Can a classification of family therapy be developed from expert consensus opinion

Systematic reviews have shown that family therapy is effective for a range of disorders (Carr, 2009a,b). However, there are many forms of family therapy and it is unclear which specific forms work best for which conditions. One problem is that reviewers have used inconsistent definitions of the field to guide the selection and exclusion of studies from reports. Furthermore, there seems to be little agreement about how to classify family therapies for comparison, leading to difficulties in establishing a clear evidence-base. The current thesis aimed to address these problems by using a Delphi survey (Linstone & Turoff, 1975), to see whether a panel of senior family therapists could agree on a definition and classification of family therapy by consensus opinion. Twenty-seven international experts on family therapy were initially recruited to complete three, iterative rounds of Delphi questionnaires. The process resulted in a consensus profile of essential, unique and proscribed elements of family therapy. There was agreement that family therapy should incorporate a set of essential (systemic) theories, practices and aspects of therapists’ training. However, there was little consensus over the specific types of practices that should be excluded and only a few unique elements of family therapy were agreed. Two classifications of the field were agreed as useful based on 1) mechanisms of change and 2) the focus of therapy (specific disorders versus relationships). Overall, results suggest that it is possible to employ consensus-building techniques to inform a contemporary definition and classification of family therapy. The use of consensus definitions may produce more informative reviews that contribute to the evidence-base. Future work would need to address how some of the broad concepts, identified by the experts panel, could be operationalised for this purpose.