The field of marriage and family therapy is evolving toward theoretical and practical models with an ecosystemic focus which encourage an awareness of different levels of system interaction yet therapists have rarely been encouraged to explore the spiritual dimension of their clients' lives, even though doing so may enrich the understanding of the metaphors and meanings which inform their existence and perhaps, their problems. This paper challenges therapists to consider the spiritual belief systems of their clients which have contributed to the development or maintenance of the presenting problem. The authors present case examples and specific suggestions for clinical practice.

In the midst of a revitalized interest in spirituality and religion in Western societies, there has been reported a resurgence of activity regarding spirituality and religion in the mental health professions, including marriage and family therapy (MFT). Little is known, however, about the beliefs, behaviours, and training experiences of MFT graduate students. Therefore it is important to examine the training (education and supervision) needs in this area. For this initial study, a sample of US MFT graduate students were surveyed regarding their spiritual and religious attitudes and practices in their personal and professional lives. In most areas, graduate students were found to be similar to the previously published reports of practising professionals. In other areas, they report even more investment in spirituality and religion. The results of the survey suggest a need to include systematic attention to these areas in graduate training curricula and in the professional supervision process.

Background: Depression costs the United States $40 billion annually. Primary care physicians play a key role in the identification and treatment of depression. This study focused on the treatment options recommended by physicians and whether physicians were following the recommended treatment guidelines.Methods: We recorded treatment recommendations by examining charts for all patients with newly detected depression. The patients were from 44 family medicine practitioners and 23 general internal medicine practitioners in a Midwest university medical center setting.Results: For both medical specialties combined, pharmacotherapy was the most widely used intervention (recommended for 52% of patients), whereas psychotherapy alone was the least frequently used intervention (recommended for 4% of patients). Family medicine practitioners recommended combination treatment (pharmacotherapy and psychotherapy) more frequently than did general internal medicine practitioners (P ‫؍‬ .022), and female physicians recommended combination treatment more frequently than did male physicians (P ‫؍‬ .010).Conclusions: Pharmacotherapy was found to be the most widely used treatment despite current evidence-based recommendations. Barriers to effective treatment plan are discussed. The implications for mental health interventions, combination therapy, and cost offset are also discussed.

The reflecting team concept, a practical application of constructivist ideas, is adapted for use in group supervision. The evolving model includes a focus on the unique "fly on the wa1l"perspective of the reflecting team. In addition to case supervision, the benefits of the model include: (a) the supervisee's ability to be at the meta-level of his or her own process; (b) the presentation of feedback in a less threatening manner; and (c) dramatic insight regarding the process, which enhances work with clients. Not only are trainees introduced to a multiverse of new ideas and perspectives, it is done in a refreshing context which integrates some of the most challenging ideas in the field.

The professional literature contains numerous theoretical and case study articles regarding the development and use of solution‐focused therapy. However, as with many models of systems‐oriented therapy in use with couples, very little has been subjected to empirical investigation. This project was designed to make a contribution to the empirical literature regarding the effectiveness of solution‐focused therapy in use with couples’ groups. This study utilized pre‐test comparisons of treatment and comparison groups, and examined pre‐ to post‐test changes in the scores of the treatment group couples. Twenty‐three treatment group couples participated in a six‐week solution‐focused couples therapy (SFCT) group. A separate group of thirteen couples served as a comparison group. The Dyadic Adjustment Scale (DAS) was used to assess changes in the couples’ relationships. Scores on the Marital Status Inventory (MSI), as a pre‐test measure indicating the couples’ likelihood of divorce, indicated no significant differences between groups. The remaining analyses revealed significant improvement in DAS scores. Self‐reports from the couples involved indicate improvement in a variety of areas after completing the six‐week solution‐focused couples group therapy process.