Masters research dissertations

Titles and abstracts to systemic masters research dissertations from UK family therapy training institutes that were awarded distinctions.

This paper uses narrative thematic analysis to analyse interviews with four adult male volunteers from the local community.  Subjects were invited to reflect on their relationship over time with their sibling closest in age.  The analysis uses the frame of time to highlight development and changes in the relationship.  Findings support those in the literature that stress the significance of adult sibling relationships.  The use of time as a frame is helpful in providing a coherent narrative, not broken by the artificial divide of childhood and adulthood. Findings regarding the resilience of sibling bonds and the influence of the sibling relationship on later parenting may be of particular use in the systemic field.

This qualitative study highlights some of the tensions of working as an independent professional within the child protection and court systems. It captures and evaluates the perspectives of six experienced professionals on the use and impact of LOIs, within complex social processes of conducting assessments with children and families. A structure of Thematic Analysis and Coordinated Management of Meaning’s Hierarchy model is used to collect and analyse data. The emerging themes were: Taking Positions, Use of Power, Context, Multiple Perspectives, Interactional Processes, Professional Guidance and Supervision. It draws out two main findings: the conflicted position of the IP and significance of collaborative approaches and systemic practices within assessment processes. Lastly, it suggests a further evaluating study into measuring LOIs.


This qualitative study examines the ways specialist family therapists at a UK charity working with victims of torture identify individual and family resilience in their work with refugee populations. A thematic analysis discovered the following themes as significant in this process: hope, cultural competency, attachment, past experiences of resilience, spirituality and religion, as well as the need for professionals to adopt an anti-oppressive and strength-based approach to look after themselves when confronted with the extremity of refugee people's narratives. The data suggests that both individual and family resilience is described as multifactorial changing over time at an individual and cultural level. Again, while the process of identifying resilience is mostly collaborative, it requires a high level of commitment by the therapist to discovering it. The study explores and highlights the need for further research into the effective clinical application of individual and systemic resilience in therapeutic work with refugee populations.

Single women's friendships offer an alternative story to the dominant discourse of the couple relationship. These friendships are seldom focussed on and have received little attention in the systemic therapy literature. This paper explores the historic and current cultural and ideological trends surrounding single women and friendship between women in an attempt to explain and understand this invisibility. Focussing in particular on close and enduring friendship between single women, connections are made between these friendships and attachment relationships. Five single women tell their stories of life-long friendship and emergent themes are observed. These include security, reciprocity, growth, enduring relationships and irreplaceable relationships. These attachment themes are used to illustrate the significance of these friendships.

The paper includes implications for the theory and practice o f systemic psychotherapy throughout. These include the consideration of the needs of single women within systemic therapy, with commitment to a non-pathologising approach. This is described as working with an emphasis on the network of relationships surrounding these women, and in particular focussing on their friendships as the main source of connection and intimacy. This is suggestive of different ways of working systemically, including incorporating friendships onto genograms and inviting friends into sessions. The therapeutic implication of promoting enduring friendship between women to attachment relationship status is also described as significant. This would place close friendship alongside the couple relationship in importance and challenge the traditional meaning of the "family". Whilst this paper celebrates systemic psychotherapy in its ability to deconstruct social myths and move closer to lived experience, it is noted that single women and their close friendships have yet remained largely overlooked. It is hoped that by opting for including single women in systemic theory and practice and giving rightful significance to their close friendships as attachment relationships that the shift away from oppressive gendered constructions might be encouraged and maintained.


In recent years, the impact of parental separation on children has become a subject of wide-ranging research. Within this, and given that in the British context 90% of children of separated parents continue to reside with the mother, there has been a growth in interest about the continued involvement of fathers in the lives of children who have experienced separation. This has tended to dwell on practical issues such as the importance of financial contribution to care of the children in maintaining father-child relationship, as well as the extent of contact in ensuring positive outcomes for children. Recent years have witnessed a greater interest in the quality of the relationship between father and child, rather than a straightforward focus on financial contribution and the extent of contact, as indicative of continuing involvement and positive outcomes.

Research has tended to use mothers’ accounts of fathers’ involvement, with a growing importance attached to children’s views on the involvement of fathers in their care. With a few exceptions, the views of fathers on all aspects of this process have been under-reported.
This study attempts to learn about paternal points of view of the relationship with their children following separation through interviews with four fathers who have separated and attempted to maintain relationships with their children. Attention is given to what they consider important in maintaining that relationship and also what constrains its development. Some consideration of fathers who bring up children alone is also given. Interpretative Phenomenological Analysis (IPA) is the method used to analyse the transcripts. The focus on unearthing the subjective experience of phenomena by the respondents, and on the attention paid to the researcher’s own prejudices in IPA made it particularly relevant to this kind of study.

There has been little focus in the literature about the possible relationships between therapy practice and beliefs about emotion held by systemic psychotherapists. In this research, five qualified systemic psychotherapists working in England were interviewed as part of an exploratory study. The participants seemed able to reflect on both their theoretical and wider beliefs about emotionality, discussing how they felt these might influence their practice. The data is discussed primarily from a social constructionist position using broader literature on emotion, including theories from both the ‘modern’ and ‘post modern’ traditions. Findings suggest this is an area systemic psychotherapists would like to consider further, including developing increased understanding of the ‘reflexive’ processes involved. Implications for practice and further research, indicated by the findings, are also highlighted.

This is an exploratory study with clinicians who took part in a Reflecting Team (RT) as part of a Family Therapy Clinic investigating clinicians' experiences, thoughts and understanding. A literature review was completed to understand the development of Reflecting Teams and the advantages and disadvantages of its use in Family Therapy. A qualitative approach was adopted and data gathered via a focus group of eight participants.

Thematic analysis was used to interpret the data and generated five global themes:

  • Theme 1 – Change in Clinicians’ Perspectives. 
  • Theme 2 – Clinicians’ Perspectives on the client experience of Reflecting Teams. 
  • Theme 3 – Finding a Fit for the Family. 
  • Theme 4 – Clinicians’ Experience of Reflecting Teams. 
  • Theme 5 – Guidelines and Considerations for an Effective Team

The study found similar themes in the literature emerged in the data. There was a mirroring, a shared experience for clinicians and families related to exposure to being in and experiencing a Reflecting Team. There is some discussion around how ethical the Reflecting Team is when families describe it as ‘shocking’ and suggestion of using a video clip to prepare families and new members of the team to the concepts and nature of the Reflecting Team. As well as the importance of asking families for feedback about their experience of the Reflecting Team. Clinicians found it more helpful being in the room with families rather than behind a screen in order to be able to respond and feel the emotions more fully in the room and develop as therapists.

Reflecting Teams continue to offer multi-perspectives, richness and diversity to families and are useful and beneficial for both families and clinicians. Further areas of research are suggested.

Due to an increase in global mobility and displacement there is a growing cultural diversity within therapeutic encounters between therapists and clients. Literature on cross-cultural therapy traditionally focuses on the culture of the client. However, due to recent theoretical shifts in the field, writers are now emphasising the importance of including the culture of the therapist in the discourse about cross-cultural therapy. This study explores the cultural identity of therapists.

Six qualified family therapists from different cultural backgrounds who have migrated to Britain were interviewed. Their experiences and the impact on their clinical work were explored. Grounded theory was used to analyse the data. Themes were identified within three areas, namely the experience of migration, reflections on the self of the therapist and reflections on cross-cultural therapy.

The findings include: Migration is described by participants as a multi-layered experience that continues to influence their lives on different levels over time, including ongoing negotiation of their cultural identities within a host culture. “Othering” and racism in different contexts, including their relationships with colleagues, influence this process. In their clinical work participants describe a position of moving between curiosity and connection, both when working with culturally similar and different clients. Participants warn against tokenism within the field of family therapy and argue for representation of minority cultures at all levels of the profession.

The findings of this study pose important challenges to the family therapy field in terms of training, supervision and addressing issues of discrimination amongst colleagues. It is viewed as important to attend to the cultures of all therapists within family therapy training and supervision. The potential of accessing the personal life experiences of therapists as a safe, non-challenging and meaningful way to do this is discussed. Further research is suggested.

Ten women at increased risk for breast cancer, based on generational family cancer history, routinely presenting at a familial breast cancer clinic (FBCC) and who in the clinical opinion of a Consultant Cancer Geneticist and a Clinical Nurse Specialist were ‘distressed’, were invited to complete a series of questionnaires and participate in a semi structured interview.

Two measures of anxiety (State Trait Anxiety Inventory, Spielberger et al 1977); a measure of negative attitudes (pessimism) about the future (Beck Hopelessness Scale, Beck & Steer 1978) and three health belief measures (Multi Dimensional Health Locus of Control Scales, Wallston et al 1978) were obtained. Analysis of these measures indicated that this group of women are reporting a high degree of State and Trait anxiety, have less belief in either their own ability (internality) or health professionals (powerful others) to ensure good health and believe more strongly that good health is a matter of chance, and are indicating a higher degree of hopelessness about the future than the general population. The only correlation between measures which reached statistical significance was that between State / Trait anxiety.

Seven commonalties (vulnerability classes), associated with cancer family legacies and life stage development were identified. Genogram information confirmed each of the women in the study encompassed several of these commonalties.

Qualitative analysis of the interviews discriminated six major categories which developed participants perceptions regarding the source and family impact of their distress. They confirmed the identified commonalties as pertinent and indicate these women think about breast cancer and its impact multi - generationally, linking their memories and experience of breast cancer in previous generations through themselves and into their children’s generation

Further research may be needed to inform what help, if any, should be made available and to whom.

The impositions of torture and exile seek to break family and social systems. Little has been written from the perspective of refugee families who have attended family therapy in the UK following torture. This qualitative study seeks to prioritise their voices. Eleven family members, from three families, were interviewed about their experiences of family therapy at a systemically oriented clinical service. A narrative analysis was carried out. The participants emphasised social aspects of their experience, the processes of finding agency in their lives and the intricacies of communication and trust-building. The families each constructed different meanings from the experience of therapy; these were enacted in the research process. The dramatic narrative forms of the interviews illustrated parallels between the power imbalances in the families’ relationships with researcher, therapist, host society and persecutor. Process research methods are suggested for further research.

The aim of this research was to evaluate the impact of introducing systemic concepts and ideas to a residential substance misuse treatment center, with the purpose of assessing the validity of continuing to develop a relational approach to the treatment of substance misuse.

The aim was addressed using a qualitative research approach by employing the focus group method to obtain data. Two focus groups were conducted with the relevant teams within Carlisle House. The discussions in the focus groups were guided by six general and open questions to stimulate conversations about their experience of the research topic, and allow for new information to emerge.

I used a thematic analysis approach to analyse the data, and the technique of triangulation (Bryman, 2008) to cross check data from both focus groups and the literature review, to ensure greater reliability and validity.

The introduction of these concepts were generally welcomed as being both empowering for service users and staff. They were viewed as presenting a significant challenge to the Centre’s beliefs about substance misuse and their accepted treatment methods, as well as a personal challenge to staff.

The evidence to support the continued development of a relational approach for the treatment of substance misuse emerged and recommendations made for the continuation of this journey.


NICE guidance recommends Behavioural Couples’ Therapy for the treatment of depression, because of its Randomised Control Trial-led evidence base. Desiring to build the evidence base for systemic therapy in the treatment of couples and depression, the Exeter Model proposes a bi-modal systemic-behavioural and systemic-empathic approach. Five couples that had undergone treatment in the Exeter Model Clinic at Exeter University’s Mood Disorder Centre, were coded according to a baseline measure of relational estrangement. The frequency of therapist use of behavioural and empathic manoeuvres, and their sequencing was tracked across therapy. No singular pattern emerged, not least due to the small sample size of the participant group and its variance. Trends in the findings suggest links between initial levels of couple estrangement and the sequencing of specific interventions. This descriptive investigation serves to better inform use of the Exeter Model, and is a preliminary step toward future evaluative research.

Background
Communication disorders following acquired brain injuries (ABIs) affect individuals, couples and families.  However, there is a lack of research into the way that partners cope in these circumstances, particularly during in-patient rehabilitation, and family involvement in rehabilitation varies greatly across services.  The purpose of this study is to explore the effects of communication disorders and ABIs on the couple relationship, and what partners felt helped them to cope at this time or could help other partners in the future.

Method
A focus group was conducted with male and female partners of people with communication disorders (PCDs) resulting from ABIs who were in-patients on a rehabilitation unit.  The group discussion was transcribed verbatim and thematic analysis was used to analyse the data qualitatively.

Results
Four super-ordinate themes and 24 sub-ordinate themes were identified.  These illustrate how partners of PCDs experience a range of emotions and changes in their relationships and roles, the different levels of formal and informal support they can access, and how they utilise previous experience when adjusting to a communication disorder after an ABI.

Conclusions
Findings from the study give an understanding of the experiences of partners of PCDs.  Increased support to this group of people is recommended, including opportunities to gain relevant information, share experiences and tell stories in order to construct meaningful narratives.  A range of ways in which support could be provided is discussed.  Further investigation into partners’ experiences and the changes in the support that they require and receive along the rehabilitation journey is required.


There is an extensive body of literature on resilience encompassing 50 years of existing work. Nevertheless, most research has focussed on individual traits of resilience, therefore a systemic approach which takes into account the relational context of resilience is needed. There is also a lack of research that explores the experiences of practitioners around the concept of resilience. This study design will be a Qualitative Research study using semi-structured interviews following an IPA methodology (Interpretative Phenomenological Analysis). This research methodology fits with the question as the aim will be to explore insights into how a given person (family therapists/systemic practitioners), in a given context (GOSH - Great Ormond Street Hospital), makes sense of a given phenomenon of lived experience (resilience). The use of IPA allows for an exploration of a systemic conceptualisation of resilience from a practitioner’s perspective.

Results showed that there were three superordinate themes that participants articulated when exploring their perceptions and experiences of the concept of resilience: relationship with the self; relationship with uncertainty; and relationship with adversity. From the research study results (based in the participants specific context), resilience can be understood as a resource generating and co-ordinating process that emerges in a relational context.

In conclusion, the research project highlighted the importance of resilience for these Systemic practitioners/family therapists and how resilience can be a helpful concept when thinking about the therapeutic relationship with families. In the context of the therapeutic relationship the process of resilience allows resources to emerge, alongside the acknowledgment of the adverse experience. This could have implications for systemic practice as the very act of exploring resilience creates space for resources to emerge. The results led to proposed suggestions regarding future research specifically regarding: what fosters team resilience; and also the potential benefits of a therapeutic space to explore team self-reflexivity.

Background

Sharing written information is a core practice in Systemic Family Therapy (Carr, 2010), based on the principles that therapeutic engagement can be enhanced and power differentials can be minimised.  The practice of copying letters to families is supported by legislation in NHS England, but not in Scotland.

Methodology

This study used Interpretive Phenomenological Analysis to explore the experiences of 4 family therapists who work in CAMHS in Scotland, who routinely copy letters to families.

Results

Themes across 4 interviews were identified, including positive impact on therapeutic engagement, addressing power issues, the value of multiple perspectives and the role of language.

Discussion

Analysis revealed that despite some challenges, transparency in letter writing practices is an integral part of therapeutic processes and has clear benefits for clinicians and families.