Training family therapists to work with children in family therapy: A modified Delphi study

The field of marriage and family therapy must address the needs of all family members, including young children. Yet research indicates that many MFTs do not feel adequately trained or comfortable to work with children, and many exclude children from family therapy sessions. The purpose of this study was to gather a consensus of recommendations from experts in the field on how to improve child-focused training. A modified Delphi methodology was used to collect both quantitative and qualitative data. Based on previous research, six open-ended questions were posed on Delphi I. Four panelists participated in qualitative interviews to clarify responses. Delphi II contained panelists responses to Delphi I and comments from panelist interviews for some items. Following Delphi II, six more qualitative interviews were conducted to address discrepancies in the data. Finally, a qualitative interview was conducted with Salvador Minuchin, who reflected on these results and offered his thoughts on this topic. Panelists believed that children should be active participants in family therapy sessions for both child and adult presenting problems. They should only be excluded during adult sexual discussions, or initially when parents are discussing how to share sensitive information. Child-focused course content should emphasize developmental issues, practical techniques to engage children and families, theoretical issues, play therapy theory, MFT treatment for child disorders, and specific issues that impact children and families. Panelists only recommended one reference for child coursework. Therapist attributes and relational skills are essential skills for MFTs to develop. Panelists recommend both deductive and inductive training methods and highlight the role of supervision to increase therapist comfort and skills with children. Therapist playfulness and creativity are important considerations in training, but no specific play therapy techniques were recommended. Minuchin discussed these findings in light of historical aspects of training and recent developments in the field. Implications for training programs and for the field are discussed