May / June 2022 Volume 21, No. 3 - Family Therapy Magazine

Systems Theory Brings It All Together in Undergraduate Education

I have learned how, through the family systems theory, we can look at how the family works as a whole rather than examining each individual member. It is a way to understand an individual based on their role/part/interactions within their family unit. —Middy, Senior Student, Family Studies Concentrator, Psychology Major Undergraduate students are at a [...]

A Larger Systems Approach: Integrating Intersectionality into Family Systems Theory

“Power, privilege, oppression.” What was your reaction reading these words? For some, resiliency, for others vulnerability, but for all, critical. Now, how about “family systems theory?” For some comfortable, for others complexity, but for couple and family therapists (CFTs) and our work with families, critical. The American Association of Marriage and Family Therapy (AAMFT) Clinical [...]

Reimagining the Application of Systems Theory Via Teletherapy Interventions

At the start of the pandemic, I was a new mom—just returning from maternity leave. As most other university instructors at that time, I was tasked with transferring my courses to an online format immediately upon my return. One of the classes that I taught was a course on Systemic Child and Adolescent Treatment. I [...]

Historical Overview of Family Systems Theory

Beginning in the mid 20th century, the practice of family therapy began to coalesce around certain key theories and systems to form an approach by which future practitioners could base their observations and work for important changes for the health of individuals and relationships. These ideas and approaches are sometimes organized and named as family [...]

What is Family Systems Theory?

When people ask me about my job, I lie—a little bit. When someone asks me what I do, I say, “I’m a family therapist." More often than not, they then ask, “So, like a psychologist?” This is when I lie. I say, “Yes, like a psychologist.” It’s not a total lie. Like many psychologists or [...]

COAMFTE Accreditation Standards Version 12.5 Implementation and Resources

The COAMFTE Accreditation Standards V12.5 was formally implemented on January 1, 2022. Many COAMFTE-accredited programs have already expressed interest in and enthusiasm for transitioning to Standards Version 12.5 with over 95% notifying the Commission that they are formally adopting the revised standards in the first year of implementation. In an effort to support programs entering the initial or renewal [...]

President’s Statement Regarding CEO Todd’s Retirement

It is with hearts full of gratitude for all the work CEO Tracy Todd, PhD, has accomplished on behalf of the MFT profession and AAMFT, that the Board of Directors received his decision for a well-earned retirement in January of 2023. During the past decade, CEO Todd has shepherded our Association in multiple ways that [...]

Decisions, Decisions, Decisions: Considerations Regarding License Portability and Compacts

State licensure has provided many significant advantages for MFTs and their clients, and the long and ultimately successful battle to obtain licensure in all 50 states ranks as the most significant accomplishment in the growth of the profession in the United States. However, MFT state licensure does have one design flaw—a person’s state-based licensure is only [...]

The Role of Family Therapists and the Social Determinants of Health: A Systemic Investment in our Global Future

A note from the authors: Before the ink had dried on our team’s previous piece in the March/April issue of Family Therapy Magazine (Family Evacuation after the Collapse of Afghanistan: 100,000+ Stories Yet to be Told; Charlés & Lewis, 2022), Russian forces had invaded the sovereign nation of Ukraine. When we first proposed this series, [...]

Supporting Children Through Their Grief Journey

An estimated 1 in 14, or 5.3 million, children in the U.S. will experience the death of a parent or sibling before they reach the age of 18 (Edelman, 2020). This estimate does not reflect deaths from COVID-19, as the analysis will not be released until sometime in 2022. No doubt, many more children and [...]

TREATNET Family and the United Nations: Family Therapy with Adolescents at Risk of Substance Abuse and Contact with the Criminal Justice System

In 2018, we (LLC and MP) met in person for the first time in the lobby outside a large conference room at the United Nations Office in Vienna. Although we had collaborated previously (Palit & Levin, 2016; Charlés & Samarasinghe, 2016), we had never met face-to-face. In Vienna, we were invited participants in a United Nations Office on Drugs and Crime (UNODC) technical consultation: “Elements of Family-based Treatments for Adolescents with Drug Use Disorders: Creating Societies Resilient to Drugs and Crime.” This consultation meeting included 25 experts across the fields of family therapy, staff from the UNODC PTRS unit, and the World Health Organization, and subject matter experts in substance use disorders and countering violent extremism. The meeting was convened for a memorable week in Vienna, with participants from over 13 countries. The goal of the meeting was “to identify key elements of effective approaches to the treatment of adolescents with drug use disorders and to provide guidance for the development of a UN training package on family therapy.” A key aspect of the “effective approaches” and “guidance” asked of us as a group of technical experts was that we had to consider FT adaptation and implementation in low and middle income countries. The challenge is clear; while research studies in many contexts illustrate how systemic family therapy practices are part of the evidence base, Busse et al. (2021) noted that:

…almost all these studies were conducted in high-income countries and almost all of them were conducted within a research context in university setting. As such, the findings might not be generalisable to studies conducted in LMICs …. Furthermore, adolescents with SUDs and their families in LMICs do not have or very little access to effective treatment such as family-based therapy. To address this accessibility gap as well as to increase quality and diversity of treatment options for adolescents with drug and other SUDs, the Treatnet Family (TF) was developed by the United Nations Office on Drugs and Crime (UNODC; 2020). (p. 2)

That package that was begun in 2018 in Vienna is now called Treatnet Family (see below for an example of some of the concepts addressed in the package). Treatnet Family has been a part of feasibility studies, has been implemented in many countries and regions, and involved hundreds of practitioners across the globe. The package is openly accessible at no cost, and as of this writing, has been translated into four languages, with more on the way. We need more multilateral efforts and collaborations like this one, and family therapy as an established field needs to hear much more and much more often about the ways practice must be adapted to meet country contexts across the globe.

A recent publication by Busse et al. (2021) described Treatnet Family (TF) as:

containing elements of evidence-based family therapy which has been developed specifically for adolescents with SUDs and their families in low resource settings. TF focuses on family interactions and uses elements of family therapy to interrupt ineffective communication within the family. It contains the key components of family therapy, such as:

positive reframing (i.e., positive labeling of a negative behavior without necessarily accepting it as fine. It involves emphasizing the possible positive intent behind a seemingly negative behavior),
positive relational reframing (i.e., positive labeling of a negative behavior in relationship to the family without necessarily accepting it as okay. Even when the behavior is self-destructive, the intent behind it can be understood and appreciated, yet not necessarily condoned).
perspective taking (i.e., developing empathy and the ability to take another person’s viewpoint into account).
relational questions (i.e., to support perspective taking, relational questions are asked [e.g., “When Narendra gets into trouble, who feels most sorry for him?”] in order to encourage perspective taking and relational thinking).
going with resistance (i.e., helping family members feel heard and understood, which reduces defensiveness and makes more productive conversations possible).

TF has six sessions, with each session lasting between 90 and 120 minutes. Each session is to be attended by the adolescent with SUDs and his/her family members because the primary focus of the sessions is on the relationships among family members. The practitioner’s role is to interrupt problematic cycles, ineffective communication, and harmful behaviors family members currently use to meet their emotional and interpersonal needs. As change in family interaction can influence each family member’s behavior, family members are encouraged to be part of the solution.” (p. 2)

For more on Treatnet Family: https://www.unodc.org/documents/southeasterneurope/UNODC_Treatnet_Family_brochure_190320.pdf

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