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- PublicationPositive practice in family therapy(Wiley, 1997-07)Positive practice, a brief integrative approach to consultation with families, is described in this paper. A clear distinction is made between the stages of planning, assessment, therapy, and disengagement. Guidelines for progression from one stage to the next are provided. Frameworks for deciding who to invite to preliminary sessions and methods for planning and organizing lines of inquiry are incorporated into this approach to practice. A three-column model is used to construct formulations. The model allows therapists and clients to map information about the pattern of interaction around the presenting problem, beliefs that constrain family members from altering their roles in these problem-maintaining patterns, and factors that have predisposed family members to hold these beliefs. Positive practice offers methods for evolving new behavioral patterns and belief systems within sessions and for arranging homework tasks for clients between sessions. It also incorporates methods for dealing with resistance, for managing therapeutic crises, for convening individual sessions and broader network meetings, for disengaging from the consultation process, and for recontracting for further episodes of therapy. This evolving approach to practice draws on ideas from many traditions within the family therapy field and takes account of recent research relevant to the practice of family therapy.
446Scopus© Citations 14
- PublicationOne Perspective on Karl Tomm's Current Approach to Systemic Practice(Family Therapy Association of Ireland, 1997)Karl Tomm occupies a pivotal position in the evolution of systemic family therapy. He played an important role in bringing the work of the original Milan systemic family therapy team to the attention of family therapists in North America, the UK and Ireland (Tomm, 1984a, 1984b). He then went on to extend and elaborate their w ork and also to integrate work from the narrative therapy tradition into systemic family therapy. The account of some aspects of his work presented in this chapter are based on a presentation he made over two days at the Mater Hospital in Dublin in April 1 997. The presentation and this account of Karl Tomm’s work clusters around four central themes.
- PublicationAn Investigation of the psychosocial impact of a compensation tribunal on women with an iatrogenic Hepatitis C infectionThe aim of this study was to investigate the psychosocial impact of a Compensation Tribunal in women with an iatrogenic hepatitis C virus (HCV) infection. Eighty-three women diagnosed with an iatrogenic HCV infection were recruited, 19 women were Pre-Tribunal and 64 women were post-Tribunal. Both standardised and disease specific psychological measures were used. A series of t-tests revealed no differences in psychological well-being and adjustment to HCV infection in women pre and post Compensation Tribunal. Chi-square tests revealed no association between PCR status and 1) psychological well-being and 2) experience of anger/blame in women post- Compensation Tribunal. A further series of t-tests revealed that women with high levels of anger and blame post-Compensation Tribunal perceived their future as more uncertain, experienced more pain, low self-esteem and psychological distress, viewed their ability to work as impeded and complained of increased stress preparing for their Compensation Tribunal. This study suggests that poor adjustment in women with an iatrogenic HCV infection post-Compensation Tribunal is not associated with attendance at a Compensation Tribunal nor PCR status but rather to experiences of anger and blame.
- PublicationBook review of: Newnes, C. & Radcliffe, N. ( 2006). Making and Breaking Children's Lives. UK: PCCS Books(British Psychological Society, 2006)The central message of this book is that distressed children who display distressing behaviour and their families are often involved with significant psychosocial challenges like poverty, unemployment, domestic violence, child abuse, inadequate educational resources, neighbourhood crime and other adversities. These children and families should be helped through thoughtful psychosocial interventions and community development initiatives which address their unique needs and requirements, not by diagnosing children with neurobiological disorders of questionable validity (like ADHD) and medicating them with drugs (like Ritalin).
- PublicationGender and conversational behaviour in family therapy and live supervisionThe association between supervisors' and therapists' gender and the conversational behaviour of 4 supervisors, 19 trainee family therapists and 20 clients before, during and after 88 live supervisory phone-in events were examined in this study. Clients' co-operation was not directly related to the genders of therapists and supervisors. The quality of supervisors' collaborative behaviour was highest for events in systems where male supervisors were supervising male therapists and lowest for events in systems where male supervisors were supervising female therapists. In systems containing female supervisors and male therapists, therapists engaged in frequent collaborative behaviour and less frequent teaching behaviour with their clients. The quality of therapists’ collaborative and supportive behaviour was highest in these systems. The unexpected results of this study suggest the way supervisors interact with therapists and therapists interact with clients does not conform to gender stereotypic conversational behaviour in which males are directive and females affiliative. It may be that individuals whose conversational behaviour does not conform to gender stereotypes decide to become family therapists or that family therapy training helps people develop alternatives to gender-stereotypical conversational behaviour.
280Scopus© Citations 8
- PublicationThematic review of family therapy Journals 2010(Wiley, 2011-11)In this article the contents of the principal English-language family therapy journals published in 2010 are reviewed under these headings: child-focused problems, adult-focused problems, substance misuse across the lifespan, couples, diversity, spirituality and mindfulness, training, revisiting history and research.
447Scopus© Citations 1
- PublicationEvidence based practice in family therapy and systemic consultation: child focused problems(Wiley, 2000-02)Evidence for the effectiveness of family therapy and family-based interventions from critical literature reviews and controlled trials is considered for families with children and adolescents who present with various difficulties. The evidence supports the effectiveness of family therapy as an effective treatment either alone or as part of a multimodal or multisystemic treatment programme for child abuse and neglect, conduct problems, emotional problems and psychosomatic problems. Implications for practice, training and continuing professional development in the field of family therapy are discussed.
3395Scopus© Citations 111
- PublicationAdult adjustment of survivors of institutional child abuse in IrelandMethod Two hundred and forty-seven adult survivors of institutional abuse with a mean age of 60 were interviewed with a protocol that included the Childhood Trauma Questionnaire, modules from the Structured Clinical Interview for Axis I Disorders of DSM IV and the Structured Clinical Interview for DSM IV Personality Disorders, the Trauma Symptom Inventory, and the Experiences in Close Relationships Inventory. Results The prevalence of psychological disorders among adult survivors of institutional abuse was over 80% and far higher than in the normal population, with anxiety, mood and substance use disorders being the most prevalent diagnoses. Survivors also had high rates of trauma symptoms and insecure adult attachment styles, and these were higher for those who had experienced both institutional and intrafamilial abuse. Conclusions There was an association between the experience of institutional abuse in childhood and the prevalence of adult mental health problems, particularly anxiety, mood and substance use disorders. Practice implications Policies, practices and procedures should be regularly reviewed and revised to maximize protection of young people in institutional care. Evidence-based psychological treatment should be made available to adult survivors of institutional abuse.
1610Scopus© Citations 57
- PublicationConcurrent individual and family therapy in a case of elective mutismIn this paper, following a literature review a family containing a child who had been electively mute for four years is described. A concurrent programme of individual and family therapy and the systemic hypothesis which guided these interventions is then presented in detail. Behavioural and psychometric data are presented to illustrate the dramatic improvement which the identified patient showed over the course of treatment. Finally, the probable mechanisms underpinning the child's improvement, and how these differed from our initial expectations, are discussed.
382Scopus© Citations 9
- PublicationHelping children to the other side of silence: A study of the impact of the stay safe programme on Irish children's disclosures of sexual victimisation.Objective. This study aimed to evaluate the effectiveness of a school based safety skills programme - The Stay Safe Programme - in facilitating the disclosure of sexual abuse among sexually victimized children and adolescents in Dublin. Method. A cohort of 145 children who had participated in the Stay Safe Programme prior to their referral to a sexual abuse assessment unit were compared with a cohort of 443 children who had not participated in the prevention programme on a range of disclosure related variables abstracted from case notes. Results. More Stay Safe participants, particularly female adolescents, made disclosures of suspected sexual abuse than non-participants. A higher rate of initial disclosure to teachers was made by Stay Safe participants and more teachers in schools participating in the Stay Safe programme initiated referrals for evaluation of suspected child sexual abuse. Following assessment a higher rate of confirmed abuse occurred among Stay Safe participants and for these confirmed cases more Stay Safe participants made purposeful disclosures and in significantly more cases referral was due to the child telling someone about the abuse. These differences in disclosure between programme participants and non-participants were unrelated to demographic factors or characteristics of the abuse. Conclusions. The Stay Safe programme was an effective secondary prevention intervention deserving widespread implementation.
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