Systemic Family PracticeJudith Lask.SFT Curriculum Group

Child and Family

What do we mean by family?

Family may be Crucial resource for helping a child Family events may predispose or

precipitate a problem Families may inadvertently maintain a

problem important source of information Affected by a child’s problem. Supporter of other interventions

Working with families essential part of CAMHS but not always done by trained professionals.

Systemic Family Practice in CYP-IAPT Has joined CBT, parent training and IPT

as evidence based approaches supported by training.

Specific focus on SFP for conduct disorder, depression and self harm, and eating disorders

Aim to improve services by “skilling up” CAMHS professionals to work more effectively with Families.

Systemic Family Practice and Systemic Family Therapy SFP is based on the same theoretical

and evidence base as SFT but denotes an intermediate level of training. Systemic Family Therapists will have another 2 years of training and be equipped to deal with the most challenging work and to move more flexibly across age range and presentations.

SFP Curriculum Group Chaired by Peter Fonagy Membership drawn from researchers and

practitioners in the field especially those connected with the main sources of evidence.

Eia Asen, Paula Boston. Charlotte Burke, David Cotterell, Ivan Eisler, Judith Lask, Barbara Mackay, Mark Rivett, Tom Sexton From the beginning supported by the

Association for Family Therapy whose aim is to support skilled and effective work with families.

Challenges in drawing up the curriculum

To provide a theoretical foundation

Base on evidence

Integrate with CYP IAPT principles

Develop skill level to work confidently

with day to day work

Develop understanding of

ethics and working with difference

Curriculum consists of

Basic module plus

Depression and Self

harmOr

Conduct disorder

orEating

Disorders

Who can do the training? CAMHS workers with1. Prior relevant professional training2. Ability to study at a postgraduate level3. Experience of working in CAMHS4. Some experience of working with families5. Opportunities to carry out required

supervised clinical practice.Some professionals who have already done an intermediate level training may benefit from the specialist modules.

What will Students Learn: Basic Module Theoretical underpinnings – a range of frameworks

including behavioral, structural, trans-generational, communication, narrative.

How to maintain effective engagement and collaborative therapeutic relationship

How to assess and formulate family in relation to presenting problem

How to work ethically with difference. Planning work and basic interventions Thinking of self in relation to work Family work in context of other interventions. Using formal and informal feedback

Specialist Module:Depression and Self Harm To make an assessment an formulation Understand developmental issues ,risk issues and make

an effective assessment and formulation. Engage with the family around the young person Help family to create safety around their young person Encourage non-blaming explanations Help family understand self harm as a communication Help family to engage in discussions around emotions Help identify patterns in order to decrease liklihood of self

harm To use questions and direct interventions in family to

enhance understanding decrease risk.

Specialist module in Conduct disorder

Engaging and motivating young people and families Building pro-social, family based behavioural skills that fit the family

and alleviate the presenting problems Generalize treatment and prevent subsequent relapse Manage complex clinical situations whilst retaining a relational SFT

focus Identify the relational processes that maintain or precipitate conduct

disorders Demonstrate the ability to apply relational formulation in conduct

disorders Be able to create shared relational treatment goals with families Monitor progress to agreed goals collaboratively Demonstrate cultural competence in SFT for conduct disorders

(including the use of interpreters) Use behavioral and structural interventions to help families to manage

their child.

Specialist Module in Eating Disorders This is a double (30 credit) module Applicants must work in a specialist eating

disorder unit and meet particular criteria. Includes work with Anorexia and Bulimia ,

multi family groups, running a family meal as well as assessment, formulation, engagement, structuring treatment etc.

Interventions that are most useful in working with these groups.

How will clients benefit Greater expertise in engaging with all family members Interventions that take into account different perspectives of

family members Greater appreciation of family culture, aspirations and strengths Enhanced collaboration with family to help referred young

person. Support and help in making necessary changes Undertanding of external and internal constraints to making

changes. Appreciation of the place of family in wider community and

network of professionals.

Availability of family focused, evidence based interventions which have specific applicability to presenting problem

Pathway to further training The Systemic Family practice curriculum

has been designed so that successful candidates should be able to enter the final 2 years of family therapy training leading to registration with UKCP.

Supervised practice There is a strong emphasis well

supervised practice by supervisors who are ideally registered with AFT as systemic supervisors as well as completing the CYP-IAPT supervision training.

Practice will be undertaken with a general caseload as well as specialist caseload (a minimum of 60 hours of supervised practice)

Some wider reverberations

Recursive process CYP IAPT developments have influenced AFT in

revising training standards Systemic Practitioners and therapist are becoming

more familiar and comfortable with ROMS The flexibility and adaptation which is a strength

of systemic work is being complemented by a greater understanding of the need for more specificity when working with particular presentations

Impact of learning from other modalities, working together, supervision, common factors, difference

The inclusion of Systemic Family Practice will hopefully bring More understanding of the importance of family and wider

context Understanding of the importance of a good, collaborative

therapeutic relationship with family Understanding of complex ethical issues in working with families More appreciation of culture and working with power in relation

to marginalized groups Need to adapt interventions to fit with presenting families and

be able to work in the here and now, with perceptions and with history

Importance of working with family as a resource and identifying and building on strengths.

The important connections between beliefs, behaviors, emotions and relationships.