Since its inception, family therapy (FT) has been distinguished by its explicit theoretical and practical focus on families and relationships as systems, with an emphasis on second order rather than first order change. As a result of these conceptual underpinnings we suggest that FT needs to look for manifestations of change which differ from individually focused disciplines such as clinical psychology. Studies of second order change have most commonly appeared in the form of conceptual papers and doctoral dissertations. We begin by revisiting the conceptual underpinnings of second order change. Building on this framework, we develop these aspects of change within the framework of recent developments in the empirical study of change. Finally, we point towards some promising directions for further evaluative work of FT as well as ways to incorporate some of these principles into training of FT students.
Second order change and evidence-based practice
Un/imaginable future selves: A discourse analysis of in-patients’ talk about recovery from an ‘eating disorder’
Abstract
Background
The limited efficacy of treatments for eating disorders has been well documented. Yet few studies have explored patients’ views about recovery or how culturally dominant ideas might be implicated in recovery or failure to recover.
Aims
This paper explores how ‘self’, ‘eating disorders’ and ‘recovery’ are discursively constructed in patients’ accounts of their treatment experiences.
Method
Semi-structured interviews were conducted with 39 participants, hospitalised, either in Britain or Australia, for anorexia nervosa and/or bulimia. Participants were asked to discuss past and present treatment experiences and their views on their recovery and future. Interviews were audio-recorded, transcribed verbatim and analysed qualitatively using a discourse analytic methodology.
Results
Participants frequently construed their eating disorder in very negative ways whilst recovery was often positively construed as, for example, entailing happiness, freedom from fear and the ability to live a fuller life. However, many, though not all, participants also talked about recovery as hard or impossible to imagine for themselves.
Discussion
The paper explores how both the imagining and the seeming inability to imagine their own recovery can be understood in relation to participants’ self-constructions and to culturally dominant notions of personhood and eating disorders. The implications of the analysis for therapeutic interventions are discussed. Copyright © 2010 John Wiley & Sons, Ltd and Eating Disorders Association.
Foreclosure Crisis in Metro Atlanta
Publisher: Community Foundation for Greater Atlanta
Published: September 2010
Summarizes the impact of the foreclosure crisis on metropolitan Atlanta by county, lists potential solutions, and profiles area nonprofits focused on addressing the crisis and community development.
Funder(s): Community Foundation for Greater Atlanta
Subject(s): Community Improvement/Development; Community Improvement/Development, Affordable Housing; Public Affairs
Developing an observing attitude: an analysis of meditation diaries in an MBSR clinical trial
Abstract
Mindfulness-based stress reduction (MBSR) is an 8-week training that is designed to teach participants mindful awareness of the present moment. In randomized clinical trials (RCTs), MBSR has demonstrated efficacy in various conditions including reducing chronic pain-related distress and improving quality of life in healthy individuals. There have, however, been no qualitative studies investigating participants’ descriptions of changes experienced over multiple time points during the course of the programme. This qualitative study of an MBSR cohort (N = 8 healthy individuals) in a larger RCT examined participants’ daily diary descriptions of their home-practice experiences. The study used a two-part method, combining grounded theory with a close-ended coding approach. The grounded theory analysis revealed that during the trial, all participants, to varying degrees, described moments of distress related to practice; at the end of the course, all participants who completed the training demonstrated greater detail and clarity in their descriptions, improved affect, and the emergence of an observing self. The closed-ended coding schema, carried out to shed light on the development of an observing self, revealed that the emergence of an observing self was not related to the valence of participants’ experiential descriptions: even participants whose diaries contained predominantly negative characterizations of their experience throughout the trial were able, by the end of the trial, to demonstrate an observing, witnessing attitude towards their own distress. Progress in MBSR may rely less on the valence of participants’ experiences and more on the way participants describe and relate to their own inner experience. Copyright © 2010 John Wiley & Sons, Ltd.
Key Practitioner Message:
This article
• Analyses the ways in which participants in a mindfulness-based stress reduction (MBSR) clinical trial describe their experiences with mindfulness practice.
• Carries out qualitative analysis of the ways in which participants’ descriptions of home-based meditation practice contained in their practice diaries change over the course of an 8-week MBSR trial.
• Demonstrates that the participants who successfully completed the 8-week course show a common developmental trajectory, as each participant used less reactive, judgemental language to describe their home meditative practice-based experiences by the end of the trial, even when, in the case of some participants, that experience was perceived as negative or distressing.
• Suggests that progress in MBSR may rely less on the valence of participants’ experience and more on the way participants describe and relate to their own inner experience.
A friend in deed? can adolescent girls be taught to understand relational bullying?
Abstract
Relational aggression is common among girls. It can be distressing for the victim and may not always be recognised as a form of bullying. This paper evaluates a school–based intervention designed to help girls understand relational bullying. Girls from a single-sex school completed a two-stage evaluation of the intervention. Students showed greater awareness of relational bullying after the intervention and indicated that it would influence them to change their behaviour. At follow-up, retention of knowledge was good. Students reported greater self-monitoring of behaviour and less exclusivity. While this is encouraging, we cannot conclude that all negative behaviours ceased. Implications and limitations of this study are discussed. Copyright © 2010 John Wiley & Sons, Ltd.
Therapeutic collaboration: a conversation analysis of constructionist therapy
Collaboration has been a frequently used construct to describe the practices of different therapeutic approaches for working with clients. Missing, however, is a sense of how collaboration is enacted in dialogues between therapists and clients. After defining ‘collaboration’, we analyse the actual conversational practices of Karl Tomm in his work with a couple, using conversation analysis. Our aim is to highlight the conversational accomplishment of collaboration in observable ways that we feel may be linked to enhancing one’s conversational and collaborative practice of therapy.