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systemagazin Zeitschriftenarchiv: Journal of Family Therapy Heft 3/2009
1/2009 - 2/2009  - 3/2009 - 4/2009 - Übersicht

Rivett, Mark (2009): Editorial: Family therapy finding room to wriggle and room to breathe in mental health contexts. In: Journal of Family Therapy 31(3): S. 211-212

Larner, Glenn (2009): Integrating family therapy in adolescent depression: an ethical stance. In: Journal of Family Therapy 31(3): S. 213-232.

abstract: Adolescent depression, particularly where suicidal behaviour is involved, is a complex and pressing mental health problem and demanding for families, therapists and services alike. This article reviews the evidence-based literature for adolescent depression including family therapy approaches. It suggests an integrative treatment approach that includes individual psychological treatment like CBT, medication where required and a family therapy intervention is supported by the literature. The focus of the latter is psychoeducation, building resilience and hope, enhancing communication, reducing relational conflict between parents and adolescents and addressing attachment and relationship issues. A systemic framework for integrating family therapy in the evidence- based treatment of adolescent depression is described. This is based on an ethic of hospitality towards different languages of therapy, which is illustrated by a detailed example from family therapy practice.

Stanbridge, Roger I., Frank R. Burbach & Simon H. Leftwich (2009): Establishing family inclusive acute inpatient mental health services: a staff training programme in Somerset. In: Journal of Family Therapy 31(3): S. 233-249.

abstract: In spite of policies advocating the involvement of families in the care of mental health service users in the UK there are few examples of training initiatives to bring this about. This article describes the delivery of a whole-team training initiative to promote family inclusive working in all acute inpatient units in Somerset. The three-day staff-training programme is described and training outcomes are reported. Staff reported a significant increase in confidence in their skills for working with families, and a pre- and post-training case note audit showed an increased consideration of the needs of families. This was accompanied by a modest increase in the average number of family meetings. Obstacles to family inclusive ways of working on inpatient units are described, and strategies to overcome these are discussed.

Lemmens, Gilbert M., Ivan Eisler, Paul Dierick, Germain Lietaer & Koen Demyttenaere (2009): Therapeutic factors in a systemic multi-family group treatment for major depression: patients' and partners' perspectives. In: Journal of Family Therapy 31(3): S. 250-269.

abstract: This study investigated helpful and disturbing factors in multi-family groups with hospitalized, depressed patients and their family members. Both patients and their partners reported the occurrence of different therapeutic factors such as the cohesion of the group, different observational processes, and guidance from the therapist. The frequency of the therapeutic factors seemed to increase for both the patients and their partners as the group sessions progressed and several differences in reported therapeutic factors were found between the patients and their partners. A number of therapeutic factors such as modelling and guidance from the therapist were found to be related with improvement of depressive symptoms of the patient. The results help to provide some insight into which processes are important in multi-family group therapy for depression.

Onwumere, Juliana, Elizabeth Kuipers, Catherine Gamble, Suzanne Jolley, Ben Smith, Rebecca Rollinson, Craig Steel, David Fowler, Paul Bebbington, Graham Dunn, Daniel Freeman & Philippa Garety (2009): Family interventions in psychosis: a scale to measure therapist adherence. In: Journal of Family Therapy 31(3): S. 270-283.

abstract: The efficacy of family interventions in psychosis is well documented. UK and USA schizophrenia treatment guidelines advocate the practice of family interventions within routine clinical services. However, less attention has been paid to the study of treatment fidelity and the tools used in its assessment. This study reports the inter-rater reliability of a new scale: Family Intervention in Psychosis-Adherence Scale (FIPAS). This measure is designed to assess therapist adherence to the Kuipers et al. (2002) family intervention in psychosis treatment manual. Reliability ratings were based on a sample of thirteen audiotapes drawn from a randomized controlled trial of family intervention. The results indicated that the majority of items of the FIPAS had acceptable levels of inter-rater reliability. The findings are discussed in terms of their implications for the training and monitoring of the effectiveness of practitioners for family interventions in psychosis.

Wane, Julia, Michael Larkin, Megan Earl-Grey & Haley Smith (2009): Understanding the impact of an Assertive Outreach Team on couples caring for adult children with psychosis. In: Journal of Family Therapy 31(3): S. 284-309.

abstract: Carers play an essential role in the lives of people suffering from mental health problems. Caring is very often a relational activity carried out by family members. Assertive Outreach (AO) services ought to be particularly well placed to support carers, but their impact upon families is not well understood. We set out to understand the intervention of AO services from a family perspective, and in particular to explore its meaning from the perspectives of pairs of carers. Three pairs of carer-parents participated in six individual open-ended interviews. Transcripts were analysed from an interpretative phenomenological perspective. All three families described a series of distressing crisis experiences prior to their relationship with AO. Carers had felt painfully excluded from their parental roles – both by their children and by services. Two further themes illuminated their subsequent relationship with AO: first, carers felt reassured; valued and included; and benefited from improvements in family relationships. Second, there were still concerns about the continuing relationship with professionals, and about the future of their family member – especially in relation to how services might secure these things. It was striking that there were different needs and concerns not only between the three couples but within each pair. Changing roles and relationships within the family were related to what families wanted from services. We note that engagement with systemic ways of working may prove fruitful for the development of AO services.

Askey, Ryan, Janet Holmshaw, Catherine Gamble & Richard Gray (2009): What do carers of people with psychosis need from mental health services? Exploring the views of carers, service users and professionals. In: Journal of Family Therapy 31(3): S. 310-331.

abstract: The development of anti-psychotic medications and deinstitutionalization has shifted the primary focus of mental health treatment from hospital to the community. As a consequence, carers have become an integral part of the care system (Thornicroft and Tansella, 2005). Historically, interventions for families with people with psychosis have tended to focus on service user outcomes that attempt to reduce or prevent relapse (Askey et al., 2007). As a consequence, carers often feel ignored or marginalized by services (Shepherd et al., 1995; Beck and Minghella, 1998; Henwood, 1998). This problem has recently been recognized, and it has been highlighted that there is a need for more involvement with carers of clients with mental illness (DoH, 1999). However, there continues to be a lack of knowledge about carers' needs and how professionals specifically meet carers' needs (Chambers et al., 2001). This article presents the results of a study aimed at exploring the views and experiences of carers, service users and professionals with regard to what carers of people with psychosis need from mental health services. It will initially review the literature on carer burden and needs, as well as interventions such as family intervention and carers' assessments/care plans which have been developed to address carer needs.

Balfour, Andrew (2009): Book Review: What Is This Thing Called Love? A Guide to Psychoanalytic Psychotherapy with Couples. By S. F. Usher. In: Journal of Family Therapy 31(3): S. 332-334

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