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- PublicationKarl Tomm's approach to systemic practiceKarl 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. He then went on to extend and elaborate their work 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 1997. The presentation and this account of Karl Tomm’s work clusters around four central themes.
- PublicationThe psychology of divorce: A synthesis of the literature(Irish Society for the Prevention of Cruelty to Children, 1995-11)In this synthesis of the international literature on psychological aspects of divorce, the causes and consequences of divorce for parents and children are summarized. The majority of parents and children show no major long-term adverse psychological consequences to divorce. Personal and contextual factors that mediate the impact of divorce on parents and children and that may account of the negative impact of divorce on a minority of parents and children are also examined. The impact of mediation and of post-divorce therapy are described and priorities for research and service development identified.
- PublicationThe correlates of phone-in frequency, duration and the number of suggestions made in family therapy supervisionThis paper deals with the relationships between characteristics of live supervisory phone-in conversations on the one hand and the processes of therapy on the other. Historically, a unique feature of family therapy supervision was the development of practices that permitted supervisors to monitor trainee therapists' behaviour with clients as it occurred and to offer support and advice on how to proceed at critical junctures during family interviews. While there is a body of received wisdom among supervisors within the family therapy field about how best to conduct live supervision, few available guidelines have been tested empirically.
- PublicationPutting families first: An evaluation of Functional Family Therapy in an Irish contextCurrent evidence suggests that up to 20% of Irish adolescents have significant behavioural problems, a figure consistent with results of epidemiological studies of youth mental health problems in other countries.Functional Family Therapy (FFT) has consistently been identified in authoritative international reviews as a family-therapy programme for treating adolescents at risk for juvenile delinquency with a particularly strong evidence-base including many controlled trials, and a well developed training and monitoring system for implementing FFT in new community-based sites.Between 2010 and 2014, a research programme to evaluate the effectiveness and implementation of FFT at Archways Families First was conducted by a research team at University College Dublin, in collaboration with Indiana University, and the team of FFT therapists at Archways Families First. The results of this programme, described in this summary report, provide strong support for the effectiveness of FFT as practiced at Archways Families First in reducing behaviour problems and the risk of juvenile delinquency.
- PublicationA study of the differential effects of Tomm's questioning styles on therapeutic allianceThis study examined the impact of Tomm’s (1988) four questioning styles on the therapeutic alliance in family therapy using an analogue method devised by Dozier in which families viewed videotaped scenes from simulated family therapy sessions portraying each of Tomm’s questioning styles and rated the alliance between the therapist and family.
- PublicationResearch on the therapeutic alliance in family therapy(Karnac, 2005)The chapter opens with a brief description of therapeutic alliance assessment scales that may routinely be used in clinical practice and then research which highlights the strong relationship between the therapeutic alliance and outcome in marital and family therapy is discussed. The remainder of the chapter is a selective review of process research which points to specific practices that therapists may incorporate into their own styles to improve the quality of therapeutic relationships.
- PublicationPhysical child abuse: A comprehensive family based approach to treatment(Irish Society for the Prevention of Cruelty to Children, 2000)Physical abuse within the family may be conceptualized as the outcome of a complex process in which a child with particular characteristics which rendered him or her vulnerable to abuse, is injured by a parent involved in an ongoing problematic behaviour pattern, subserved by particular belief systems and constrained by historical, contextual and constitutional predisposing factors. When families are referred by statutory child protection agencies to therapy services for treatment, initially a contract for comprehensive assessment should be established with the family and referrer. Assessment should involve interviews with all members of the child system and should cover relevant risk and protective factors and a verbal reconstruction of the abusive incident. A contract for treatment may be offered if the assessment shows that the parents accept responsibility for the abuse, are committed to meeting their child's needs, are committed to improving their own psychological wellbeing and where they have the ability to change. Treatment should be based on clear contracts to meet specific targets. Treatment and case management plans involve a central focus on improving parent-child interaction through direct work with parents and children together. This may be supplemented with couples work, interventions in the wider system and individual work for parents focusing on parent-craft and the management of personal difficulties such as mood and anger regulation. Children may also receive input in therapeutic pre-school placements.
- PublicationFathers in family therapy: Lessons from researchTreatment outcome research has shown that for 2/3 to 3/4 of cases family therapy is an effective intervention for child focused problems. One factor that has consistently been shown to enhance the effectiveness of family therapy is father involvement. Where fathers do not attend at least some therapy sessions, it is more likely that the family will drop out of treatment or that therapy will not lead to problem resolution. An important question arising from this finding is how best to engage fathers in family therapy and how to create opportunities within therapy for fathers to contribute to resolving presenting problems. In this paper the implications for clinical practice of research on the role of fathers in families and family therapy will be explored.
- PublicationThe development of family therapy in Ireland(Springer, 2013-06)In Ireland family therapy is a small profession, with under 200 registered therapists. The Irish family therapy movement began in the mid-1970s. By 1980 the Family Therapy Network of Ireland in the Republic of Ireland and the Northern Ireland Branch of the UK Association Family therapy had been founded. At present there are three main family therapy training centers in Ireland: two in the south (the Mater University Hospital, affiliated to University College Dublin and Clanwilliam Institute) and one in the north (at Queen’s University Belfast). There is no statutory registration and licensing of family therapists in Ireland. Accredited professional family therapy programs in Ireland are 4-year part-time courses culminating in masters level qualifications. A primary degree in medicine, nursing, psychology, social science or education is a prerequisite for entry. Family therapists in Ireland work in both private practice and the public health service. Most family therapists in the public sector are employed as social workers, psychologists, psychiatrists or nurses, and conduct family therapy as part of their broader professional roles. Couple therapy in Ireland is provided by family therapists, and also by voluntary couple counselors based in networks of local centers, some of which were originally religiously affiliated, without a formal connection to national family therapy associations. The three major future challenges for Irish family therapy are creating a research infrastructure, developing a career structure in the public health service, and introducing statutory registration.
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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.
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