Despite wide agreement in the systemic field that therapists should take a non-blaming stance, historically there has been little exploration of how this stance is achieved in practice. The difficulty in knowing how to put ‘non-blaming’ into practice is further heightened by competing models of intervention with families affected by psychosis. This study contributes to a body of literature that is concerned with how complex issues of morality are achieved dialogically by considering how family therapists manage the tension of intervening to promote change whilst maintaining a multi-partial, non-blaming stance. Two therapies carried out with families affected by psychosis are analysed using the methods of Conversation Analysis (CA) and Membership Categorization Analysis (MCA). In both therapies the sequences examined are drawn from the second session of therapy where explicit blaming events occur. By examining blaming events chronologically through the course of a session the study shows how the rules about the way blame is talked about are achieved interactionally. The analysis demonstrates that systemic theory’s emphasis on the importance of being non-blaming is grounded in a sophisticated understanding of the threat blame poses to co-operation and agreement. In both therapies, the delicacy and ambiguity with which blame is treated serves to enable the conversation to continue without withdrawal. However the cost of ambiguity is a possible misunderstanding of the intent of the speaker. The resulting misalignment, where it continues over several turns and sequences, leads to explicit blame becoming relevant as a solution to a redundant pattern of interaction. The findings indicate that the management of blame requires both the exploration of blame and its interruption when emotions and conflict run high. The former enables understanding and movement towards therapeutic goals while the latter is necessary to promote therapeutic and family alliances. An unintended consequence of the injunction to be non- blaming might be the premature closing down of topics, militating against problem resolution. The study concludes that CA and MCA offer a wealth of knowledge about mundane conversational practices that can be applied fruitfully to systemic therapy process research, teaching and supervision.

This study is a qualitative enquiry into family therapists’ experiences of working with young people who self-harm and their families. To date, in spite of self-harm being a serious public health concern, there is relatively little exploration of the subject in family therapy literature. The study attempts to describe, understand and illuminate family therapists’ experiences: the therapeutic issues encountered, the stances adopted in response to the issues encountered, and the emotional impact on the therapist of working with this client group. A total of nine experienced family therapists participated in semi-structured interviews. The study employed a grounded theory method for data analysis. The analysis yielded a theory of therapists’ experiences that included a Core Category and three Main Categories. The Core Category that emerged was: •Cultivating the Practice of Hope – Withstanding the Pull to Hopelessness. The three Main Categories were: •Making the Situation Safe •Conversing Therapeutically – The Practice of Hope •Team and Organisational Processes: Supporting Therapists. The Core Category is the central feature of this theory. It proposes that the central concern for the therapist is how to stay engaged with the family and the young person in the context of serious risk of self-harm and in situations where change is difficult to achieve and hopelessness can pervade. The therapist has to try to understand and make sense of family members’ distress, and be touched by and open to their feelings of despair and hopelessness without becoming overwhelmed and despairing themselves. The therapist response to this dilemma is the stance of hopefulness. It is both a therapeutic stance and orientation, and is enacted in practice through finding ways to cultivate hope in the therapeutic encounter. While the Core Category is the central ‘story’ the three Main Categories are linked to the Core Category. The Main Category, Making the Situation Safe describes the initial stage of the work, with its focus on ensuring the safety of the young person. The Main Category, Conversing Therapeutically – the Practice of Hope describes how the therapists enacted the ‘practice of hope’. The Main Category, Team and Organisational Processes: Supporting Therapists describes how the context in which the therapists work, the nature of relationships, the team and organisational structures, play a critical role in supporting therapist hope, so that they can withstand the pull to hopelessness. This study aims to make a contribution towards articulating a framework for family therapy with adolescents who self-harm and introduces a new vocabulary – the language of hope and hopelessness.

There are approximately 1.3 million youth who have been diagnosed with a co-occurring disorder. The purpose of this study was to analyze the relationship between the type of therapy (brief strategic family therapy or family functional therapy), demographic factors (age, race, type of drug used), and therapy discharge status (successful or unsuccessful) in male youth with a co-occurring disorder of attention-deficit hyperactivity disorder and substance use disorder. A correlational research design of a cross-sectional nature was used for this study and secondary data were obtained from a mental health agency located in Hampton Roads Virginia. The theoretical basis for this study was Bowens family systems theory. A purposeful convenience sample was used from archival data (n=392). Independent sample t-Tests were conducted to analyze differences between demographic groups and discharge status, and it was found that males whose drug of choice was alcohol had a statistically significant lower successful discharge rate (p=.031). Type of therapy unrelated to discharge status at a statistically significant level (p=.418). Results of a multiple logistic regression analysis showed that non-White/Caucasian males were 1.86 times more likely to have a successful discharge status from the program (p=.048). Age, drug type, and therapy used were unrelated to discharge status at statistically significant levels (p>.05). This study can educate therapists about their preconceived notions regarding ethnicity and the potential to successfully complete therapy. This could result in more empowerment shared with clients of these ethnic groups which could positively impact completion of therapy.