The Heart of the Matter: A Proposal for Placing the Self of the Therapist at the Center of Family Therapy Research and Training

Abstract

As it faces the transition marked by the death or retirement of most of its first-generation founders, the field of family therapy finds itself still unable to answer the critical question of what it is that makes family therapy work. The two dominant approaches to answering this question, the common-factors perspective and the model-specific factors perspective, remain divided at this juncture by a fundamental difference of emphasis between the two. This article proposes a way of integrating the two perspectives via the hypothesis that therapists achieve maximum effectiveness by committing themselves to a family therapy model of proven efficacy whose underlying worldview closely matches their own personal worldview. The implications of this hypothesis for the training of family therapists are examined.

Finding the Common Core: Evidence-Based Practices, Clinically Relevant Evidence, and Core Mechanisms of Change

“…While promoted as a potential answer to better outcomes in CMHC, EBP (we would argue more particularly, EBTs) are not universally accepted. Some argue that these programs are nothing more than good common care ''repackaged'' or good case management and general care that does nothing more than bring a systematic lens to treatment (Hubble et al 1999;Simon 2006). The resulting debates over common factors or model specific factors seem to lose one of the core elements: how treatment works, and what interacts to enhance or detract from the change process that occurs in treatment (Eisler 2006).…”

“…It is common sense that the practitioners themselves are a key mechanism of change in psychotherapy, yet in typical CTR they are standardized, with any resulting differences treated as noise (or fidelity drift). On the other hand, in the common factors literature (e.g., Simon 2006), practitioners are treated as the sole source of treatment effects. We take the middle ground, not as a neutral stance, but because we believe both treatment models and practitioners likely contribute in unique ways as well as through complex interactions to youth outcomes (Sexton 2007).…”

Therapist Use-of-Self Orientations Questionnaire: A Reliability and Validity Study

“…successful MFT outcomes Simon 2006). In fact, Simon (2006Simon ( , 2007 hypothesized that at the ''heart'' of the therapist's clinical effectiveness is the self of the therapist, and in particular the degree of fit between therapists' personal world view and the therapy model chosen to guide their therapy.…”

“…In fact, Simon (2006Simon ( , 2007 hypothesized that at the ''heart'' of the therapist's clinical effectiveness is the self of the therapist, and in particular the degree of fit between therapists' personal world view and the therapy model chosen to guide their therapy. Attention to the therapist's use of self also has long been recognized as an important aspect of MFT training (c.f., Aponte et al 2009;Aponte and Winter 2000;Haber 1990;Rober 1999).…”

Dialogical construction of the selves of trainees as competent researchers

“…A central role for the self of the therapist had been proposed based on Simon (2006Simon ( , 2007. Trainees had completed a series of exercises around dialogue and self, of which the last, introduced in two parts, was to help them focus on how they constructed their own self as a systemic therapist:…”