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Several are noted below: Treatment Focus What is the problem? An acting out teen? An over-controlling and hyper-functional parent? If you target and change one but not the others, is that a success?
Family Family deterioration holds they are all inter-linked, so how can you say one is more important to treat or more important to track for research outcomes?
Definition of Success If a miserably married couple divorces after couples therapy, is that a therapeutic failure?
What if you ask people instead of theories? Treatment Model — many different schools of family therapy use the same techniques e. So, how do you include these overlapping techniques in one therapy model which you think will prove superiorand remove them from a compared model without hamstringing it?
Finding your method is significantly more effective compared to another method when the second method is purposely weakened means little.
Retention and Relapse Family therapists traditionally have been more concerned than individual therapists with issues of retention during treatment, and relapse prevention after treatment. This means that showing a large effect size for some kind of family therapy at the end of treatment with the families that stay in treatment means little.
What about the ones that dropped out? How long does the treatment effect last? Family and couples therapy is often much more flexible. Some therapists stick with the one-hour-once-a-week model. Gottman, for example, does not, and will initially see couples for more than an hour, and by the end of therapy will space sessions out to perhaps one a month as a way to reduce relapse.
True Improvement versus Halted Decline Liddle et al. The issue is that when married couples in treatment are compared to married couples on a wait-list, the couples on the wait-list decline into the very distressed range.
Thus, the treatment really has only to halt the decline in order to yield significant results. Methods — Methods in family therapy are varied, and range from self-report questionnaires, observational techniques, and physiological readings, to therapist rating scales.
Self-report questionnaires are easy to use and score, but limited in what they reveal. Further, what does it mean if two family members disagree significantly in their responses? Do you average the discrepant scores? Always pick the spouse whose first name comes first in an alphabetical list?
Observational techniques are very time consuming and require great inter-rater reliability, but reveal a lot. However, the task used to observe the family shapes the results; conflict-management-tasks pull for negative emotions and conflict, while game-playing-tasks pull for problem-solving and easy communication.
Further, the observational method must be studied and proven. Physiological readings are generally left out of individual therapy research.Dr.
Jennifer Holland Wayer is a third generation native of Crestview and a graduate of Crestview High School. Dr. Wayer acquired her Associate Degree at the University of Florida, then her Bachelor Degree at the University of South Alabama.
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