A growing evidence-base shows that family therapy works, but many gaps in our knowledge remain about the conditions under which family therapy is effective and how it works. In this paper, ten critical research questions about family therapy that need to be addressed are considered. In short these are:

1. 1. Is family therapy as effective in community settings as it is in specialist clinics?

2. 2. For what problems is family therapy cost-effective?

3. 3. Does family therapy work for under-researched problems and populations?

4. 4. Do social-constructionist and narrative approaches to family therapy work?

5. 5. Can family therapy protocols be enhanced for non-responders?

6. 6. Can family therapy be combined with other psychotherapies to effectively treat specific problems?

7. 7. Can family therapy be combined with pharmacotherapy to effectively treat specific problems?

8. 8. What specific factors contribute to the effectiveness of family therapy with particular problems?

9. 9. What common factors contribute to the effectiveness of family therapy?

10. 10. What therapist and client factors contribute to the effectiveness of family therapy?

Yes, I have heard about family psychotherapy — but opinions are no substitute for data. (Garfield, 1982)

MDFT is a family-based intervention for adolescent substance abuse and associated mental health and behavioural problems (Liddle, 2010). Integrative in several ways, MDFT uses an ecological or contextual conceptual framework to understand the developmental tasks of teens and their families. Research-derived knowledge about risk and protective factors, and proximal causes, correlates and contributors to adolescent drug and related problems inform clinical thinking and interventions with every case. A multisystems approach, MDFT assesses and intervenes in four areas: (1) the adolescent as an individual and a member of a family and peer network; (2) the parent(s), both as individual adults and in his or her role as mother, father or caregiver; (3) the family environment and family relationships, as manifested in day-to-day family transactional patterns; and (4) extrafamilial sources of influence such as peers, school and juvenile justice. Interventions are made within and coordinated across domains. Progress in one area or with one person has implications for and use in others. Individual meetings with parent(s) and teen set the stage for family sessions, and family meetings may offer content and new outcomes that need to be brought to extrafamily meetings with juvenile justice or school personnel. MDFT was developed and tested as a treatment system rather than a one-size-fits-all approach. A treatment system offers different versions of a clinical model that vary according to factors such as clinical sample characteristics (older versus younger adolescents, juvenile justice involved versus no involvement in juvenile justice systems), and treatment parameters (type of clinical setting and treatment dose).

Multisystemic therapy (MST) is a family- and community-based treatment of serious emotional and behavioural problems presented by adolescents. The development of this model began in the late 1970s, and today MST is a leading evidence-based treatment of serious antisocial behaviour in youths, with programs transported to more than 30 states in the United States and 12 nations, including Australia and New Zealand. This article rerviews the theoretical rationale that underlies MST and presents the central clinical features of the intervention model. In addition, the training and quality assurance protocols used to promote MST program fidelity and treatment adherence are described. Finally, findings from approximately 15 published randomised and two quasi-experimental clinical trials with youths presenting serious clinical problems (e.g., violence, substance abuse, serious emotional disturbance, sexual offending, and chronic illness) are summarised.

Family-based treatment has for at least two decades now come to be seen as the treatment of choice for adolescents with anorexia nervosa (AN). Yet, involving the parents in the treatment for adolescents with bulimia nervosa (BN) have remained largely unexplored. We have recently adapted manualised family-based treatment for adolescent AN (FBT-AN) to a large group of adolescents with BN (FBT-BN). This manuscript will highlight the key tenets of manualised FBT-BN, briefly describe the three treatment phases, and summarise the main differences of this model in its application for AN versus BN. Finally, reference will be made to the first randomised controlled trial of FBT-BN showing preliminary support for the parents' involvement in the treatment of adolescent BN.

This research project explored the ongoing process of constructing a narrative, following childhood sexual abuse. Twenty-two men and women aged 25–70 were interviewed about their childhood sexual experiences with adults using narrative inquiry methodology. These experiences occurred in different social and historical contexts, when the theoretical understandings and treatment of the issue of child sexual abuse were significantly different from the present. Many factors made disclosure even more difficult then than it is now including: respect for authority; rigid gender roles; the taboo surrounding sexual issues; lack of supportive adults; and lack of language to describe what was happening. Participants told four differing narratives about their experiences: narratives of silence; narratives of ongoing suffering; narratives of transformation; and narratives of transcendence. These narratives were examined in relation to the changing social and historical context and the current dominance of the victim and survivor paradigm in the child sexual abuse literature.

Among the Maori of New Zealand, Aboriginals of Australia, and other Indigenous peoples, family dynamics strongly influence the ways that issues emerge in counseling. This study explores aspects of gender and power within the context of birth practices in rural Nepal. In-depth interviews were conducted with 15 postpartum women, as well as family members, to collect narratives of birthing experiences that highlight issues of oppression, marginalisation, and power struggles. Implications for multicultural and social justice awareness in family therapy are discussed, especially with regard to the subtle, disguised ways that power operates behind the scenes, often sabotaging efforts by health and mental health professionals to be most helpful.

This article explores the characteristics of open and closed relationships in 170 gay men according to their levels of satisfaction, their attachment styles, and the rules of having sex outside their relationships for open couples. We found no significant difference between open or closed relationships in levels of satisfaction or attachment styles. However, we found that gay men in open relationships who have explicit rules about having sex with other men are significantly more satisfied that those gay men with no rules. A content analysis of the rules is presented and implications for therapy are drawn from the findings.