Multigenerational Family Trauma
Trauma has long been recognized as having an impact on mental health, and it is widely reported in the literature that traumatic events can have long-range generational effects. A central clinical feature of trauma in a family is the silence that surrounds traumatic experiences - experiences that are intolerable within the frameworks within which we make sense of, and manage the world. Families may deny, repress, re-write or carefully omit important stories and events; perhaps out of a fear of inflicting pain, or because of the need to live within family frameworks of loyalty and hierarchy. An ongoing theme of family therapy literature looks at how long-past trauma can be re-enacted, generation after generation, in a family or community line.
Williamsroad clinical practice, training, and case-based research has an ongoing research focus on the intergenerational transmission of trauma, and training clinicians to first identify the markers of old trauma in a family, and then respectfully and safely unpack the stories and realign the relationships within a family to free family members from re-living and re-enacting the trauma.
Working with Complex Families with Multiple Co-Morbidities
Complex families are notoriously difficult to help, using individual treatment models. Family and systemic interventions have been shown to be more effective than other interventions for these families.
Complex families show some or several of the following patterns:
- Individuals in the family may suffer from physical illness, mental illness, addiction, eating disorders and behavioural disorders, a history of trauma, family violence, developmental issues in children, or multiple diagnoses.
- Social disadvantage is a common feature of complex families
- Different members of the family can be involved with different or several community service agencies or professionals
- The family may have previously been involved with a number of professionals, including doctors, social workers, psychiatrists and psychologists, youth workers, and alternative therapists
- The family may be angry or disappointed with past or current professionals or agencies who tried to intervene in their suffering (some families have a compelling set of reasons or justifications)
- The family is doing the best they can under difficult services, but external organisations may frame their struggles as 'resistant to treatment' or 'non-compliant'.
- Patterns of suffering are often repeated between generations
- Some members of the family may have repeated interactions with the police or with emergency or psychiatric hospitals; children may be in frequent trouble with school discipline functions or even juvenile justice.
- A key characteristic of these complex families is that the relationships within the family, and the ways the family interacts with the world, exacerbate the suffering rather than mitigate it.
Williamsroad specialises in a multi-systemic attachment focused model for dealing with complex families, which is attachment-informed and well grounded in evidence. Unlike individual intervention models, the model seeks to engage the whole family in systemic change, and to include services and interdisciplinary health and allied health teams in the intervention.
We are developing, and refining this model in our
Expertise in Systemic & Family Therapy
Psychotherapy interventions are recognised as effective, and cost-effective interventions for psychological suffering, but there are key client characteristics in individual psychotherapy which can help predict the extent to which therapy will be effective. When the whole family or the larger interpersonal system is included, the client characteristics for therapeutic effectiveness become less significant, and therapist markers begin to emerge.
The Williamsroad Family Therapy Centre has been looking at the field of practicioner expertise and client outcomes in Systemic & Family Therapy for over 10 years.
Our research has identified key 'habits of mind' and 'habits of practice' common across elite Family Therapists, which are linked to consistently better client outcomes. These include:
- Attention to maintaining a balanced therapeutic alliance within the family, and controlling the 'emotional climate' in the room
- Critical self-reflection outside the client room
- 'In-the-moment awareness of layers of family dynamics
- And several other markers
Elite practicioners typically have over 10 years clinical practice in which to hone their expertise. However, not all family therapists with long experience have the markers - or the consistently better client outcomes - of elite practice.
Likewise, a small number of less experienced practicioners show many of the markers of elite practice, without the years to develop them.
Williamsroad research staff are very curious about the phenomenom of elite practice:
- How to use real-world research techniques to evaluate the effectiveness of therapy as it unfolds in real-time, case by case,
- How to accelerate development of elite 'habits of mind' in trainee family therapists; through structured individual and group supervision, carefully focused seminars and role-plays, participation in larger therapy teams with mixed experience, and other means
- How to place a systemic or family therapist in a larger therapeutic system to bring out elite practice in the other healthcare and community professionals
Systemic Interventions for Drug & Alcohol Addiction
Individual psychotherapy interventions are shown to be effective for drug and alcohol addiction, but the clinical research for systemic and family interventions is not so clear-cut. The Williamsroad Family Therapy Centre is currently in the process of setting up clinical effectiveness evaluation of systemic interventions for people struggling with drug & alcohol problems.
Systemic Interventions for Children & Adolescents
To find out more, or to be involved in a research project on one of these topics, contact the Williamsroad reception.