Journal of Marital and Family Therapy

1989, Vol. 15, NO.4,349-365

BASIC FAMILY THERAPY SKILLS, I:

CONCEPTUALIZATION AND INITIAL FINDINGS
Charles R. Figley Thorana S. Nelson
Florida State University Purdue University

This is the first report on a program of research designed to identify the most
important characteristics of the beginning marriage and family therapist. The
paper first surveys the literature in family therapy, social work, and psychology
and finds that, although these factors are discussed for beginning psychothera-
pists, no set of skills are derived empirically. This study recruited all available
members of the American Family Therapy Association (AFTA) and Approved
Supervisors of the American Association of Marriage and Family Therapy
(AAMFT) who were experienced educators and trainers of family therapists.
After nominating the most important generic-type characteristics for beginning
family therapists, the participants rated the items, yielding a list of not only the
most important skills, but also personal traits of beginners based on mean scores
of the ratings. The final section of the paper discusses the implications of these
findings and notes the current and future activities of the research program.

In October of 1988, the American Association for Marriage and Family Therapy’s
Commission on Accreditation for Marriage and Family Therapy Education (COAMFTE)
introduced the revised version of the Manual on Accreditation (Commission on Accred-
itation for Marriage and Family Therapy Education, 1988). This was the result of
hundreds of hours of consultation by the leaders in the field. The purpose of the Manual
is: “to describe the standards and process for achieving accreditation” (p. 1)in the field.
The Manual on Accreditation (Commission on Accreditation for Marriage and Family
Therapy Education, 1988)states that: “Those applying for doctoral programs must have
the ability and previous education to fulfill the institution’s doctoral requirements for
. . . clinical skills for practice in marital and family therapy” (p. 9). Yet, there is no
standard set of minimal competencies for these graduates; no measurable set of skills
are specified.
The Standard Curriculum described in the COAMFTE Manual specifies areas of
study and goes on to explain each area and the types of course content necessary to meet
~

The authors gratefully acknowledge Cassandra Erickson, MS, who served as the first author’s
research assistant and performed many important tasks for this project. Also, we want to acknowl-
edge and thank the second author’s daughter, Stacy Nelson, who performed several important
tasks. Finally, we wish to acknowledge and publicly thank our fellow family therapy trainers who
participated in our study and deserve special credit. They donated their precious time and insights
in three separate surveys. Their efforts have made this research project and article possible.
Charles R. Figley, PhD, is Professor of Family Therapy and Director, Interdivisional PhD
Program in Marriage and Family Therapy, MFT Clinic, Sandels Building, Florida State University,
Tallahassee, FL 30306-2033.
Thorana S. Nelson, PhD, is Assistant Professor of Marriage and Family Therapy and Director,
Marriage and Family Therapy Center, Purdue University, 523 Russell Street, West Lafayette, IN
47907.

October 1989 JOURNAL OF MARITAL AND FAMILY THERAPY 349

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requirements, including supervised clinical practice. However, the only indication that
minimal clinical skills exist is in the section discussing evaluation (Commission on
Accreditation for Marriage and Family Therapy Education, 1988, p. 27):
Students graduating from accredited programs should manifest the essential quality and
characteristics of well-trained, competent marital and family therapists. Regardless of
the treatment model they employ, competent marital and family therapists share certain
fundamental qualities. These are as follows:
(a) Current knowledge, understanding, and articulation of their conceptual frame-
work;
(b) Knowledge of the literature of marital and family therapy;
(c) Knowledge of methodology of case management;
(d) Accounting of supervised experience and training;
(e) Knowledge and maintenance of a n adequate record keeping system; and
(0 Adherence to the AAMFT Code of Ethics.
The lack of specificity of minimal family therapy skills or competencies does not
suggest that the Standard Curriculum is necessarily flawed or that the Commission is
misguided. Indeed, this approach to mental health care education certification is con-
sistent with others that are sanctioned by the Department of Education. It simply
suggests that there is a universal assumption that the result of all of this training and
education will be a skilled practitioner, without ever specifying how skilled they are in
what areas or what these behaviors might look like.
Moreover, marriage and family trainees are expected to begin to see clients early
in their programs, for some the very first month of their training. For many of these
students, being thrust into the extremely responsible role of a family therapist is a
highly stressful experience, more so if the student has no prior therapy experience at
all. This is so, even when the student receives live supervision.
If a set of basic, minimal skills could be established and empirically verified, they
could be used as a guide for family therapy educators in prioritizing and teaching the
fundamentals of family therapy practice. They would also serve as valuable markers
when assessing trainees for readiness to see clients or for requiring more training. These
markers would be an extremely useful pedagogical tool that would not only reassure
the trainee that she or he is now prepared to work with families under live supervision,
but would also assure that clients are receiving adequate treatment, even by trainees.
It is not our agenda to define these criteria. Rather, we have made initial attempts to
identify them, based on data from our colleagues, We invite and expect comment upon
these ideas. This project is an offering t o begin a process of identification of important
characteristics: traits, attributes, skills, and behaviors in family therapy practice.

REVIEW OF THE SKILLS TRAINING LITERATURE

Our cursory review of the skills training literature in family therapy, social work,
psychology, and psychiatric nursing led us to conclude that an empirically generated
set of skills in psychotherapy is visibly lacking.

Family Therapy
In the family therapy literature, a few specific skills of practice are discussed.
However, these skills appear to evolve from either theoretical formulations or clinical
experience, not from empirical study. Moreover, they only briefly discuss basic skills and
methods of evaluating and developing such skills. These issues also are presented within
the context of describing and developing marriage and family therapy supervision skills,
not clinical skills. While this is laudable, we believe it is insufficient.

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 Cleghorn and Levin (1973) identified three kinds of skills: (a) perceptual, (b) con-
ceptual, and (c) executive. They believe these skills are critical for all family therapists
and propose a method for defining therapist variables through specific training objec-
tives. Constantine (1976) also identifies a set of skills he believes are critical, taught
through specific, goal-directed training. Linking the teaching of family systems concepts
to family medicine residents, Doherty and Baird (1986) identify a sizable number of
skills they teach, drawn from the literature. Similarly, Falicov, Constantine and Breun-
lin (1981) identify three categories of family therapy skills that they teach: (a) obser-
vational, (b) conceptual, and (c) therapeutic. Kniskern and Gurman (1979) describe
relationship and structuring skills (pp. 83-85) and the contributions of trainee attitudes
toward family therapy.
Liddle has written several papers discussing the importance of various family
therapy skills, particularly for beginning therapists. He has noted (1978) that the
importance of the ability to learn these skills is influenced by several factors. These
include, for example, acceptance of family systems perspectives, faculty interaction, and
degree of previous experience and training. Later, with Halpin (Liddle & Halpin, 1978),
he noted the importance of personal therapy for trainees, based on the assumption that
unresolved feelings about one’s family of procreation andlor orientation can affect ther-
apeutic efficacy. Later, Liddle and Saba (1982) describe the structure and content of an
introductory family therapy course which attempts to teach three sets of skills: (a)
joining, (b) restructuring, and (c) consolidating.
Tomm and Wright (1979) describe a comprehensive and detailed outline of family
therapy characteristics to aid in the training of family therapists. The authors introduce
three major functions performed by a family therapist and differentiate them into
general therapeutic competencies:(a) perceptual, (b)conceptual, and (c)executive skills.
While this body of literature provides a conceptual base, there appears to be no
comprehensive, empirically based set of basic skills of practice in marriage and family
therapy. What about the more established mental health fields? Have these fields estab-
lished a basic set of competencies for practice or a t least a set of empirically-based skills
of beginning clinicians?

Social Work
The field and profession of Social Work has, for many years, identified a core set of
knowledge and model curriculum and training programs. Indeed, it appears that, as a
mental health profession, social work has made the most progress compared to others.
One of the reasons might be that social work has tended to focus on professionalization
and incorporates research and clinical innovations from other areas. With regard to
family therapy training, for example, Bardill and Sanders (1988) reviewed the inter-
relationships between social work and family therapy and, among other things, proposed
a curriculum for master’s level family therapy education in social work. Although not
specifically tied t o skills, it is an important contribution toward identifying and quan-
tifying the competencies of social workers and family therapists.
A description of a “generic social case w o r k emerged in a 1929 report of the Milford
Conference, a group of agency executives and board members (National Association of
Social Workers, 1974, p. 3). Efforts to identify and refine these generic skills continued,
though theory-specific skills emerged as well (e.g., Smalley, 1970; Robinson, 1930). In
1952, the Council on Social Work Education evolved, (replacing the NCSWE) due largely
to the Hollis-Taylor Report (1951).
During the 1960s and 1970s there were several attempts to define a common base
of social work practice (Bartlett, 1959, 1970; Gordon, 1962, 1969; Gordon & Schutz,
1977) and then to delineate a unified or integrated theory of social work knowledge,
purposes, values, and skills (Goldstein, 1973; Meyer, 1983; Middleman & Goldberg,

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1974; Pincus and Minahan, 1973). More recently, there has been an emphasis in the
field of social work on upgrading professional education (Pharis & Williams, 1984). Yet,
according to Bagarozzi (1988),there still does not exist a clearly defined list of basic
skills of social work practice.
Shulman (1981), however, identified 27 communication, relationship, and problem-
solving skills drawn from the literature which he called “worker helping skills.” Recently,
Bagarozzi (1988) has noted that advances in models of training in clinical social work
practice make it much more amenable to empirical verification. In a n earlier paper,
Bagarozzi (1983) proposed a “hierarchy of helping skills” within a model of clinical
practice which were based on Kaslow’s (1977) categories of perceptual, conceptual, and
executive skills. Yet, similar to our conclusions in family therapy, neither Bagarozzi,
Shulman, nor other clinical social work educators have identified a set of skills that
were either empirically derived or correlated with practice effectiveness. Generally, the
same can be said for training in the practice of clinical or counseling psychology.

Psychology
There is a large body of literature in clinical and counseling psychology training
which has a good mix of empirical studies and training innovations. In the last decade,
with the increasing importance of mental health in this country, the employment market
of psychologists has changed from chiefly educational settings to primarily mental
health delivery agencies (Banikotes, 1978) and health care (Asken, 1979). Like other
professions, this trend has led to the importance of psychologists’ obtaining the requisite
skills, competencies, and credentials to work in these settings (Dana & May, 1987). Yet,
there exists no list of empirically derived skills in the clinical practice of psychology.
With regard to the psychology clinical training research literature, the emphasis
has been more on deficits in skills rather than skills development. Studies by Lovitt
(1974), who focused on deficits in skills development of clinical psychologists, Spitzform
& Hamilton (1976), Drummond, Rodolfa, & Smith (19811, and Sturgis, Verstegen, Ran-
dolph and Garvin (1981) are typical.
Sturgis et al., (1981), for example, reported the results of a one-page questionnaire
completed by 167 directors of psychology internship sites. Among the questions asked,
was one about the directors’ “perceptions of any deficiencies seen in the academic
training of the interns” (p. 569). A total of 264 deficiencies were listed and grouped into
15 response clusters. The two clusters most often indicated were those dealing with
assessment/testing skills, and with diagnosis of psychopathology. The third-ranked
cluster of deficiencies was the lack of general clinical experience, lack of openness to
different ideas, and lack of alternative theoretical views on the part, of interns. Less
frequently mentioned deficiencies, in descending order, were: interview skills, psycho-
therapy skills, report writing, family therapy, ethics, community experience, consulta-
tion, vocational counseling, and psychopharmacology. These findings seem to be consis-
tent with other surveys (e.g., Drummond, Rodolfa & Smith, 1981).
A number of research reports help identify the importance of specific skills in clinical
practice. Truax (1963), for example, reports the results of a 5-year research program
studying the positive effects of therapists’ levels of accurate empathy, nonpossessive
warmth (unconditional positive regard), and genuineness on client outcome. In a later
report (Truax, Carkhuff & Kodman, 1965), they extend the previous findings by eval-
uating them in group psychotherapy. (Cf. also Truax & Mitchell, 1971). These skills
have remained among those which are basic to counselor training.
Carkhuff, Piaget, and Pierce (1968) identify perceptual and communicative skills
to be the basic ones for practicing counselors in psychology, and tested these skills among
beginning counselors at three different educational levels. Matarazzo, Wiens and Saslow

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(1966) (also Matarazzo, 1971) describe their experimental methods of teaching psychoth-
erapeutic skills, yet the skills were not empirically derived but, rather, a result of a
literature search.
Perhaps the person most connected with skills training is Ivey, with his microcoun-
seling approach. Ivey, Normington, Miller, Morrill, and Haase (1968) describe a video
method for training counselors in the basic counseling skills in a short period of time.
The skills include attending behavior, reflection of feelings, and summarization of
feelings.
Marshall, Kurtz and Associates (19821 provide one of the most comprehensive
summaries of interpersonal helping skills. In their introductory chapter, they identify
nine generic skills that were most frequently found in the professional literature: (a)
empathy, (b) questioning, (c) genuineness, (d) respect, (e) attending, (0 reflection of
feelings, (g) confrontation, (h) concreteness, and (i) immediacy.
Still missing in the psychology training literature, however, is a list of empirically
derived skills in the clinical practice of psychotherapy.

THE BASIC FAMILY THERAPY SKILLS PROJECT

Recognizing the need to begin to fill an important gap in family therapy, the authors
established the Basic Family Therapy Skills Project in 1987, to begin the process of
meeting the need for an empirically derived set of basic skills for family therapists. A
program of research and development was planned which would be guided by four
fundamental goals. The first two are connected exclusively with the project’s research
program: (a) to generate a list of skills, in order of importance, which are basic to family
therapy practice and are generic or theory-free; and (b) to generate a list in order of
importance of the basic family therapy skills for each of the major family therapy
theories or clinical approaches. The third goal was to identify a program of family
therapy training designed to teach the most critical of these skills. Finally, the fourth
goal was to identify a set of teaching methods, techniques, exercises and experiences for
each of the selected skills.

Costs and Benefits of a Skills Focus

The focus of the research program is on identifying the basic family therapy skills
that educators believe to be critical to beginning family therapists: those necessary and
sufficient for working with client families under some form of supervision.
But why basic family therapy skills? By focusing so narrowly on skills as a means
of training or even identifying family therapist effectiveness,we are making some basic
assumptions that may not be accurate. Some of the arguments against our approach
could be: (a) Family therapy competence cannot be measured; it is an art that defies
both explication and quantification; (b) even if it is possible, by developing a list of such
skills, we risk creating sameness among family therapists: there would be little variation
in personal characteristics and clinical approaches, an outcome which would run counter
to many other basic assumptions in the field of family therapy; (c)with such an approach
we run the risk, as teachers of family therapy, of being neither respectful of our student
family therapists nor helping them develop the skills they already have and wish to
have; and (d) such a list may be incomplete and using it may deprive trainees of an
important clinical education.
Yet, it appears to us and other trainers, that beginning students are hungry for
direction, for concrete advice on what to do as a new family therapist. We have found
that beginning student family therapists are reassured by the fact that there is a set of
definable and attainable skills that, when mastered, are effective in treating marriages

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and families. After mastering such skills, trainees can confidently gain the experience
they need to forge ahead on their own.
The ultimate challenge of developing such a list of definable and attainable basic
family therapy skills is measurement. Measurement is a critical feature in at least five
ways: (a) accurately assessing the consensus beliefs of our colleagues about the central
core family therapy skills; (b) clearly articulating a precise definition of each of these
core skills; (c) developing sensitive and reliable measures of these skills; (d) assessing
the degree to which these skills correlate with actual therapist effectiveness; and (e)
assuming they are correlated, measuring the effectiveness of various training approaches
and methods in developing these skills in our trainees.
One approach, of course, is to identify the skills exhibited by the most effective
family therapists. Such an approach is quite defensible, especially since the current
trend is to learn by example: modeling the “masters” in family therapy.

Our Approach
The approach we have taken is to ask our colleagues, our fellow family therapy
supervisors and trainers, what they think about this question; to allow them, collectively,
to specify the basic, core set of skills based on their years of clinical and training
experiences and what they actually attempt to convey to their beginning family ther-
apists. We recruited a panel of experts who would first propose and later, rate, the degree
of importance of a set of basic family therapy skills. The project hopes to establish
empirically, through a series of panel studies, a list of skills which are critically impor-
tant to possess by beginning family therapists, particularly those new to psychotherapy
practice. By so doing, we hope the overall quality of family therapy training and practice
will be improved substantially.

Limitations of Our Approach

With every approach, of course, there are limitations. In our approach, for example,
we restricted our sample to family therapy supervisorsltrainers: those most experienced
in training family therapists. However, perhaps we are getting exactly the wrong advice
about what set of skills are important to beginners.
It is also possible (and in some cases probable) that respondents nominated skills
based on their own frustrations in training and observation of deficits. Those skills most
easily acquired may have been passed over due to their obviousness. Moreover, some
skills appear to be more appealing and, thus, more apt to be identified as more important
because they are so generally appealing (e.g., establish rapport, express caring). Yet,
those sets of skills that are harder to define and describe (e.g., establish positive expec-
tations for change, knowing when to trust one’s own clinical judgment) are less likely
to be rated as highly important.
We are aware that our efforts are only at the rudimentary, beginning stages. We
hope, however, that eventually our efforts, in concert with our colleagues, will lead to
developing the most effective family therapists possible. As the newest mental health
field, family therapy educators continue to struggle to identify the key ingredients to
effective family therapy practice. This project represents our best efforts so far to begin
the process of developing a comprehensive set of family therapy competencies.

RESEARCH METHODOLOGY

Sample
As a way of beginning t o generate a list of basic skills critical for beginning family
therapists, we began by recruiting participants who should be the most knowledgeable
about these skills: experts in marriage and family therapy education. We were able to

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secure two important lists: 1,234 Approved Supervisors (AS) in the American Associa-
tion for Marriage and Family Therapy (AAMFT) (as of 10/87) and the 903-person
membership list of the American Family Therapy Association (AFTA) (as of 12/87).
Both groups screen applicants carefully and admit only those who are among the most
senior and experienced clinical educators in this area.
The theoretical orientations of our samples are found in Table 1. The numbers
represent respondents who indicated a particular personal orientation or approach to
therapy. Many of the samples (49%) indicated an integration of models rather than a
“pure” theory. Even within the group indicating only one approach, many responded
“integrated,” “eclectic,” o r “systemic” (13%for Survey I, nominating items and 15% for
Survey 11, rating the nominated items). For both Survey I ( n = 206) and Survey I1
(n = 3721, the single greatest category represented is “structural/strategic” (54% for
Survey I and 51% for Survey 11). The next larger group represented is transgenerational
theories, including a mix of Bowen, Framo, and contextual (19% for each Survey).
Approximately 9-10% of each sample indicated they used components of intrapersonal
theories, including psychodynamic and object relations theories. Therefore, while the
samples are heavily structural, strategic, or a combination, they are balanced with other
theoretical approaches.

Procedures
Late in 1987, we sent personal letters to all 2,137 potential participants, informing
them of our study. We indicated we were enlisting the assistance of all members of the
American Family Therapy Association and AAMFT-Approved Supervisors to partici-
pate in a series of panel surveys to help identify and measure what family therapy
educators consider the minimum basic skills that a trainee therapist should possess to
begin working with clients.
The minimum criteria for participation was experience as a family therapy trainer
during the past 3 years and agreement to participate in the study. Each person willing
to participate was asked to return an enclosed postcard, including additional comments
she or he would like to provide. We alerted them that we would be sending them a brief
questionnaire shortly following their reply which would require no more than 20 min-

Table 1
Theoretical Orientations of the Survey Respondents
Theoretical Survey I Survey I1
Orientation n = 206 n = 372
n % n %
Structural/strategic 112 54% 188 51%
structural 37 65
strategic 29 40
structural/strategic 29 42
Milan 8 12
Transgenerational 39 19% 71 19%
Symbolic Experiential 24 12% 30 8%
Intrapersonal 18 9% 39 10%
New Epistemology 5 2% 11 3%
Feminist 2 2
“Systemic” only 15 7% 38 10%
“Integrated”or “Eclectic”only 13 6% 19 5%
Missing 31 15% 70 19%
Note. The percentages will not sum to 100; 49%of the samples indicated a mix of theories.

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Utes to complete. In return, we promised to send each participant a summary of this and
future studies.
The card we enclosed was a business-reply type (no postage necessary) postal card
addressed to the project office on one side and, on the other side, a series of questions
which focused on the respondent’s willingness to participate in the study, confirmation
of eligibility (supervised at least one family therapy student in the last 3 years), name,
address, phone number, and comments she or he wished to make a t that time.
A total of 744 cards were returned, 56 of which were marked as nonparticipants
due to ineligibility (too few or no beginning level trainees in the previous 3 years) or
lack of willingness to participate, and included various suggestions. A total of 688
volunteers were included in the study.
The first survey was conducted early in 1988. A personal letter was sent to all 688
participants thanking them for returning the participation card and explaining the
brief, open-ended questionnaire enclosed. Also enclosed was a self-addressed, stamped,
reply envelope for returning the questionnaire to us.
The 2-page questionnaire included a brief background and experience section. The
purpose was to verify the participant’s eligibility and to provide information for making
comparisons among the sample based on major demographic and professional training1
activitylidentity variables.
The next section asked the participant to respond to the request: “Please list in as
few words as possible basic skills that are generic (transcend all theoretical orienta-
tions) .”
The final section, devoted to nominations for theory-specific skills, similarly asked
the participant to: “Please list in as few words as possible the basic skills that are theory-
specific (critical when working within a particular theoretical orientation). First, please
n
note your theoretical orientation:

Survey I Results
A total of 688 respondents were sent questionnaires. A total of 429 completed
questionnaires were returned. For the purpose of identifying a manageable number of
nominated skills, we identified a group of 208 of the most experienced family therapy
educatoritrainers from among the 429 who nominated generic skills. This produced a
“manageable” list of 1,092 characteristics which included personal traits as well as
skills.
Sorting and categorizing. Very soon after we read all of the completed question-
naires, it became apparent that there was little agreement among the teacherltrainers.
There was no apparent consensus about beginning, basic “skills” or, more precisely,
characteristics. We intentionally left terms undefined (with the exception of “beginner”
which was defined as someone with less than 100 hours of family therapy experience;
even this definition may have been open to interpretation). The respondents were given
as much freedom as possible to tell us what they thought was essential.
Similarly, we did not define “basic”or “essential.”We asked respondents t o nominate
skills “that a trainee therapist should possess t o begin working with clients.” Depending
upon the orientation of the supervisor, working with clients may come sooner or later
in a trainee’s process. For example, those using one-way mirrors and close live super-
vision may have trainees begin working with clients sooner than those who don’t use
one-way mirrors or live supervision. Similarly, different supervisors may feel more
comfortable, in general, having trainees begin working with clients, while others may
desire their students to have more extensive role-play practice or some experience in
other kinds of interviewing situations.
For those thinking about pre-experience behaviors, characteristics or basic person-
ality traits may have been included in the operative definition. For others, perhaps

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those who work with therapists who have previous clinical experience, certain kinds of
techniques or technical skills may have been important. Most likely, all thought about
the kinds of things they attempt to teach and about trainees who had been deficient in
some perceived important area or another.
Finally, we chose not to ask the respondents in Survey I to distinguish between a
“skill” and any other type of therapist characteristic (e.g., traits, attitudes, values,
behaviors). Although we asked for skills, thinking about pre-practicum, teachable
behaviors, most participants included items that would more likely be categorized as
personal traits, such as “curiosity about the human condition.” We briefly considered
omitting these characteristics in the next phase in which the “skills” would be rated by
degree of importance. Consistent with established methods in qualitative research, we
chose t o err on the side of inclusion rather than exclusion. As noted earlier, the biggest
challenge in this area of research is measurement. The levels of abstraction for the
various nominated items ranged from quite concrete to quite abstract. We decided to
include nominated abstract personal traits in our second survey (asking for ratings) in
order to gather as much data as possible. Attitudes, indications of potential ability, and
existing abilities, as well as therapy techniques, seemed quite important to our nomi-
nators.
We chose to use an inductive method to attempt to reduce the number of skills to
something manageable for our panel to rate. Again, this method is quite consistent with
established methods of qualitative research. We wanted to make the survey flexible and
open ended enough to allow people to give us their ideas, but structured enough to
assemble some meaning from it. We also needed to reduce the total number of skills and
to eliminate obvious redundancies.
Items that were essentially similar were then conceptually grouped. The second
author made judgments about similarities and groupings. The first author then checked
the groupings, making minor suggestions and changes. Consensus was reached on all
292 therapist characteristics.
For example, several items were clearly personality traits while others concerned
the ability to join with clients or relate to them interpersonally. Still others related to
the supervisory process or relationship and others t o basic knowledge about theory and
human or family development. Ten categories were chosen inductively to aid respondents
in the rating process by providing them with perceptual sets. (Categories included: (a)
Self-Attributes; (b) Interpersonal SkillsiJoining; (c) General Therapeutic Skills; (d)
Theoretical Thinking/ Knowledge; (e) Assessment/Initial Interview; (0 Goal Setting; (g)
Intervention; (h) SessiodTherapy Management; (i) Case ManagementlProfessionalism;
and (i) Supervision. Each group contained between 10 and 110 items.)
The authors clearly understood that this sort of inductive process is influenced by
the researchers’ theoretical biases. In this case, the first author’s orientation is behav-
ioral, but generally integrative in methods of systemic intervention. The second author
currently practices and supervises from a family systems integration of structural/
strategic, Milan systemic (constructivist), and Bowen family systems models of family
therapy.

Survey ZI: Assessment of the Most Important Marital and Family Therapy (MFT)
Generic Skills
Development of the Skills Rating Inventory. We constructed a set of questionnaires
which would allow our study participants to rate the characteristics of beginning mar-
riage and family therapists. Knowing that our participants would be unwilling to rate
all 292 of these generic characteristics (both skills and traits), we divided them among
4 questionnaires with approximately 85 items per questionnaire, and randomly assigned
one of the four forms of Survey I1 to each of our 688 participants.

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 The first part of the survey asked a question to further confirm the qualifications
of the participants in Survey 11: “HOWmany beginning level therapists have you super-
vised in the last three years? (supervision = actual case supervision.)” Many partici-
pants had previously indicated confusion with the criteria. For example, would workshop
presentations t o dozens of participants qualify as supervisiodtraining? We had decided
that we needed precise information based on actual “hands-on”supervision.
The final part of each questionnaire included the generic characteristics with Likert-
type response alternatives: 1 = very important; 2 = important; 3 = undecided; 4 =
unimportant; 5 = very unimportant; plus two other choices: 6 = inappropriate for
beginning therapists; and 7 = inappropriate for family therapists. The items were
grouped by category ([a1self-attributes, [bl interpersonal skills, [c] general therapeutic,
Id] theoretical thinking/knowledge, [el assessmenthnitial interview, [fl goal setting, [g]
intervention, [hl case managementiprofessionalism, [il sessionitherapy management,
and ti] supervision) to enable the respondent to consider each characteristic within the
context of other, similar characteristics.

Results of Survey II
Participants. A total of 488 respondents returned their surveys. Among these, 116
surveys were not used due to incomplete information or lack of eligibility (lack of
experience with beginning therapists). Data from 372 Survey I1 questionnaires were
analyzed.
Table 2 includes a description of the respondents. The sample includes more males
(60.4%)than females (39.3%)and was almost exclusively Caucasian (94.1%).Although
the sample was composed exclusively of experienced family therapy educatorsltrainers,
only 56.7% identified themselves primarily as family therapists. A total of 18.9% chose
either ‘‘psychologist’’(16.7%)or “counseling psychologist”(2.2%)as their primary profes-
sional identity while 9.7% chose “social worker.”
The most frequent highest academic degree among the participants was the PhD
(42%), followed by the MSW (16%), and the MA/MS (10%)and DEd/EdD (10%).The
primary professional occupation was nearly equally split between teacherltrainerlsuper-
visor (46.5%)and clinical practitioner (45.9%).Similarly, the primary place of employ-
ment was identified as private practice (33.6%),academic setting (28.2%),and “other”
settings (20.2%),excluding mental health centers and family therapy institutes. Regard-
ing state licensureicertification, social work led all groups (33%),followed nearly evenly
by psychology (28%) and marriage and family therapy (27%),addictions/alcohol licen-
sure/certification was as distant 4th, with 17% holding this distinction. More would
have indicated certification or licensure in marriage and family therapy if more states
regulated the profession. Therapeutic orientations of the participants are found in Table
1.
Mean ratings of therapist characteristics. Data were analyzed to determine the
mean ratings for each of the 292 generic characteristics, using the 1-5 Likert-type
responses. The mean scores for the characteristics ranged from 1.17 t o 3.73. Table 3 is
a listing of the top 100 items, along with mean scores and standard deviations. Table 4
presents the number of items from each category represented in the top 100 items.
Frequencies for participants choosing one of the “inappropriate” options were tabulated,
but excluded from the Table since they were so infrequent for this top group of charac-
teristics (skills and personal traits).
In terms of number of items present in the top 100 rated basic therapist character-
istics, it would appear that “Self-Attributes’’are quite important. This is especially true,
as this category had the largest number of items nominated. A t the same time, it also
appears that this category may be least important in terms of the number of possible

358 JOURNAL OF MARITAL AND FAMILY THERAPY October 1989

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 Table 2
October 1989

Backgrounc [nformation
Primary Professional Identification ( n = 370) Primary Place of Em
Frequency %
Family therapist 211 56.7 Private practice
Psychologist 62 16.7 University
Counseling psychologist 8 2.2 Mental health cente
Social worker 36 9.7 Family therapy inst
Psychiatrist 9 2.4 Other
Nurse 2 .5
JOURNAL OF MARITAL AND FAMILY THERAPY

Minister 12 3.2 State LicensurelCert

Professional counselor 6 1.6
Highest Academic Degree ( n = 363) None
Frequency % SWlACSW
PhD 157 42 Psychologist
MNMS 38 10 MFT
MSW 60 16 MD
MDivlMTh 9 2 RN
ACSW 10 3 Counseling Psych.
MEd 5 1 Pastoral Counseling

5
MSS 1 0 AddictionslAlcohol
DEd/EdD 30 10 Other
b DMidSTDlThD 16 5
Ethnicity (n = 357)
DSW 3 1
PsyD 5 1
MD 16 5 Caucasian
Primary Professional Occupation (n = 369) American Indian
Frequency % Asian
Teacheritrainerlsupervisor 172 46.5 Black
Clinical practice 170 45.9 Hispanic
Administrator 17 4.6 Other
Researcher 5 1.4
Other 5 1.4 Sex(n = 357)
Secondary Professional Occupation (n = 368) Female
Frequency % Male
Teacherltrainerlsupervisor 172 46.7
Clinical practice 140 38
Administrator 25 6.8
Researcher 23 6.3
Other 8 2.2
357

"Several respondents reported multiple licensure.

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 Table 3
100 Top Generic Skills
M SD Category
Observe professional ethics 1.17 .41 CM/P
Possess integrity 1.18 .43 Self
Know ethics of profession 1.19 .42 CM/P
Basic Interviewing skills 1.20 .49 A/I
Ability to accept others as valid and important 1.24 .48 T/K
Ability to observe 1.24 .43 T/K
Avoid blaming family 1.24 .48 T/K
Desire to learn 1.30 .46 Self
Grasp what a system is 1.30 .58 T/K
Utilize supervisory feedback 1.33 .50 sup.
Accept feedback 1.33 .55 SUP
Establish rapport 1.38 .49 IP/J
Intellectually curious 1.40 .64 Self
Respond to feedback from family 1.41 .50 T/K
Flexible (self-attribute) 1.43 .58 Self
‘hke responsibility for mistakes 1.44 .58 Self
Ability to think in systemic and contextual terms 1.44 .54 T/K
Give credit for positive changes 1.45 .65 GS
Possess common sense 1.49 .65 Self
Communicate sense of competency/authority/trustworthiness 1.51 .50 Self
Awareness of interaction 1.51 .57 MI
Ability to distinguish content from process 1.52 .76 TIK
No debilitating personal pathology 1.53 .70 Self
Set reachable goals 1.54 .76 Goals
Ability to analyze process at a n elementary level 1.54 .71 A/I
Determine the presenting problem 1.54 .86 A/I
Nonjudgmental 1.54 .74 Self
Listen actively 1.56 .58 IP/J
Reframe 1.56 .78 Interv
Respectful of differences 1.57 .61 Self
Nondefensive 1.58 .54 Self
Set clear goals 1.58 .79 Goals
Remain clear-headed in highly emotional situations 1.58 .64 GS
Check for comprehension (of interventions) 1.58 .74 Interv
Understand theory 1.58 .67 T/K
Communicate orally effectively 1.59 .54 Self
‘hke direction 1.59 .64 SUP
Patient 1.59 .57 Self
Maintain respect (interpersonal skills, joining) 1.60 .68 IP/J
Aware of impact of own communication style 1.60 .57 Self
Maintain therapeutic relationships 1.61 .66 IP/J
Understanding that one reality doesn’t work for everyone 1.61 .65 Self
Avoid solving problems for family 1.61 .77 Interv
Terminate therapy responsibly 1.61 .58 S/TM
Gather information regarding sequences and patterns 1.62 .74 A/I
Interrupt destructive communication cycles 1.62 .73 Interv
Appreciate differences 1.63 .60 IP/S
Recognize coping skills/strengths 1.63 .66 A/I
Ability to recognize boundaries 1.64 .58 A/I
Ability to diagnose family interaction 1.64 .77 A/I
Plan with family 1.64 .73 Goals
Defuse violentkhaotic situations 1.64 .77 GS
Sense of humor -- 1.65 .73 Self

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 Table 3, continued
M SD Category
Structure sessions effectively 1.65 .71 S/TM
Commitment 1.65 .60 Self
Meet clients “where they are” 1.67 .69 IP/J
Tracking skills 1.67 .82 A/I
Follow through with interventions (e.g., homework) 1.67 .79 Interv
Avoiadeflect scapegoating 1.68 .78 Interv
Offer rationale for intervention 1.68 .67 SUP
Control and manage own anxiety 1.69 .71 Self
Alleviate obstacles to effective working relationship 1.70 .69 SiTM
Discuss client concerns 1.70 GS
.69
Generate hypotheses 1.70 GS
1.04
Knowledge of human interaction 1.71 .62
T/K
Maintain control of session .81
1.71 S/TM
Be sensitive 1.72
.62 IP/J
Express empathy 1.72
.64 IP/J
Willing to deal with own issues as they affect therapy 1.72
.71 SUP
Relate to colleagues professionally 1.72
.72 CM/P
Set appropriate limits 1.73
.59 S/TM
Close sessions effectively 1.73
.65 S/TM
Make appropriate referrals 1.73
.73 CMP
A desire to be a family therapist .83
1.73 Self
Change case plan with new information 1.73
.84 GS
Curious about the human condition 1.73
.87 Self
Background in family life cycle stages 1.74
.72 T/K
Ability to understand dynamics of presenting problem 1.74
.78 A/I
Ability to recognize dynamics of communication 1.75
.66 A/I
Ability to connect clinical material with theory 1.76
.59 T/K
Normalize problems 1.76
.78 Interv
Avoiadeflect blaming 1.76
1.00 Interv
Assess progress of treatment 1.77
.69 SUP
Open sessions effectively 1.77
.83 S/TM
Make case plans 1.77
.84 CMP
Ability to join without losing sight of self in the therapy process 1.77
.92 IP/J
Be accepting 1.78
.72 IP/J
Self-directed 1.78.74 Self
Ability to recognize dynamics of triangling 1.78.79 A/I
Appreciation of circularity 1.78.SO T/K
Establish positive expectations for change 1.78.83 GS
Express authenticity 1.79.76 IP/J
Curiosity about self 1.79.85 Self
Express caring 1.79.75 IP/J
Recognize clients’ worldviews 1.79.90 A/I
Intelligent 1.so.64 Self
Express warmth 1.80.68 IPlJ
Maintain professional image 1.80.82 CM/P
Set boundaries 1.80.90 Interv
Congruent 1.81.65 Self
Able to think analytically 1.81.76. Self
Note. T/K = Theoretical thinking/Knowledge; Self = Self attributes; IP/J = Interpersonal skills/
Joining; GS = General therapeutic skills; Interv = Interventions; S/TM = SessionPTherapy
management; CM/P = Case management/Professionalism; Sup = Supervision; A/I = Assessment/
Initial interview; Goals = Goal setting.

October 1989 JOURNAL OF MARITAL A N D FAMILY THERAPY 361

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 Table 4
Items Represented by Category
# Items on # Items in %
Category Survey top 100 (in top loo/# possible)
T/K 43 12 28
Self 78 24 31
IP/J 31 13 42
GS 27 7 26
Interv 35 9 26
SPTM 15 7 47
CM/P 12 6 50
SUP 10 6 60
A/I 35 13 37
Goals 6 3 50
Note. TIK = Theoretical thinking1Knowledge; Self = Self attributes; IPW = Interpersonal skills/
Joining; GS = General therapeutic skills; Interv = Interventions; SiTM = SessionPTherapy
management; CM/P = Case managementiProfessionalism; Sup = Supervision; A/I = Assessmenti
Initial interview; Goals = Goal setting.

self-attribute items ranked in the top 100 in comparison to the total number in the
survey (31%).It is not obvious how these figures should be interpreted.

DISCUSSION
While the questionnaire asked respondents to nominate generic skills, it is quite
interesting that a large number of personal attributes were nominated. We had been
thinking of behaviors in the context of therapy that could be taught to beginning
therapists-behaviors that could be demonstrated, explained, and measured in some
way. Our aim was to develop a number of resources for teaching these behaviors and,
eventually, an instrument that could be used in research that would measure the
behaviors, with a goal of identifying the important behaviors for effectiveness in therapy.
As the results indicate, our respondents gave us much more!l
Approximately one-half of the top 100 “generic skills” are more appropriately
described as “personal traits.” Indeed, only 5 of the top 25 items are clearly teachable
behaviors ([a]basic interviewing skills, [bl establish rapport, [cl give credit for positive
changes, [d] ability t o distinguish content from process, and [el set reachable goals) and
even some of these might arguably be considered “personal trait.” Our fellow educators/
trainers seem to believe, based on these data, that the person of the therapist is as
important, if not more so, than the skill of the therapist.
It is probable that our respondents were aware that, for therapy training to be
effective, a foundation of abilities, values, attitudes, and other traits is essential for
effective family therapy. While traits are difficult to both measure and develop, it is
clear that they must be considered in future studies, as well as training, in family
therapy.
To effectively compete with the more established fields of mental health professions
for both students and clients and to more effectively raise the standards of practice,
family therapy education must be dynamic and innovative. This study was an initial
step in a programmatic effort to empirically establish a list of basic characteristics of
beginning family therapists. To our knowledge, this has never been done in any field in
psychotherapy.
The Basic Family Therapy Skills Project will soon report on the results of Survey
111, which will establish the top characteristics of the major theory-specific approaches
in family therapy. Beyond this, we will attempt to further explicate and verify these top

362 JOURNAL OF MARITAL AND FAMILY THERAPY October 1989

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characteristics. For example, it will be necessary to evaluate the correlation between
possessing these top characteristics and actual clinical effectiveness. However, prior to
this verification, such a list of characteristics should be useful to the field i n several
ways.
First, such a list will enable educatorshainers to be certain that these character-
istics are taught, assessed, or at least discussed at some point in the training process.
Second, they could be the core components for an instrument that could help establish
the general readiness of family therapy trainees to see family clients-either under live
supervision or not. Third, they could be useful in evaluating candidates for admission
into advanced MFT training programs. Finally, they might be useful to the AAMFT’s
Commission on Accreditation and the Membership Committee in developing more com-
petency-based criteria (in addition to completing established, model curricula) for entry-
level marriage and family therapy graduates.

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 NOTE

*It is possible that, by not defining “skill” for them, we prevented them from thinking behav-
iorally, thus undermining ourselves. In retrospect, however, it has provided us with a n opportunity
for examining the foundations of our (collective) ideas about what family therapy is and how i t is
accomplished.

1 FAMILY-CENTERED
PRACTICE
The Interactional Dance
beyond the Family System
by John Victor Compher
“What we learn about the disjuncture among
the child welfare, mental health, education, and
juvenile justice systems is not pleasant, but we
can begin to see how to get the best of it all by
using Compher’s interactional dance model.”
-Ruth W. Mayden, Dean of Bryn Mawr
School of Social Work and Social Research
Interactional relationships between social service
professionals and the families with whom they
operate are studied in this volume. Dramatic ex-
amples and discussions of typical service system
dances and treatment processes are presented to
help families change their symptomatic behavior
and benefit from the helping community.
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October 1989 JOURNAL OF MARITAL AND FAMILY THERAPY 365

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