Clinical Competencies Specific to Family-Based Therapy
Stinchfield, Tracy Anne, Counselor Education and Supervision
Research has indicated that traditional office-based family therapy services are not always effective with at-risk families and that there is an increasing trend toward home-based delivered services (W. Snyder & E. McCollum, 1999). In this qualitative study, the author explored experienced home-based family therapists' perceptions of the competencies most salient to the provision of family-based therapy. Several themes emerged from this study. The author presents 2 central themes: joining--including joining with the family, the family's community, and school personnel--and bridging the gap between academia and current community-based programs.
Counselor educators' primary responsibility is preparing students to be future counselors. Part of a counseling student's developmental process is gaining the skills and knowledge necessary to provide ethically sound counseling to future clients. One of counselor educators' roles is clinical supervisor to counselor trainees. In providing supervision, the ethical guidelines established by the Association for Counselor Education and Supervision state that the "knowledge and skills conveyed should reflect current practice, research findings, and available resources" (as cited in Bernard & Goodyear, 1998, p. 308). In this qualitative study, I explored the knowledge and skills conveyed to counseling students in relation to an at-risk population being served by family-based therapists.
Children and adolescents with serious emotional, behavioral, and mental health disorders have encountered a service system that has struggled to identify their needs and implement services to meet these needs. "Traditionally, this population of children, if they received services at all, received outpatient therapy in clinic and office settings or received treatment via inpatient hospitals or residential treatment centers" (Stroul & Goldman, 1996, p. 453). Office-based service delivery has, in fact, hot been effective with some families in the improvement of their presenting concerns (Snyder & McCollum, 1999). Friedman (as cited in Meyers, Kaufman, & Goldman, 1998) reported the ineffectiveness of academic training programs in stating,
While the public service delivery system has concentrated on developing a range of services to enable it to better serve those youngsters for whom traditional mental health settings and services are ineffective and/or inappropriate, academic training programs have not only continued but perhaps even increased their focus on traditional forms of therapy in traditional mental health settings. (p. 7)
In addition, Snyder and McCollum believed that "the home is likely to find increased use as the setting in which family therapy is delivered" (p. 229). In the past two decades, federal and state governments have made numerous attempts to construct and implement treatment for this population.
Existing research is evaluative of which "factors relate to successful program outcome, usually defined as maintaining the identified adolescent with the nuclear or extended family" (Werrbach, 1992, p. 506). Knowledge and skills should reflect current research; however, research has not been grounded in understanding the competencies specific to family-based services.
A brief description of the counselor's role in family-based therapy might shed light on a field with which counselor educators and future family-based therapists may be unfamiliar. The role of a family-based therapist is that of clinician. Services are family focused, and only families determined to be at-risk are considered appropriate clients. For the purposes of this study, at-risk was defined as children and adolescents with severe emotional and behavioral problems who have not been successful with less intensive mental health services, such as outpatient therapy, and are likely to be placed in more intensive, out-of-home services. …