used in a coordinated way to produce the required adherence and clinical skill (written case conceptualizations, videotape presentation and live supervision). CONCLUSION: Family vulnerability and chronicity factors are a major challenge of modern research. MDFT questions the reciprocal adjustments that have to be made by the subject and his/her familial environment. It also helps to clarify the therapeutic interventions in order to enhance better adolescent development. For this purpose, MDFT offers a specific therapeutic frame, for it is a family therapy focused on adolescents with cannabis abuse problems. Its action and questioning on parental practices and adolescents lead to better psycho-educational support. It focuses the therapeutic process on emotions and family capacity for change.