1. Systemic Family
Practice
Judith Lask.
SFT Curriculum Group

2. Child and Family

3. What do we mean by family?

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

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. 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. 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. 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. Curriculum consists of
Depression
and Self harm
Basic module
plus
Or
Conduct
disorder
or
Eating
Disorders

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. What will Students Learn: Basic
Module






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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. Specialist Module:Depression
and Self Harm








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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. Specialist module in Conduct
disorder






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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. 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. How will clients benefit




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

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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. 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. 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. Some wider reverberations

20. Recursive process

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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. 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.