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Family Process Heft 4/2013
1/2013 - 2/2013 - 3/2013 - 4/2013 - Überblick


Lebow, Jay L. (2013): Editorial: Evidence in Couple and Family Therapy - The Legacy of Alan Gurman. In: Family Process 52 (4): 571-575.


von Sydow, Kirsten, Rüdiger Retzlaff, Stefan Beher, Markus W. Haun & Jochen Schweitzer (2013): The Efficacy of Systemic Therapy for Childhood and Adolescent. Externalizing Disorders: A Systematic Review of 47 RCT. In: Family Process 52 (4): 576-618.

abstract: Systemic (family) therapy is a widely used psychotherapy approach. However, most systematic efficacy reviews have focused solely on „family-based treatment“ rather than on the theoretic orientation „systemic therapy.“ We systematically review trials on the efficacy of systemic therapy for the treatment of childhood and adolescent externalizing disorders. All randomized (or matched) controlled trials (RCT) evaluating systemic/systems-oriented therapy in various forms (family, individual, group, multi-family group therapy) with child or adolescent index patients (0-17 years) suffering from mental disorders were identified by data base searches and cross-references. Inclusion criteria were as follows: index patient diagnosed with a DSM- or ICD-listed mental disorder, and trial published in any language up to the end of 2011. The RCTs were analyzed for their research methodology, interventions applied, and results (postintervention; follow-up). A total of 47 trials from the United States, Europe, and China, published in English, German, and Mandarin, were identified. A total of 42 of them showed systemic therapy to be efficacious for the treatment of attention deficit hyperactivity disorders, conduct disorders, and substance use disorders. Results were stable across follow-up periods of up to 14 years. There is a sound evidence base for the efficacy of systemic therapy for children and adolescents (and their families) diagnosed with externalizing disorders.


Retzlaff, Rüdiger, Kirsten von Sydow, Stefan Beher, Markus W. Haun & Jochen Schweitzer (2013): The Efficacy of Systemic Therapy for Internalizing and Other Disorders of Childhood and Adolescence: A Systematic Review of 38 Randomized Trials. In: Family Process 52 (4): 619-652.

abstract: Systemic therapy (ST) is one of the most widely applied psychotherapeutic approaches in the treatment of children and adolescents, yet few systematic reviews exist on the efficacy of ST with this age group. Parallel to a similar study on adults, a systematic review was performed to analyze the efficacy of ST in the treatment of children and adolescents. All randomized or matched controlled trials (RCT) evaluating ST in any setting with child and adolescent index patients were identified by database searches and cross-references, as well as in existing meta-analyses and reviews. Inclusion criteria were: index patient diagnosed with a DSM-IV or ICD-10 listed psychological disorder, or suffering from other clinically relevant conditions, and trial published by December 2011. Studies were analyzed according to their sample, research methodology, interventions applied, and results at end-of-treatment and at follow-up. This article presents findings for internalizing and mixed disorders. Thirty-eight trials were identified, with 33 showing ST to be efficacious for the treatment of internalizing disorders (including mood disorders, eating disorders, and psychological factors in somatic illness). There is some evidence for ST being also efficacious in mixed disorders, anxiety disorders, Asperger disorder, and in cases of child neglect. Results were stable across follow-up periods of up to 5 years. Trials on the efficacy of ST for externalizing disorders are presented in a second article. There is a sound evidence base for the efficacy of ST as a treatment for internalizing disorders of child and adolescent patients.


Tseliou, Eleftheria (2013): A Critical Methodological Review of Discourse and Conversation Analysis Studies of Family Therapy. In: Family Process 52 (4): 653-672.

abstract: Discourse (DA) and conversation (CA) analysis, two qualitative research methods, have been recently suggested as potentially promising for the study of family therapy due to common epistemological adherences and their potential for an in situ study of therapeutic dialog. However, to date, there is no systematic methodological review of the few existing DA and CA studies of family therapy. This study aims at addressing this lack by critically reviewing published DA and CA studies of family therapy on methodological grounds. Twenty-eight articles in total are reviewed in relation to certain methodological axes identified in the relevant literature. These include choice of method, framing of research question(s), data/sampling, type of analysis, epistemological perspective, content/type of knowledge claims, and attendance to criteria for good quality practice. It is argued that the reviewed studies show „glimpses“ of the methods‘ potential for family therapy research despite the identification of certain „shortcomings“ regarding their methodological rigor. These include unclearly framed research questions and the predominance of case study designs. They also include inconsistencies between choice of method, stated or unstated epistemological orientations and knowledge claims, and limited attendance to criteria for good quality practice. In conclusion, it is argued that DA and CA can add to the existing quantitative and qualitative methods for family therapy research. They can both offer unique ways for a detailed study of the actual therapeutic dialog, provided that future attempts strive for a methodologically rigorous practice and against their uncritical deployment.


Jewell, Tom, Alan Carr, Peter Stratton, Judith Lask & Ivan Eisler (2013): Development of a Children’s Version of the SCORE Index of Family. Function and Change. In: Family Process 52 (4): 673-684.

abstract: The Systemic Clinical Outcome and Routine Evaluation (SCORE) Index of Family Function and Change is a recently developed outcome measure. It was designed to be acceptable to adults and children aged 12 and over. Thus far no research has been conducted using the SCORE in children under the age of 12. The aim of this study was to pilot a children’s version of the SCORE. An existing 29-item version of the SCORE was completed by a sample of seven children aged 8-10. Time was allowed for group discussion with the children. Feedback from this stage of the study was used to develop a draft version of the SCORE for children. An expert panel of clinicians and researchers were also consulted. A pilot version of the Child SCORE was administered to 80 children aged 7-10 in an inner London primary school. Thirty-five children also completed the measure for a second time, 1¬†week later. Findings suggested that the Child SCORE was acceptable to children in the 8-11 age range. Values for internal reliability and test-retest reliability were good. The Child SCORE appears to be a promising instrument. Further research is required to confirm its acceptability to clinical populations, and to demonstrate sensitivity to change.


López-Larrosa, Silvia (2013): Quality of Life, Treatment Adherence, and Locus of Control: Multiple Family Groups for Chronic Medical Illnesses. In: Family Process 52 (4): 685-696.

abstract: The Multiple Family Groups (MFGs) approach for patients with a chronic medical illness and their families is a structured psychoeducational program that unfolds in six weekly 90-minute sessions. In the MFGs, patients and family members explore new ways to balance illness and nonillness priorities in family life (Steinglass, 1998; Steinglass, 2000 Cuadernos de Terapia Familiar, 44-45, 11; Steinglass, Ostroff, & Steinglass, 2011 Family Process, 50, 393).


Hernandez, Mercedes, Concepción Barrio & Ann-Marie Yamada (2013): Hope and Burden among Latino Families of Adults with Schizophrenia. In: Family Process 52 (4): 697-708.

abstract: This study examined hope and family burden among Latino families of individuals with schizophrenia. The sample consisted of 54 family members, one family member per outpatient adult recruited from public mental health programs in a diverse urban community. Hierarchical linear regression analyses were used to test the hypothesis that the family member’s increased hope for the patient’s future would be associated with decreased family burden beyond effects explained by the patient’s length of illness and severity of symptoms. Results supported the study hypothesis. Family hope for the patient’s future was associated with four of five types of family burden. Findings point to the prominent role of hope as a source of resilience for Latino families dealing with severe mental illness of a loved one.


Polenick, Courtney Allyn & Lynn M. Martire (2013): Caregiver Attributions for Late-Life Depression and Their Associations with Caregiver Burden. In: Family Process 52 (4): 709-722.

abstract: Late-life depression (LLD) has detrimental effects on family caregivers that may be compounded when caregivers believe that depressive behaviors are volitional or within the patient’s capacity to control. In this study we examined three person-centered caregiver attributions that place responsibility for LLD on the patient (i.e., character, controllability, and intention), and the impact of such attributions on levels of general caregiver burden and burden specific to patient depressive symptoms. Participants were 212 spouses and adult children of older adults enrolled in a depression treatment study. Over one third of caregivers endorsed character attributions, which significantly predicted greater levels of both general and depression-specific burden. Intention attributions were significantly associated with general burden, but not depression-specific burden. Contrary to our expectation, controllability attributions did not predict either type of burden. Our findings suggest that the assessment of family caregiver attributions for LLD may be useful in identifying caregivers at risk for burden and subsequent health effects, as well as those who may need education and support to provide effective care to a vulnerable population of older adults.


van Ee, Elisa, Marieke Sleijpen, Rolf J. Kleber & Marian J. Jongmans (2013): Father-Involvement in a Refugee Sample: Relations between Posttraumatic Stress and Caregiving. In: Family Process 52 (4): 723-735.

abstract: Despite increased attention to the role of fathers within families, there is still a dearth of studies on the impact of trauma on father-involvement. This study investigates the quantity of father-involvement and the influence of posttraumatic stress on the quality of involvement in a refugee and asylum seeker population. Eighty refugees and asylum seekers and their young children (aged 18-42 months) were recruited. Measures included assessment of parental trauma (Harvard Trauma Questionnaire), quantity and quality of involvement (quantity of caregiving and Emotional Availability Scales), and perception of the father-child relationship (interview). The results show that fathers were less involved in caregiving tasks and play activities than mothers. No parental gender differences were found on each of the Emotional Availability Scales. Traumatic stress symptoms negatively affected the perception and the actual quality of parent-child interaction (sensitivity, structuring, nonhostility). Nevertheless, almost all fathers described their relationship with their child as good and their child as very important to them. As the quality of father-involvement is of importance to the development of the child, traumatized fathers are as much in need of clinical intervention as mothers. Despite the impact of posttraumatic stress, refugee fathers clearly are involved in the lives of their children. Mechanisms such as a deliberate withdrawal when stressed and compensation might enable affected fathers to step into the interaction when needed, raise the quality of involvement with their child, and diminish the negative impact of stress resulting from trauma and migration.



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