Despite convincing outcome evidence and the popularity of family therapy, little is known about how interpersonal change actually comes about in this context. To synthesize and integrate what is known and to offer recommendations for future, clinically relevant research, all published process studies on family therapy were reviewed. Included were naturalistic studies of conjoint treatment in which the focus was the in-session verbal behavior of the participants or their self-reported perceptions of actual interactions. Dating from 1963, 36 studies met the inclusion criteria. The review was organized according to 3 hierarchically ordered levels of in-session processes (L. S. Greenberg, 1986): observations of (a) speech acts, followed by studies of (b) important incidents or change episodes and (c) the therapeutic relationship. The implications of what is "known" are followed by a discussion of what is not "known" and suggested directions for future research. Since the 1950s, when family therapy was considered an unusual, if not heretical, mode of treatment, its popularity has been rapidly accelerating. Family therapy is now routinely taught to students in all of the major mental health professions and to practitioners seeking to improve their skills in professional workshops, conferences, and free-standing training centers. The process of family treatment is described, debated, and analyzed not only in practice-oriented periodicals and books but also in wellrespected journals of psychotherapy research. Despite the ever-growing popularity of family therapy, little is known about how interpersonal change actually comes about in this context. One reason for this lack of knowledge may be because, to date, investigators have emphasized the global efficacy of family

What We Do and Don't Know About the Process of Family Therapy

This article presents a conceptual framework for family therapy process research that integrates a new process perspective with family systems theory. Consistent with a systemic epistemology, the framework focuses on the circular interaction, over time, between and within the therapist and family systems and their subsystems. Attacking the process--outcome distinction, the framework targets key variables and patterns in change processes that occur within and outside of sessions. The empirical implications of each framework component are explored. The article concludes with three methodological criteria for developing and evaluating certain research instruments to be used in process studies within the new conceptual framework.

A conceptual framework and methodological criteria for family therapy process research.

This article examines developments in empirical research in family therapy training since Kniskern and Gurman's (1979) review. It assesses present knowledge concerning training outcomes in marital and family therapy, evaluates research methodologies, and makes recommendations for future rearch.

Outcome research on family therapy training: a substantive and methodological review2

This article reports the development of a scale for evaluating family therapist skills. The scale includes ten items within each of five skill categories. All items were found to discriminate significantly between videotaped segments of effective and ineffective family therapist skills. Also all skill categories discriminated significantly between experienced and inexperienced family therapists. The interrater reliability and internal consistency of the categories were also judged to be acceptable. Suggestions are presented for uses of the scale in therapist training research.

A family therapist rating scale

This paper reports on a study of the therapy process of 63 initial interviews The purpose of the study was to determine if the therapists' use of executive and joining skills had an effect on whether families continued in therapy until family and therapist agreed on termination In addition, we tested for the effect of solution-focused interviewing We found that executive skills accounted for the majority of variance in outcome Family members' discussion of solution information was significantly correlated with outcome, but did not enter into the regression equation

Anatomy of an initial interview: The importance of joining and structuring skills

The Allred Interaction Analysis for Counselors is an instrument for systematically analyzing counselors' and clients' verbal behaviors. It was constructed to provide marriage and family counselors-in-training a method for acquiring meaningful, objective feedback on their counseling behaviors. The interrater reliability coefficients have been high. Results of validity studies have been encouraging. Though the instrument was initially designed from analysis of structured family counseling, research indicates it may have rather wide application for many different counseling approaches and settings.

The AIAC, A Design for Systematically Analyzing Marriage and Family Counseling: A Progress Report*

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G. Hugh Allred

Papers

The AIAC, A Design for Systematically Analyzing Marriage and Family Counseling: A Progress Report*

How To Make A Good Marriage Better