Alan Carr

• PhD, FPsSI, FBPsS
• University College Dublin

Background: Childhood obesity is a global public health concern. In Ireland, the age standardized prevalence rates for obesity in children and adolescents are about 1% higher than the average for countries in the WHO European Region. The Parents Plus Healthy Families program (PP-HF), an 8-week, group-based, multicomponent parent training intervent...

A new version of the Systemic Clinical Outcome Routine Evaluation (C‐SCORE) was developed for use with couples to assess, plan and monitor progress in therapy. This study aimed to examine the psychometric properties of C‐SCORE in an international community sample of 300 participants. Exploratory and confirmatory factor analysis showed that a twenty...

The 48-item Healthy Habits Questionnaire (HHQ-48) was developed to (1) monitor positive changes in family lifestyles following engagement in the Parents Plus Healthy Families (PP-HF) parent training programme and (2) be utilised as a standalone measure in clinical settings to identify and track problematic influential behaviours amongst families of...

This study is a quantitative synthesis of meta-analytic evidence for the effectiveness of very broadly defined positive psychological interventions (PPIs), i.e. interventions that enhance wellbeing through pathways consistent with positive psychology theory. The definition covers a wide range of PPIs including single and multi-element PPI programs...

Background Previous research has suggested that parents can experience positive contributions as a result of raising a child on the autism spectrum. A better understanding of positive contributions among this population can inform clinicians and policymakers and lead to improved outcomes for families. This review aimed to systematically examine stu...

A meta-analysis of positive psychology intervention (PPIs) studies was conducted. PPIs were defined as interventions in which the goal of wellbeing enhancement was achieved through pathways consistent with positive psychology theory. Data were extracted from 347 studies involving over 72,000 participants from clinical and non-clinical child and adu...

Background This study examined family adaptation among parents of school age children with autism spectrum disorder (ASD) who do not have a comorbid diagnosis of intellectual disability (ID). Family adaptation was measured by parents’ perceived family quality of life and satisfaction with life. Associated factors were derived from the Double ABCX m...

Little is known about how parents’ experiences of respite services or ‘short breaks’ for a child with complex medical needs relate to family functioning and the manner in which parents cope. The aim of this study was to examine the relationship between parents’ satisfaction with short breaks, family functioning and parental coping and to determine...

Background: The Scottish Child Abuse Inquiry (SCAI) commissioned the research project to document the outcomes of institutional abuse in long-term child care in Scotland. Objective: To profile the experiences of survivors abused in long-term child care in Scotland, and to develop a model which linked maltreatment, risk and protective factors, an...

An RCT was conducted to evaluate the effectiveness of the Say Yes to Life (SYTL) positive psychology group psychotherapy program compared with treatment as usual (TAU). The current interim report is based on data from the first 82 cases recruited into the trial. There were 57 trial completers at post-treatment. At pretreatment on demographic and cl...

The present study aimed to update previous meta-analyses of gCBT, and focus specifically on recent studies in which the Beck Depression Inventory (BDI) was used to assess outcome. PsycINFO, PubMed, EMBASE, and Cochrane were searched for eligible studies. Both randomized controlled trials (RTC, k = 9) and non-RTCs (k = 1) published since 2000 were i...

Purpose The purpose of this paper is to appraise “transference” and “countertransference” when working with people with intellectual disabilities (PWID). Design/methodology/approach A review of the literature was conducted, followed by a discussion. Findings No research articles were found. Potential reasons for this are discussed. Historical...

A systematic review of published and unpublished English language articles identified 14 studies containing 18 comparisons between functional family therapy (FFT) and another condition in the treatment of adolescent disruptive behavior and substance use disorders. In 11 of these comparisons, assignment to conditions was random, while nonrandom assi...

[ Video abstract: https://youtu.be/Immb4BRPeVA ] Parents Plus (PP) programs are systemic, solution-focused, group-based interventions. They are designed for delivery in clinical and community settings as treatment programs for families with child-focused problems, such as behavioral difficulties, disruptive behavior disorders, and emotional disord...

The Waterford Mental Health Survey aimed to document the prevalence of personality disorders (PDs) in patients attending the public mental health service in Waterford, Ireland and outline the implications of this for service development. Between July 2011 and June 2014, 100 inpatients and 99 outpatients were evaluated with the Structured Clinical I...

My reviews of the evidence base for family therapy conducted over the past 15years have been guided by four key questions. Does systemic therapy work? What sorts of systemic therapy work for specific problems? What processes occur in effective systemic therapy? Is systemic therapy cost-effective? In this paper answers to these questions are given....

Despite the widespread adoption of manualized model‐driven approaches to family therapy, little is known about how therapists implement and families experience the specific guiding practices involved in individual models. The aim of the present study was to use a qualitative methodology to describe therapist implementation and family experiences of...

The SCORE (Systemic Clinical Outcome and Routine Evaluation) is a 40‐item questionnaire for completion by family members 12 years and older to assess outcome in systemic therapy. Twenty‐eight and 15‐item short versions of the SCORE have previously been validated with samples containing some families attending adult mental health services and some a...

The third edition of the hugely successful Handbook of Child and Adolescent Clinical Psychology incorporates important advances in the field to provide a reliable and accessible resource for clinical psychologists. Beginning with a set of general conceptual frameworks for practice, the book gives specific guidance on the management of problems comm...

Background: Previous research has consistently shown the negative impact that peers can have on adolescent substance use patterns. Few studies have examined the positive influence adolescents can have on their peers. This study aimed to examine the relationship of positive peer influence with indices of substance use and also to compare abstinent a...

A systematic review of self-report family assessment measures was conducted with reference to their psychometric properties, clinical utility and theoretical underpinnings. Eight instruments were reviewed: The McMaster Family Assessment Device (FAD); Circumplex Model Family Adaptability and Cohesion Evaluation Scales (FACES); Beavers Systems Model...

[ Video abstract: https://youtu.be/rYXCfFMLYpk ] To evaluate the effectiveness of Functional Family Therapy (FFT) 42 cases were randomized to FFT and 55 to a waiting-list control group. Minimization procedures controlled the effects of potentially confounding baseline variables. Cases were treated by a team of 5 therapists who implemented FFT with...

One-hundred-ninety-nine adult mental health service users were interviewed with a protocol that included the Childhood Trauma Questionnaire, the Structured Clinical Interviews for Axis I and II DSM-IV disorders, the Global Assessment of Functioning scale, the SCORE family assessment measure, the Camberwell Assessment of Need Short Appraisal Schedul...

This study evaluated the Parents Plus - Parenting when Separated Programme, an intervention specifically designed to address the needs of separated parents in an Irish context. In a randomized control trial, 82 separated parents with young children were assigned to the Parents Plus - Parenting when Separated Programme treatment group and 79 to a wa...

The SCORE (Systemic Clinical Outcome and Routine Evaluation) is a 40-item questionnaire for completion by family members 12 years and older to assess outcome in systemic therapy. This study aimed to investigate psychometric properties of two short versions of the SCORE and their responsiveness to therapeutic change. Data were collected at 19 center...

Patients and referrers are increasingly seeking effective psychological treatments for depression as an alternative or adjunct to antidepressant medication. This paper describes a new group-based psychological intervention for major depressive disorder—the Say ‘Yes’ to Life (SYTL) program. This program integrates evidence-based interventions from c...

This study aimed to evaluate the effectiveness of positive systemic practice ( PSP ) in the context of a controlled trial. PSP is a model of family therapy for adolescent emotional and behavioural problems. A series of thirty‐seven consecutive patients assigned to a PSP treatment group and thirty‐five similar patients consecutively assigned to a wa...

This review updates similar articles published in JFT in 2000 and 2009. It presents evidence from meta-analyses, systematic literature reviews and controlled trials for the effectiveness of couple and family therapy for adults with various relationship and mental health problems. The evidence supports the effectiveness of systemic interventions, ei...

This review updates similar articles published in the Journal of Family Therapy in 2001 and 2009. It presents evidence from meta-analyses, systematic literature reviews and controlled trials for the effectiveness of systemic interventions for families of children and adolescents with various difficulties. In this context, systemic interventions inc...

This study evaluated the effectiveness of an eight-session mindfulness-based cognitive therapy (MBCT) group intervention programme for treating depression in coronary heart disease (CHD) patients. Thirty-two depressed CHD patients were assigned to an MBCT treatment group, and a demographically and clinically similar group of 30 cases were assigned...

In an Irish context we conducted a retrospective archival study of functional family therapy ( FFT ) for adolescents with behavioural problems. Strengths and difficulties questionnaire data were collected from 118 families at the beginning and end of therapy (at baseline and follow up for dropouts) in a community‐based clinic in a socially disadvan...

The Systemic Clinical Outcome and Routine Evaluation (SCORE) Index of Family Function and Change is a recently developed outcome measure. It was designed to be acceptable to adults and children aged 12 and over. Thus far no research has been conducted using the SCORE in children under the age of 12. The aim of this study was to pilot a children's v...

In Ireland family therapy is a small profession, with under 200 registered therapists. The Irish family therapy movement began in the mid-1970s. By 1980 the Family Therapy Network of Ireland in the Republic of Ireland and the Northern Ireland Branch of the UK Association Family therapy had been founded. At present there are three main family therap...

In this study a 29-item version of the systemic clinical outcome and routine evaluation (SCORE), which contained all items from the SCORE-15 and SCORE-28, was used to develop norms for both the 15 and the 28 versions of the SCORE from the same sample. In a random digit dialling telephone survey, a stratified national random sample of 403 adults liv...

Leaves on a stream: The effectiveness of a mindfulness-based exercise on the frequency, and difficulty in " letting go " of, anxious self-statements Dan Hartnett Researcher, School of Psychology, University College Dublin Alan Carr Professor of clinical psychology, School of Psychology, University College Dublin A controlled trial was conducted to...

The study objectives were to investigate whether a heterogeneous sample of Irish chronic pain patients could be classified into subgroups using the Multidimensional Pain Inventory (Kerns, Turk, & Rudy, 198526. Kerns, R., Turk, D. and Rudy, T. 1985. The West Haven-Yale Multidimensional Pain Inventory. Pain, 23: 345–356. [CrossRef], [PubMed], [Web of...

This study examined the effectiveness of the Parents Plus Programme for families of pre- school children with significant behavioural problems, comparing those with and without developmental disabilities. Twenty-two parents of children with developmental disabilities and conduct problems (the disability group), and 17 parents of children with condu...

Irish adolescents (N= 294) were profiled after being classified as having high, moderate or low subjective well-being on the basis of their scores on the Oxford Happiness Inventory, the Satisfaction With Life Scale and the General Health Questionnaire-12. Compared with the low well-being group, the high well-being group reported fewer family and pe...

This study examined the association between depression and autobiographical memory deficits. Specifically, it evaluated the impact of depression, complexity of a distraction task, self- or other-referential set and positive or negative cue-word valence on the retrieval of specific autobiographical memories. A sample of 24 depressed women and 24 mat...

The results of two major surveys of more than 3000 primary school children in the Republic of Ireland were compared with Irish normative data for over 3000 children of the same age on the Raven’s Standard Progressive Matrices (RSPM). The recent surveys were conducted almost two decades after the normative data were collected. Significant increases...

Three major epidemiological studies of psychological disorders in Irish children were reviewed. These are the first systematic investigations to be conducted in Ireland and all have been completed within the last 5 years. The studies were conducted in Dublin (N = 2029), Clare (N = 1361) and Cork (N = 733). In all three studies children were screene...

In the present study a group of sexually abusive adolescents who had completed a community based treatment programme were compared with a group of non-offending peers matched for age, sex, and socio-economic status. Physical abuse, parental separation, and school related educational and behavioural difficulties were more common in the histories of...

A survey of all clinical ps ychologists employed by eight health boards in the Republic of Ireland in 1994/1995 was conducted and the response rate was 54%. The views of the 67 respondents on their actual, desired and expected future work roles are described in this paper. There were clear differences between the actual roles of respondents and the...

Thirty-two chronic pain patients classified as dysfunc~onal (N=15); interpersonally distressed (N=9); or adaptive copers (N=8) on the West Haven-Yale Multidimensional Pain Inventory were evaluated before and aftera 3.5 week outpatient multimodal chronic pain management programme. Five patients also participated in a post-treatment focus group in wh...

In this study of 20 male and 20 female conduct disordered adolescents matched for age and sociodemographic variables. distinct psychosocial prNiles were identified. Girls had fewer conduct problems overall because, compared with boys, they had fewer overt behaviour problems. Boys showed higher levels of cruelty, bullying, destructiveness, weapon ca...

A cluster analysis of responses of 78 carers of people with learning disabilities to service needs scales identified high- and low-need groups, each with distinct profiles. In comparison with the low-need group, the high-need group reported greater needs for familial social support; help explaining their child’s handicap to others; assistance with...

The aim of the study was to evaluate the immediate impact of Critical Incident Stress Debriefing (CISD) on people who had recently experienced a stressful event. Post traumatic symptoms were evaluated with the Impact of Events Scale (IES) before CISD and again six weeks later and were compared to those of controls and a group who had received a bri...

The results of a 1993 survey of 111 clinical psychologists practising in Ireland are presented in this paper. Fifty-five percent of respondents were female and 45% were male with a mean age of 39 years and 7 months. A third of the group had a two year masters degree in clinical psychology; a third had on-the-job training; and a third had a diploma,...

Providing a solid foundation for evidence-based practice, this book offers reviews of evidence from over 150 rigorously conducted research trials into the types of psychological treatments that may be effective for common psychological problems in childhood and adolescence. (PsycINFO Database Record (c) 2012 APA, all rights reserved)

In this article the contents of the principal English-language family therapy journals, and key family therapy articles published in other journals in 2012 are reviewed under these headings: therapy processes in the treatment of child-focused problems, autism, adolescent substance use, human immunodeficiency virus, depression and grief, fragile fam...

Social and emotional development (SED) entails the acquisition of skills for expressing and regulating emotions, and managing social relationships. During middle childhood, with the transition to primary school and increasing involvement with peers, important gains are made refining rudimentary skills developed during the preschool years. From 6 to...

Controlled studies suggest that clerical child sexual offenders may be better adjusted psychologically than their lay counterparts, although no studies of Irish clerical offenders have been reported. The aim of this study was to compare clerical and non-clerical sexual offenders with a normal control group, within an Irish context, on broad-band pe...

The aims of this study were to develop scales to assess experiences of sexually abused children in the Irish criminal justice system (CJS); identify aspects of the CJS which children experience as negative; compare the perceptions of children, parents and professionals of sexually abused children's experiences of the CJS; and determine correlations...

In this article the contents of the principal English-language family therapy journals published in 2009 are reviewed under these headings: narrative therapy, child-focused problems, adult-focused problems, substance abuse across the lifespan, illness across the lifespan, family violence, couples, diversity, developments in systemic practice, train...

Adult survivors of institutional abuse were interviewed with a comprehensive assessment protocol which included the Childhood Trauma Questionnaire, the Institutional Child Abuse Processes and Coping Inventory, the Structured Clinical Interviews for Disorders of the Diagnostic and Statistical Manual of Mental Disorders IV axis I disorders and person...

This article describes the development, in an Irish context, of a three-factor, twenty-eight-item version of the Systemic Clinical Outcome and Routine Evaluation (SCORE) questionnaire for assessing progress in family therapy. The forty- item version of the SCORE was administered to over 700 Irish participants including non-clinical adolescents and...

A growing evidence‐base shows that family therapy works, but many gaps in our knowledge remain about the conditions under which family therapy is effective and how it works. In this paper, ten critical research questions about family therapy that need to be addressed are considered. In short these are: Is family therapy as effective in community se...

Objective: To document the adult adjustment of survivors of childhood institutional abuse. Method: Two hundred and forty-seven adult survivors of institutional abuse with a mean age of 60 were interviewed with a protocol that included the Childhood Trauma Questionnaire, modules from the Structured Clinical Interview for Axis I Disorders of DSM I...

The effectiveness of a prison-based cognitive behavioral program designed to modify psychological risk factors associated with sexual offending was evaluated. The Irish Prison Service Sexual Offender Intervention Programme, is a manualized 10-month Cognitive Behaviour Therapy [CBT] program involving three 2-hour group sessions per week, which are f...

The aim of this study was to evaluate a manualized cognitive behavioral group intervention for early-stage breast cancer patients. Sixty-nine women were recruited at an Irish specialist oncology hospital and assigned to a 6-week cognitive behavior therapy (CBT) program or an educational control group. Participants were assessed at baseline, 6 weeks...

Aims To compare the effectiveness of a manualised group cognitive behaviour therapy (CBT) programme for people with bipolar disorder (BPD) and major depressive disorder (MDD). Method In addition to treatment as usual (TAU), 17 people with BPD and 17 matched controls with MDD completed 8 or 12 sessions of twice weekly group CBT, followed by 6 boost...

In this paper the contents of the principal English-language family therapy journals, and family therapy papers from other journals published in 2008, are reviewed under the following headings: child-focused problems, adult-focused problems, couples, diversity, developments in systemic practice, training, research, and recent deaths of significant...

To develop a psychometric instrument to evaluate psychological processes associated with institutional abuse and coping strategies used to deal with such abuse. As part of a comprehensive assessment protocol, an inventory containing theoretically derived multi-item rational scales which assessed institutional abuse-related psychological processes a...

Clinical features, epidemiology and aetiology of post-traumatic stress disorder (PTSD) are outlined. Treatment outcome studies involving children with PTSD who have survived traumatic accidents, natural disasters and child sexual abuse are reviewed. An evidence-based assessment and treatment protocol is outlined for children and adolescents with PT...

Two hundred and forty seven survivors of institutional abuse in Ireland were classified with the Experiences in Close Relationships Inventory as having fearful (44%), preoccupied (13%), dismissive (27%), or secure (17%) adult attachment styles. The group with the secure adult attachment style had the most positive profile, while the most negative p...

The literature on bipolar in children and adolescents was reviewed to provide an update for clinicians. REVIEW PROCESS: Literature of particular relevance to evidence-based practice was selected for critical review. An up-to-date overview of clinical features, epidemiology, prognosis, aetiology, assessment and intervention was provided. Bipolar dis...

This review updates a similar paper published in this Journal in 2000. It presents evidence from meta-analyses, systematic literature reviews and controlled trials for the effectiveness of couples and family therapy for adults with various relationship and mental health problems. The evidence supports the effectiveness of systemic interventions, ei...

This review updates a similar paper published in the Journal of Family Therapy in 2001. It presents evidence from meta-analyses, systematic literature reviews and controlled trials for the effectiveness of systemic interventions for families of children and adolescents with various difficulties. In this context, systemic interventions include both...

What Works with Children, Adolescents, and Adults? provides an up-to-date review of research on the effectiveness of psychotherapy and psychological interventions with children, adolescents, adults, people in later life, and people with intellectual and pervasive developmental disabilities. Drawing on recent meta-analyses, systematic reviews, and k...

In this article the contents of the principal E nglish‐language family therapy journals and key family therapy articles published in other journals in 2013 are reviewed under these headings: models of family therapy, developments in family therapy practice, couple therapy, training, diversity, international developments, research and DSM ‐5. Pract...

IntroductionStage 1. PlanningStage 2. Assessment and FormulationStage 3. TherapyStage 4. Disengaging or RecontractingSummaryFurther ReadingReferences

Transgenerational Family TherapyPsychoanalytic Family TherapyAttachment-Based TherapiesExperiential Family TherapyMultisystemic Family TherapyPsychoeducational Family TherapyClosing CommentsGlossaryFurther Reading

Child-Focused ProblemsAdult-Focused ProblemsCommon FactorsClosing CommentsGlossaryFurther Reading

At first glance, Mrs. Green presented complaints similar to many other women. After being a “no-show” at other doctors’ offices, Mrs. Green finally kept an appointment with an obstetrician-gynecologist (OB-GYN). Her complaints ranged from extended and boring waiting room delays and discourteous medical staff to the difficulty and expense of parking...

"Alan Carr has once more demonstrated his unique ability to combine an encyclopaedic breadth of knowledge with clear pragmatic ideas about how to apply this knowledge in clinical practice. The 2nd edition of this book is more than just an update with new sections on common factors in therapy and on integrative models of family therapy which are par...

Recent psychotherapy research has investigated the physical reactions of therapists to their clients and the potential utility of these reactions in therapeutic settings. These bodily reactions can range from nausea and genital pain to headaches. They are collectively known as body-centred counter-transference. The current exploratory study used th...

The literature on depression in children and adolescents was reviewed to provide an update for clinicians. REVIEW PROCESS: Literature of particular relevance to evidence-based practice was selected for critical review. Meta-analyses and controlled trials were prioritized for review along with key assessment instruments. An up-to-date overview of cl...

The report describes the intake interviewing exercise in a family therapy training unit developed for postgraduates in clinical psychology. The teaching method includes pre-class reading, video modelling, and simulated practice with live feedback. The academic material and other similar practice exercises are contained in the core textbook for this...

Background This study aimed to evaluate the effectiveness of the Parents Plus programme with families of pre-school children with developmental disabilities and significant behavioural problems in the Irish health service. The Parents Plus programme is a group-based parent training package involving video modelling, which was designed to be effecti...

In this paper the principal English-language family therapy journals published in 2005 are reviewed under the following headings: research in family therapy, couples, families and wider systems, parental alimentation syndrome, diversity, training, and deaths.