Uncovering processes of change in systemic family therapy with blended families : a narrative case study

Abstract

This study intended to bridge the gap between process-outcome research and real-life practice in family therapy with blended families. Change process research in couple and family therapy lags substantially behind treatment efficacy studies (Heatherington et al., 2005; Sexton & Datchi, 2014), particularly among stepfamily relationships (Lebow, 2018; Papernow, 2018a). This narrative case study embarked on a systemic inquiry which explored the process of change as told by the participating couple and family therapist along the course of systemic therapy. Data was collected systematically through interviews and a diary method at preset points along their initial four sessions. The findings underscored the need for a systemic understanding of couple help-seeking as a dyadic process, to assist timely intervention. The narrative which emerged continued to highlight the protracted formation phase of blended families. Change emerged as a multifaceted and multi-layered relational process. Negotiating relationships with parents outside the household was a central facet of therapy, accentuating needs around trust and affirmation within the couple subsystem. Clinical implications suggest facilitating transparency about co-parenting responsibilities, navigating different levels of decision-making, and reorganising boundaries within the blended family infrastructure. A primary mechanism for change included improving communication, while demonstrating the utility of directive strategies in the beginning phase of therapy to de-escalate conflict. The participants described that difference was created in the couple and family system through seeing their family life story and their opportunity to rewrite it. Further implications include considerations for long-term therapy for families with complex needs and specialised services to support blended families.