Medical family therapy

Domain V · Systemic, relational, group & community · McDaniel, Hepworth, Doherty · 1992

What it is

Research note (read first). The founders' books (McDaniel, Hepworth & Doherty 1992; McDaniel, Doherty & Hepworth 2014) are cited here from publisher descriptions, catalogue records and secondary sources; their chapter-level wording is not reproduced. The weak points were checked against legitimate…

Format

• MedFT has no fixed phase protocol or session count. Sources describe an episodic, collaborative course whose shape depends on the setting. The phase sequence below is a working structure taken from the books' usual chapter order (referral and collaboration; assessment; intervention; ending with an…
• Setting determines format. The two scaffolds below decide what the course looks like.

Who practises it, and how they are trained or regulated

• Doherty & Baird's levels of family involvement (1986) were written for physicians. They work as a dial for how deep to go with a given family: (1) minimal emphasis on the family; (2) ongoing medical information and advice; (3) feelings and support; (4) systematic assessment and planned intervention to help the family cope; (5) brief family therapy aimed at family problems that were there before the illness. Marvel,…
• Training and credentials. No licence or certification is needed to practise under the name. MedFT is taught in graduate programmes (e.g. East Carolina University's doctoral programme, where the Delphi study was done) and in continuing education. The University of Rochester Institute for the Family runs a week-long annual June intensive, co-directed by Susan McDaniel and Tziporah Rosenberg. It combines clinical…

Questions to explore with your client

• What drew you to it, and what are you hoping it will change?
• Does it involve any substance, plant preparation, remedy or supplement? Has your doctor or prescriber been told, especially about any medication you take?
• Does it involve fasting, a special diet or 'detox'? Have you discussed this with your doctor?
• Is it a group, retreat or community? How do they respond if someone wants to leave or raises a concern?
• How do you and the practitioner understand what is happening, in spiritual or cultural terms? Is that a source of comfort, worry, or both?
• Who runs it, and what training or registration do they hold?
• What actually happens in a session or meeting, and how often?
• What does it cost, and is there pressure to commit to more?
• How do you feel afterwards, in the hours and days that follow?
• Does it fit with, or clash with, the work we do here?

What practitioners of it watch for

• Over-identification, avoidance of end-of-life topics, rescuing.
• Enmeshment presented as closeness; a sole carer heading for burnout.
• Professionals dominating; the patient being talked about rather than to.
• Denial dressed up as "normal life" when medical tasks are being neglected.
• Mismatch between family members about prognosis; complicated grief; exhaustion in the carer.

When to involve someone else

• New or worsening physical symptoms, or advice to stop or change prescribed medication: involve the client's doctor or prescriber.
• Signs of coercion, isolation from family and friends, escalating costs or secrecy: discuss openly and consider safeguarding.
• A crisis or thoughts of suicide: follow your crisis protocol. In the US, call or text 988; in the UK and Ireland, Samaritans on 116 123.

Drawn automatically from the guide's own sections. Stay curious: neither endorse nor dismiss what the client values, and check anything that matters against the full guide and its sources. Not medical advice.