Integrating Spirituality into MFT Training: A Reflexive Curriculum and Qualitative Evaluation.

When clients enter the therapy room they bring unique spiritual beliefs and values in with them; however, marital and family therapists (MFTs) often lack training to assist in this important area of diversity. Current training recommendations encourage therapists to explore their own spirituality to identify personal limitations that may occlude positive client outcomes; however very little information exists on the implementation and usefulness of this type of training. This article will describe a curriculum and report results from a qualitative study of students who participated in a reflexive spirituality practicum course offered in a COAMFTE accredited doctoral program at a private, religious institution. Through this, we hope to provide a training model to further spiritual integration activities in MFT.

Treating troubled families: therapeutic scenario in India.

India, a country of diverse cultures, languages, life styles, and ethnicities, is becoming a land of economic change, political stability, technological advancement, and changing traditional structures of relationships as well as health consciousness. Being known for its ancient traditions, rituals, religious orientation, spiritual outlook and folk beliefs, Indian families attempt to continue certain healthy and traditional elements such as warmth, strong bond, hierarchy, extended support, cultural orientation, shared values and time, tolerance, respect for the aged and inculcation of religious teachings and traditions in families. These factors, or practices, in fact have strong therapeutic value in supplementing the growth and development of individuals in the family system in spite of its transitional position. This paper deals with the review of family-based mental health services and focuses on the changing trends of those practices in India and the advancement of Indian families in their engaging ability with mentally ill members as well as with the treating team.

Integrative problem-centered metaframeworks therapy I: core concepts and hypothesizing.

Over the last 20 years psychotherapy and family therapy have been inundated with a plethora of empirically validated treatments for particular disorders. That trend will increase. Psychotherapists will increasingly be exhorted and ultimately required to integrate empirical data and multicultural competence into their practice. Additionally, individual psychotherapy's default dominance of psychotherapeutic discourse needs to integrate and come to theoretical and clinical terms with the implications of the growing body of research demonstrating the validity and value of a multisystemic perspective. This article (and its companion article) presents a comprehensive, integrative, multisystemic, and empirically informed psychotherapeutic perspective to help therapists and psychotherapy trainers successfully address these challenges-Integrative Problem Centered Metaframeworks (IPCM) Therapy. This first article presents and illustrates IPCM's theoretical foundation, core concepts, and "case formulating" components. It delineates a Blueprint for the practice and teaching of 21st century psychotherapists who can meld science and art into best practice.

Mind-body therapy: attitudes, beliefs and practices of graduate faculty and students from accredited marriage and family therapy programs in the U.S. and Canada.

CONTEXT: Interest in CAM and mind-body therapies (MBT) among mental health professionals has increased over the last decade. Individuals seeking treatment for mental health concerns often use MBTs and expect clinicians to be aware of such treatments. Yet, current data reveal a critical gap in training, practice, and the needs of those seeking treatment. OBJECTIVE: To determine the attitudes, beliefs, and practices of marriage and family therapists regarding MBTs. DESIGN: Electronic survey method using Likert-type scale questions. PARTICIPANTS: Clinical faculty members and graduate students (N = 140) from accredited Marriage and Family Therapy programs in the United States and Canada. RESULTS: Findings revealed that a majority of respondents believed that graduate programs should introduce MBT topics during course of training and that MBTs are valuable in the treatment of various clinical problems. Respondents were familiar with at least one form of MBT and reported using such in personal and professional settings.

Therapist Personal Agency: a model for examining the training context.

This study reviews the creation and testing of a model of Therapist Personal Agency during MFT training. A model including self-efficacy, trainee developmental level, supervisor working alliance, family of origin relationships, and psychological states was supported by data collected from a national sample of MFT students. The model supported by the data was consistent with much of the previous research regarding the correlates of therapist self-efficacy. Furthermore, the model accounted for 20% of the variance in therapist performance as measured by therapist reports of the working alliance. The results also highlighted the importance of attending to the relationships, interactions, and experiences that take place within the training environment and secondly, the added value that may accrue from focusing on the trainee's extended network of family relationships. A brief case example serves to illustrate the importance of tending to Therapist Personal Agency. In sum, this study provides preliminary support for holistic training methods that focus upon the whole person of the therapist.

Challenge and urgency in defining doctoral education in marriage and family therapy: valuing complementary models.

In this overview, I comment on the strong theme of the need to define and improve the quality of doctoral education in marriage and family therapy that pervades the three essays. Deficits in research training are the central concern, although the essayists take different perspectives on the nature of the research training needed. The different perspectives can be understood in terms of three different models of doctoral education. The institutional model focuses on professional training with little financial support for students and lower expectations for faculty research. The community of scholars model emphasizes a balance of research and practice with students required to attend full-time and financial support provided. Research is a mix of faculty- and student-driven and is often focused on professional issues. The star researcher model often held out as the ideal, although not yet represented in marital and family therapy (MFT), emphasizes faculty externally funded programmatic research with students working on and supported by faculty grant funding. The value and role of all three models in MFT doctoral education are described and discussed.

Conducting family meetings in palliative care: themes, techniques, and preliminary evaluation of a communication skills module.

OBJECTIVE: To develop a communication skills training module for health care professionals about how to conduct a family meeting in palliative care and to evaluate the module in terms of participant self-efficacy and satisfaction. METHODS: Forty multispecialty health care professionals from the New York metropolitan area attended a communication skills training module at a Comprehensive Cancer Center about how to conduct a family meeting in oncology. The modular content was based on the Comskil model and current literature in the field. RESULTS: Based on a retrospective pre-post measure, participants reported a significant increase in self-efficacy about their ability to conduct a family meeting. Furthermore, at least 93% of participants expressed their satisfaction with various aspects of the module by agreeing or strongly agreeing with statements on the course evaluation form. SIGNIFICANCE OF RESULTS: Family meetings play a significant role in the palliative care setting, where family support for planning and continuing care is vital to optimize patient care. Although these meetings can be challenging, this communication skills module is effective in increasing the confidence of participants in conducting a family meeting.

Clinical reasoning for child and adolescent mental health practitioners: the mindful formulation.

This article outlines a systematic approach to the formulation of clinical problems for practitioners working with children and their families. Whilst assessments in child and adolescent mental health often use a range of theoretical and practical approaches for data collection, there are relatively few resources to assist the clinician in integrating this information to develop a formulation that leads to a well considered intervention plan. The formulation approach presented here was designed to assist in training child and adolescent clinicians in a method that facilitates the process of understanding complex cases. This is done by examining the patterns of strength and difficulty identified during an assessment and systematically providing an explanation for these using ;the Four Ps' - predisposing, precipitating, perpetuating, and protective factors - to structure the clinician's thinking. Interventions that address patterns of strength and difficulty for each of the ;Four Ps' are recommended when working with complex clients. This formulation approach may take more time than merely summarizing the case, but the benefits are a more comprehensive understanding of the client. This means that problems often associated with working with complex cases can be identified and addressed, reducing the risk of drop out, poor engagement or treatment failure.

Integrative module-based family therapy: application and training.

The field of marriage and family therapy is currently at a crossroads. The challenge for contemporary therapists is how to incorporate the wisdom of previous models with the accountability that comes from evidence-based practice. The Integrative Module-Based Family Therapy treatment model provides a formalized series of steps that clinicians can use in their case planning and implementation. It is based on nine clinically relevant modules for assessment and intervention that are consistent with current best practices and empirically supported treatments. It thus meets the need for a structured family therapy practice and training approach that is respectful of the "art" of family therapy while still adhering to the principles of the "science" of evidence-based treatment.

Their home is their castle: learning to do in-home family therapy.

The client's home is emerging as a typical site in which family therapy is delivered, yet training programs tend to train students in an office-based model. This qualitative study examines the process that three student interns went through as they learned to do home-based therapy after having been trained in a clinic setting. All three found that the experience of working in the clients' homes challenged their beliefs about therapy as well as the models of a professional relationship; all reformulated their views on therapy because of this challenge. A model is proposed that describes the students' journey from being a clinic-based to becoming a home-based therapist.

Systems consultation and Head Start: an alternative to traditional family therapy.

As Marriage and Family Therapists (MFTs) enter Head Start programs, systems consultation emerges as a viable alternative to providing therapy to enrolled children and families. As systems consultants, family therapists can offer organizational consultation, training, and support to Head Start staff, classroom interventions, and direct work with families. This article describes a multidimensional model for providing comprehensive mental health consultation to Head Start programs. It explores the skills necessary for MFTs to work effectively as systems consultants. Finally, recommendations are made for applying the model in both university and private settings.

Parallel process in the supervision of child psychotherapy.

Parallel process is a phenomenon in which therapists unconsciously replicate the problems and dynamics of their clients during supervision. It has the unconscious aim of provoking the supervisor to demonstrate how to handle a perplexing situation. Recognizing and resolving parallel process when it occurs is an important supervisory skill. This paper focuses on the unique characteristics of parallel process in child psychotherapy. It reviews various types and manifestations, discusses several case examples, and outlines strategies for intervention.

Family theatre: an interdisciplinary strategy for teaching family assessment.

RN students in a 2-year post-diploma programme undertake the integration of the concept of family as client, and the relationship between chronic illness and the work of families. The authors present a collaborative, interdisciplinary strategy to teach family assessment, which combines the resources and talents of nurses and drama students.

Using video playback to train family therapists.

This paper presents a small group design, part of a two-year training program in family therapy, using video playback to enhance self-awareness. Congruence among multiple channels of communication enhances therapist effectiveness; the visual mode has unique advantages in identifying incongruence. Details of the design are described, emphasizing the staging of gradually increased risks from general exercises to more specifically personal foci. The concurrent building of an atmosphere of safety is essential for risk-taking.

Learning multiple family therapy through simulated workshops.

Multiple Family Therapy (MFT) can be learned more rapidly through simulated workshops. A chronological approach to a simulated workshop is outlined describing mechanics and techniques. The hardest parts of simulated and real MFT are taking off and landing. Specific exercises are detailed to facilitate the early phases when professionals tend to simulate excessive psychopathology. However, recovery is usually rapid and dramatic in simulations; thus, the workshop leaders appear impressive. How to end "healthily" is the final challenge. Group input for assessment of simulated and real MFT is essential. From this feedback, subassertives and schizophrenics may be at the highest risk for deleterious effects from real MFT.

The simulated family as an aid to learning family group treatment.

Role-playing by students as "family members" and "therapist" in a simulated family situation provides a stimulating learning experience for the participants and the student audience.