Family therapy and systemic practice play a vital role in both adult and child and adolescent mental health in-patient services. and We also excluded one treatment study that was a randomized controlled trial from this analysis because the family functioning measure was only administered to mothers and not their family members. A total of 86% [34–35, 37–39, 40] of studies were judged as low risk of reporting bias and one study  was judged as unclear. Close this message to accept cookies or find out how to manage your cookie settings. As originally hypothesized, our analysis of level of family involvement showed that mothers of family members who attended at least 80% of the preventive intervention sessions experienced a statistically significant decrease in depressive symptoms when compared to those of family members who attended fewer sessions. This finding in itself shows that drug treatment was far less acceptable to the patients in the study than was couple therapy. Despland, Jean-Nicolas Patients allocated to the different treatments were matched on all relevant characteristics, such as age of patient and partner, gender of patient, chronicity and severity of depression. The following studies were excluded from this review and meta-analyses: non-randomized trials; studies without maternal depression as a primary outcome; studies without a family functioning measure; studies focused on addiction or substance misuse/abuse; studies of mothers with medical conditions; studies of infants with medical conditions or complications at birth; studies that focused on only the mother-infant dyad without any other adult family member participation; studies of parents of children age two years old and older; studies with trauma-based interventions; studies with domestic violence interventions; studies that were not written in English; studies not published in peer-reviewed journals; and studies published prior to 1995. family therapy in North America. Ten principles for practice are described to guide therapists in integrating the trauma lens into their family therapy practice. When looking at outcome, it emerged that the majority of deaths in the family intervention and the control groups were owing to suicide (4%). "languageSwitch": true The Cochrane Collaboration Grades of Recommendation, Assessment, Development, and Evaluation  system was used to rate the overall quality of the seven included studies. Examples of family therapeutic interventions include: behavioral marital therapy, cognitive-behavioral skills training (e.g., couple communication, problem-solving, conflict management), interpersonal therapy, and solution-focused therapy. Dosage was measured by number of sessions attended by mothers and intervention duration in hours in the prevention studies. This decision was made given the differences in the sample characteristics between the two types of studies (i.e., the treatment studies only included mothers diagnosed with Major Depressive Disorder and the prevention studies included mothers with varied levels of depressive symptoms) and the focus of the intervention (i.e., treatments focused on depression and preventive interventions primarily focused on general functional improvement during the transition to parenthood). The trial involved an initial baseline assessment of patients with depression and their partners, followed by an intervention (treatment) phase. A two-stage review process was used for eligible studies; first, the quality of the research design was assessed in each study and second, threats of bias were assessed . For this reason, this result should be interpreted with caution. Six studies (86%) [34–37, 39, 40] were judged as moderate quality because these studies included unclear risks of bias. } The majority of the studies that met the inclusion criteria included interventions that were delivered by mental health professionals (e.g., social workers, doctoral trained Licensed Marriage and Family Therapist, psychologists, psychiatrists). In brief solution-focused therapy (Reference De ShazerDe Shazer, 1985) the problem saturated ways of talking are deliberately ignored, with the focus instead on the patterns of previous attempted solutions. Furthermore, there is evidence that there is a tendency to improved compliance with medication for individuals whose relatives receive family intervention, suggesting that family intervention does encourage drug compliance. One study  was judged as very high quality since the risks of bias were low across all domains. Over the past five decades a whole range of systemic approaches have been developed. The term family therapy can be misleading. Research has shown that untreated perinatal depression can adversely affect birth outcomes [5–6], result in poor maternal-infant interaction [7–8] and increase the risk for child maltreatment . Nevertheless, two studies report a trend towards increased ability to live independently, but these results are not statistically significant. Other studies (Reference MartinMartin, 1985; Reference Herscovici and BayHerscovici & Bay, 1996) have replicated these results, with systemic family therapy being the main treatment, although used in combination with a mixture of individual and in-patient treatments. To date, some 19 RCTs have been identified. Research has shown that family therapeutic interventions that aim to prevent or reduce perinatal depression target communication skills related to expectations (including those that pertain to gender roles and the transition to parenthood) and emotional support [34–40], conflict management [38–39], and problem-solving skills related to shared responsibility in infant care and household activities [36–39]. Looking at the various studies, it transpires that there was no universally accepted definition of relapse. There are some limitations in our study. As to the term therapy, it tends to imply the presence of illness or dysfunction, located in the family rather than one of its individual members, and may thus be quite unacceptable to families who often believe that it is the patient and not them whom requires help. The search syntax for each database was pilot tested, and the syntax was further refined until finalized. Writing – review & editing, * E-mail: Fallon.P.Cluxton-Keller@dartmouth.edu, Affiliations Department of Family Therapy Dissertations and Applied Clinical Projects. Earn 1.0 CE Credits Lynn Ponton on the Challenges and Joys of Working with Teens . GRADE includes a thorough assessment of the study design and its execution, consistency of the results, directness of evidence, precision, and publication bias . and Asking each to comment and reflect on the answers given by the various family members creates feedback that changes the fabric of family interactions. The PRISMA checklist is included in S1 Table. An important area for future research on this topic is the inclusion of same-sex couples. The systemic approach is essentially a contextual approach – seeing and treating people in context. Strategic family therapy is more effective for the female subjects than the male subjects. All studies were published in peer-reviewed journals. 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