Older Mind Matters

Family therapy and systemic practice - older people are adults too!

I’m a member of the Association for Family Therapy and Systemic Practice (AFT for short) so I’ll declare an interest now. In fact I became the Treasurer last year (help!) What I want to highlight though are two useful resources available on the AFT website.

Firstly AFT has published an updated evidence base for family therapy and systemic practice, updated by Professor Peter Stratton. This is a very important and useful document and it’s great that it can be downloaded from the public pages – get it here. The document lists conditions for which there is evidence that systemic family and couple therapy is effective or efficacious. There are 22 conditions listed in adults and – surprise surprise! - older people are adults, so those of us working in older people’s mental health need to be know about this and bring the evidence base to the attention of relevant people including commissioners, service planners, and managers.

The other valuable resource is called NICE Clinical Guidelines recommending Family and Couple Therapy complied by Dr Lucy Davis and it can be found here. Older adults don’t really figure in the NICE clinical guidelines recommending family and couple therapy, but the document lists the NICE-SCIE dementia guideline published in 2006 (CG42 - find it here) under clinical guidelines recommending “involvement with families and carers”. The Dementia guideline is currently being updated with publication scheduled for summer 2018. But again older people are adults too, and so Clinical Guidelines supporting the use of family and couple therapy for conditions of adults include older people.

I suppose that the final thought I take away from the two documents is a point that Peter Stratton makes strongly (page 22 of the Evidence Base):

“ The message from these sources is consistently that systemic family and couple therapy is effective in a variety of forms and contexts, for whatever conditions and circumstances have been researched … (BUT) … there are many areas of everyday systemic practice that have not been researched.”

So, to any systemic family and couple therapist reading this, the message is clear – we need to research and evaluate our practice. If we don't, then we will continue to be eclipsed by therapies with a stronger research track record, but which do not offer the same potential benefits to families and couples.

PS: I do try to make a modest contribution - download a pre-publication version of the review paper that Victoria Sharman and I wrote on family therapy and dementia here. The reference to it is International Psychogeriatrics (2014) 26 (12): 2037-50.

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