Problem Centered Systems Therapy of the Family*

Epstein, Nathan B.; Bishop, Duane S.

doi:10.1111/j.1752-0606.1981.tb01348.x

Cited by 115 publications

(110 citation statements)

References 15 publications

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“…Combined family therapy-The combined family therapy condition consisted of pharmacotherapy plus family therapy based on the problem-centered systems therapy of the family (19). The problem-centered systems therapy of the family model is a short-term multidimensional family treatment that focuses on comprehensive assessment, problem identification, and task-oriented problem solving.…”

Section: Description Of Treatment Conditionsmentioning

confidence: 99%

Treatment Matching in the Posthospital Care of Depressed Patients

Miller¹,

Keitner²,

Ryan³

et al. 2005

AJP

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Objective-This study assessed the efficacy of 1) matching patients to treatments and 2) adding additional family therapy or cognitive therapy in a group of recently discharged patients with major depression.Method-Patients with major depression were recruited during a psychiatric hospitalization. After discharge, they were randomly assigned to one of four treatment conditions that were either "matched" or "mismatched" to their pattern of cognitive distortion and family impairment. The four treatment conditions were 1) pharmacotherapy alone; 2) combined pharmacotherapy and cognitive therapy; 3) combined pharmacotherapy and family therapy; and 4) combined pharmacotherapy, cognitive therapy, and family therapy. Randomly assigned treatment continued for 24 weeks on an outpatient basis.Results-Among patients with at least moderate depressive symptoms at hospital discharge, low rates of remission (16%) and improvement (29%) were obtained. Matched treatment led to a significantly greater proportion of patients who improved and greater reductions over time in interviewer-rated depressive symptoms than mismatched treatment. However, matched treatment did not produce greater change in self-reported depression or interviewer-rated suicidal ideation. Treatment that included a family therapy component also led to a greater proportion of patients who improved and to significant reductions in interviewer-rated depression and suicidal ideation than treatment without family therapy.Conclusions-These results suggest that 1) current treatments are not very efficacious in the aftercare of hospitalized depressed patients, 2) treatment matching moderately improves outcome for patients who are symptomatic at hospital discharge, and 3) inclusion of family therapy improves the outcome of posthospital care for depressed patients.Recognition of the prevalence and seriousness of depressive disorders has led to the development of numerous treatments for depression, including medications, individual psychotherapies, marital/family therapy, as well as combinations of pharmacological and psychosocial treatments. In general, all of these treatments have been found to be efficacious. However, there has been considerable variability in absolute response rates. Conclusions about possible differences between treatments are unclear, with the most common finding being equivalence among active treatments (1).Our knowledge about treatments for depression has a number of significant additional limitations. First, there is a high degree of heterogeneity among individuals labeled 1 Address correspondence and reprint requests to Dr. Miller, Psychosocial Research Program, Butler Hospital, 345 Blackstone Blvd., Providence, RI 02906; ivan_miller@brown.edu (e-mail NIH-PA Author ManuscriptNIH-PA Author Manuscript NIH-PA Author Manuscript "depressed," with descriptions ranging from the mildly depressed "worried well" to psychotic, suicidal patients. Despite this heterogeneity, a majority of treatment research in depression has been conducted on a rela...

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Section: Description Of Treatment Conditionsmentioning

confidence: 99%

Treatment Matching in the Posthospital Care of Depressed Patients

Miller¹,

Keitner²,

Ryan³

et al. 2005

AJP

View full text Add to dashboard Cite

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“…On the other hand, we did adhere rigorously to the macromoves of therapy (Epstein and Bishop, 1981). Thus the same sequence was followed with each family.…”

Section: Discussionmentioning

confidence: 99%

“…The approach adopted was the system-based problem solving McMaster model (Epstein and Bishop, 1981 ;Goodyer et al, 1982). Readers unfamiliar with the model are referred to these sources.…”

Section: Choice Of Therapy Modelmentioning

confidence: 99%

Family therapy in a community mother and toddler project

Koziarski¹,

Hodgson²,

Nicol³

1986

Journal of Family Therapy

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A home centred family therapy approach is described based on the McMaster model. This approach was applied in a controlled trial of three forms of intervention for mother and toddler problems. In this paper the experience of applying the approach is reported.There has been renewed concern in recent years about the mental health of the family of the preschool child (Brown and Harris, 1978;Richman, 1982;. Rates of psychiatric disorder have been found to be very high in these epidemiological surveys, between 25 and 40% for maternal disorder and around 15% for child disorder. In this paper we describe a community based family therapy approach to this problem.The work described here is part of a larger clinical trial in which three interventions designed to tackle the problems of mothers and toddlers are being compared with each other and with a control group. The three interventions are an intensive health visiting approach, in which a health visitor with skills in helping with psychological problems visits the family for a short term intervention (Brown et al., 1985; Rickelton et al., 1985); mother and toddler groups (report in preparation) and family therapy. Cases were alloted to these four regimes by random allocation. MethodThese methodological details are given so that the reader can identify the type of families that were seen in the study and compare them with his or her own practice.The study area This was an inner city area based on traditional ship-building and heavy engineering. Unemployment was high: over 30% in the largest of the five

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“…It yields seven scales: the six domains of family functioning (identified in the McMaster Model) and a General Family Functioning Scale that assesses the overall health/ pathology of the family. Epstein & Bishop (1981) suggest that the FAD is both a reliable and valid instrument.…”

Section: Familyassessment Devicementioning

confidence: 99%

Family Life and Relationships in the Health of the Nation Outcome Scales for Children and Adolescents (HoNOSCA)

MacGregor¹

2006

Psychiatr. bull.

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Aims and MethodThe Health of the Nation Outcome Scales for Children and Adolescents (HoNOSCA) were developed as a routine measure of outcomes in child and adolescent psychiatry. In a preliminary study we administered sub-scale 12 of HoNOSCA (Family Life and Relationships) to 20 families and compared the results with two well-established measures of family functioning and a measure of abnormal psychosocial situations associated with psychopathology.ResultsStrong correlations were found between HoNOSCA sub-scale 12 and both self-assessed and clinician-assessed measures of family functioning. However, there was little relationship between HoNOSCA (12) and a measure of abnormal psychosocial situations.Clinical ImplicationsHoNOSCA (12) appears to provide a quick and valid assessment of overall family dysfunction and can be used in a time-efficient manner as a means to assess where further more comprehensive family assessment or family therapy may be required.

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Problem Centered Systems Therapy of the Family*

Cited by 115 publications

References 15 publications

Treatment Matching in the Posthospital Care of Depressed Patients

Treatment Matching in the Posthospital Care of Depressed Patients

Family therapy in a community mother and toddler project

Family Life and Relationships in the Health of the Nation Outcome Scales for Children and Adolescents (HoNOSCA)

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