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Basic Family Therapy 6E


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Table of Contents

Foreword ix Introduction xiii 1 The Development of Family Therapy 1 Family therapy's early years 1 1990s and the new millennium 9 Summary 13 References 14 2 Healthy Families and Their Development 19 Ethnic variations 21 The functions of families 21 Family development 22 The clinical importance of family developmental stages 23 Optimal family functioning 24 Summary 26 References 26 3 Some Basic Theoretical Concepts 27 Theories derived from individual and group psychotherapy 27 Other theories that have been used in family therapy 28 Other concepts and terms 41 Summary 46 References 46 4 Adopting and Refining a Model of Family Therapy 50 The nature of theories and models 50 Developing your model of family therapy 52 Selecting and adapting a model of family therapy 54 Summary 54 References 55 5 Models for the Assessment of Families 57 Critical distinctions in assessment 58 Conceptual approaches to family assessment 59 The Beavers Systems Model of Family Functioning 64 The Darlington Family Assessment System 66 Respective utility of family assessment models 67 Summary 68 References 68 6 The Family Diagnostic Interview 70 The initial contact 70 Joining the family and establishing rapport 71 Defining the desired outcome 75 Reviewing the family's history, determining its developmental stage and constructing a genogram 75 Assessing the current functioning of the family 79 Developing a diagnostic formulation 83 Offering the family feedback and recommendations 84 Discussing and arranging the next step 85 Feedback to referring professionals 86 Summary 86 References 87 7 Establishing Treatment Goals 88 Defining the desired state 89 Intermediate and final goals 92 Motivating families to consider and set objectives 92 Summary 93 References 94 8 When is Family Therapy Indicated? 95 Basic criteria for employing family therapy 96 Differing views on the place of family therapy 97 Some views on indications 98 The 'decision tree' 100 Contraindications for family therapy 103 Summary 105 References 106 9 Practical Points in the Treatment of Families 108 Involving reluctant family members 108 Maintaining a therapeutic alliance 113 Involving children in family sessions 115 The therapist's use of self 118 Transference issues 118 Contracts 119 The spacing of sessions 119 Confidentiality 120 Observers 121 Co-therapy 123 Summary 125 References 125 10 Common Family Problems and Their Treatment 127 Introduction 127 Task accomplishment problems 127 Serious basic task accomplishment problems 132 Communication problems 134 Poorly defined and dysfunctional role patterns 137 Summary 144 References 144 11 Complex Problems and Second-Order Change 147 Interrupting problem patterns 147 Techniques focusing on changing meaning 156 The use of humour 161 Strategic teams 162 A second-order cybernetic approach: therapy as conversation 163 Summary 167 References 168 12 Other Therapeutic Approaches 172 Experiential approaches 172 Video playback 175 Family music therapy 175 Family art therapy 176 Family play therapy 177 Family resilience and ecological interventions 178 Family therapy and serious mental illness 182 Mindfulness practices 186 Innovative formats for service delivery 187 Conclusion 190 References 190 13 A Method of Therapy 199 Treatment by stages 200 Termination in family therapy 211 Summary 212 References 213 14 Couple Therapy 215 The history of couple therapy 215 General considerations in couple therapy 217 Current approaches to couple therapy 220 Divorce therapy and mediation 227 Sex therapy 228 Summary 230 References 231 15 Terminating Treatment and Dealing with Treatment Interruptions 236 Treatment contracts 236 Open contracts 237 Indications for ending treatment 238 How to terminate treatment 241 Termination tasks and ritual 243 Emotional and psychological aspects of termination 243 Follow-up 244 Dealing with treatment interruptions 245 Summary 246 References 247 16 Teaching and Learning Family Therapy 248 Who learns family therapy? 250 The different possible learning experiences 251 Methods of learning family therapy 251 Audiovisual aids 253 Objectives 254 Learning family therapy skills 255 The content of training 256 Supervision 257 Learning to supervise 258 Consultation 260 Summary 263 References 263 17 Research in Family Therapy 265 Why is family therapy research important? 266 Is family therapy effective? 266 What makes family therapy effective? 267 Is family therapy cost-effective? 270 How can practitioners be more involved in research? 270 Summary 271 References 272 18 Ethics and Family Therapy 275 Informed consent 277 Therapists' values 278 Confidentiality 279 Ethical decision making 281 Keeping informed and up to date 283 Ethical issues in family therapy research 283 Summary 284 References 284 Appendix 286 Index 291

About the Author

Philip Barker is Professor Emeritus of Psychiatry in the University of Calgary. Now retired from active clinical practice, he practiced family therapy, and supervised many students from the early 1970s. A Life Fellow of the Royal College of Psychiatrists and a Life Member of the Canadian Psychiatric Association, he is the sole author of the previous five editions of BPF. Dr Jeff Chang is an active proponent of family therapy: he will promote the book at future presentations.


It was a pleasure and a privilege to read the sixth edition ofthis book. It is more difficult, however, to write anadequate introduction, as there are few enthusiastic phrases thathave not already been invoked to describe the various editions ofPhilip Barker s book that have appeared since the first in1981. I would like to be clear that this is an eminently readable bookfor those who are new to the discipline. Anyone who is not new tothe discipline, however, and has seen a previous version will knowthis; readers and reviewers before me have commented on the skillof the author, who could write a book on the complex andtheoretically diverse domain of family therapy that is at oncescholarly yet thoroughly accessible. Readers of previous editionswill find the update worthwhile and may be reassured to note afamiliar ordering to many of the chapters. Glenda M. MacQueen, MD, FRCPC, PhD. - Vice Dean, Facultyof Medicine, University of Calgary, Canada

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