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Acad Psychiatry 32:405-413, September-October 2008
doi: 10.1176/appi.ap.32.5.405
© 2008 Academic Psychiatry
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* Child/Adolescent Psychiatry
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Reinventing Family Therapy: Teaching Family Intervention as a New Treatment Modality

Allan M. Josephson, M.D.

Received May 15, 2007; revised August 31, 2007; accepted November 14, 2007. Dr. Josephson is Professor and Chief of the Division of Child and Adolescent Psychiatry at the University of Louisville. Address correspondence to Allan M. Josephson, M.D., Bingham Clinic, 200 E. Chestnut St., Louisville, KY 40202; allan.josephson{at}louisville.edu (e-mail).

OBJECTIVE: This article discusses the pedagogy of teaching family therapy in the new millennium. It draws on the strengths of "family systems therapy" but goes beyond it—suggesting a new paradigm, new terminology, and a new teaching perspective. It discusses the historical background of family therapy training, a scientific foundation for what residents should be taught, and an integrative clinical model for how it could be taught. METHODS: The article is the synthesis of the perspectives and experience of a child and adolescent psychiatrist educator who began his career at the end of the systemic era in psychiatry and continues it through the developments of the neurobiologic era. It draws on selected literature from the fields of family therapy, child and adolescent psychiatry, developmental psychopathology, and general psychiatry. RESULTS: This article submits that the term "family therapy" should be replaced by the term "family intervention"; the evidence base indicates that family interventions are effective; family risk and protective factors influence the onset and course of disorders; families help shape and maintain cognitive schema; intervention must start with thorough case formulation; and family interventions should be coordinated with other interventions, include parent management training, and build on family strengths. CONCLUSION: Family intervention is an important clinical process in child and adolescent psychiatry, and contemporary education must address the multiple ways clinicians can assist families. Future models will be successful to the degree they build on the past contributions of systems thinking and include the perspectives of developmental psychopathology. Contemporary education should teach that family interventions are not optional but ideally can be integrated with other interventions in a sequential manner, emphasizing the interrelationship between self and system.




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E. Beresin
Innovation and Inspiration in Child and Adolescent Psychiatric Education
Acad Psychiatry, September 1, 2008; 32(5): 346 - 349.
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