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Findings for practice from PACFA’s first literature review on Family and Relationship Therapy: A commentary

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Ione Lewis[1] Australian College of Applied Psychology

Address for correspondence:
Professor Ione Lewis
Australian College of Applied Psychology
Level 5, Wynyard Green
11 York Street
Sydney, NSW 2000
Email: ione.lewis@acap.edu.au


Experiential Family Therapy

The concepts of Experiential Family Therapy, such as self-actualisation and expressing inner thoughts, are difficult to define and so few research studies exist which demonstrate the effectiveness of this model. A key finding for practice is that experiential activities used as an adjunct to family therapy enhance motivation and engagement in the therapy.

Structural Family Therapy

Structural Family Therapy is rarely used alone in contemporary practice, although elements are often integrated into practice with families and couples. Most research is based on case studies, which cannot be generalised, so there is not a strong evidence base for its effectiveness. Elements of structural family therapy are applied in the Maudsley model of family therapy, which has a strong evidence base for effectiveness with anorexia nervosa compared to individual therapy, especially with adolescents.

Cognitive Behavioural Therapy

Behavioural Couple Therapy has a strong evidence base for working with alcohol dependence. It is effective in promoting abstinence and improving the quality of the couple relationship. It outperforms individual therapy as a treatment for alcohol dependence.

Multi-systemic Therapy

Multi-systemic Therapy is a non-traditional form of therapy which is delivered at home with on call workers available at times of crisis. The model intervenes across school, home, neighbourhood and educational systems. It is effective in reducing the rates of offending by young people and improving families’ social functioning.

Family Problem Solving

Family problem solving, which focuses on family goal setting and reducing the impact of problems on family functioning, is effective in reducing young people’s levels of depression and anxiety, reducing PTSD and reducing levels of depression in adults on methadone maintenance.

Solution Focused Therapy

There is a research base for the effectiveness of Solution Focused Therapy. Interventions such as the miracle question, promoting hope and possibility, finding exceptions to the problem, using problem scaling to evaluate the extent of the problem and giving strengths-based feedback are effective with a range of presenting problems.

Narrative Therapy

Narrative Therapy was developed in South Australia by Michael White. It is a postmodern model which looks at the influence of ‘dominant’ stories on people’s lives and helps people become aware of how these might be limiting or constraining their lives.  Interventions such as re-authoring and re-storying are used to reconstruct more nuanced and affirming life stories and beliefs. Most research on Narrative therapy is at the level of case studies, which are not generalisable to other client populations. However, there is an evidence base for the externalising intervention of Narrative therapy. Externalising is effective with children who are soiling (for example, parents and children fighting sneaky poo). However, the usefulness of a postmodern approach with family violence is questionable.

Conclusion

The review concluded that further Australian research which is methodologically sound is needed in all of the modalities reviewed, to assess their effectiveness in the Australian context.

Reference:

Evans, P., Turner, S. & Trotter, C. (2012). The Effectiveness of Family and Relationship Counselling and Therapy: A Review of the Literature. Melbourne, Vic: PACFA.

 


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