Describe your personal major learning points (aka “learning take-aways”) from this course.

M5 Content Guide 2 – Research, Outcomes, and Family Intervention
An
interesting fact is that family therapy evolved out of research in
which family interactions were observed, especially families with
members who had a serious mental disorder or substance use disorder.
Family interaction research was conducted at the Mental Research
Institute in Palo Alto, California in the late 1950s led by
anthropologist Gregory Bateson, with clinical practitioners Virginia
Satir, John Weakland, Don Jackson, Jay Haley, and Paul Watzlawick.
Peter Steinglass and his associates (1987) conducted studies observing
families who had an alcohol dependent member while at George Washington
University in Washington, DC. Murray Bowen at Georgetown University
observed families within an inpatient setting who had a member who had
schizophrenia. Others, including Wynne (1988), Boszormenyi-Nagy and
Framo (1985) and Lidz and Lidz (1949) were psychiatrists or
psychologists who initially began doing research with families with
members affected by schizophrenia. Only later did the above researchers
therapeutic methods.
The focus of these many family researchers ultimately shifted to
developing family therapy models and family interventions, but left
behind the importance of researching the methods. This led to diverse
ideas and theoretical concepts, at the expense of scientific research
that did not rigorously test these theories and strategies that could
explain family processes and facilitate therapeutic change. Such
research testing was essential for verifying the efficacy and safety of
various family interventions, yet was overlooked for some years.
As the marital and family therapy field has evolved, research and
research coursework has been integrated as a requirement of graduate
social work, mental health and family therapy programs. Research about
family therapy and theory now continues to expand due to the scholarly
work of faculty teaching in graduate programs. Research using the
scientific method is now a foundation of all family therapy theory and
the practices that are developed. A “good theory” is important as it
can explain family dynamics, it can make useful and specific
predictions, it can support which methods work best for certain
populations, the theory can be tested scientifically, and its utility
will be supported by ongoing research by independent researchers. Over
time, a good theory will evolve as new information is gained from
research and practice. However, too often the importance of research has
gotten lost and many practitioners dismiss its significance and
relevance to their own practice, thinking they know best what to do.
Family interventions and counseling in any form (individual, group,
family) should never be practiced based on conjecture, speculation,
one’s own personal experience, or based on clinical intuition- “it felt
like the right thing to do”. Sound clinical practice must be based on
well-grounded theory that has been scientifically validated or at least
has evolving scientific support from quality clinical research.
Practitioners also need to be able to articulate any theoretical model
with which they are using and be able to explain what they are doing and
why they are doing it. They also must know the limits of a model, draw
on clinical expertise, client feedback, and recognize when their chosen
methods are not effective.
Presently, Evidence-Based Treatment (EBT) models are prioritized in
therapy. These are models that have been validated and popularized by randomly-controlled trials
(RCTs). RCTs are studies in which individuals receive an experimental
treatment are compared with a control group- those receiving no
treatment or who receive some commonly used “standard treatment”. The
experimental treatment follows a specific protocol which is usually
manual-ized (uses step-by-step instructions for implementation) so
interventions are delivered consistently across populations, settings,
and practitioners. When the experimental group shows a statistically
significant response to the treatment as compared to the control group,
the treatment is considered to be “evidence-based.”
Another research approach is the use of Case Studies that
provide an in-depth examination of one or a few family intervention
cases where a specific theory and method was used. While this can be a
useful starting point to explore a given intervention method, it has
many limitations due to the lack of control for variables that affect
each case. Without controlling for these variables, it isn’t possible to
identify a direct cause-effect relationship between the intervention
and outcomes.
Cohort studies use a select group of families with similar
characteristics to explore whether the approach consistently shows
effectiveness in family participation, retention, and change, compared
to another group where these methods are not used.
Correlation studies are often used to identify whether a
systematic and strong relationship exists between two or more variables
that improve therapeutic outcome of families. Two examples of a
correlation study are:
-better outcomes for families who attend psycho-educational groups
along with family intervention sessions compared to for those who do
not.
-increased abstinence rates for clients who are engaged in individual
and family sessions vs those only attending individual and group
therapy.
For those who plan a career in human services, it is important to
gain understanding of basic statistics and basics of doing social
science research, so that one can at least read and develop some basic
analysis of family intervention research. Gathering feedback from
families and clients as to what was helpful and what was not helpful
should also not be under-estimated as to its importance to assess your
own effectiveness. This will help you learn to self evaluate your own
practice.
References:
Boszormenyi-Nagy, I., & Framo, J. (Eds.) (1985). Intensive family
therapy: Theoretical and practical aspects. 2nd Edition Brunner/Mazel
Lidz, R.W. & Lidz, T. (1949). “The family environment of
schizophrenic patients”, American Journal of Psychiatry, Vol. 106, 1949,
pp. 332–345.
Mental Research Institute. ( n.d.) About MRI. https://mri.org/about
Steinglass, P., Bennett, L.A., Wolin, S.J. & Reiss, D. (1987). The Alcoholic Family. Basic Books
Wynne L.C., Ryckoff L.M., Day J. & Hirsch, S. I. (1958): Pseudomutuality in the family relations
of schizophrenics. Psychiatry, 21:205-220

Wynne,
L. (Ed.) (1988). The State of the Art in Family Therapy Research :
Controversies and Recommendations. Family Process Press.

M5 Discussion- Indepth Reflection and Summary of Learning
In
this last discussion, carefully reflect upon the chapter readings,
content guides, discussions, quizzes, videos, the assignment, and
intervention models. Write and submit a short essay post of about 250
to 400 words and address all of the following steps:
Describe your personal major learning points (aka “learning
take-aways”) from this course. Include all significant concepts,
learning points, insights and realizations about families, family
dynamics, systems theory, family development cycles, intervention
models, how working with families differs from individual methods, etc.
Which concepts, models and theories about family intervention did you find especially of value?
Are there mistaken beliefs and misconceptions you once held about
families and family interventions that have changed as a result of this
course? Please describe what you originally thought and what has changed
for you?
How might you continue to apply what you have learned in future courses?
Specifically, how might you apply your new knowledge in your work and/or personal life?

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