Supervisor multicultural competence and its relation to supervisory process and outcome

This study investigated the direct and indirect effects of marriage and family therapy trainees' perceptions of their supervisors' multicultural competence in supervision on the supervisory working alliance, trainees' multicultural competence (case conceptualization abilities in etiology and treatment), and perceived supervision satisfaction. Path analyses revealed supervisor multicultural competence to be positively associated with supervisory working alliance and perceived supervision satisfaction. In addition, supervisor multicultural competence seemed to have a negative effect on trainee etiology conceptualization abilities. Finally, results suggested supervisory working alliance to be a significant mediator in the relationship between supervisor multicultural competence and supervision satisfaction. Findings are discussed within the context of theoretical, empirical, and practical implications for multicultural supervision.

Textual representations of diversity in COAMFTE accredited doctoral programs

The use of the Internet is growing at a staggering pace. One significant use of the Internet is for potential students and the parents of potential students to explore educational possibilities. Along these lines potential marriage and family therapy students may have many questions that include a program's commitment to cultural diversity. This study utilized qualitative content analysis methodology in combination with critical race theory to examine how Commission On Accreditation for Marriage and Family Therapy Education (COAMFTE) accredited doctoral programs represented cultural text on their World Wide Web pages. Findings indicate that many COAMFTE-accredited doctoral programs re-present programmatic information about diversity that appear to be incongruent with cultural sensitivity. These apparent incongruities are highlighted by the codification, inconsistent, and isolated use of cultural text. In addition, cultural text related to social justice was absent. Implications and suggestions are discussed.

Marriage and family therapist interns' experiences of growth

Few studies have investigated therapist interns' growth experiences, both personal and professional, and the interplay between them. This qualitative study explored the reciprocal process of growth during clinical training: the personal life experiences that affect professional growth and the professional/clinical experiences that affect personal growth. Thirteen marriage and family therapist interns, using Internet discussion formats, identified numerous personal, clinical, and professional growth experiences. Implications of this study, illustrating the recursive and interactive flow between therapists' personal and professional growth, are presented.

Practicing as a postmodern supervisor

In this article, aspects of postmodern supervision are explored that highlight the blurring of boundaries that occurs between the multiple roles performed by supervisors. An approach to supervision is detailed that shows how a supervisor who navigates between roles can assist supervisees in constructing identities congruent with the stories they tell about themselves as successful therapists. Six of the many possible roles that supervisors play are illustrated through dialogue taken from a group supervision session. In the last part of this article, concepts that inform a postmodern approach to supervision, borrowed from the literature on narrative and constructionist therapy, are discussed.

Multiracial recruitment in the field of family therapy: an innovative training program for people of color

This article describes the creation of a training program designed to increase the number of family therapists of color in the family therapy field. In 1992, a partnership between New York City schools of social work, community agencies, and the Ackerman Institute for the Family created the Diversity and Social Work Training Program. Elements critical to the program's success were recruitment strategies, mentorships, partnerships with outside organizations, provision of a long-term institutional commitment, biracial collaborations, and institutional change. This article describes the design, structure, and process of this program's evolution and its impact 12 years later.

Family systems training in psychiatric residencies

Both extensive research and common sense dictate that attention to families is necessary for appropriate care of psychiatric patients. However, training in family skills has often been difficult to integrate into psychiatric residency programs because of conflicting paradigms, turf battles, constraints of time and money, and confusion over whether family-centered care or family therapy should be taught. Current changes in residency accreditation mandate that family skills (not necessarily family therapy in its sophisticated form) be part of all residency programs. This article reviews the history of systems training in residencies, current accreditation requirements, and the GAP proposal for family systems skills, knowledge, and attitudes that that are teachable within the limited time available to residents. The application of these core skills is described using a case example and formulation. Challenges in teaching and ways of overcoming programmatic constraints are outlined.

Systemic training for healthcare professionals: the Chicago Center For Family Health approach

There has been increasing interest in family-centered, collaborative, biopsychosocial models of care by health and mental health professionals and consumers. This trend has led to growing demand and development of specialized training in family systems approaches to health care. This article describes the Families, Illness, and Collaborative Healthcare programs developed at the University of Chicago affiliate, the Chicago Center for Family Health. The program philosophy is guided by the following principles: a systems orientation focused on the family, a Family Systems Illness Model, a family resilience framework, a family-centered collaborative model of health care, and a social justice and advocacy orientation. Specific training components that implement these principles are described, including intensive certificate and fellowships; workshops, conferences, and institutes; and consultation and training services for community-based organizations. Discussion includes professional networking opportunities, funding challenges, and policy recommendations.

The state of the art of training in systemic family therapy in Switzerland

This article presents a training program in systemic therapy with families and couples. Our training institute was founded by an interdisciplinary group of psychologists, psychiatrists, sociologists, and social workers in 1987 in Meilen (Zürich), Switzerland, and has from the beginning been connected to the field of family therapy in Europe and the United States. The specific organization of our institute, our training program, and the theoretical base of the training concept are highlighted. Our multidimensional treatment and training model is grounded in a variety of conceptual frameworks and inspired by the tradition of Enlightenment in European philosophy. We pay special attention to the personal and professional development of the emerging family therapist.

Training in family psychology: a competencies-based approach

After providing an overview of the family psychology landscape and the competencies-based movement in professional psychology, attention is paid to eight family-specific competencies in the following areas: the application of scientific knowledge to practice, psychological assessment, psychological intervention, consultation and interprofessional collaboration, supervision, professional development, ethics and legal issues, and individual and cultural diversity. Effective strategies for providing family-focused education and training to psychology trainees at the doctoral, internship, and postdoctoral levels and to psychologists through continuing professional education in these core competency domains are provided.

Challenges of an outcome-based perspective for marriage and family therapy education

Marriage and family therapy (MFT) and marriage and family therapy education (MFTE) have undergone many changes during the short history of MFT. This article describes the current trends and controversies in MFTE, including shifts toward outcome-based education (OBE). We present recommendations for MFTE, including the move toward OBE, the development of core competencies of MFT, attention to interdisciplinary issues, and recognition of the need for both foundational education and encouragement of trainees' unique styles and approaches.

It was the best of times, it was the worst of times: doctoral students' experiences of family therapy research training through alternative forms of data representation

In this study, we interviewed 14 doctoral students from 10 COAMFTE-accredited doctoral programs to learn more about how they experienced their research training and what they might suggest to strengthen the research culture in their training programs. We solicited somewhat unconventional data--metaphors, poetry, free associations, critical experiences--to (a) tap into our participants' underlying thought processes, (b) capture the multifaceted nature of their doctoral research training, and (c) represent the richness of our participants' subjective experiences. The themes we identified reflect both positive and negative research training experiences and suggest several ways that family therapy program faculty might improve their programs' research training and culture.

Implementing family intervention following training: what can the matter be?

Family interventions (FI) have been established as an effective treatment for psychosis. Training in this intervention is now widely available in the UK. This paper reports a review of published literature that investigates whether, following this training, graduates provide this evidence-based treatment for individuals with psychosis and their caregivers. It further seeks to identify the barriers to implementation in cases where the treatment is not provided and assess benefits for service users and carers when it is. The review was conducted using the MEDline, PsycINFO, CINAHL and Embase databases. Studies that have attempted to evaluate the rates of implementation of FI by graduates of FI training programmes were identified, retrieved and reviewed. Six studies investigating the rates of implementation upon graduation were identified. The findings of these six studies were generally consistent. Rates of implementation by graduates of training programmes are usually low and a small number of graduates work with most of the families who are seen. The studies reviewed failed to assess service user and carer outcomes or consider the full range of likely impediments to the implementation of this evidence-based intervention. A key barrier to the implementation of FI is the reliance upon professionally developed and facilitated approaches. Alternative models that are service user and carer-led may provide a potential solution to the problem of implementation. Implications for future research and practice are considered.

Overcoming bias toward same-sex couples: a case study from inside an MFT ethics classroom

This article illustrates a teaching case in which a marriage and family therapy (MFT) trainee learned to develop cultural sensitivity toward same-sex couples despite religious beliefs that put her at risk of discriminating against that population. The case took place during a marriage and family therapy ethics course in the spring of 2003. From two first-person perspectives, the authors illustrate the processes that facilitated the student's change, addressing the class activities, discussions, and pivotal moments of teaching and learning that promoted the student's cultural competency and helped her to resolve this personal and ethical dilemma. A set of classroom techniques (creating a safe environment, using a stance of curiosity, finding alternative learning formats, extrapolating ideas from multiple sources, and capitalizing on students' experiences outside of class) used in the case are detailed throughout the article.

Co-constructing a cross-cultural course: resisting and replicating colonizing practices

This article examines the cross-cultural complexities of teaching and learning processes at different levels in a family therapy training program delivered in a different country. It presents two interlinked narratives of an advanced family therapy training program delivered in Slovenia by a U.K-based family therapy training institute. The context in which the training was negotiated and planned is discussed, highlighting issues at the macrosystemic level. Dilemmas that arose in relation to differing beliefs about teaching and learning are elaborated. We examine power relationships, ways that we positioned ourselves and each other, and how we tried and sometimes failed to take these into account. We question how the issue of spoken language and its meanings creates its own constraints and power structures, and how we respond to the impossibilities of translation. We argue that it is through the examination of uncomfortable processes that we develop self-reflexivity and work toward more equitable relationships.

Publication patterns of faculty in commision on accreditation for marriage and family therapy education programs

Journal articles published by faculty in Commission on Accreditation for Marriage and Family Therapy Education (COAMFTE) programs from 1998 to 2002 were analyzed to determine patterns regarding the amount and type of research conducted by this group. Fifty-eight percent of the articles were identified as research. Slightly more than 10% of these dealt with clinical processes and outcomes. Forty percent of studies reported a specific source of funding. Twenty-nine percent of research articles used qualitative methods, with percentages rising over the course of time. Results suggest the average number of publications per faculty member was relatively low, particularly for senior faculty. Implications for these findings are discussed.

Integrating research and clinical training in marriage and family therapy training programs

The future of the profession and practice of marriage and family therapy (MFT) rests with those who promote the integration of research and clinical practice. The Boulder scientist-practitioner model is useful in conceptualizing MFT training, but it is not the perfect solution. Four MFT programs (two master's and two doctoral) are featured in this article for their work in integrating research and practice. Helpful strategies presented include: Encouraging students to question the therapy process; integrating research in the curriculum and supervision; discussing the positives and negatives of empirically supported treatments; focusing on change; and developing creative classroom experiences to use within the scientist-practitioner model.

Studying marriage and family therapists in the 21st century: methodological and technological issues

In this article, I present data from two waves of research on demographic characteristics and practice patterns of marriage and family therapists (MFTs) conducted in 2000 and 2002. The research focuses on the methodological and technological issues in studying this population. Specifically, an online survey with MFTs obtained lower response rates and was therefore more expensive relative to phone and mail methods. Questions about evidence-based therapies (EBTs) were asked two different ways with significantly different results based on how the questions were phrased. A discussion of the relative advantages and disadvantages of using different survey methodologies and consideration of issues pertinent to studying EBTs are included.

Using psychosocial interventions within a high-security hospital

Psychosocial interventions have been used for many years in caring for people with mental health problems. The few interventions that have a recognised evidence base are cognitive behavioural therapy (CBT), family interventions, and education programmes for patients and carers. The process of implementing these interventions in a forensic setting will be described and recommendations will be made for future practice.

Student-faculty perceptions of multicultural training in accredited marriage and family therapy programs in relation to students' self-reported competence

Although the marriage and family therapy field's recent attention to multicultural issues is laudable, there appears to be little clarity on what constitutes an effective multicultural training program and the impact of the effects of such training on trainee multicultural competence. The field continues to be challenged at different levels-training, practice, research, the setting of the standards and the work of the Commission on Accreditation for Marriage and Family Therapy Education, and the goals and strategic plan of the American Association for Marriage and Family Therapy Board. This study focused on assessing the extent of multicultural integration at different levels of training and the relationship between such training and students' perception of their own multicultural competence.

Evidence-based practice for marriage and family therapists

The purpose of this article is to integrate science into clinical practice by introducing marriage and family therapists to the ideas of evidence-based practice (EBP). Evidence-based practice, which originated in the medical field, refers to the process of using research to make clinical decisions that best meet the needs of each client. Included in the description is a brief history of EBPs and ideas about learning EBPs. Suggestions are also made about the use of EBPs in MFT training programs, and resources are provided to enable clinicians to use EBPs in clinical practice.

Family intervention in routine practice: it is possible!

Family Intervention for individuals with schizophrenia has a wealth of evidence to attest its efficacy. However, there is little literature available about actual family work services, what they consist of and how they operate. With the publication of the National Institute for Clinical Excellence guidelines for schizophrenia in 2002, there is increased pressure on mental health services to deliver evidence-based Family Interventions to individuals with schizophrenia and their families. This article will outline how a specialist mental health Trust have been able to successfully establish and implement a designated Family Intervention service into routine practice.

Toward Effective Quality Assurance in Evidence-Based Practice: Links Between Expert Consultation, Therapist Fidelity, and Child Outcomes

This study validated a measure of expert clinical consultation and examined the association between consultation, therapist adherence, and youth outcomes in community-based settings. Consultant adherence to the multisystemic therapy (MST) consultation protocol was assessed through therapist reports, and therapist adherence to MST principles was assessed through caregiver reports in 2 samples of families (N1 = 178, N2 = 274) and therapists (N1 = 87, N2 = 162). Caregiver reports of youth behavior and functioning were obtained in the second sample pre- and posttreatment. Random effects regression models demonstrated associations between consultant behavior, therapist adherence, and posttreatment youth behavior problems and functioning. Instrumental aspects of consultation supported therapist adherence and improved youth outcomes; supportive aspects of consultation were negatively associated with adherence and outcomes. These findings suggest the availability to clinicians of expert consultation can impact clinician fidelity to a treatment model and child outcomes.

Trends in family therapy supervision: the past 25 years and into the future

This investigation repeats a survey of American Association for Marriage and Family Therapy (AAMFT) Approved Supervisors done in 1976 and 1986. Despite negative contemporary contextual influences, the AAMFT Approved Supervisor credential is still attractive to the same percentage of the AAMFT clinical membership as formerly and reflects in general the demographic characteristics of marriage and family therapists (MFTs) in clinical practice. Across the last quarter century there has been a steady increase in female AAMFT Approved Supervisors and those with terminal master's degrees. These and other trends are discussed with a view toward what supervision is becoming and what it needs to become.

Student impairment and remediation in accredited marriage and family therapy programs

This research addresses the extent of student impairment in Commission on Accreditation for Marriage and Family Therapy Education (COAMFTE) accredited marriage and family therapy programs, indicators of impairment used by program directors, faculty time devoted to impaired students, and the frequency of student dismissal. The data come from a survey of 44 COAMFTE program directors that was conducted during the spring of 2001, as well as responses to an open-ended items asking for a description of "the most troublesome student" to come to the attention of the respondent. The authors discuss the findings with respect to similar studies in counseling psychology and the larger literature on clinical training. Finally, the authors offer suggestions for future research.