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Runninghead:Theoretical Comparison

Family Systems Therapy and Behaviour Therapy; A theoretical Comparison


Lindsay A. Birchall
University of Calgary

Counselling Theories and Professional Practice EDPS 602


Dr. Barry Hollowell
November 17th, 2014

Table of Contents
Abstract3
Introduction.4
Four Major Elements of a Good Theory..4
The Philosophical Element...5
The Descriptive Element..6
History of Dysfunction.6
Behaviour: Cause & Effect...7
Problem Behaviours.8
Cultural Factors....9
The Prescriptive Element.9
Therapeutic Relationship & Therapist Role10
Therapeutic Process11
Observations...11
Practice11
Individual vs. System Change......12
Change Tasks...12
Implementation.13
Cognitive-Behavioural Family Therapy..14
The Evaluative Element...14
Behaviour Therapy & Systemic Family Therapy-Measurability15
Manualizing Approaches.16
Current Empirical Research....17
Conclusion..18

Abstract
Within Psychotherapy many different therapeutic approaches exist. Most approaches can
be categorized within a framework of worldviews (i.e. Rationalism, Humanism, Collectivism,
Empiricism) that exist on a continuum of subjective, experiential, objective and analytic
interpretations of human experience (Miller, 1992, In Truscott, 2010). A theory is a map, or a
system of ideas that attempts to make sense of existing information and assist with future
predictions based on the use and explanation of existing phenomenon (Truscott, 2010; Hollowell,
n.d.). For the purpose of this paper, Systemic Family Therapy (SFT), and Behaviour Therapy
(BT) will be examined, comparing and contrasting essential elements of each. Using the
framework of What is a good theory (i.e. Philosophical, Descriptive, Prescriptive, Evaluative),
we can evaluate how well SFT and BT provide us with a core set of logical assumptions, give us
a comprehensive and cohesive explanation of existing information, deliver us with the applied
benefits of change tasks and stand up to the critical review of their evidence base, (Hollowell,
n.d.).

Introduction
Systemic Family Therapy (SFT) is rooted in Collectivism, a world view that values
growth-promoting objective experiences with others (Truscott, 2010). Social contexts give life
meaning and purpose; people and groups are active, purposeful, autonomous, creative and
integrated into a social mix, striving toward healthy functioning, (Truscott, 2010). Individuals are
best understood by exploring interpersonal influences and problems are best solved when others
are involved in the solution.
In contrast, Behaviour Therapy (BT) is rooted in Empiricism which values rationale
thought and objective experience. It assumes that people are reactive and separate from -yet
determined by-their environments, (Truscott, 2010, p.10). Our behaviours are assumed to be the
result of learning and the product of situation specific forces (Corsini & Wedding, 2014).
Problems are a result of external situations or learned habits that impose on the individual and
can be addressed by applying specific techniques which show measurable outcomes.
Four Major Elements of a Theory
Within a theory there are four major elements: Philosophical, Descriptive, Prescriptive
and Evaluative. All elements must be present for the theory to have positive benefits to any
therapeutic situation, (Hollowell, n.d.). The philosophical element examines the assumptions on
which a theory was founded. Importantly, readers should not be left to infer assumptions; the
more explicit the theoretical constructs are presented the more likely clinicians will accept the
logic behind those assumptions, (Hollowell, n.d.). The descriptive element of a theory is how
well the theory explains existing information and phenomena (Hollowell, n.d.). The theory
should describe and account for the range of possible human experiences, including experiences
of individuals across gender, cohort or culture (Hollowell, n.d.). This element is imperative to the
applied benefits; it must give us some guidance regarding what and how to change, (Hollowell,

n.d., p.3). Lastly, the evaluative element, often considered to be the most important element
within a theory, assesses the degree to which theoretical constructs can be tested, and ultimately
verified (Hollowell, n.d.). Because evidence based interventions are often a required element of
any therapeutic approach, the evaluative element is crucial to clinical utility.
The Philosophical Element
SFT and BT both present clear and fairly concise philosophical assumptions, making
them reasonable to conceptualize as a clinician. In SFT a paramount assumption is that the family
is considered to be a basic human system, in which subsystems exist in various categories (e.g.
spousal, parental, sibling and extended), (Corsini & Wedding, 2014). These systems and
subsystems are separate from each other but may interact, and each impact the individual in
different ways (e.g. a women may be a mother, sister and a spouse and interact with multiple
systems such as the family, the workplace or the health care system). One significant contributor
to the theory of SFT was Salvador Minuchin, who asserted three core assumptions. One, the
clients behaviour serves a function or purpose within the family (Adelman, Farwell & Saathoff,
2008). Two, the clients behaviour may be a function of the familys inability to operate
productively, especially during developmental transitions (Adelman, Farwell & Saathoff, 2008).
And three, the clients behaviour may be a symptom of dysfunctional patterns handed down
across generations (Adelman, Farwell & Saathoff, 2008).
Within BT there are also key assumptions explicitly identified within the literature. One
dominant assumption is that problematic behaviours are developed, maintained and changed
primarily through learning, (Truscott, 2010). In contrast to SFT, BT only examines the
individuals behavioral patterns, excluding the behaviours of others they interact with, such as
family members. Basically, Behaviour theory asserts that if we can accept that our behaviours are
learned, then they can also be unlearned and new behaviours can be developed to replace

dysfunctional ones, (Truscott, 2010). Although many contemporary behaviourists may not
subscribe to the idea that people have no free will, that we are born a blank slate or that a persons
environment solely determines their behaviours, early behaviourists believed this to be true
(Moore, 2013). Strict behaviourism is mainly concerned with objective and scientifically
measurable, observable behaviours (i.e. externalized behaviours) and does not take into account
internal events. BT been widely criticized for ignoring these internal events of thoughts, emotions
and cognitive processes (Moore, 2013). In contrast, although SFT supports the notion of
observable behaviours (e.g. a therapist may observe a dysfunctional interaction between family
members), SFT does not discount contributors to peoples behaviours, such as thoughts and
emotions. As BT has evolved into the more contemporary and popular Cognitive Behaviour
Therapy, the integration of individuals thoughts, feelings and emotions, as contributors to their
behaviours and learning patterns, has developed.
The Descriptive Element
In order for a theory to demonstrate descriptive utility, it must be clearly understood by its
users. Dense, convoluted or complicated theories are often discarded, regardless of their
accuracy of ideas, (Hollowell, n.d., p.3). Importantly, the easier the theoretical constructs are
to grasp, the higher the theory may be rated on this particular measure of utility, (Hollowell,
n.d., p.3). In general, both SFT and BT provide clear, concise and comprehensive descriptive
elements.
History of Dysfunction. BT assumes that only factors in the present should be considered
when examining a problem behaviour (e.g. what may be reinforcing the problem), rather than
investigating past factors that could have initially triggered the problem (Truscott, 2010). Within
SFT the history of the systems dysfunctional patterns is paramount, especially when considering
generational behaviour patterns within a family or dysfunctions that are a result of a familys

developmental transitions (Adelman, Farwell & Saathoff, 2008). Family therapists are especially
interested in persistent and repetitive behavioural sequences because they divulge the familys
typical interactive patterns, (Truscott, 2010, p.). These dysfunctional patterns are described using
the redundancy principle, because the range of options members can generate for dealing with
problems is highly restricted by their past experiences, (Corsini & Wedding, 2014).
Behaviour: Cause & Effect. SFT acknowledges that patterns of behaviours may be
learned within the family, and that those behaviours serve some functionality for the individuals.
Within SFT this cause and effect relationship is considered to be a circular causality. A circular
causality accounts for many individuals behaviours within a system, whereby any cause is an
effect of a previous cause and in turn becomes the cause of a later event and so on, making the
transactions between members highly intricate and complicated (Truscott, 2010, p.116).
BT presents with a much more simplistic cause and effect model. Within BT all
behaviours are assumed to have a fulfilling function, for the individual. Within behaviourism the
assumption that behaviours are learned is central to the descriptive element of the AntecedentBehaviour-Consequence (ABC) model. Basically, an environmental stimulus, which is
considered to be the antecedent, elicits a specific observable behavioural response, which then is
considered to be learned based on the payoff or cost that occurs after the behaviour (i.e. the
consequence). Negative consequences reduce the likelihood of the behaviour (i.e. punishment)
and positive consequences increase the frequency, intensity or duration of the behaviour (i.e.
reinforcement). For example, a child that asks for a cookie, and gets one, the child may learn to
request things they want. By determining the specific payoffs and costs for an individuals
behaviours, clinicians can determine the function of behaviour (e.g. communication) which is a
process called Functional Behavioural Analysis or Assessment.

In BT the function of a behaviour in is basically the reason a behaviour occurs. This has
been learned and maintained through patterns of environmental reinforcement and punishment
(Corsini & Wedding, 2014). For example, a child that receives attention for problems behaviours
(e.g. crying when having to leave for school) and not for positive behaviours (e.g. leaving for
school without making a scene) may increase the frequency of the problem behaviour as a way of
getting more attention from a parent (Wedding & Corsini, 2014). Common functions of
behaviours include: self-stimulation/reduction of boredom, attention seeking, communication,
avoidance, frustration tolerance/stress management/reduction of anxiety and control seeking
among others (Leaf & McEachin, 1999). In contrast, SFT does not prescribe to a particular set of
behavioural functions, but it does support the notion that dysfunctional behavioural transactions
between family members are maintained through reciprocal interactions (i.e. a cause and effect
relationship).
Although the ABC model with BT is very clear and concise in its explanation of human
behaviours, it has been criticized for being too narrow. Moore, (2013) explains that a causal
explanation of observable behaviour output must be in terms of something other than direct input
from observable environmental stimulithis something is the mind and the unobservable
cognitive structures that underlie behaviour, (Moore, 2013, p.682). As such, many
psychologists believe that behaviour analysis is inadequate in explaining human behaviours
because it cannot secure a genuine understanding of how other phenomenon (e.g. thoughts,
emotions) contribute to peoples behaviours, (Moore, 2013).
Problem Behaviours. Similarly to BT, observable behaviours are important to SFT.
Within SFT, troubled behaviour is considered to be maintained by problematic transactions
within the family; a circular causality (Corsini & Wedding, 2014). A personal problem may be
thought of as a product of a vicious cycle between a behaviour or quality someone considered to

be undesirable, and an action intended to solve or eliminate it, (Truscott, 2010, p.117). From a
BT perspective this vicious cycle of transactions may be interpreted as individual behaviours that
are receiving reinforcement from others within the transaction; therefore maintaining the problem
behaviour (i.e. ABC). There is congruency between BT and SFT in their use of a cause and effect
relationship for behaviours problems, but they differ in what they attribute the root cause of the
behaviours to be.
Cultural Factors. SFT has evolved over the years to embrace individual differences.
Indeed, more recently, challenged by the postmodern inquiries into the diversity of perspectives
for viewing life, and because work and family roles and responsibilities have changed
dramatically in the last 30 years, SFT made a significant effort to look beyond observable
interactive patterns within the family and examine how gender, culture and ethnicity shape the
perspectives and behaviour patterns of family members (Corsini & Wedding, 2014, p.377).
Today, family therapists believe in a comprehensive picture of family functioning that, at
minimum, understands the cultural context and the form of the family seeking help, (Corsini &
Wedding, 2014, p.377). In contrast, BTs core principles and methods are assumed to be effective
and applicable across cultures and do not deem it necessary to actively evaluate how such
individual characteristics, like culture or gender, impact the therapeutic process. However, it is
recommended that BT consider an individuals culture as part of their environment when
examining a clients behaviours and their response to treatment (Corsini & Wedding, 2014).
Culture can play a large part not only the therapeutic relationship, but also an individuals
attribution of symptomology and their participation in the therapeutic process, (Corsini &
Wedding, 2014).
The Prescriptive Element

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For a theory to be helpful it must give us some guidance regarding what and how to
change, (Hollowell, n.d., p.3); this is called the prescriptive element of theory. From personal
experience, it is important that prescriptive elements be broad enough to incorporate clinical
flexibility, but also be specific enough to maintain treatment integrity within change tasks. It is
not the sheer number of change tasks a clinician should be interested in, rather, one should
consider the clarity and detail presented within the change tasks themselves. Ultimately,
prescriptive efficacy largely determines theoretical utilityif we cannot put the prescriptive item
into practice, the suggestion is not particularly helpful! (Holowell, n.d., p. 3, 5).
Therapeutic Relationship & Therapist Role. It is important to examine the therapeutic
relationship for both BT and SFT. Similarly, therapists in both BT and SFT are considered the
agents of change and their roles are directive in nature. Interestingly, a therapeutic alliance is not
considered necessary within either approach. Within BT and SFT, therapists are expected to
introduce new information and behavioural patterns into the family or to the individual in order
for positive behavioural change to occur (Corsini & Wedding, 2014; Truscott, 2010). Within BT
the client-therapist relationship is understood as an opportunity for modeling desired adaptive
interpersonal behaviours as well as a source for social reinforcement, (Truscott, 2010, p.44).
Likewise, within SFT the therapists main role is to interrupt the maladaptive interactions that are
occurring between individuals by providing new perspectives or behaviours into the system
(Corsini & Wedding, 2014). It is the therapists responsibility to plan and structure sessions
within BT and target goals are developed collaboratively with the client. Conversely, the client is
not involved in goal development within SFT.
Surprisingly, insight is not considered to be necessary component to either SFT or BT.
Within SFT insight is actually considered to be a hindrance; it is better that members of the
system struggle together to incorporate and accommodate the new information introduced by the

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change tasks, (Truscott, 2010, p.118). Within BT, although insight is not required, it is accepted
and even considered helpful. Because BT is considered to be transparent; the end goal of therapy
is for the client to become proficient in the use of strategies so they are able to become their own
therapists, (Corsini & Wedding, 2014). This is not a goal of SFT, rather, an outside individual,
such as a therapist, is required to identify and change dysfunctional behaviours patters. This is
because the members of the system are considered unable to do so on their own. Basically, the
more that individuals in the system attempt to resolve the problem, (i.e. return to homeostasis),
the more the problem is maintained and the less likely a plausible solution can be reached,
(Truscott, 2010). A therapist is always necessary to change dysfunctional patterns of interaction.
Therapeutic Process. Observations. Initially, before change tasks are recommended,
therapists in both SFT and BT observe the clients problem behaviours. BT focuses on
observation within the exact context of the problem (e.g. childs behaviour in the grocery store).
In contrast, the systemic family therapist may ask the family to engage in a re-enactment of
their problem interactions (e.g. disagreement between family members), if direct observation is
not possible. These Enactments are family role plays that emphasize acting out difficulties so the
therapist may observe patterns. Discussing conflicts or complaints is not helpful within
enactments; the therapist and the family need to see that problems and interventions can be
proposed immediately and tried out, (Truscott, 2010). Similarly, in BT, the observation should
exclude discussions; observing the behaviour as it naturally happens is imperative.
Practice. Within BT clients are expected to be active in the change process. The therapist
often gives clients homework to practice, strengthen or generalize what the client has learned
within the session to his or her life, (Truscott, 2010). When client change is not occurring, the
therapist accepts responsibility and alters the change tasks; the client is never blamed or labeled
as resistant, (Truscott, 2010). Similarly, SFT recommends that individuals within the system

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practice new interaction patterns within the family. The therapist is always responsible for
providing individuals with new information as a means to facilitate change and this may require
multiple avenues or attempts. It is through this process in SFT that a new view point and selfactualizing processes are mobilized for the family members, (Wedding & Corsini, 2014).
Individual vs. System Change. BT focuses on changing individuals behaviours. SFT also
focuses on changing individuals behaviours, but places greater importance on changing the
system itself (e.g. family). First-order change in SFT involves improvement in symptoms
expressed by the individual, without changing the organization of the system (Truscott, 2010).
This type of change is similar to BT in that focuses only on what the individual can do to improve
their problem behaviours. Second-order change tasks involve fundamental changes in the
systems organization, in this case the family, (Truscott, 2010). Ideally, communication patterns
and transactional rules are changed (e.g. spouses may learn to productively have a disagreement)
so that the problem behaviours are no longer necessary to the systems functioning (Corsini &
Wedding, 2014). BT does not consider changes to the functioning of family members. Although,
from personal experience, when a family member is involved in reinforcing maladaptive
behaviours (e.g. avoidance, tantrums, aggression), a Behaviour therapist would provide them
with new perspective and recommend they alter their reactions. In contradiction to BT, SFT
believes that that individual behaviour change (i.e. first-order) cannot maintain positive
interactions, without the use of second-order changes. When second-order change occurs
communication and behavioural transaction patterns are now differentthe problem no longer
presents itself for any participants in the system, (Truscott, 2010, p.117).
Change Tasks. The systemic family therapist may prescribe specific change tasks such as
Reframing or the Therapeutic Double Bind. Reframing presents the family system with new
information and describes how undesired symptoms are a function of desired family processes,

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(Truscott, 2010). The family changes communication and relationship responses in light of seeing
the problem behaviour from a new perspective. The Therapeutic Double Bind actually prescribes
the symptom, to interrupt the established feedback loop, (Truscott, 2010). Families are given a
choice to continue manifesting the behaviour or to cease the behaviour, thereby stopping the
problem, (Truscott, 2010). Within BT the therapist may also recommend specific change tasks
such as Exposure-based interventions, where the individual may systematically expose
themselves to the fear eliciting stimuli, Relaxation-based interventions, to promote physical
relaxation as replacement behaviours used within exposure-based interventions, Response
Prevention, where individuals are prevented from engaging in compulsive type rituals or Operant
strategies/Contingency Management Procedures, which manipulate environmental stimuli to
reduce undesired behaviours and increase desired behaviours through the use of strategies such as
Shaping, Token Economies or Time-Out, (Truscott, 2010). Although there are many more change
tasks then have been discussed here, SFT and BT change tasks are all congruent in their
assignment of strategies, in which the client must first make a choice to change their behaviours,
then actively practice those strategies, in order to eliminate the problem. Other therapeutic
approaches, such as Existential or Person-Centered therapies may focus more on the subjective
experience of the client (e.g. developing authenticity) in comparison to the objective experiences
required for change within SFT and BT.
Implementation. From personal experience, although behavioural interventions may
appear straight forward to implement, because they are highly manualized, they are very difficult.
Clinicians need to consider all elements of the individual in order to successfully implement
change tasks (e.g. language and cognitive abilities). Similarly, because the SFT works with the
behaviours of multiple individuals, one would assume the implementation of change tasks may
be challenging. Both approaches require a high adherence to treatment recommendations for

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positive client change. So, the client and the therapist must both be willing and active participants
in the therapeutic process for problem behaviours to resolve. Lastly, because client success is
dependent on multiple individuals who must be willing to change their behaviours and
perceptions, SFT may have limited success when one member of the system is resistant.
Cognitive-Behaviour Family Therapy. Interestingly, BT and SFT converge in a specific
type of therapy termed Cognitive-Behaviour Family Therapy. Therapists engage in techniques
that work on the familys cognitions surrounding dysfunctional interactions, which are assumed
to play an integral part in the development of behaviours. Basically, teaching individuals and
their families to change their distorted beliefs and evaluate their thought patterns gives rise to
new cognitive schemas (i.e. thought patterns learned early in family life) and cognitive
restructuring, (Corsini & Wedding, 2014).
The Evaluative Element
Lastly, we will examine the evaluative element of SFT and BT. It is the degree to which
theoretical constructs can be tested, and ultimately verified, that supports the evaluative element
of a theory (Hollowell, n.d.). Although other elements are important, the evaluative element is
critical when choosing evidence based interventions. When evaluating evidence base for both BT
and SFT it is important to consider what constructs are being measured (e.g. frequency and
severity of compulsions) and what the evidence supports (e.g. does the use of exposure therapy
reduce the frequency and severity of compulsions?), (Hollowell, n.d.). In examining the evidence,
there are many individual factors that impact the utility of each approach, such as cohort (e.g.
children, adolescence, adults), gender, culture, spirituality, diagnosis (e.g. depression, anxiety,
OCD, etc.), and cognitive abilities. These factors play a significant role, not only data analysis,
but more importantly clinical utility. For example, a therapeutic model that indicates evidential
support for behaviour change in adolescent women may not be successful with adult men. Or,

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one therapeutic approach may work harmoniously within an individuals spiritual beliefs but not
be congruent with anothers. As such, we need to be aware and careful in our analysis of the
evidence when investigating the efficacy of any individual therapeutic approach. Although it is
beyond the scope of this paper to analyze each factor with respect to the utility of both BT and
SFT, it is important to consider these factors when choosing evidence based interventions.
Behaviour Therapy & Systemic Family Therapy-Measurability. Historically, research
in BT begun approximately 50 years before research in SFT. BT has a substantial evidence base
of its core principles. In addition, operationalizing behaviours and constructs are inherent to BT
and must be implemented within any therapeutic change task, even when research is not being
conducted (e.g. using Applied Behavioural Analysis). For this reason, BT it is inherently more
measurable then most other therapeutic approaches, such as SFT.
Although BT has been criticized for its supposition that research findings on animal
behaviours can be generalized to the treatment of human behaviour (Moore, 2013), research
within the human population has grown significantly since the initial conceptualization of BT
principles. Importantly, Ivan Pavlov (Classical Conditioning), J. B. Watson (Classical
Conditioning in humans), Edward Thorndike & B. F. Skinner (Operant conditioning, positive
reinforcement, punishment), Joseph Wolpe (Systematic Desensitization/exposure therapy), Albert
Bandura (Social Learning Theory) and Nathan Azrin (Applied Behavioural Analysis, token
economy), are still celebrated today for their countless contributions to behavioural research.
Many of the paradigms they observed over 100 years ago continue to hold clinical utility today.
Historically, examining the beginnings of SFT, we can also see an initial evidence base in
its core assumptions. However, in contrast to the measurability of behaviour techniques, SFT is
complicated and challenging, because of the virtual relationships and boundaries it attempts to
assess, (Corsini & Wedding, 2014). In 1958, Ackerman, developed literature that brought forth

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the concept of interlocking pathologies, endorsing that an individuals problems cannot be


understood apart from other members of the systems the individual interacts with, (Corsini &
Wedding, 2014, p.381). Similarly, Minuchin developed several specific techniques that aimed to
reorganize unstable family structures (Minuchin, Montalvo, Guerny & Schumer, 1967). However,
the early years of systemic therapies only produced anecdotal data, nothing empirical.
Manualizing Approaches. Measuring the various interactions between numerous and
complex contributors to a unit, such as a family, is difficult. Change may occur in a multitude of
behaviours (e.g. intraphychic, communication, relationship) and in different variations for
different group members, which challenges measurability, (Corsini & Wedding, 2014). Plus, the
types of family (e.g. ethnicity, background, level of family functioning, etc.) highly influences the
change process and is also difficult to measure in a baseline-outcome fashion, (Corsini &
Wedding, 2014). Manualizing approaches has been a recent focus for all types of psychotherapies
for this reason.
Qualitative methods have become more popular when examining the benefits of SFT,
such as efficacy studies or effectiveness studies (Corsini & Wedding, 2014). One criticism of this
research is that the results are not always translatable into specific recommendations for realworld therapy, which is a significant pitfall that has not only plagued SFT, but also BT (Corsini &
Wedding, 2014). Often, behavioural principles in BT are implemented in highly contrived clinical
environments. Sometimes these situations are too artificial to generalize those learned behaviours
outside of the specific and controlled settings they are taught (Moore, 2013).
Westen, Novotny and Thompson-Brenner (2004) recommend researchers focus on
researching techniques that work in real-life and avoid clinic based interventions altogether. This
notion proposes a challenge when therapists work from different perspectives or use manualized
techniques (Corsini & Wedding, 2014). Within BT, the clinician should strive to work within the

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specific setting that the problem behaviour occurs, which is congruent with this recommendation.
However, this is not always possible. And, although manualization of techniques has improved
not only the research methodology, but the empirical outcomes and treatment integrity, it may
also increase the risk of inflexible programming that is less adaptable to individual differences.
This will likely reduce positive client change. That being said, evidence for Family systems
therapy is now comparable to research on many other interventions strategies, (Wedding &
Corsini, 2014, p.401), supporting the recent increase in its manualized approaches.
Current Empirical Research. There is now evidentiary support for the use of SFT for
the treatment of individuals with conduct disorder, high-risk adolescents, individuals with actingout problems and parent management training (Corsini & Wedding, 2014). Participation in SFT
programs has reduced individuals likelihood for relapse and rehospitalisation for those diagnosed
with schizophrenia (Corsini & Wedding, 2014). And, there is ample evidence to support the use
of SFT with multiple cohorts (Carr, 2014; Von Sydow, Beher, Schweitzer & Retzlaff, 2010),
when combined with other therapeutic approaches, such as Cognitive Behavioural Therapy
(Yongmei, et al., 2014), for specific disorders (Pilling, et al., 2002), and within different systems
(e.g. spousal, family, parent-child) (Brendel & Maynard, 2014; Stratton & Lask, 2013; Shadish &
Baldwin, 2003). Systemic Family Therapy now holds a sufficient research base to support its
efficacy not only as a theory, but as a therapeutic approach.
The Society for Clinical Psychology (a division of the American Psychological
Association) publishes a list of empirically supported psychological treatments; on this list 60 out
of 77 treatments listed are behavioural or cognitive-behavioural in nature (Corsini & Wedding,
2014). This list is an accurate representation of the literature available for empirically supported
treatments; research on behavioural and cognitive-behavioural treatments is much better
developed than any other form of psychotherapy, (Corsini & Wedding, 2014, p.217).

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Importantly, Behavioural Therapy and Cognitive Behavioural therapy approaches have been
shown to be effective within hundreds of studies with just about every type of psychological
problem (Corsini & Wedding, 2014, p.216). In a literature reviews by Corsini and Wedding
(2014) and Truscott (2010), they recognise evidence that supports BT for the treatment of
multiple disorders, including anxiety disorders, depression, substance-use disorders,
schizophrenia, eating disorders, sexual dysfunction, sleep disorders, borderline personality
disorder, problem gambling, Autism Spectrum Disorder, Attention Deficit Hyperactive Disorder,
and Obsessive Compulsive Disorder. Importantly, BT has shown to be successful with both
children and adults, as well as across a wide range of even more specific groups, (Corsini &
Wedding, 2014; Seligman & Ollendick, 2005; Kendall, 2000). Lastly, BT is reinforced by a large
assembly of empirical evidence supporting individual change tasks (e.g. modeling, exposure
therapy, social skills training, etc.), (Corsini & Wedding, 2014; Truscott, 2010). Because many of
BTs techniques are manualized, for example Leaf & McEachins (1999) behavioural curriculum
for children with ASD, one can be confident in treatment integrity when implementing such
techniques. Clearly, the evidence base is solid for BT
Conclusion
In conclusion, as clinicians looking for evidence based interventions, that hold logical
assumptions, concise and succinct descriptions, and evidence based change tasks, we can be
confident in the utility of both BT and SFT. When we have the opportunity to work with the
childs family and the school, together, we can anticipate better outcomes for not only the student,
but the adults supporting them. BT and SFT provide school psychologists with substantial
literature on both their theoretical basis and their therapeutic approaches, backed by empirical
evidential support. As such, we can be confident in their value and efficacy.

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