Integrated Family Therapy, while embracing different positions from a range of theoretical contributions to constitute a paramodern position, retains from the 1st edition a structure to therapeutic intervention. This structure services to reinforce the emphasis placed on orientation to therapy in the earliest stage as crucial, for shorter and for longer term engagement with families.
This edition of Integrated Family Therapy also places importance on assessment. This is to ensure that therapeutic steps taken in working with families toward a shared understanding of problems and potential solutions are thoroughly explored and agreed in a co-constructed manner. The assessment phase, whilst explicit, offers a landscape for curiosity, for information gathering, for exploring priorities and for reflecting with families how future progress might develop. Strong emphasis is also placed upon systemic formulation, where a shared understanding of the problems is pulled together into a coherent narrative, open for exploring with families and for setting out clearly future intervention goals.
Case examples have been used to highlight some of the ways in which change can be achieved in short, medium and longer term systemic intervention with families. Integrated Family Therapy is positioned away from a manualised approach to therapy and instead holds on to using a unique combination of influences from different models of systemic family therapy outlined in other sections of this book/website, according to the needs of each family. Therefore achieving change with each family will be different, although some universalities still exist. For example, families where attachment histories have been relatively secure and who have internalised, as individual family members and as a family unit, a range of emotional and external resources might do well with a constructivist approach to therapy or respond quickly to structural changes. Families who have experienced challenges to forging attachments or who have histories of developmental trauma might require longer-term intervention for change to be achieved.
Finally, Integrated Family Therapy attends to some of the considerations in time and content for leaving the family on their journey. Whether intervention is brief or longer-term, the expectation is always that the family will at some point leave therapy to face challenges and achieve successes using their own resources and support network. Some of the considerations to endings are explored in this section.
While the boundaries between the stages of therapy can overlap, being mindful and attentive to each stage can offer containment and direction for a family and minimise therapeutic drift. Implicit in this is continuous attention to use of self of the therapist.