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AFT's Information for Commissioners offers a concise overview of Systemic Family Therapy and its evidence base, to inform and support Commissioners in delivering high-quality, effective and safe services. 

Systemic Family Therapy has proven effectiveness in 

  • improving outcomes
  • preventing distress and difficulties escalating into crisis
  • promoting mental health and recovery
  • developing individual resilience and family strengths
  • improving risk assessment and intervention
  • involving families and carers in care and service planning
  • increasing staff skills in working in partnership with families
  • reducing relapse and readmission

Family and Systemic Psychotherapy Research
Research has shown that systemic family and couple therapy is as effective—and in many cases more effective—than alternative interventions, often at a lower cost.

Systemic family therapy has been found to be effective for children's and adults' difficulties, both when individuals have acquired a mental health diagnosis and when there is more general or complex distress. It is effective across the lifecycle, spanning developmental stages from under fives to old age. Working therapeutically with individuals together with their families and/or significant others enables the use of individuals’ relationships as a resource, and reduces stress and difficulties for all family members. Family therapy has also been found to be particularly effective during severe and complex disorders requiring extensive treatment. Systemic family therapy can sometimes include relational work with individuals, psychoeducational approaches and multiple family groups.

Reviews of research (see below) list the following circumstances in which family therapy has been proven to be effective for children, adolescents and the important people in their lives:

 Problems in infancy; sleep, feeding and attachment
 Child abuse and neglect
 Child and adolescent conduct problems such as behavioural difficulties, attention deficit hyperactivity disorder (ADHD), and delinquency
 Emotional problems including anxiety, depression, grief, bipolar disorder, self harm and suicidality
 Body¬related problems including enuresis, encopresis, recurrent abdominal pain, medically unexplained symptoms and poorly controlled asthma and diabetes
 Drug abuse
 Eating disorders including anorexia, bulimia and obesity
 First episode psychosis

Reviews of research show effectiveness of family therapy for adults and families affected by:

 Relationship difficulties and distress
 Psychosexual problems
 Intimate partner violence
 Anxiety disorders
 Mood disorders and depression
 Alcohol and drug problems
 Schizophrenia
 Adjustment to chronic physical illness
Carr, Alan (2016) How and why do family and systemic therapies work ? Australia and New Zealand Journal of Family Therapy. 37(1) 37-55
Carr, Alan (2014) The evidence base for family therapy and systemic interventions for child¬focused problems, Journal of Family Therapy, 36(2) : 107¬157.
Carr, Alan (2014) The evidence¬base for couple therapy, family therapy and systemic interventions for adult¬focused problems. Journal of Family Therapy, 36 (2) pp.158¬194.
Retzlaff, R. et al (2013) The efficacy of systemic therapy for internalizing and other disorders of childhood and adolescence: A systematic review of 38 Randomized Trials. Family Process. 2013; 52(4): 619¬652. ).
Von Sydow, K., et al (2013). The efficacy of systemic therapy for childhood and adolescent externalizing disorders: A systematic review of 47 RCTs. Family Process, 52:576¬618.
Von Sydow, K., et al (2010). The efficacy of systemic therapy with adult patients: A meta¬content analysis of 38 randomised controlled trials. Family Process, 49:457¬485.

Read the evidence base for Systemic Family and Couples Therapy

Information for Employers -  See Information Sheet (2018) Considerations for Employers and Commissioners - to clarify different terms, qualifications and considerations for employers and commissioners.The Professional Affairs Committee (PAC) of AFT has a panel of National Assessors who are prepared to support employers with the recruitment of family therapists.  Please see our recommended standards for the employment of family and systemic psychotherapists (terms and conditions for family and systemic psychotherapists) and our guidelines for the use of National Assessors. If you require a National Assessor please contact the AFT office on 01925 444414.  

Other information:

Guidance on Caseload and Clinical Activity for Family and Systemic Psychotherapists (PDF)

Sample job descriptions

Guidance paper on the management of trainees through transition to full specialist practitioner status

Clinical supervision policy

AFT are pleased to advertise posts on our "Jobs" page. 

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