The Effectiveness of Family Therapy
In effort to explore the framework of family and modify behaviors and communications concerning relatives, family therapy may be applied (Nichols, 2010). This enables each person to favorably transition, “therefore, improvement can be lasting because each family member is changed and continues to exert synchronous change on each other” (Nichols, 2010, p. 6). Hence, among clinicians, family therapy has been practiced, researched, and addressed. More specifically, various articles such as T.L. Campbell’s, Effectiveness of family therapy, validate the effectiveness of familial treatment particularly in response to the demand of healthcare-insurance companies and governments. These entities established the need of evidence-based healthcare as illustrated within the commentary (Campbell, 1997). The following summarizes the article, analyzes the results, discusses problematic issues associated with the methodology, and features the applicable benefits to clients. Furthermore, additional sources are utilized to support these findings.
From the aforementioned article, the author provides an overview of the American Association of Marriage and Family Therapy (AAMFT) publication, Journal of Marriage and Family Therapy (JMFT). This special edition examined several articles and provided substantial evidence of the effectiveness of the treatment. Campbell, along with other clinical researchers, was granted the opportunity to assess these empirical texts and studies enveloping an extensive range of disorders and familial issues. Subsequent to these deliberations, he composed a compilation of reviews for each study which consisted of various components and incidents within the arena of family therapeutic processes. The first review illustrated the utilization of a meta-analysis. Clinicians from the University of Memphis observed 163 cases of family or marital family. The foremost evidence concluded that individuals that received marriage and family therapy (MFT) were more functional than untreated individuals in the control group. This was proven in nearly 67% of these instances. Additionally, marital therapy was slightly more effective than family therapy, yet at an insignificant rate. These methodologies have also proven to be more cost effective than conventional means. However, there were problems associated with the study. First, these findings are dated prior to 1988, hence questioning current applicability and relevance. Next, examining marital and family therapy as a solution to all problems is too broad of a range to proficiently consider. Although this methodology is useful, practitioners must determine which conditions and disorders require such application as opposed to other techniques (Campbell, 1997).
The second article Campbell referenced
examined the effectiveness of family therapy in the treatment of schizophrenic
disorders. Campbell considered that “here is where
the value and superiority of family therapy is most evident. This field is the Cadillac of family therapy
outcome research” (Campbell,
1997). In effort to inspect such
phenomenon, M.J. Goldstein and D.J. Miklowitz utilized two generations of
conclusive research. The first
generation employed six random assessments which evaluated family
psycho-educational programs in comparison to conventional means. These findings indicated a decline in relapse
from 40-50% to 10% or less, thus supporting the notion that family
psycho-education should be a standard technique utilized to treat
schizophrenia. The second generation of
investigations compared varying family psycho-educational methods. The most prevalent conclusion of this portion
of the study was the fact that multifamily psycho-education was deemed more
efficient and cost effective than individual family psycho-education. However, attendance and participation are
vital to the success of such treatment. Other
concerns associated with this research involve the relevance of family therapy
in regard to issues excluding schizophrenic disorders. Yet, Goldstein and Miklowitz determined that
all family interventions involving other disorders would benefit from such
research (Campbell,
1997).
The third
article in review addressed family and marital therapy in terms of
depression. It begins with the
perception that although mediation and psychotherapy are effective means of
treating depression, overall results are unfavorable. Hence, practitioners may take an
interpersonal approach employing familial tactics. More specifically, researchers examined the
link between family distress and marital disputes as causes of depression. It was determined that marital therapy was as
effective as individual therapy, and increased martial satisfaction. Again, it was considered cost effective as
well. Nevertheless, it was proven that
this methodology was less effective than individual therapy for patients
experiencing severe depression and relapse rates were constant. Overall, these findings indicate that marital
therapy in particular should be employed if the client is experiencing marital
distress and conflict. Moreover, marital
therapy grants a 60% probability of improvement as opposed to those untreated,
with 40% of those describing the relationship as non-distressed following
treatment. However, as with
schizophrenia, those afflicted with extreme depression should seek
pharmacological treatment in conjunction with family and marital therapy (Campbell, 1997).
From one
of the remaining articles in Campbell’s
review, the focal point regarded family therapy provided for children with
behavioral disorders and delinquency.
The article illustrated a family intervention method, parent management
training (PMT), in relation to conduct disorders (CD), attention-deficit
hyperactivity disorder (ADHD), anxiety disorders, and autism. Overall, PMT was proven to be an effective
means of treating conduct disorders, autism, and anxiety. Those with conduct disorders and autism
achieved favorable long terms effects.
In addition, families with autistic children improved parenting skills,
child behavior, and quality of life.
However, PMT poses several problems or complications as follows: (a)
conduct disorders are adversely affected by marital discord requiring
additional implementation of marital therapy, (b) although PMT improves parenting skills and
noncompliance, decreasing aggression of those with children diagnosed with
ADHD, it has no affect on the symptoms associated with the disorder, (c) in
terms of anxiety disorders, it is difficult to determine methodological
conclusions (Campbell, 1997).
An
additional source in support of the aforementioned conclusions explores the effectiveness
of functional family therapy (FFT) in comparison to juvenile probation. Practitioners utilized the juvenile justice
system of a large western state consisting of juvenile offenders. The subjects were randomly selected to
participate in the FFT program or receive standard probation. The participants included 38 therapists and
917 families across 14 counties. After
12 months post-treatment both groups were compared utilizing a risk assessment
consisting of 100 interview items in regard to criminal history, school
participation, use of free time, employment, peer relations, family, alcohol,
and drug history, mental health, attitude, and social skills. The results indicated that in general, FTT
effectively reduced behavioral problems among juveniles with high adherent
therapists achieving greater reductions than therapists exhibiting low
adherence. Juveniles receiving treatment
from high adherence therapists showed a reduction of 35% in felonies, 30% in violent
crime, and 21% in misdemeanors as opposed to those receiving standard
probation. Hence, family therapy was
more beneficial than conventional probation (Sexton & Turner, 2011).
Similarly,
a study concerning the effectiveness of couple and family therapy (CFT)
considered the methodology as advantageous and in many instances superior to
alternative means depending upon applicability to the disorder or issue in
question. Furthermore, “this means that
in comparison to no treatment controls, patients receiving virtually any type
of couple or family therapy do significantly (in the statistical sense) better
at termination and at follow-up” (Pinsof, Wynne, & Hambright, 1996). In effort to support these conclusions,
researchers examined 71 studies in which CFT patients were compared to
untreated individuals. The results
indicated a 51% differential between their outcomes (Pinsof, Wynne, &
Hambright, 1996).
Despite
these indications, problems or concerns associated with family therapy are:
(a) the need to further enhance research effectiveness, (b)
attain the ability to focus on
specific disorders and issues, (c) improve defining,
operating, and measuring of data and terms, (d) target cost effectiveness, (e)
provide long term treatment to determine the duration of the outcome, and (f)
address gender, sexual orientation, and culture (Pinsof, Wynne, &
Hambright, 1996).
In
conclusion, family therapy is a beneficial methodology employed to assist individuals
experiencing family issues (Nichols, 2010).
These situations are inclusive of mental disorders, physical handicaps,
obstructed communication, rebellion, juvenile delinquency, marital issues, or
death. Each of these circumstances may profit
from the application of this technique (Campbell,
1997). Family therapy empowers each
member to adjust their behavior and consequently encourage positive change in
others. This fusion enhances the ability
of family to maintain such positive developments over time (Nichols, 2010). It has been repeatedly proven that such
measures are significantly more effective than the lack of treatment. Furthermore, depending upon the issue, family
therapy may supersede alternative resolution tactics. Despite certain concerns, when adequately
applied this methodology is quite effective (Pinsof, Wynne, & Hambright,
1996).
References:
Campbell, T.L. (1997). Research reports:
Effectiveness of family therapy. Families,
Systems, &
Health, 15, 123-129.
Estrada, A.U., &
Pinsof, W.M. (1995). The effectiveness of family therapies for selected
behavioral disorders of childhood. Journal of Marital and Family Therapy, 27, 403-440.
Goldstein, M.J., & Miklowitz, D.J. (1995).
The effectiveness of psychoeducational family
therapy in the treatment of schizophrenic
disorders. Journal of Marital and Family
Therapy, 21, 361-376.
Nichols, M. P. (2010). Family
therapy: Concepts and methods (9th ed.). Boston: Allyn & Bacon.
Pinsof, W.M., Wynne, L.C., &
Hambright, A.B. (1996). The outcomes of couple and family
therapy:
Findings, conclusions, and recommendations. Psychotherapy,
33(2), 321-331.
Prince, S.E., & Jacobson, N.S.
(1995). A review and evaluation of marital and family therapies
for affective disorders. Journal of Marital and Family Therapy, 27, 377-401.
Sexton, T. & Turner, C.W. (2011). The
effectiveness of functional family therapy for youth with
behavioral
problems in a community practice setting. Couple
and Family Psychology:
Research and practice, 1, 3-15.
Shadish, W.R., Ragsdale, K., Glaser, R.R.,
& Montgomery,
L.M. (1995). The efficacy and
effectiveness of marital and family therapy:
A perspective from meta-analysis. Journal of
Marital and Family Therapy, 27, 345-360.
