From a few charismatic individuals practising idiosyncratic innovative methods of family therapy, the field has developed into an immense skilfully marketed enterprise in many countries, particularly the United States, with hundreds of books, scores of training courses, several dozen journals, and a year-round programme of local, national, and international conferences and workshops on offer.(56)

Formal training may be given as follows/57

1. University-based degree-granting programmes that view family therapy as a distinct and separate profession with its own body of knowledge, and offering diploma, masters, PhD, and post-doctoral training.

2. Free-standing institutes that also tend to see family therapy as a distinct discipline. These provide generally part-time training, but of shorter duration than most university-based programmes. A prerequisite for entry in most is that the candidate have completed basic training in one of the health professions.

3. Within university-affiliated hospitals and clinics that provide professional training in psychiatry, psychology, social work and occupational therapy. Many provide a comparatively brief course in the theory and practice of family therapy, which is usually offered as part of general professional training.

Although there is a tremendous range of training, most programmes include the following.

• Supervision of clinical work with the supervisor (and often other students) observing the trainee and family from behind a one-way screen. Some clinicians consider the one-way screen to be dehumanizing and too objectifying of the family, as well as adding to the trainee's performance anxiety. They advocate instead a model of co-therapy between trainee and supervisor, often with other students sitting in the interview room in full view of the family.

• Video-recording the trainee's clinical work with the family, which the trainee then reviews with the supervisor and fellow students, is widely used. Tapes of particular models conducted by eminent therapists are also popular.

Whether family therapy training requires familiarity with concepts and techniques of a variety of schools or whether it is preferable to develop expertise in only one school remains controversial. The free-standing institutes tend to be run by practitioners of a particular school so that, after a generally cursory overview of the field, training is limited to a specific model. This is even more likely when training is part of general professional training in psychiatry, psychiatric nursing, psychology, and social work.

Diversity of schools and training reflects a deeper uncertainty as to whether family therapy is a distinct profession, a method of conceptualizing psychopathology, or a diverse set of therapeutic techniques to add to the clinical armamentarium of the mental health professional. This issue is further complicated by the trends toward integrating psychodynamic, attachment, systems, feminist, and narrative approaches mentioned above.

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