9781572303072

An ideal introduction to practicing family therapy, this work provides students and new therapists with the basic skills and tools necessary to become empathic, confident, and successful practitioners in today's rapidly changing field of mental health. Written from a biopsychosocial perspective, chapters take readers step by step through the entire therapy process. Numerous case examples and recent research findings complement the text, and special sections on getting started, gaining self-confidence, diagnosing DSM-IV disorders, and understanding managed care offer practical guidance for entering the field.

JoEllen Patterson, PhD, is Director of the COAMFTE-approved Marriage, Family, and Child Counseling Program at the University of San Diego and serves on the Behavioral Science faculty of Sharp HealthCare's Family Practice Residency. Her publications focus primarily on training and integration of mental health services with healthcare delivery systems.

Lee Williams, PhD, is Assistant Professor in the Marriage, Family, and Child Counseling Program at the University of San Diego. A licensed family therapist and an Approved Supervisor of the American Association of Marriage and Family Therapy, Dr. Williams has published articles on topics including premarital counseling, family therapy training, and supervision.

Claudia Grauf-Grounds, PhD, teaches in the Marriage, Family, and Child Counseling Program at the University of San Diego. She also serves on the Behavioral Science faculty of Sharp HealthCare's Family Practice Residency and is Director of San Diego's New Life Clinics, a multidisciplinary mental health practice.

Larry Chamow, PhD, has been a practicing family therapist for 18 years. He serves on the faculties of the Marital and Family Therapy Program, University of San Diego, and the California School of Professional Psychology. An Approved Supervisor of the American Association of Marriage and Family Therapy and a member of the American Family Therapy Academy, he conducts his private practice at the Pacific Family Institute in Carlsbad, California.

1. The Beginning Family Therapist: Taking on the Challenge

1

(10)

Getting Started

4

(1)

Managing Anxiety and Issues of Confidence

5

(1)

Stages of Therapist Development

6

(3)

Obsessing about Clinical Work

9

(1)

Conclusion

9

(2)

2. Before the Initial Interview

11

(10)

Dealing with Families' Expectations and Anxieties about Therapy

11

(2)

Suggestions for Initial Contact with the Client

13

(2)

What Information Should Be Obtained?

15

(3)

Who Should Come to Therapy?

18

(1)

Initial Hypothesizing

19

(2)

3. The Initial Interview

21

(15)

Developing a Connection: How to Join with Clients

21

(2)

Establishing Credibility

23

(2)

Defining Client Expectations for Therapy

25

(3)

Building Motivation

28

(2)

Handling Administrative Issues

30

(4)

Conclusion: The First Session and Beyond

34

(2)

4. Guidelines for Conducting Assessment

36

(33)

Initial Assessment

37

(2)

Potential Issues of Harm

39

(9)

Assessing for Substance Abuse

48

(4)

Assessing for Biological Factors

52

(2)

General Psychosocial Assessment

54

(14)

Conclusion

68

(1)

5. Developing a Treatment Focus

69

(28)

Developing an Initial Treatment Plan

69

(2)

Select a Problem List

71

(1)

Examine History of Problems and Previous/Current Treatment

72

(1)

Conceptualize the Case and Make a Diagnosis Using a DSM-IV Multiaxial Assessment

72

(8)

Establish Long-Term Treatment Goals

80

(2)

Select Treatment Modality, Objectives, and Interventions

82

(3)

Determine Length and Frequency of Treatment

85

(3)

Consider Referrals to Outside Resources

88

(7)

Conclusion

95

(2)

6. Basic Treatment Skills

97

(21)

The Rush to Intervention versus Developing a Relationship

97

(3)

Basic Counseling Skills

100

(8)

The Development of Expertise as a Family Therapist

108

(10)

7. Working with Families and Children

118

(29)

Assessment of Child and Adolescent Disorders

119

(2)

Family Interventions When Children Are the Clients

121

(3)

The Family Life Cycle Revisited

124

(16)

Special Issues with Divorcing and Remarried Families

140

(4)

Mediation and Child Custody Evaluations

144

(1)

Special Issues with Single-Parent Poor Families

145

(2)

8. Working with Couples

147

(22)

Keys to Providing Solid Couple Therapy

148

(1)

Creating a Therapeutic Triangle

149

(6)

When Couple Therapy Might Not Work

155

(1)

Common Problems Presented in Couple Therapy

155

(3)

Longitudinal Research on Couples

158

(3)

Special Topics

161

(6)

Structured Separation

167

(2)

9. When a Family Member Has a Mental Illness

169

(24)

Individual and Family Concepts

169

(3)

Individual Diagnosis in a Family Context

172

(2)

Depression

174

(7)

Anxiety

181

(5)

Alcoholism and Drug Abuse

186

(7)

10. Getting Unstuck in Therapy

193

(23)

Understanding Clients' Ambivalence about Change

194

(1)

Therapist's Reluctance to Intervene

195

(1)

Therapist-Client Agenda and Timing Mismatch

196

(2)

Therapist's Lack of Theoretical Clarity

198

(1)

Supervision

199

(1)

Self-Supervision Questions

200

(1)

Peer Consultation

200

(1)

Doing a Literature Search

200

(1)

Dealing with Cancellations and "No Shows"

201

(5)

Difficulty Getting Other Family Members to Therapy

206

(1)

Handling Secrets

207

(1)

How Agencies Contribute to Being Stuck

208

(3)

Countertransference: How Therapist's Issues Interfere

211

(3)

Other Personal Influences

214

(2)

11. Termination

216

(9)

Mutual Terminations

217

(4)

Therapist Terminations

221

(1)

Client Terminations

222

(3)

12. Family Therapy in the Future: Pertinent Issues for Beginning Clinicians

225

(10)

Managed Care: Implications for You and Your Clients

226

(1)

What Every Family Therapist Needs to Know

227

(4)

The Question That Binds: What Harms and What Helps?

231

(4)

References

235

(8)

Index

243

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Essential Skills in Family Therapy From the First Interview to Termination

Essential Skills in Family Therapy From the First Interview to Termination

1572303077

Summary

Author Biography

Table of Contents

Supplemental Materials