
Read Centre Director Professor Jenn McIntosh's recent interview with Nicky Paterson, as they explore how workforce capacity building and partnerships will shape the future of family therapy and systemic practices.
Question: What’s coming down the line for family therapy and systemic practice workforces?
JM: Let’s first consider who and what the family therapy and systemic practice workforce is. At the Bouverie Centre, we support both clinical family therapists as well as a significantly larger group of allied practitioners who make up the mental health workforce. We are living in a wonderful era of recognition that mental health approaches need to change, supported by the Victorian Royal Commission into Mental Health and Wellbeing, specifically its mandates for what amounts to service modernisation. These workforces are stepping out of a decades-long focus on individualistic views of psychopathology and default equivalents in treatment, toward a more contemporary relational context of understanding and treating mental health and alcohol and other drug challenges. Workforces are encouraged to think systemically. This means:
- Thinking about people, and their mental health, in the context of their relationships, and
- Recognising that all trauma is relational in some way – in causation and/or impact and in healing and solution.
Question: What are the challenges of this?
JM: There’s a great relief and energy for this new direction, both here at the Bouverie Centre and across Australia with our systemically-trained colleagues. A challenge we’re facing is that the majority of our workforces are not family-therapy trained, because pursuing that clinical qualification is a 3-year pathway through a Masters degree. Some will do that, and many won’t be able to.
So a question and challenge that we’re addressing here at Bouverie is ‘what is the in-between space?’ Where can we support teams and practitioners to acquire “enough” of a systemic perspective to enable a genuine family sensitive response. How can we support managers to embed that in their services. And these are services right across the life course from infancy, childhood, adolescence, young adulthood, to adulthood and elder care. So increasingly, we are supporting workforces to operate in a family-sensitive and inclusive way, without reliance on becoming specialist family therapists.
Traditionally when services have attempted family inclusive work, it’s been a little bit transactional, with a focus on what information the family could give or on sharing information about the treatment of their family member. Services have come at it with some suspicion and then energy, moving from the old paradigm where we may have erred toward thinking that families “cause the problem, so why include them in treatment”? It’s exciting to shake this up, to be part of helping the workforce re-narrate this, to say, ‘it’s now our core business to help people in close relationships to help each other’. This is really the heartland of what we’re now trying to do.
Question: What are we doing at the Bouverie Centre to uplift the sector?
JM: We’re doing a lot. Capacity uplift of the workforce is our bread and butter. It’s about two-thirds of what we do. We are a national resource for many services aligning their mental health care approach in a family-inclusive way. We respond to services seeking training from entry-level family-sensitive practice to advanced clinical skills.
At the skills building end of the spectrum, we offer an exciting model where external practitioners come to our centre and intern in our Walk-In Together clinic. This is for 3 months, working with Bouverie therapists, who remain some of the most experienced family therapists in the Southern Hemisphere. In this program, we teach a single-session approach to family consultation and family work. We showcase this approach in our new service model, called RAFT (Rapid Access Family Therapy), an exciting addition to the way we work at Bouverie.
Question: What’s an example of how the Bouverie Centre uplifts the sector?
JM: We are currently working with the Peninsula Mental Health Group (PMHG), an exemplar area mental health service, to understand how it has traditionally conceptualised family inclusion in acute psychiatric response settings (community crisis outreach and inpatient). These services are working hard and fast to redefine the scope and nature of what they do through their models of care. Central to this is how family-inclusion principles could inform brief, crisis-driven responses. Our Practice and Service Development team is working closely with PMHG to deepen the rationale for family inclusion and to support them to operationalise this approach. Here the implementation approach is “train to sustain skills”. Offering secondary consultations, supervision and a Community of Practice is standard in the training packages we offer.
Question: How can we support knowledge about training impact?
JM: Workforce capacity research is at the heart of our work at Bouverie. We do this within our own training systems through embedded surveys and a longitudinal follow-up study of how our training has impacted practitioner confidence and capacity. We want to understand where people are starting from, their knowledge gain, and the short-term and one-year-on impact of training. We see uplift of confidence and capacity as key, and we track that. We are curious about clinicians’ confidence in supporting people in distress across a number of contexts. As good systemic thinkers we are also interested in tracking training impact on the self, namely, does training in family therapy help resource you as a family member yourself, and how you conduct yourself in your own family life. We are finding that people who take our family therapy training almost exclusively report sustained impact within their own families. How good is that?
In our First Nations graduate certificate, we have taken a finer lens to understanding how that one-year culturally informed teaching program impacts First Nations practitioners’ confidence and capacity, their sense of self, healing of intergenerational trauma, and place in community.
At the other end of the spectrum, we coordinate large scale projects like FaPMI (Families where a Parent has a Mental Illness), and we run the statewide audit of those services, tracking service responsiveness to, and inclusion of, families.
We try to integrate all this knowledge - namely years of data collected from across the state right through to smaller training programs - and to integrate it all, adjusting our training to better meet the needs of our workforce and the families they care for. Our goal is to pay it forward into the field, through meaningful training guidelines. We now have clear state-wide and national directions around family inclusion, and Bouverie has an evidence-based approach for translating these into action.
Question: Final thoughts?
JM: The meaningful design of training and implementation is important to us. One of the characteristics of the way Bouverie goes about training is co-design. Frankly I hate that word, because on one level people are treating it as a politically correct tickbox, but what does it really mean? It means earning the trust of a service, so we can work alongside them to see and understand their systemic knowledge base, skills and competence, and support them to learn in the way that works best for them.