Essential Skills in Family Therapy, Second Edition: From the First Interview to Termination » (2nd Edition)

JoEllen Patterson, PhD, is Professor of Marital and Family Therapy at the University of San Diego and Associate Clinical Professor in the Department of Family and Preventive Medicine and the Department of Psychiatry at the University of California, San Diego.

Lee Williams, PhD, is Professor of Marital and Family Therapy at the University of San Diego and does couple therapy with veterans at the VA San Diego Medical Center.

Todd M. Edwards, PhD, is Associate Professor and Director of the Marital and Family Therapy Program at the University of San Diego and Assistant Clinical Professor in the Department of Family and Preventive Medicine at the University of California, San Diego.

Larry Chamow, PhD, is Clinical Professor of Marital and Family Therapy at the University of San Diego and is in full-time private practice at the Pacific Family Institute in Carlsbad, California.

Claudia Grauf-Grounds, PhD, is Professor and Chair of Marriage and Family Therapy at Seattle Pacific University and a clinical faculty member at the University of Washington School of Medicine.

Readable and concise yet immensely informative, this bestselling text prepares students and new therapists to work confidently and effectively in real-world clinical practice with families. The authors offer wise and compassionate guidance on everything from intake and assessment to treatment planning, the nuts and bolts of specific interventions, the nuances of establishing therapeutic relationships, and how to troubleshoot when treatment gets “stuck.” They help the novice clinician navigate typical dilemmas and concerns, and spell out the basics of therapist self-care. Vivid case examples, sample forms, and quick-reference tables enhance the utility of the text.

New to This Edition

*Updated throughout to reflect current clinical findings and practices.

*Many new or revised case examples.

*Now more integrative—shows how to flexibly draw on multiple theories and techniques.

*New topics, including “Dealing with Clients We Dislike.”

Chapter 1 The Beginning Family Therapist: Taking On the Challenge 1

Getting Started 4

Managing Anxiety and Issues of Confidence 4

Stages of Therapist Development 6

Obsessing about Clinical Work 9

Dealing with Burnout 9

The Big Picture 11

Conclusion 11

Chapter 2 Before the Initial Interview 13

Dealing with Families' Expectations and Anxieties about Therapy 13

Suggestions for Initial Contact with the Client 15

What Information Should Be Obtained? 17

Who Should Come to Therapy? 18

Initial Hypothesizing 21

Conclusion 23

Chapter 3 The Initial Interview 24

Stages of the Initial Interview 24

Developing a Connection: How to Join with Clients 25

Handling Administrative Issues 27

Defining Client Expectations for Therapy 31

Building Motivation 36

Establishing Credibility 38

Conclusion: The First Session and Beyond 41

Chapter 4 Guidelines for Conducting Assessment 42

Initial Assessment 43

Potential Issues of Harm 46

Assessing for Substance Abuse 55

Assessing for Biological and Neurological Factors 58

General Psychosocial Assessment 63

Conclusion 76

Chapter 5 Developing a Treatment Focus 77

Developing a Treatment Plan 78

A Sample Treatment Plan 100

Variables That Impact Treatment 103

Conclusion 104

Chapter 6 Basic Treatment Skills and Interventions 105

The Rush to Intervention versus Developing a Relationship 105

Basic Counseling Skills 108

Interventions Unique to the Systemic Family Therapist 119

Becoming More Sophisticated in Using Interventions 122

Conclusion 123

Chapter 7 Working with Families and Children 125

Assessment of Child and Adolescent Disorders 126

Family Interventions When Children Are theClients 128

The Family Life Cycle Revisited 134

Variations in Family Development 151

Conclusion 159

Chapter 8 Working with Couples 160

Keys to Providing Solid Couple Therapy 161

Special Topics 173

When Couple Therapy Might Not Work 182

Conclusion 183

Chapter 9 When a Family Member Has a Mental Illness 184

Individual and Family Concepts 184

Individual Diagnosis in a Family Context 187

Depression 192

Anxiety 199

Alcoholism and Drug Abuse 204

Impulse Control Disorders 209

Conclusion 216

Chapter 10 Getting Unstuck in Therapy 217

Understanding Clients' Ambivalence about Change 218

The Therapist's Reluctance to Intervene 219

Therapist-Client Agenda and Timing Mismatch 220

Therapists' Lack of Theoretical Clarity 222

Supervision 223

Self-Supervision Questions 225

Doing a Literature Search 226

Dealing with Cancellations and No-Shows 229

Difficulty Getting Other Family Members to Therapy 231

Handling Secrets 232

How Agencies Contribute to Being Stuck 233

Countertransference: How Therapist Issues Interfere 236

Dealing with Clients We Dislike 238

Conclusion: A Final Reminder 240

Chapter 11 Termination 241

Mutual Terminations 242

Therapist Terminations 246

Client Terminations 249

Conclusion 250

Chapter 12 Family Therapy in the Future: Pertinent Issues for Beginning Clinicians 251

Healthcare Reform: Implications for You and Your Clients 252

Emerging Trends in Treatment 256

The Personal and Professional Journey of Being a Therapist 262

Conclusion 264

References 265

Index 279