Systemic Family Practice – Dr Judith Lask


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Systemic Family Practice – Dr Judith Lask

  1. 1. Systemic Family Practice Judith Lask. SFT Curriculum Group
  2. 2. Child and Family
  3. 3. What do we mean by family?
  4. 4. 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
  5. 5. Working with families essential part of CAMHS but not always done by trained professionals.
  6. 6. 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.
  7. 7. 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.
  8. 8. 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. 
  9. 9. Challenges in drawing up the curriculum To provide a theoretical foundation Develop understanding of ethics and working with difference Develop skill level to work confidently with day to day work Base on evidence Integrate with CYP IAPT principles
  10. 10. Curriculum consists of Depression and Self harm Basic module plus Or Conduct disorder or Eating Disorders
  11. 11. Who can do the training? CAMHS workers with 1. Prior relevant professional training 2. Ability to study at a postgraduate level 3. Experience of working in CAMHS 4. Some experience of working with families 5. Opportunities to carry out required supervised clinical practice. Some professionals who have already done an intermediate level training may benefit from the specialist modules. 
  12. 12. What will Students Learn: Basic Module         Theoretical underpinnings – a range of frameworks including behavioral, structural, transgenerational, 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
  13. 13. 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.
  14. 14. 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.
  15. 15. 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, str ucturing treatment etc.  Interventions that are most useful in working with these groups.
  16. 16. 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
  17. 17. 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.
  18. 18. 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)
  19. 19. Some wider reverberations
  20. 20. 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
  21. 21. 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.