'User-friendliness' is described as a therapist stance which involves attentiveness to the quality of the 'therapeutic relationship', both between therapist and family and between service providers and their public. This article draws on research published in the last seven years from within and outside the family therapy field which can help improve this relationship. I will argue that the issues which challenge user-friendly practice need to be related to the theories which inform family therapy and to the traditional tension within the research field between focusing on measurable outcomes or on user satisfaction. The urgency for a clear analysis of what can make family therapy practice more sensitive to its public comes partly from the relative state of maturity which family therapy has now reached and its need actively to work alongside other approaches. Other crucial influences considered are a greater public demand for choice and improvements in public services, and social policy trends towards greater efficiency and accountability within the helping services.
This article looks at some of the effects on practitioners of the increasing complexity and variety of ideas within the family therapy field. In adopting the currently popular notion of ‘default position’ from information technology, I argue that therapists can easily feel that their work has a random quality to it. I examine how our own default positions can be based on force of habit, a quest for novelty or the effects of stress. Some suggestions are offered for how we can more accurately go about choosing ideas that will be of help to the families with which we work and to ourselves.
This paper will examine how therapists can make sense of and use some of the incongruous and apparently absurd replies which clients sometimes make to their therapists' questions. It will be argued that the convention of relying on therapist questions can create its own problems, not least because clients often feel at a disadvantage. Careful attention to the question-answer process in therapy can play an essential part in the therapeutic alliance and can give us clues as to what may be some of the often unstated preoccupations of our clients.Questions without answers must be asked very slowly.(Anne Michaels, Fugitive Pieces)
Video recordings have been used for many years in family therapy for supervisory or therapist review purposes, but have usually had little direct relevance for clients. This article describes how video recordings can be used jointly by therapist and family to discuss episodes and themes in the sessions, rather like the current use of reflecting teams. The danger of the abuse of power in video feedback is also discussed — a danger which is present in all forms of therapy, however ‘user friendly’ they aim to be.
SUMMARY
New routines for drug handling were used in a 24‐week outpatient double‐blind trial of naproxen versus acetylsalicylic acid in 80 patients with juvenile rheumatoid arthritis. The clinician ordered tablets from the pharmacy for each patient by stating name, weight and randomization number. The pharmacy dispensed the drugs in sealed and labelled 1‐week medication containers. Totally, 2176 containers were packed and distributed to the patients. Two errors in ordering of drugs were detected. Patient compliance was studied by tablet count in used containers returned by 25 of the patients. The calculated compliance was 95%. The procedures for drug handling seem useful and may increase the validity of clinical trials. The staff at the local pharmacy can be valuable partners in the planning and performance of clinical drug trials.
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