Following the COVID‐19 pandemic, psychological therapies rapidly moved online in mid‐2020. The Association for Family Therapy and Systemic Practice in the UK (AFT) surveyed the attitudes and practices of systemic therapists in the UK in early October 2020, exploring members’ views and gathered information about ongoing needs. A sample of 312 people were included in a mixed methods analysis. In total, 65% of respondents felt their overall experience of using online video technology professionally was positive, further reflected in responses to two open‐ended questions. Detailed thematic analysis revealed that many positive comments were related to the practical advantages of online working, whilst many negative comments were related to technique and the therapeutic relationship. Possible respondent biases are discussed, and the implications of this change in practice are explored. It remains to be seen if this marks the beginning of a more permanent shift in our field as we explore the potential of new technologies.
Practitioner Points
The vast majority of UK systemic therapists felt that their experience of online video technology was positive.
They noted many practical advantages but also identified many challenges regarding therapeutic techniques and the therapeutic relationship.
Therapists developed a range of creative solutions to maximise the therapeutic opportunities of online video.
Although research has shown the efficacy of family interventions in psychosis, there has been little research into families' own experience of services in routine clinical settings. Fifteen of the first twenty-two referrals to a Somerset Family Interventions Service agreed to take part in semistructured interviews regarding family satisfaction and clinical outcome. High levels of engagement and satisfaction with the service were reported in spite of initial apprehension regarding family sessions. Family members thought that the sessions had helped them deal more effectively with problems and relatives' symptoms. They valued the opportunity for open discussion, developing new perspectives and problem-solving, as well as liaison/closer working with mental health services. Positive therapeutic qualities/skills (e.g. empathic, non-judgemental approach; mutually agreed goals) were highlighted. This study also indicated that successful engagement in family work requires referral at an early stage. The findings of this study, particularly those relating to the therapeutic relationship, are discussed, including their relevance for future research.
This paper argues that the current national policy context offers an opportunity to develop more family-inclusive mainstream mental health services. It outlines a strategy to enhance working partnerships with carers and families and discusses its training implications. The first phase of a trust-wide training programme in Somerset is described and the potential role for family therapists in promoting the wider application of systemic ideas is considered.
This paper describes a project in which family interventions in psychosis services were successfully established in a routine clinical setting. This has involved the development of a whole‐team training approach, an accredited one‐year training course, and a clinical approach which integrates the systemic and cognitive‐behavioural psychoeducational approaches. Since the original description of this project (Burbach and Stanbridge, 1998) the training course and service have been evaluated and the clinical approach has been further developed. These developments, particularly the ‘cognitive interactional’ approach and collaborative therapeutic stance, are detailed. The paper explores the factors which have contributed to the successful establishment and maintenance of the service, and describes more recent initiatives to bring about more family/carer‐friendly mental health services.
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