The following article outlines the Safety First Model for working with high-risk young people in crisis. This hierarchical model prioritises emotional and physical safety by using multi-systemic and family-based interventions. A typical case example is used to illustrate the model and the structures and strategies employed at each level. The intervention model empowers families, facilitates their connections with other providers, and minimises the need for hospital admissions. The model also promotes collaborative and systemic practice in a child and adolescent mental health service.

In 1983 the Fourth Australian Family Therapy Conference had the theme ‘Merging the Streams — Integrating Trends in Family Therapy’. In his keynote address Brian Stagoll outlined concerns regarding the nature of family therapy as it was then developing in Australia. This article revisits some of these themes to see where we have come from, where we are heading and which topics continue to be ignored. Evidence is drawn from articles that stood out for me in the Australian Journal of Family Therapy (later the Australian and New Zealand Journal of Family Therapy) and selected relevant papers from the 1983 conference itself. Finally, I speculate upon possible reasons for the absence of discussion on certain issues, most strikingly: systemic influences upon indigenous Australians, farm families, working with children in families, certain aspects of gender, the systemic implications of addiction; and environmental impacts on families now and for the future. The danger for family therapy is becoming stuck in a closed system that ignores the wider system.

The contention of this article is that systemic family therapy has much to gain from a realistic appraisal of its research base, which is as positive as possible. And that through such an appraisal we can find ways of developing the scope of family therapy to the benefit of the profession and thereby, of our clients. Family therapy will benefit if practitioners can present an informed view of research. As a preliminary approach to this objective, I review reasons why perceptions of family therapy underestimate its research base, and why therapists might resist involvement with research. The article then explores the reasons for regarding randomised controlled trials as a ‘gold standard’, and why they are not well fitted for the purpose of evaluating or developing a relational therapy. Next is a consideration of alternative approaches to research, including a consideration of what clients actually want from their therapy, then a brief review of the positive findings of outcome research. Greater emphasis on researching processes in therapy is proposed, and consideration of the ‘common factors’ debate is shown to support priorities that are specific to systemic therapies. The article concludes with suggestions for increasing the involvement of family therapists with research, both as consumers and as research practitioners.

This case study explores Parent and Child Therapy (PACT), an attachment-based intervention for mothers and children experiencing intractable relationship distress originally developed by Heather Chambers (a Child Psychotherapist and Family Therapist working in New Zealand). We describe the use of PACT with a mother–child dyad presenting a history of severe abuse and neglect. The child had been diagnosed with Conduct Disorder and co-morbid Attention Deficit Hyperactivity Disorder. We consider the themes arising in the therapy, the emotional process experienced by the mother and child, the initial outcome and 10-month follow up. The case study indicates that PACT can be learned and used by practitioners outside of the team that conceptualised and developed it. The case highlights the links between externalising difficulties and attachment disorganisation and points to PACT as a promising treatment for the chronic sequelae of early interpersonal childhood trauma. The need for research and possible directions of this research are discussed.

Liz Mackenzie's involvement with family therapy began in 1978 at the Psychiatry Department of the Adelaide Children's Hospital. She contrasts the field then and now, naming some of the dysfunctional facets of family therapy. She became manager of a specialist foster/residential program in the non-government sector, definitely the most difficult, extending and satisfying period in her working life. In 2007, she is back where it began for her, in the (renamed) Women's and Children's Hospital, working in a Child and Adolescent Community Health team

This article presents a series of ‘snapshots’ of the history of the journal now known as the ANZJFT (Australian and New Zealand Journal of Family Therapy). While a full, detailed history of the journal from its inception is beyond the scope of this paper, the authors offer glimpses of the journal at key points in its 25-year history, and from these, readers can reconstruct some of the changes that have occurred, and the continuities in values and attitudes that the ANZJFT has attempted to preserve, throughout its existence. The authors comment, from their own recent experience, on particular dilemmas, which they have faced, and use their own data to update a bibliometric survey of the journal originally carried out by Davis and Lipson (1996).

In this article I review the changes in thinking about childhood depression since the 1950s, with an emphasis on the struggles to find language for childhood depression. My interface with these changes is described, with a particular focus on the development of the Children's Depression Scale (CDS). Clinical applications of family therapy using the CDS in treatment of childhood depression are then illustrated with a composite case example. The idea is developed that depression in children can be seen as a blocked communication, and that increasing emotional expressiveness in families is an appropriate therapeutic aim and intervention. The relevance of the historical context to current practice is considered.

The following conversation describes a narrative means of uncovering (or ‘deconstructing’) some of the invisible forces that undermine parents' capacities in caring for their children in preferred ways. In the authors' experience, parents can be hugely resourceful and provide a clear account of what they ‘should’ be doing, yet seem unable to act upon their own good advice – it is as though an external agent, named below as ‘Virus X’, prevents them from being the parents they would like to be. Through naming this external agent, identifying its influences and noticing parents' acts of resistance in the face of these influences, antidotes to Virus X can be developed. This paper describes the development of such an approach within a child behaviour management group. In keeping with the playful approach encouraged by narrative therapy, the authors of this paper join forces to act as investigative journalists in exposing Virus X to the readers.

In this article I wish to argue that the qualities and dynamics of sibling relationships may have been overlooked in family therapy. In overlooking them, we have also overlooked a significant feature in the emotional life of children. I would like to suggest that sibling relationships are where children practise identity. In these relationships we can learn how to be one in a group. Family Therapy treatment may not make enough use of the dynamic of the sibling relationship.

The difficulties associated with conducting valid family therapy research within a clinical practice discourage many potential researchers. This article will describe collaboration between a group of academics, researchers and clinicians who decided to explore the process and efficacy of systemic family therapy conducted within a working private practice. The specific questions we are addressing are, whether the requests clients bring to their first session of therapy can be reliably classified by practitioners, whether these requests change over time, and whether the nature of the request is associated with therapist and client ratings of therapeutic outcome. Additional questions about the form and nature of the therapeutic alliance as experienced by both client and practitioner are also being explored. This paper will map the passage of the work from inception to its current state where over 140 clients are active participants. In doing so attention will be paid to the obstacles encountered: practical, financial and ethical, and the solutions devised to address these.

This article addresses the clinical issue of selecting assessments of attachment that are relevant to decision making for families. The validity of three commonly used methods of assessing attachment in preschool-aged children was compared using a sample of 51 low-income mother–child dyads. Thirty-eight of the children had been abused or neglected. The dyads were seen in a Strange Situation that was classified using each of the three methods: (a) the Ainsworth-extended method, (b) the Cassidy-Marvin (C-M) method, and (c) the Preschool Assessment of Attachment (PAA). Validity was evaluated in terms of maltreatment status, maternal sensitivity, child DQ, and maternal attachment strategy. The PAA and C-M classifications matched in only 37% of cases. The Ainsworth-extended method differentiated secure versus insecure children on two variables. The C-M method differentiated secure versus insecure children on one variable. The PAA differentiated secure versus insecure children on all four variables and subgroups on one. Moreover, it was tied to other family relationship variables in meaningful ways. If applied in clinical settings, these three methods would result in very different groups of children being seen as safe and at risk. We argue that clinicians cannot afford to be uninformed about the validity of alternative means of assessing attachment.

Used widely throughout the parenting literature, the phrase ‘Catch them being good’ encapsulates much of current practice that has been shown to be effective in reducing instances of non-compliance in children with complex and challenging behaviours. ‘Catching your child being good’ is obviously in line with the strategies of praise, encouragement and positive reinforcement. But for some parents, ‘Catching their child being good’ after long periods of defiance becomes almost an impossible task. Metaphorically speaking, ‘Cleaning your glasses’ is a necessary pre-requisite for effectively ‘catching your child being good’. This metaphor and an associated six-phase therapeutic intervention seek to enhance a parent's ability to ‘Catch their child being good’, by working through parental distortions, restraints and negativity. This paper introduces the metaphor's origin and use; describes keys concepts; and gives a detailed case example to highlight the advantages and limitations of the intervention.

In this article we explore and discuss the relevance of the concept of powerlessness in systemic practice. The views and concerns of systemic trainees' groups are compared with those of experienced therapists'. We interviewed 12 experienced systemic therapists and investigated what made them feel powerless and how they dealt with it. Extracts from interviews are quoted and summarised in the text. We argue that therapists' powerlessness is a marginalised subject in the systemic approach and that open discussion about the topic would enhance therapists' self-reflexivity and contribute to a fuller understanding of the part that power and powerlessness play in the therapeutic relationship. We consider the place of gender, culture and wider sociopolitical contexts in the experience of therapists' powerlessness. Finally we discuss the implications of our findings for systemic therapy, training and supervision.

This article is concerned with the experience of infants who endure long hospitalisations. It explores the concept of the baby as subject; that is, infants as active, psychic participants in their earliest relationships. It explores therapeutic possibilities with hospitalised infants from an infant mental health perspective. It advocates for family therapists to equip themselves for infant–parent therapeutic work.

Children organise self-protectively in response to anxiety-provoking or dangerous parental behaviours. When children's self-protective responses are extreme and persist over time, they may come to the attention of health professionals in the guise of emotional, behavioural or somatic symptoms. A parallel phenomenon is that harmful parental behaviours may be embedded in the emotional processes of the intergenerational family unit, reflecting the parents' own experiences of comfort and danger, as well as the particular manner in which these experiences have been integrated into the parents' current functioning. Using a case study of a three-year-old girl with medically unexplained urinary retention, the article explores how information about attachment relationships and unresolved parental loss or trauma can inform our understanding of implicit, anxiety-driven processes within the family, and to facilitate family interventions and symptom alleviation. The case shows that the Dynamic-Maturational Model of attachment has significant applications in the areas of family therapy theory and practice, psychosomatic medicine and consult-liaison psychiatry.

Serious and life-threatening illnesses in the infant population present complex theoretical and practical challenges for both the family unit and hospital staff. These challenges operate at a minimum of three levels, namely the infant's internal system, the parent–infant relationship and the acute medical context. This article describes infant-directed singing as an intervention in restoring an attachment bond disrupted by serious illness. In particular, the following will be considered: the need for family focused interventions within the acute medical setting, the usefulness of attachment theory in the acute care context; a technical description of infant-directed singing and a cybernetic conceptualisation of the relevant staff–mother–infant interactions.

This study investigates ways in which systemic psychotherapists address sexual issues. Qualitative data were collected through semi-structured group and individual interviews and analysed using discourse analysis. Particular attention was paid to participants' accounts of the ‘resources’ they draw on and of perceived ‘constraints’ when approaching the subject of sex. Main findings indicate that systemic training and practice would benefit from greater inclusion of sexual issues to overcome current deficiencies in the field.

The author attempts to discern themes underlying his clinical practice. Although his approach is somewhat behaviourist in orientation, it is hoped that the 12 themes (or organising principles) can be compared and contrasted with those arising from other approaches to child, adolescent, and family work. The author invites readers to analyse the way they have pieced together a composite approach from a range of sources.

There is wisdom in the saying that ‘To a person with a hammer everything looks like a nail’. As a therapist my hammer is talking, naturally and inevitably, and most things look like they need talking. But, there are times when I put my talking tool aside and select another tool and my three tennis balls are one of the tools for which I reach.