Public Participation: Moving Beyond the Four Walls of Therapy.

Family therapists have an ethical responsibility for public participation, to work toward creating a better society. Serving the public interest and developing laws to promote the profession and the public good can be achieved through policy advocacy and political participation. Political and policy work are important but overlooked aspects of family therapy, which is significant given the consequences differing policies have for clients and the profession. This paper reports on results from a random, national survey of licensed family therapists' (N = 174) advocacy actions. Findings indicate family therapists have overarching policy concerns yet lack proactive legislative and activist engagement. The exploration of therapists' actions and beliefs presented in this paper, serves as a springboard for therapists' movement into the public arena. Video abstract accessible by clicking here.

A Brief Report on the Ethical and Legal Guides For Technology Use in Marriage and Family Therapy.

Marriage and family therapists (MFTs) use ethical codes and state licensure laws/rules as guidelines for best clinical practice. It is important that professional codes reflect the potential exponential use of technology in therapy. However, current standards regarding technology use lack clarity. To explore this gap, a summative content analysis was conducted on state licensure laws/rules and professional ethical codes to find themes and subthemes among the many aspects of therapy in which technology can be utilized. Findings from the content analysis indicated that while there have been efforts by both state and professional organizations to incorporate guidance for technology use in therapy, a clear and comprehensive "roadmap" is still missing. Future scholarship is needed that develops clearer guidelines for therapists.

Couples Counseling for Aboriginal Clients Following Intimate Partner Violence: Service Providers' Perceptions of Risk.

Interventions for family violence in Aboriginal communities should take a culture-based approach and focus on healing for the whole family. The purpose of this research was to identify risk issues from the perspective of service providers for couples counseling with Aboriginal clients following intimate partner violence. A total of 25 service providers participated in over the phone interviews concerning risk with Aboriginal men in couple counseling. Five concepts emerged including (a) collaterals, (b) commitment to change, (c) violence, (d) mind-set, and (e) mental health. It was concluded that culturally competent interventions should involve the entire community and have a restorative approach. The concepts were compared and contrasted with the available literature.

A randomized clinical trial of family therapy in juvenile drug court.

The objective of this article is to examine the effectiveness of 2 theoretically different treatments delivered in juvenile drug court--family therapy represented by multidimensional family therapy (MDFT) and group-based treatment represented by adolescent group therapy (AGT)--on offending and substance use. Intent-to-treat sample included 112 youth enrolled in juvenile drug court (primarily male [88%], and Hispanic [59%] or African American [35%]), average age 16.1 years, randomly assigned to either family therapy (n = 55) or group therapy (n = 57). Participants were assessed at baseline and 6, 12, 18 and 24 months following baseline. During the drug court phase, youth in both treatments showed significant reduction in delinquency (average d = .51), externalizing symptoms (average d = 2.32), rearrests (average d = 1.22), and substance use (average d = 4.42). During the 24-month follow-up, family therapy evidenced greater maintenance of treatment gains than group-based treatment for externalizing symptoms (d = 0.39), commission of serious crimes (d = .38), and felony arrests (d = .96). There was no significant difference between the treatments with respect to substance use or misdemeanor arrests. The results suggest that family therapy enhances juvenile drug court outcomes beyond what can be achieved with a nonfamily based treatment, especially with respect to what is arguably the primary objective of juvenile drug courts: reducing criminal behavior and rearrests. More research is needed on the effectiveness of juvenile drug courts generally and on whether treatment type and family involvement influence outcomes. TRIAL REGISTRY NAME: Clinical Trials.gov, Identified NCT01668303.

[Psychotherapeutically Competent Child Guidance-General Framework and Legal Foundations]. / Psychotherapeutisch kompetente Erziehungsberatung - ihre Rahmenbedingungen und rechtlichen Grundlagen.

Assistances in education are pedagogical and therapeutic benefits connected with it. For child guidance as an assistance in education therefore psychotherapeutic competence is constitutive. The article describes the professional and legal framework of a psychotherapy in child guidance. It specifies on the one hand the composition of the multi disciplinary team (including child and youth psychotherapists and psychological psychotherapists) and the additional therapeutic qualifications acquired by the skilled employees. On the other hand it traces the judicial border between a medical psychotherapy with its scientifically recognised psychotherapy procedures and methods and a psychotherapy in child guidance. The applicability of the new law on the rights of patients with its requirements on a contract governing medical treatment (standards of medical specialists, duty to provide information, information provided for self-determination as well as documentation) on child guidance is discussed as well. The author argues for the preservation of psychotherapeutic competence in child guidance as a benefit sui generis and sees precisely in its therapeutic competence its specific contribution to the advancement of the assistances in education.

New roles for family therapists in the courts: an overview with a focus on custody dispute resolution.

Many legal issues involve conflicts that are at least as much psychological and relational as they are legal in nature. Juvenile and family courts have always embraced a helping philosophy under the parens patriae legal doctrine. These courts address problems where family relationships are central, for example, custody and coparenting disputes, divorce, child abuse and neglect, foster care, intimate partner violence, and juvenile delinquency. Family therapists are playing a growing role in all of these matters. In this article, we use child custody disputes as a more in-depth example for exploring new, potential roles for family therapists, particularly as mediators and parenting coordinators. To show the breadth of the role for family therapists, we also more briefly consider the topics of child abuse and neglect, foster care, juvenile delinquency, and drug and alcohol issues.

Marriage and family therapy: examining the impact of licensure on an evolving profession.

Regulatory responsibilities for the profession of marriage and family therapy have shifted from the American Association of Marriage and Family Therapy (AAMFT) to state regulatory boards. The impact of these changes has not been adequately addressed. The purpose of this article is to highlight many of these changes and explore their implications. The educational, experience, and supervision requirements of states regulating the profession of marriage and family therapy in 2007 are examined using descriptive data from 47 regulatory entities and then compared with the current (2012) regulatory standards from 51 regulatory entities. In turn, these are compared with AAMFT prelicensure clinical membership requirements. Results indicate a marked difference between AAMFT prelicensure and state licensure requirements in both 2007 and 2012, but that state requirements continue to evolve. Additionally, the changing roles of the AAMFT and the Association of Marital and Family Therapy Regulatory Boards (AMFTRB) within the profession are explored.

Therapeutic change in Colombian families dealing with violence: therapists, clients, and referring systems in conversation.

There is a gap in the Marriage and Family Therapy literature regarding clients', therapists', and family judges' theories of change in relational therapy for family violence. We conducted in-depth interviews with eleven court-referred families, their therapists, and two family judges in Bogota, Colombia. Interviews focused on their expectations of therapy outcomes, their understanding of change, and their evaluation of individual and relational therapy outcomes. We followed a grounded theory approach to data analysis. Analyses showed that therapists, family judges, and clients hold different expectations and theories regarding therapeutic change. Findings are discussed based on existing research on clients' and therapists' ideas about change. Implications for future research and practice are presented.

A randomized controlled trial of multisystemic therapy and a statutory therapeutic intervention for young offenders.

OBJECTIVE: To evaluate whether Multisystemic Therapy (MST) is more effective in reducing youth offending and out-of-home placement in a large, ethnically diverse, urban U.K. sample than an equally comprehensive management protocol; and to determine whether MST leads to broader improvements in youth sociality and in mediators believed to be responsible for change in MST. METHOD: 108 families were randomized to either MST (n=56) or the comprehensive and targeted usual services delivered by youth offending teams (YOT, n = 52). RESULTS: Although young people receiving both MST and YOT interventions showed improvement in terms of reduced offending, the MST model of service-delivery reduced significantly further the likelihood of nonviolent offending during an 18-month follow-up period. Consistent with offending data, the results of youth-reported delinquency and parental reports of aggressive and delinquent behaviors show significantly greater reductions from pre-treatment to post-treatment levels in the MST group. In this study MST was observed to have some delayed impact on offending, the nature and causes of which will require further study. CONCLUSIONS: The superiority of the MST condition in reducing offending and antisocial behavior suggests that MST adds value to current U.K. statutory evidence-based youth services. The provision of MST does not supplant existing services but is best used to facilitate the appropriate and cost-effective organization of statutory services for young persons and their families.

The psychosocial treatment of parental alienation.

Parental alienation occurs in divorces when one parent indoctrinates the child to dislike, fear, and avoid contact with the other parent. Mental health professionals who treat children and adolescents are likely to encounter victims of parental alienation in clinical practice, and it is important to identify and treat these youngsters earlier, when the condition is mild, rather than later, when the parental alienation is almost intractable. This article presents an overview of the treatment of parental alienation, which is called reunification therapy. All the parties involved in the case have a role in the prevention and treatment of parental alienation.

[Quality management and practice-oriented research in a clinic-network of mother-/father-child rehabilitation centres]. / Qualitätsmanagement und Praxisforschung im Klinikverbund von Mutter-/Vater-Kind-Einrichtungen.

The Research Network Prevention and Rehabilitation for Mothers and Children is an association of currently 24 rehabilitation centres for mothers, fathers and their children, and a scientific team at the Hannover Medical School. The Research Network combines practice-oriented research on mother and child health with the further development of treatment programmes and the implementation of internal quality management in mother-/father-child rehabilitation centres in accordance with DIN EN ISO 9001. The present paper describes the concept of the Research Network and the work contents addressed over the last three years. The advantages and disadvantages of this association and the changes initiated in practice were evaluated from the point of view of 19 quality managers of the participating clinics. The data were collected by means of semi-structured interviews, and a qualitative content analysis was performed in order to quantify the responses. The concept of the Research Network has proven successful. In the view of the quality managers of the clinics, implementation of DIN EN ISO 9001 has lead to structuring of the processes, improved internal communication, and increased motivation in the team. The major obstacles were the lack of time and human resources. In all clinics, the participation in practice-related research projects und scientifically monitored concept development has contributed to optimizing everyday practice. The exchange between the quality managers in external quality circle meetings was of central importance. The conjunction of internal quality management, practice-related research and concept development in a network can be recommended also for other associations of clinics, health centres or medical practices.

After family treatment drug court: maternal, infant, and permanency outcomes.

This study reports on maternal functioning, infant developmental, and permanency outcomes for 52 families following maternal participation in a family treatment drug court (FTDC) for perinatal substance users. Although the majority of families experienced positive child welfare outcomes, over time, maternal functioning deteriorated and infant developmental concerns were identified. Even when promising interventions like FTDC are used, long-term needs of families affected by perinatal substance use need to be considered and addressed.

Physicians vs. Wannabes: TMA sues podiatrists, chiropractors, family therapists.

The Texas Medical Association is embroiled in scope-of-practice lawsuits against the regulatory boards of three health care groups. TMA is suing podiatrists, chiropractors, and family therapists.

[Child endangerment: a research update regarding etiology, consequences, diagnostics, and intervention]. / Kindeswohlgefährdung: Ein Forschungsupdate zu Atiologie, Folgen, Diagnostik und Intervention.

In Germany child protection law is governed by the term "child endangerment". Based on a definition of that term recent research on child maltreatment is reviewed. Regarding etiology the need to go beyond risk factors and to consider risk mechanisms is highlighted. The discussion on the impact of child maltreatment focuses on the often underestimated effects of early neglect. After a review of progresses regarding the evaluation of maltreated children and the assessment of risk based on a systematic literature review suggestions for design of effective family interventions after abuse or neglect are made.

How effective are family treatment drug courts? Outcomes from a four-site national study.

Family treatment drug courts (FTDCs) are a rapidly expanding program model designed to improve treatment and child welfare outcomes for families involved in child welfare who have substance abuse problems. The present study compares outcomes for 250 FTDC participants to those of similar parents who did not receive FTDC services in four sites. Results show that FTDC parents, compared to comparison parents, entered substance abuse treatment more quickly, stayed in treatment longer, and completed more treatment episodes. Furthermore, children of FTDC parents entered permanent placements more quickly and were more likely to be reunified with their parents, compared to children of non-FTDC participants. Finally, the FTDC program appears to have a "value added" in facilitating positive child welfare outcomes above and beyond the influence of positive treatment experiences.