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• Handbook of Clinical Family Therapy
• Copyright
• Contents
• Contributors
• Preface
• Chapter 1: Family Therapy at the Beginning of the Twenty-first Century
• Systemic Focus
• Biobehavioral-Psychosocial Foundation
• Applying Generic Strategies of Change
• Accenting Broad Curative Factors
• Shaping Strategies Relative to Specific Difficulties
• Labeling Problems
• Building on Empirical Foundations
• Maintaining A Multisystemic Focus
• Maintaining a Realistic Frame
• Enhancing the Durability of Change
• Length of Treatment
• Stages of Change
• Mixing Individual, Couple, and Family Session Formats
• A More Limited Worldview
• Conclusion: Toward One Family Therapy
• References
• Part I: Problems in Children and Adolescents
• Chapter 2: Attachment-Based Family Therapy for Depressed and Anxious Adolescents
• The Theoretical Base
• Attachment Theory
• Repairing Attachment
• Clinical Foundation
• Clinical Structure of ABFT
• The Clinical Model
• Task One: Relational Reframing
• Task Two: Building Alliance with the Adolescent
• Task Three: Building Parent Alliance
• Task Four: The Attachment Task
• Task Five: Promoting Competency
• Empirical Support
• ABFT for Anxious Adolescents (ABFT-A)
• Low Income, Minority Patients
• References
• Chapter 3: Family Therapy for Attention-Deficit/Hyperactivity Disorder (ADHD)
• ADHD as a Family Illness
• Family Interactions and Dysfunction
• Associated Problems in the ADHD Family
• ADHD and Family Structure
• ADHD: Gender and Ethnicity Considerations
• Treatment of ADHD as a Family Illness
• Family Intervention
• Possible Components of Family Intervention for ADHD
• Conclusions
• References
• Chapter 4: Brief Strategic Family Therapy for Adolescents with Behavior Problems
• Behavioral Problems in Adolescence
• Problem Definition and Clinical Characteristics
• Family Characteristics
• Overview of BSFT
• Theoretical Background
• Clinical Intervention Strategies for Adolescents with Behavioral Problems
• Establishment of a Therapeutic Relationship—Joining
• Diagnostic Assessment of the Family
• Treatment Goals: Restructuring
• Termination of Treatment
• Special Consideration in Treatment
• Engagement of Hard-to-Reach Families
• Working with Individual Family Members: One Person BSFT
• Research Evidence
• Marijuana
• Engagement and Retention
• Externalizing Behaviors
• Family Interactions
• Recommended Readings
• References
• Chapter 5: Multisystemic Therapy for Adolescents with Serious Externalizing Problems
• Theoretical and Conceptual Foundations
• Theory of Social Ecology
• Pragmatic Family Therapies
• Empirical Support
• Implementing MST
• MST Treatment Principles and Process
• Implications of Principles and Process for MST Intervention Strategies
• Special Considerations in the Treatment of Serious Problems in Youth
• Home-Based Model of Service Delivery
• Quality Assurance and Improvement System
• Implications for Clinicians
• References
• Chapter 6: Multidimensional Family Therapy: A Science-Based Treatment for Adolescent Drug Abuse
• Background and Overview
• Adolescent Substance Abuse: How Characteristics of the Clinical Problem Suggest the Needed Clinical
• Operating Principles of MDFT
• Methods of Assessment and Intervention in Multidimensional Family Therapy
• Multidimensional Assessment
• Multidimensional Interventions: Facilitating Adolescent, Parent, and Family Development
• Specific Intervention Strategies for Treating Adolescent Substance Abuse Within the MDFT Framework
• MDFT Interventions
• Stage 1
• Stage 2 and 3: Work the Themes/Request Change
• Stage 3: All Modules. Seal the Changes. Exit
• Clinical Guidelines
• Special Considerations in the Treatment of Adolescent Substance Abuse
• The Use of Drug Screens in MDFT
• Decision-Making for Individual or Joint Sessions
• Therapist Assistant Duties
• Research Evidence Supporting the Effectiveness of MDFT
• Randomized Controlled Trials
• Studies on the Therapeutic Process and Mechanisms of Change in MDFT
• Economic Analyses
• Transportation or Technology Transfer Studies
• MDFT Interventions
• Summary
• References
• Chapter 7: Functional Family Therapy for Externalizing Disorders in Adolescents
• The Evolution of Functional Family Therapy
• The Functional Family Therapy Treatment Model
• A Systematic, Intentional, and Phasic Change Map
• Core Principles of Therapeutic Change
• Respect and Strength-Based Belief in People
• Scientific Foundations of Functional Family Therapy
• Conclusion
• References
• Part II: Problems in Adults
• Chapter 8: Psychoeducational Multifamily Groups for Families with Persons with Severe Mental Illness
• Schizophrenia and the Family
• The Role of Brain Abnormalities in Schizophrenia
• Biological Effects on Psychological Functioning
• Quality of Life and Experienced Burden
• Expressed Emotion
• Stigma
• Social Networks, Social Support, and Families
• Implications for an Optimal Environment
• The Roots of Family Psychoeducation and Multifamily Groups
• Goals for Working with Families
• Common Elements of All Empirically Validated Family Psychoeducational Approaches
• Joining
• Educational and Training Workshop
• Community Reentry
• Communication Skills Training
• Social and Vocational Rehabilitation
• Psychoeducational Multifamily Groups
• The Multifamily Group as a Therapeutic Social Network
• Overview of the PMFG Method
• Joining
• Education for Families: A Workshop Format
• Family Guidelines
• Process and Techniques for PMFGs
• The Problem-Solving Process
• PMFG Techniques for Problem Solving
• Fitting Family Psychoeducation to the Culture of the Consumer and Family
• Modifications for Bipolar Disorder
• Adaptations
• Research Evidence Supporting Family Psychoeducation and Multifamily Groups
• References
• Chapter 9: Optimizing Couple and Parenting Interventions to Address Adult Depression
• A Description of Depression
• A Couples/Family Description of Depression
• Justification for Intervening at the Couple/Family Level
• What We Know: Clearly Established Guidelines for Couple and Parenting Intervention with Depressed In
• Couple Interventions
• Parenting Interventions
• Conclusions and Recommendations
• Implications for Clinical Decision-Making
• What We Think We Know: Additional Considerations for Working with Depressed Couples and Families
• Separation and Divorce
• Suicidality
• Inpatient Populations
• Mutual Acknowledgment of the Problem
• Refusal of One Partner to Attend
• What We’d Like to Know: How to Optimize Future Interventions Through a Public Health Perspective O
• Promise for Couple/Parenting Interventions Based on Public Health Models
• Moving Forward
• Conclusion
• References
• Chapter 10: Couples Therapy for Alcoholism and DrugAbuse
• Brief Introduction to Couple-Based Treatment for Substance Use Disorders
• Alcoholism and Drug Abuse: A Relationship-Based Conceptualization
• Defining Alcohol and Drug Use Disorders
• Prevalence of Alcohol and Drug Use Disorders and Comorbidity with Relationship Problems
• The Interplay between Substance Use and Marital Adjustment
• Three Common Models for the Treatment of Substance Use and Couple Distress
• Overview of Behavioral Couples Therapy
• Assessment and Treatment Strategies for Understanding This Problem
• Assessment of Substance Use
• Assessment of Relationship Problems and The Seven Cs Evaluation Framework
• Substance Abuse-Focused Interventions
• Consumption of Medication Designed to Help with Maintaining Sobriety
• Relationship-Focused Interventions
• Relapse Prevention: Posttreatment Activities to Maintain Therapy Gains
• Special Considerations
• Intimate Partner Violence
• Effect of Couples Therapy on Children in the Home of Participants
• When Both Partners Use
• Human Immunodeficiency Virus (HIV) Risk Behaviors
• The Effects of Gender and Culture Using BCT
• Research Evidence
• Alcoholic Patients
• Drug-Abusing Patients
• Conclusion
• References
• Chapter 11: Making Treatment Count: Client-Directed, Outcome-Informed Clinical Work with Problem Dri
• Roots of the Approach
• Specific Intervention Strategies
• Developing an Individualized Service Delivery Plan
• Formal Client Feedback
• Integrating the Plan and Feedback into a Flexible Continuum of Care
• Research Evidence Supporting Client-Directed, Outcome-Informed Clinical Work
• Conclusion
• References
• Chapter 12: Family Therapy: Working with Traumatized Families
• Primary Response to Trauma
• The Traumatized Family
• Axioms Associated with Assessing Systemic Family Patterns
• Individual Reactions
• Altered Family Worldview
• Centrality of Family Members’ Perceptions Associated with the Traumatic Event
• Structural/Organizational Changes Resulting in a Systemic Traumatic Stress Response
• Family Therapy and the Traumatized Family
• Safety
• Figley’s Empowerment Model
• Conclusion
• References
• Part III: Couple Relationship Difficulties
• Chapter 13: Integrative Behavioral Couple Therapy
• Central Ideas Behind Integrative Behavioral Couple Therapy
• Assessment
• Intervention Techniques and Strategies
• Acceptance-Focused Strategies
• Change-Focused Strategies
• Clinical Skills in IBCT
• Assessment and Feedback—Session 1–4
• Intervention
• The Last Session
• Empirical Support for IBCT
• References
• Chapter 14: Brief Integrative Marital Therapy: An Interpersonal-Intrapsychic Approach
• Predictable Patterns of Marital Difficulty
• The Development of Brief Integrative Marital Therapy
• Assessment and Treatment Formulation
• Carrying Out the Assessment
• Universal Areas of Couple Assessment: The Seven C’s
• Focal-Functional Assessment
• Goal Setting
• Principles of Intervention and Therapeutic Techniques
• Interruption and Modification of Collusive Processes
• Blocking Interventions
• Linking Individual Experience and Relational Experience
• Creating Therapeutic Tasks: Instigative Interventions
• The Sequencing of Interventions
• Varied Pathways to Therapeutic Couple Exposure
• The Healing Role of Communication and Problem-Solving Intervention
• Special Issues in the Practice of BIMT
• The Therapist’s Role and Mechanisms of Change
• Therapeutic Alliances
• The Structure of Therapy and the Place of Individual Treatment
• Couple Therapy and the Larger Family
• Termination
• The Efficacy of BIMT
• References
• Chapter 15: Creating Secure Connections: Emotionally Focused Couples Therapy
• Introduction
• EFT Roots and Assumptions
• Treatment in EFT
• Mechanisms of Change
• The Three Stages and Nine Steps of Change
• Primary Processes and Interventions in EFT
• Creating and Maintaining a Therapeutic Alliance
• Task One: To Access, Shape, and Expand Emotion
• Task Two: Restructuring Interventions
• Special Issues in EFT
• Diversity
• Contraindications
• Attachment Injuries
• EFT with Trauma Survivors
• Dealing with Impasses
• Family Therapy and EFT
• EFT Research
• Process Research
• Outcome Research
• References
• Chapter 16: Domestic Violence-Focused Couples Treatment
• Outcome Results
• Rationale for Variations in Treatment
• Assessment of Appropriateness for Conjoint Treatment
• Disguised Presentation
• Assessment Procedures
• Eligibility and Exclusion Criteria for Conjoint Treatment
• Gender-Specific Pretreatment Group
• Individual Couple or Multicouple Treatment
• Theoretical Basis of Conjoint Treatment
• Solution-Focused Brief Therapy—the Primary Picture
• Shifting to the Secondary Picture
• Treatment Structure
• Minimizing Risk
• First Conjoint Session
• Troubleshooting After the First Session
• Couples Minimize Violence
• Strategies Used in Subsequent Sessions
• Developing a Vision of a Healthy, Violence-Free Relationship
• Teaching and Practicing Communication Skills
• Metadialogue
• Addressing Pain and Anger from a Solution-Focused Perspective
• Dealing with Relapse
• Troubleshooting Throughout the Treatment Process
• Primary Aggressor May be Frustrated about Partner’s Lack of Trust
• Couples May Decide to Separate
• One Partner Stomps Out of the Session
• Honeymoon Period
• Termination
• Alumni Group/Ongoing Couples Treatment
• References
• Chapter 17: Treating Affair Couples: An Integrative Approach
• Introduction to Treating Affairs
• Extramarital Affairs as Interpersonal Trauma
• An Integrated Approach to Treating Affairs
• Stage 1: Addressing the Impact of an Affair
• Assessment
• Therapeutic Components of Stage 1
• Stage 2: Context
• Therapeutic Components
• Stage 3: Moving On
• Therapeutic Components
• Special Considerations in the Treatment of Affairs
• Problems Encountered in Stage 1 of Treatment
• Problems Encountered in Stage 2
• Problems Encountered in Stage 3
• General Considerations in Responses to Affairs and Implications for Treatment
• Preliminary Findings Regarding Treatment Effectiveness
• Conclusion
• References
• Chapter 18: Couple Sex Therapy: Assessment, Treatment, and Relapse Prevention
• Sexual Function and Dysfunction
• Male Sexual Dysfunctions
• Female Sexual Dysfunction
• Biopsychosocial Approach to Sexual Dysfunction
• Sex Therapy Assessment
• The Process of Sex Therapy
• Guidelines for Couple Sex Therapy
• Male Sexual Dysfunctions
• Premature Ejaculation
• Erectile Dysfunction
• Inhibited Sexual Desire
• Ejaculatory Inhibition
• Female Sexual Dysfunctions
• Inhibited Sexual Desire
• Nonorgasmic Response during Couple Sex
• Sexual Pain and Vaginismus
• Resistance to Sexual Interventions and Exercises
• Building a Functional Couple Sexual Style
• Relapse Prevention Programs
• Culture and Religion Issues in Sex Therapy
• Special Issues with Unmarried Couples
• Sex Therapy with Gay Couples
• Sex Therapy for People Without Partners
• Sensitive and Secret Issues
• New Directions in Sex Therapy
• References
• Further Reading
• Part IV: Relationship Difficulties in Families
• Chapter 19: Family Therapy with Stepfamilies
• Research On Stepfamilies
• Developmental-Systems Framework for Working with Stepfamilies
• Interventions with Stepfamilies
• Accurate Family Assessment
• Psychoeducation with Stepfamilies
• Therapeutic Orientation
• References
• Chapter 20: Integrative Family Therapy for Families Experiencing High-Conflict Divorce
• Divorce
• Focuses for Intervention
• Creating a Therapeutic Contract
• Assessment
• Intervention Strategies
• Choosing the Formats for Sessions
• Alliance Building
• Setting Realistic Goals
• Moving from the Initial to the Intervention Phase of Treatment
• Interventions Utilized in All Cases
• Interventions Utilized when Suggested by the Assessment
• General Considerations About Treatment
• The Timing of Interventions
• Responding to Resistance
• The Open-Ended Strategy
• The Role of the Therapist
• Evaluation of the Treatment
• References
• Chapter 21: Differentiation and Dialogue in Intergenerational Relationships
• The Problem Area
• The Roots of the Treatment Approach: A Relational, Multigenerational Perspective
• Intergenerational Narratives: Cultural Assumptions
• Differentiation and Dialogue
• Intervention Strategies
• Clinical Challenges in Working with Clients “Under the Spell of Childhood”
• Differentiation: “Waking from the Spell of Childhood”
• Therapeutic Witnessing
• Understanding and Forgiving Parents
• Updating the Relationship
• The Loving Update
• Special Considerations and Limitations
• Research Supporting This Approach
• Conclusion
• References
• Chapter 22: An Integrative Approach to Health and Illness in Family Therapy
• Foundations: Biopsychosocial Systems Theory and Mending the Mind-Body Split
• Theoretical and Historical Foundations
• Empirical Foundations
• Specific Intervention Strategies for Treating Families Experiencing Health Problems
• Pre-Session Preparation
• Initial Sessions
• Middle Stages
• Termination
• Special Considerations
• Collaboration
• Ethical Issues: Confidentiality and Informed Consent
• Somatization
• Cultural Influences
• Conclusion
• References
• Chapter 23: Families in Later Life: Issues, Challenges, and Therapeutic Responses
• Theoretical Orientation
• The Therapeutic Process
• Assessing, Analyzing, and Perturbing
• Cocreating New Realities
• Supporting and Validating
• Facilitating Resilience
• Special Considerations
• Session 1
• Session 2
• Session 3
• Conclusion
• References
• Author Index
• Subject Index