A systems approach to child abuse: Management and treatment issues

This article provides an updated overview of the empirical literature regarding Multiple Family Therapy's (MFT) applications to non‐psychiatric conditions and problems. Although the evidence is not as strong for these disorders as for psychiatric disorders, the benefits of MFT approaches are apparent in the following areas: family management of several severe chronic medical illnesses; prevention of educational failure and exclusion; and treatment of marital distress. MFT research in non‐psychiatric settings has been faced with unique challenges that have mitigated the quality and quantity of outcome and process research produced over the past decade. Future research efforts should focus on: (1) stronger commitment to the evaluation of ongoing MFT programmes; (2) identification and manualization of major MFT programmes; (3) more Randomized Clinical Trials (RCTs) on the effectiveness of MFT programmes in community settings; and (4) higher priority for research on MFT's change processes and patterns of interaction. Practitioner points The treatment of chronic physical diseases is optimized by involving family members, and MFT is a valuable way of doing so: workshops delivered in brief formats are most feasible MFT should be considered for non‐psychiatric problems with the risk of isolation and stigmatization. The presence of other families sharing the same challenges is very useful MFT practitioners should attempt to operationalize their MFT model and include an evaluation component in their therapeutic implementation as routine practice

Section: Family Relationship Problemsmentioning

confidence: 99%

Evidence base for Multiple Family Therapy (MFT) in non‐psychiatric conditions and problems: a review (part 2)

Cook‐Darzens

Gelin

Hendrick

2017

“…This has prompted the development of an alternative and more intensive form of family intervention, multi-family therapy (MFT) in which several families are seen together to maximize family resources, encourage cooperation and support between families and help resolve the stuck therapeutic situations that sometimes develop in any treatment context (Asen and Scholz, 2010;Eisler et al, 2010). MFT, originally pioneered by Laqueur et al (1964) has been applied in a variety of conditions, including schizophrenia (Anderson, 1983;McFarlane, 1993), substance misuse (Kaufman and Kaufman, 1979), depression (Lemmens et al 2009a(Lemmens et al , 2009b, chronic medical illness (Steinglass, 1998), child abuse (Asen et al, 1989) and eating disorders (Eisler, might otherwise require inpatient or day care. It draws on the theoretical concepts of the family therapy approach developed at the Maudsley Hospital (Dare et al, 1990;Eisler, 2005;Eisler et al, 2010;Lock and Le Grange, 2013) that places a strong emphasis on mobilizing family resources as a way of overcoming the eating disorder in the young person, and integrates it with the intensive form of MFT developed by Asen and colleagues (Cooklin et al, 1983;Asen and Scholz, 2010).…”

Section: Practitioner Pointsmentioning

confidence: 99%

“…() has been applied in a variety of conditions, including schizophrenia (Anderson, ; McFarlane, ), substance misuse (Kaufman and Kaufman, ), depression (Lemmens et al . ), chronic medical illness (Steinglass, ), child abuse (Asen et al ., ) and eating disorders (Eisler, ; Scholz and Asen, ; Scholz et al ., ; Slagerman and Yager, ; Wooley and Lewis, ). Asen and Scholz () provide a detailed review of MFT and also describe the general theoretical concepts and techniques and variety of formats and settings in which it can be used.…”

mentioning

confidence: 99%

Intensive multi‐family therapy for adolescent anorexia nervosa: an open study of 30 families

Salaminiou¹,

Campbell

Simic

et al. 2015

The article reports on an innovative treatment for adolescent anorexia nervosa (AN) – intensive multi‐family therapy – in terms of symptoms, patients’ and parental psychological functioning and treatment acceptability. In all, thirty patients and their families took part in the study and were assessed at baseline, 3 and 6 months. At 6 months two‐thirds had gained sufficient weight to be in the normal weight range with significant improvements in AN cognition, mood and self‐esteem. Only two of the thirty families discontinued treatment early and both patients and parents scored high on treatment satisfaction, though parents scored significantly higher than patients. These results compare favourably with outcome data from larger more rigorous evaluations of single family therapy for adolescent AN currently considered to be the treatment of choice. While larger, randomized studies are needed, the results are promising and suggest that multi‐family therapy may be a useful additional treatment approach for this group of young people. Practitioner points Multi‐family therapy may provide an effective intervention for adolescent anorexia nervosa and compares well with other, more rigorously evaluated interventions. Multi‐family therapy is highly successful in engaging families in treatment leading to minimal dropout rates. Satisfaction with multi‐family therapy is high for both adolescents and parents.

“…In this way the multiple family paradigm has inspired more traditional therapeutic activities in general mental health services, such as relative support and carer groups, and it is now a well-established ingredient in the work with people with schizophrenia (Kuipers et al, 1992). Multiple family therapy is now also practised in many other presentations and conditions (O'Shea and Phelps, 1985), including drug and alcohol abuse (Kaufman and Kaufman, 1979), chronic medical illness (Gonsalez et al, 1989;Steinglass, 1998), Huntingdon's disease (Murburg et al, 1988), child abuse (Asen et al, 1989), eating-disorder patients (Dare and Eisler, 2000;Scholz and Asen, 2001;Slagerman and Yager, 1989), and more specifically bulimia nervosa (Wooley and Lewis, 1987), and a mixture of in-and outpatient children and adolescents presenting with a variety of problems (Wattie, 1994). It is likely that its cost-effectiveness in times of dwindling resources does explain in part the increasing popularity of the multiple family therapy approach.…”

Section: Reflections and Further Perspectivesmentioning

confidence: 99%

Multiple family therapy: an overview

Asen

2002

165

124

In recent years there has been increased interest in working with groups of families systemically. Multiple family therapy is applied in different settings and to a whole range of different presentations. These include work with multi‐problem families; with schools, parents and pupils; with adult mentally ill individuals and their families; and with eating‐disordered teenagers and their families. Principles and aims of multiple family therapy are presented, specific projects described and trends for future work outlined.