Clinicians agree on the benefits of family involvement for therapeutic purposes. I found evidence for that when dealing with schizophrenics, but not for depressed patients. Do they benefit from family involvement as well?
Thank you, Stephen. Yet, I am not convinced that adding family therapy to TAU (antidepressants and/or individual psychotherapy) improves efficiency in depressed (not bipolar) adults (who do not have marital problems)... Either no research has focused on that, or studies resulted in null-findings that were not published. Have we identified another gap between clinical practice and theory/research?
Thanks for your insightful comments and questions, Kris. Yes, there is a gap between family therapy practice and research.
Richard Niolon (2011) summarized some of the challenges and findings in family therapy research:
"...So Does Family or Couples Therapy Work?
...Pinsoff and Wynne (2000) answer that family and/or couples therapy is better than individual therapy for:
schizophrenia
depression in women in distressed marriages
marital distress
adult substance abuse
adolescent conduct disorders and substance abuse
anorexia in young females
childhood autism
aggression and non-compliance in ADHD children
dementia
and cardiovascular risk factors
and is better than no treatment for all of the above in addition to
obesity
hypertension
child conduct disorder
and chronic illness in childhood
Gurman and colleagues (in Garfield and Bergin) would add “medical” disorders (like eating disorders, diabetes, and asthma), anxiety, and phobias to the list of problems that benefit more from family or couples therapy than individual therapy. Gurman and colleagues offer that, generally, about two thirds of clients in any kind of family therapy get better, which is fairly similar to the numbers gained in individual therapy intervention research. They would add more specifically that:
Better gains are found when both members of a couple work on marital problems.
Better gains occur when the therapist is more active in the early phases of therapy.
Basic mastery of the theory and techniques by the therapist seems enough to halt deterioration, but more skill by the therapist is required for positive growth in therapy.
Therapy with two therapists is just as good as therapy with one therapist.
And short term therapy (20 sessions and under) can produce positive results.
Summary:
In summary, we can say this. The research regarding the effectiveness of family therapy is complicated. However, generally speaking, research supports that family therapy, when conducted by people who know the theories and techniques well, can be helpful for a wide range of problems, although not for all problems. It would seem that overall, the different models of family therapy are equally valid and effective."