Psych · Child and adolescent psychiatry — family assessment and therapy
Family assessment and therapy in CAP
Also known as Family therapy in child psychiatry · Systemic family assessment CAP · Parent training CAMHS · PCIT · Family-based treatment · ABFT · Multisystemic therapy · Functional family therapy · MDFT · Family accommodation
Exam-exhaustive fellowship reference on family assessment and therapy in child and adolescent psychiatry — genogram and structural assessment, circular questioning, EE and accommodation, and indication-matched packages (PCIT/PMT, FBT, ABFT, FFT/MST, MDFT). FRANZCP-primary, globally tagged.
Practise this topic
On this page
Study tools
Your progress
Saved on this device.
Target exams
Red flags
- Active child abuse, neglect, or intimate partner violence — separate, protect, report under local law; do not run joint 'communication skills' sessions
- Medical instability (e.g. severe anorexia) or acute suicide risk — stabilise the child first; family work supports but does not replace medical/risk care
- Requests for coercive holding, rebirthing, or forced-regression 'attachment therapy' — refuse (APSAC); offer evidence-based alternatives
- Therapist triangulation into high-conflict co-parenting or custody warfare — restore multi-partiality; child protection lens
- Confidentiality blur with competent adolescents — explicit sharing contract before conjoint sessions
- Prescribing psychotropics for relational problems without an indicated psychiatric comorbidity
Meet the patient
A 15-year-old with anorexia nervosa sits between two parents who have not slept for a month. The father wants the team to "talk to her about eating"; the mother whispers that it is all her fault. The registrar reaches for a family-therapy referral form. The examiner reaches for the safety screen first.[2][17]
The question on this ward round is never "do they need family therapy". It is "which package, for which indication, and is it safe to do it together?" Answer that, in that order, and you hold the topic.[1][2]
References18ShowHide
- [1]Retzlaff R, von Sydow K, Beher S, et al. The efficacy of systemic therapy for internalizing and other disorders of childhood and adolescence: a systematic review of 38 randomized trials Fam Process, 2013.PMID 24329407
- [2]Lock J, Le Grange D, Agras WS, et al. Randomized clinical trial comparing family-based treatment with adolescent-focused individual therapy for adolescents with anorexia nervosa Arch Gen Psychiatry, 2010.PMID 20921118
- [3]Couturier J, Kimber M, Szatmari P Efficacy of family-based treatment for adolescents with eating disorders: a systematic review and meta-analysis Int J Eat Disord, 2013.PMID 22821753
- [4]Diamond GS, Wintersteen MB, Brown GK, et al. Attachment-based family therapy for adolescents with suicidal ideation: a randomized controlled trial J Am Acad Child Adolesc Psychiatry, 2010.PMID 20215934
- [5]Diamond GS, Reis BF, Diamond GM, et al. Attachment-based family therapy for depressed adolescents: a treatment development study J Am Acad Child Adolesc Psychiatry, 2002.PMID 12364840
- [6]Miklowitz DJ, George EL, Richards JA, et al. A randomized study of family-focused psychoeducation and pharmacotherapy in the outpatient management of bipolar disorder Arch Gen Psychiatry, 2003.PMID 12963672
- [7]Henggeler SW Multisystemic Therapy(®) : Clinical Overview, Outcomes, and Implementation Research Fam Process, 2016.PMID 27370172
- [8]Henggeler SW, Melton GB, Smith LA Family preservation using multisystemic therapy: an effective alternative to incarcerating serious juvenile offenders J Consult Clin Psychol, 1992.PMID 1460157
- [9]Thomas R, Abell B, Webb HJ, et al. Parent-Child Interaction Therapy: A Meta-analysis Pediatrics, 2017.PMID 28860132
- [10]Sexton T, Turner CW The effectiveness of functional family therapy for youth with behavioral problems in a community practice setting J Fam Psychol, 2010.PMID 20545407
- [11]Brestan EV, Eyberg SM Effective psychosocial treatments of conduct-disordered children and adolescents: 29 years, 82 studies, and 5,272 kids J Clin Child Psychol, 1998.PMID 9648035
- [12]Liddle HA, Dakof GA, Parker K, et al. Multidimensional family therapy for adolescent drug abuse: results of a randomized clinical trial Am J Drug Alcohol Abuse, 2001.PMID 11727882
- [13]Liddle HA Multidimensional Family Therapy: Evidence Base for Transdiagnostic Treatment Outcomes, Change Mechanisms, and Implementation in Community Settings Fam Process, 2016.PMID 27565445
- [14]Calvocoressi L, Lewis B, Harris M, et al. Family accommodation in obsessive-compulsive disorder Am J Psychiatry, 1995.PMID 7864273
- [15]Lebowitz ER, Panza KE, Bloch MH Family accommodation in obsessive-compulsive and anxiety disorders: a five-year update Expert Rev Neurother, 2016.PMID 26613396
- [16]Butzlaff RL, Hooley JM Expressed emotion and psychiatric relapse: a meta-analysis Arch Gen Psychiatry, 1998.PMID 9633674
- [17]Hay P, Chinn D, Forbes D, et al. Royal Australian and New Zealand College of Psychiatrists clinical practice guidelines for the treatment of eating disorders Aust N Z J Psychiatry, 2014.PMID 25351912
- [18]Chaffin M, Hanson R, Saunders BE, et al. Report of the APSAC task force on attachment therapy, reactive attachment disorder, and attachment problems Child Maltreat, 2006.PMID 16382093