Clinical Psychology

Some General Characteristics. Certain aspects
of family therapy differentiate it from the customary
individual therapy. For example, family members
have a shared frame of reference, a common his-
tory, and a shared language of connotations that
may be foreign to the therapist. The therapist has
to learn the family roles and something about the

family’s idiosyncratic subculture. This information

is used to enhance communication or to confront

family members. At the same time, the therapist

must remain detached and not become overly iden-

tified with one faction of the family at the expense

of another. This can be a difficult and delicate task

because family members will often attempt to use

psychiatric disorders. Finally, I have expertise in the

systems issues inherent in running a school for students

with psychiatric disorders. I know how to work with

professionals from a variety of disciplines to facilitate

their ability to do their best work and make progress

toward shared goals for our students.

What are the future trends you see for clinical

psychology?

I see a need to continue to disseminate evidence-based

treatments for childhood disorders to mental health

practitioners in the community so that more youth

have access to the most effective treatments available.

By virtue of working in an internship training program,

I also see the necessity of resolving the now chronic

issue of the mismatch between the smaller number of

internship slots available and the larger number of

applicants coming out of graduate programs.

What are the special challenges involved in working

with adolescents in a family or group context?

The developmental differences between a 13-year-old

and a 19-year-old are enormous as teenagers tackle

many transitions from middle school to high school

and beyond. When working with adolescents, it is

important to acknowledge the increasing importance

of peer relationships and the need to facilitate the

development of independence and autonomy.

In the context of family therapy, learning to nego-

tiate and problem-solve within the family is a necessary

skill for teenagers and their parents. It is particularly

important to support parents as they negotiate a dif-

ferent relationship with their adolescent than they had

with their child. Parents have to manage the often scary

process of letting their teenager try new things even

though they know their teen isn’t always going to suc-

ceed. The family therapist has to juggle the roles of

coach for the teenager and the parents in order to

model effective problem-solving skills.

In group therapy, it is important for therapists to

be thoughtful when determining the membership of

therapy groups. For example, groups consisting only of

teenagers with conduct problems run the risk of facili-

tating more maladaptive behaviors among group

members. Group therapists also must be mindful of

setting clear rules about confidentiality among group

members, particularly in this time of easy access to

social media.

Greta Francis

BOX15-2 Clinical Psychologist Perspective: Greta Francis, Ph.D., ABPP (Continued)

Greta Francis

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