THE FAMILY
10.1177/1066480704273639
Doerries, FosterJOURNAL:
/ A DELPHI
COUNSELING
STUDY AND THERAPY FOR COUPLES ANDAMILIES
F / July 2005
Essential Skills for Novice Structural
Family Therapists: A Delphi Study of
Experienced Practitioners’ Perspectives
Denyse B. Doerries
Victoria A. Foster
College of William and Mary
The considerable number of essential skills identified in the litera-
ture creates a challenge for family therapist instructors and supervi-
sors who must develop a coherent curriculum for clinical training
and supervision. This study used a modified Delphi method to obtain
a consensus from experienced structural family therapists concern-
ing the most essential skills needed by novice structural family ther-
apists. The therapists concluded that relational skills are of primary
importance to establish a therapeutic relationship that would facili-
tate the structural interventions. A critical component of the rela-
tional factor was the ability of the novice therapist to provide a
vision of hope to clients and establish expectancy for change. The
study provides an added dimension to understanding the essential
training needs of novice structural family therapists from the practi-
tioner’s perspective and brings research in essential skills for novice
therapists closer to actual clinical practice. Implications for further
research and clinical training are discussed.
Keywords: family therapy; essential skills; training family thera-
pists; Delphi study
F amily therapy has established its efficacy as a treatment
modality (Avis & Sprenkle, 1990; Kniskern & Gurman,
1988); however, the field continues to struggle to identify key
ingredients for the practice of successful family therapy
(Anderson, 1992; Figley & Nelson, 1990). The literature pro-
vides some guidance for teachers of family therapy with
regard to necessary skills for novice therapists but cautions
that these skills tend to be theoretically based rather than clin-
ically confirmed (Figley & Nelson, 1989, 1990). Family ther-
apy purports differences in both form and content from other
therapy models; thus, identifying those skills specific to fam-
ily therapy needed by novice family therapists becomes
essential to promote competence (Anderson, 1992; Figley &
Nelson, 1989, 1990).
Structural family therapy (SFT) is one of the most widely
used family therapy models and is applicable in a variety of
THE FAMILY JOURNAL: COUNSELING AND THERAPY FOR COUPLES AND FAMILIES, Vol. 13 No. 3, July 2005 259-265
DOI: 10.1177/1066480704273639
© 2005 Sage Publications
settings with diverse clients. With clear and understandable
tenets, SFT lends itself to the teaching and supervising of
novice family counselors (Becvar & Becvar, 2003). However,
most published studies on supervision and essential skills for
novice family therapists emerge from academicians rather
than field-based practitioners and supervisors (Sprenkle &
Bailey, 1997). Structural family therapists and supervisors
outside of academic settings may adhere to different frame-
works than those endorsed as the standards in the field
(Storm, Todd, Sprenkle, & Morgan, 2001). Feedback from
such experienced therapists is needed to close the gap
between what is prioritized in the educational settings and
what is actually being practiced in the field in training and
supervision. The purpose of this study was to identify essen-
tial skills that novice structural family therapists need from
the perspective of experienced therapists.
BACKGROUND
According to Fish and Busby (1996), “As a field under-
going continual transformation and theoretical and practical
challenges, family therapy is well-positioned to find the
Delphi method useful” (p. 472). Furthermore, the Delphi
method is well suited to bridging the gap between research
and practice. A number of studies use a Delphi methodology
to obtain perspectives of experts concerning essential skills
needed by novice family therapists (Blow & Sprenkle, 2001;
Figley & Nelson, 1989, 1990; Scott, Edwards, & Russell,
1997; Winkle, Piercy, & Hovestadt, 1981). The Basic Family
Therapy Skills Project (Figley & Nelson, 1989, 1990)
employed a Delphi method to identify the foundational skills
that novice family therapists need to be effective. These stud-
ies polled expert panels composed of primarily university-
affiliated academic trainers and supervisors of novice family
therapists to identify these skills. The first study identified
101 generic therapy skills that the participants described as
259
260 THE FAMILY JOURNAL: COUNSELING AND THERAPY FOR COUPLES AND FAMILIES / July 2005
the most important skills that novice family therapists needed
to possess. The second study (Figley & Nelson, 1990) further
delineated 100 basic skills needed in SFT, brief family ther-
apy, and strategic family therapies. The generic skills focused
on the relational aspects of therapy, whereas the family
therapy skills focus was on techniques.
Employing the same methodology and polling primarily
academicians, Scott et al. (1997) identified key variables,
including therapeutic skills, that are essential to positive out-
comes in marriage and family therapy (MFT), thereby further
expanding knowledge with regard to essential elements for
successful family therapy. This study identified 217 variables
that were rated as very important to successful MFT out-
comes. These variables were then collapsed into five catego-
ries: (a) therapist variables, (b) client variables, (c) therapist-
client relationship variables, (d) therapy process variables,
and (e) setting or context variables. This study found that the
therapist variables could be grouped into four categories: (a)
personal qualities of the therapist, (b) therapist executive
skills, (c) therapist relationship skills, and (d) therapist
perceptual-conceptual skills (Scott et al., 1997). The authors
concluded that it was important that therapists not only pos-
sess personal maturity and character but also be able to exe-
cute the tasks of therapy, recognize interactional patterns of
behavior, and create a positive relationship with the client.
Within the process variables, the ability of the therapists to
emphasize the families’ strengths as well as the ability to
work productively by being actively engaged in the therapy
process were considered the key factors to successful
outcomes.
The considerable number of essential skills identified in
the literature creates a challenge for family therapist instruc-
tors who must develop a coherent curriculum for clinical
training and supervision. The current study provides an added
dimension to understanding the essential training needs of
novice family therapists from the practitioner’s perspective
and brings research in essential skills for novice therapists
closer to actual clinical practice.
METHOD
Qualitative research methods aim to illuminate the study
question, and the concern is with information richness rather
than representativeness (Creswell, 1998). The equivalent
terms for reliability and validity for qualitative data are credi-
bility, dependability, and confirmability. With the Delphi
study, credibility is directly related to the selection of the panel
of experts who must fit the area of inquiry, as did the panel in
this study. Member checking, thick description, and peer
debriefing impart trustworthiness to qualitative studies, and
each of these methods was included in this research design.
Throughout the entire process of the study, a peer
debriefer provided an external check of the methods, mean-
ings, and interpretations of the data. This peer debriefer held a
doctorate in counseling and was a practicing family therapist.
Her role included asking hard questions about the research
process and serving as a sounding board for the researchers’
explorations of their thoughts, feelings, and reactions.
This study used a modified Delphi method to obtain a con-
sensus from experienced professional family therapists con-
cerning the most essential skills needed by novice family
therapists (Fish, 1989; Scott et al., 1997). The Delphi method
samples a group of knowledgeable persons with the goal of
gaining a consensus of opinion on a particular topic (Dalkey,
Rourke, Lewis, & Snyder, 1972; Fish, 1989; Fish & Busby,
1996; Winkle et al., 1981). The method structures communi-
cation by providing a chance for the participants to first
express their opinions individually and anonymously, get
feedback from the group about these views in written form,
see other views of the same ideas, and have an opportunity to
then revise their own views (Fish & Busby, 1996). Data from
the Delphi method provide thick description in the
participants’ response to the survey question.
In the first phase of a Delphi study, the participants are
individually requested to generate written responses to an
open-ended question and provide their responses to the
researcher. In the second phase, the researcher edits the
responses from all the participants by eliminating redun-
dancy and categorizing the information to increase clarity.
The participants are then asked to rank the edited responses of
the whole group. In the third phase, the researcher once again
edits the group responses and submits the list back to the par-
ticipants for their final ranking to gain consensus on the
question posed.
To narrow the focus from the large number of skills previ-
ously identified in the literature as essential and to add mean-
ing to the discussion, the current Delphi study was modified
in two ways. First, the participants were initially asked to gen-
erate and rank the 10 most essential skills needed by novice
family therapists instead of rating behaviors on a 7-point
Likert scale. Secondly, rather than having three rounds of
questionnaires, this study used a focus group after the second
round of opinions was collated. The focus group allowed the
7 experienced therapists to reach a consensus concerning the
15 most essential skills needed by beginning family therapists
based on the responses generated from the previous two
rounds of the Delphi study. This modification also provided
more in-depth understanding of the disagreements between
the therapists and the process used to reach consensus. Fur-
thermore, the focus group provided opportunities for member
checking and additional complex information about the
process of becoming a family therapist.
A focus group typically involves an interactive group dis-
cussion with an open-response format for the purpose of
understanding the participants’ views on a chosen topic
(Piercy & Nickerson, 1996). This focus group differed
because the main directive was discussing the list of skills
generated during the second Delphi round and coming to a

consensus about the 15 most essential skills needed by novice
family therapists. Notes were taken on a blackboard during
the discussion, the session was audiotaped and transcribed,
and researcher notes were taken.
Participants
In a Delphi study, the selection of the participants, based
on the extent of their knowledge of the subject matter, is the
critical component that assures the quality of the outcome. To
bring this research into a more clinical/applied setting and
provide an expanded perspective of the most essential skills
for novice family therapists, a purposive sample of 7 experi-
enced professional structural family therapists was selected
to participate in this modified Delphi study. The participants
for this study were chosen on the basis of the depth of their
experience in clinical settings with family therapy as well as
their involvement in a long-term SFT supervision group.
These participants all had 30 credits beyond their master’s de-
gree, more than 10 years of experience each as structural fam-
ily therapists, and were licensed by the Board of Health Pro-
fessions in their state. Four of the therapists were licensed
clinical social workers, 1 was a licensed professional coun-
selor, and 2 were licensed psychologists. The varied profes-
sional backgrounds of the participants provided a rich and
textured element to the study.
All of the participants were female with 5 being Caucasian
and 2 being African American. Their average age was 40.
This group of therapists worked on a daily basis with clients
in both private practice and social agencies and possessed sig-
nificant expertise with regard to the key skills needed by nov-
ice family therapists entering a real-life clinical setting. All
the participants provided supervision as a component of their
professional role. All 7 considered the SFT model as the
foundation of their clinical practice based on their training
and supervision.
Procedures
Letters describing the nature of the study were distributed
to all the members of a family therapy clinical supervision
group who had 5 or more years of experience in the group and
as a practicing family therapist. Informed consent forms and
an addressed, stamped envelope were provided. The experi-
enced therapists were asked to return the consent forms indi-
cating their willingness to participate in the Delphi study.
Questions about the nature of the research and what their par-
ticipation in this study would entail were answered at the
meeting of the group. Seven participants agreed to participate
in this study. Each participant then received addressed, stamped
envelopes for mailing their responses to the researcher.
PROCESS, DATA ANALYSIS, AND RESULTS
The Delphi study was analyzed as each round of responses
was completed. The first round of analysis collated all of the
Doerries, Foster / A DELPHI STUDY 261
responses of the 7 participants to the following question:
“List the 10 most essential skills you believe are necessary for
beginning structural family therapists to learn.” This resulted
in one complete list of 105 skills. After consulting with a peer
debriefer, skills that were considered duplications were col-
lapsed into one category. Because this was just the first round
of responses, most of the categories were left intact, and the
original wording was maintained resulting in a table of 71
skills (Table 1).
In the second round of responses, each experienced thera-
pist reconsidered the top skills needed by novice family thera-
pists by ranking these 71 skills generated from all the thera-
pists into the top-20 most essential skills. The participants
returned these rankings with additional suggestions concern-
ing conceptual groupings as well as ranking the top 20. This
ranking was then analyzed by tallying the number of times
each item (1-71) was ranked as essential. The item ranked
most frequently became number 1 on the next list of essential
skills. Further collapsing of categories occurred at this point
based on comments from the therapists and a redundancy of
answers. For example, from the list of 71 items, item number
12, “Identify family process; read the family; identify pat-
terns in the family,” was combined with the item number 47,
“Process vs. content,” because so many of the therapists gave
them the same rank.
Based on the frequency count, a list of 15 skills with the
number of participants who ranked them as essential was gen-
erated from most frequent to least frequent (Table 2). In addi-
tion, the investigator labeled the skills as a personal character-
istic, a conceptual variable, or a process variable based on the
research of Greenberg and Neimeyer (1986) and Scott et al.
(1997). For example, the item ranked most frequently as the
most essential by all 7 of the therapists—tolerate intensity—
was described as a personal characteristic.
This list of 15 items was then presented to the 7 partici-
pants for discussion and consensus on a final list. Once again,
they were asked to rank the skills in order of importance for
novice family therapists, only this time, as noted before, they
were to come to consensus as a group. Field notes were taken
both during and after the discussion concerning who spoke,
who was listened to, who interrupted whom, and how con-
flicts were resolved. The effect of peer pressure was noted on
the decision process. The following is the final list generated
and grouped by the 7 participants (Table 3).
Process of the Focus Group
The main purpose of using a focus group in this study was
to draw upon respondents’ attitudes, feelings, beliefs, experi-
ences, and reactions in a way that would not be feasible using
other methods—for example, observation, one-to-one inter-
viewing, or questionnaire surveys. These attitudes, feelings,
and beliefs may be partially independent of a group or its
social setting but are more likely to be revealed via the social
gathering and the interaction that being in a focus group
262 THE FAMILY JOURNAL: COUNSELING AND THERAPY FOR COUPLES AND FAMILIES / July 2005

TABLE 1
Delphi Round 1 Results
# Essential Skill

1. Recognize the structure of the hierarchy 40. Taking care of oneself

2. Set up simple enactments 41. Establishing boundaries
3. Read closeness and distance in relationships 42. Ability to sit and be with someone
4. Sit quietly with tension 43. Recognizing alliances/coalitions
5. Map family/family-of-origin genograms 44. Establishing leadership in the room
6. Read metamessages, body language 45. Effective use of silence
7. How to deliver clear, concise directives and assessments/ 46. Decision making in how to deal with presenting problems
messages 47. Process versus content
8. Balance nurturing/support and accountability 48. Sense of comfort in receiving supervision
9. Unbalancing the status quo/interfere in the patterns 49. Ability to see strengths in the midst of weaknesses
10. Intervene directly whenever abusive behaviors occur 50. A kind, strong voice
11. Learn about balance between control and nurturance 51. Humility
12. Identify family process; read the family; identify patterns in 52. Tolerate intensity
family 53. Be directive to change patterns
13. Find ways to connect/join 54. Willing to look at self and how you engage in process
14. Be able to take direction/supervision 55. Understanding that you are a beginner and the only way to
15. Look for themes in families/develop themes learn is by doing
16. Develop a hypothesis about the family functions 56. Flexibility
17. Identify consequences for the family if changes occur 57. Clarity
18. Have compassion for family (not a skill, but important) 58. Persistence
19. Be able to be quiet and listen 59. Caring
20. Learn how to move a family around 60. Fully present to listen
21. Skillful listening 61. Being aware when their intervention plan is incompletely or
22. Empathy unsuccessfully executed because of their personal issues
23. Giving a vision of hope that it is possible to change 62. Gathering each family member’s definition of the problem,
24. Skillful use of humor attempted solutions, frame of other members, and self in such
25. Open-ended questions—good use of a way that members feel heard and validated
26. Validating feelings 63. Bringing the problem into the room and offering alternative
27. Assessing and planning transactions among family members (enactment)
28. Theory based—how does this apply to family? 64. Taking leadership
29. A clear sense of therapy stages—beginning, middle, end; what 65. Understanding systems thinking
does it look like? 66. Conducting a structural assessment with restructuring goals
30. Safety—how to plan for that for self and for family 67. Reframing in such a way that the family is challenged to think
31. Use of self in therapy—strengths and weaknesses and act differently, congruent with restructuring goals
32. Awareness of importance of breath 68. Take action both verbally and in the room based on restructur-
33. Working with resistance ing goals
34. Staying of focus 69. Engage the family in a mutually agreed-upon contract for
35. Ability to work at one’s own issues treatment
36. Opportunity for ongoing supervision 70. Offer hope, goals, and a direction for change
37. Aware of being inducted 71. Be willing to show humanity and be connected with the client’s
38. Thinking systems/systemically struggle—open hearted, empathic, warm, sharing of self
39. Patience

entails. Compared to individual interviews, which aim to
obtain individual attitudes, beliefs, and feelings, focus groups
elicit a multiplicity of views and emotional processes within a
group context. The focus group involves organized discus-
sion with a selected group of individuals to gain information
about their views and experiences of a topic. Focus groups are
particularly useful when there are power differences between
the participants and decision makers or professionals and
when one wants to explore the degree of consensus on a given
topic.
The design of this focus is consistent with standard focus
group methodology: It has a purposive sample, it used ques-
tions generated by the Delphi study to focus the discussion, it
used an experienced facilitator, all comments made by the
participants were recorded and transcribed, and facilitator’s
notes were taken on nuances of the interaction. The partici-
pants in this group were long-term members of a clinical
supervision/consultation group led by two supervisors who
worked and trained with Salvador Minuchin during the devel-
opment of SFT. One of these supervisors was also one of the
participants in this study, and her status as a leader was appar-
ent in the focus group discussion. This supervisor spoke more
often and interrupted more frequently. Her longstanding rela-
tionship with the other members of the group influenced the
 Doerries, Foster / A DELPHI STUDY 263

TABLE 2 TABLE 3
Delphi Round 2 Results Delphi Focus Group Final Results
# Essential Skill Conceptual Skill

1. Tolerate emotional intensity (7) P 1. Thinking systemically

2. Thinking systemically (6) C 2. Identifying and understanding family patterns
3. Giving a vision of hope for change (6) Pp 3. Conducting a structural assessment
4. Conducting a structural assessment (5) C 4. Identify themes in families/develop themes
5. Identify and understand the families’ patterns (5) C
6. Find ways to join or connect with the family (5) Pp Structural (Doing) Skill
7. Willing to take direction or supervision (4) P
8. Identify themes in families/develop themes (4) C 1. Develop a systemic hypothesis about family functions
9. Develop systemic hypothesis about family functions (4) C
10. Be able to be quiet, sit with someone, and listen (4) Pp Structural and Conceptual
11. Use of the self in therapy; awareness of one’s strengths and
weaknesses (4) P 1. Establishing boundaries
12. Taking care of oneself (4) P 2. Creating enactments
13. Patience (4) P
14. Establish boundaries (4) C Relational
15. Enactments—bring the problem in the room and offer alterna-
1. Tolerate emotional intensity
tive methods of transaction (4) C
2. Be able to be quiet, sit with someone, and listen
3. Taking care of oneself
NOTE: P = personal variables; C = concepts; Pp = process variables. 4. Patience

dynamics but did not inhibit the discussion. Additionally,
those members who worked with extremely challenging fam-
ilies and who were directly supervising novice therapists also
working with these same families were influential in the
group process. All members expressed their opinions,
expanded upon each other’s perspectives, and engaged in a
dialectical process of weighing and reconciling diverse
positions.
DISCUSSION
Although the participants were limited to only 7, the fact
that the panel was a purposive, representative sample com-
posed of currently practicing, full-time SFT clinicians from
community settings is appropriate in qualitative work and
sets it apart from previous studies. When discussing the
essential skills needed by novice family therapists, the partic-
ipants had the doing of family therapy very much in mind.
This group of experienced clinicians struggled with the
dichotomy of relational versus structural skills, which
appears inherent in family therapy. The field notes indicate
that power differentials among the participants, primarily
based on years of supervisory experience, influenced the pro-
cess. However, the group resolved this dissonance through
constructive dialogue and negotiation. The result of their
struggles provides this study an additional dimension that
involves their attempts to integrate the relational with the
structural skills. The participants discussed at length the
importance of relational skills in the execution of the structur-
ing/restructuring interventions. Without the necessary rela-
tional skills, the experienced therapists believed that SFT
could not be effective. It is in the action of family therapy that
Relational/Structural
1. Giving a vision of hope for change
2. Find ways to join or connect with the family
3. Willing to take direction or supervision
4. Use of the self in therapy; awareness of one’s strengths and
weaknesses
the relational factors emerge as a factor of primary impor-
tance. Similarly, the therapists found expectancy and hope as
more related to the action of therapy than their theoretical
underpinnings. These insights coincide with research indicat-
ing that relational factors account for 30% of the change pro-
cess, whereas model or techniques factors account for 15%
(Miller, Duncan, & Hubble, 1997)—a perspective supported
conceptually by Lambert (1992) and Blow and Sprenkle
(2001). Furthermore, the results from this study are consis-
tent with findings from a Delphi study of clinicians in
academic settings regarding variables that contribute to
successful family therapy outcomes (Scott et al., 1997).
The experienced therapists developed overlapping catego-
ries such as structural/conceptual and relational/structural,
because they did not see them as separate entities. The focus
group defined relational skills more broadly than was noted in
the literature using descriptive phrases such as “tolerating
emotional intensity,” “being quiet and listening,” “having
patience,” “taking care of oneself,” “giving a vision of hope
for change,” “willing to take direction or supervision,” and
“using oneself in therapy.” Using oneself was described as
“being aware of one’s strengths and weaknesses.” The experi-
enced therapists believed that novice therapists need a greater
awareness of themselves and their values, attitudes, and
264 THE FAMILY JOURNAL: COUNSELING AND THERAPY FOR COUPLES AND FAMILIES / July 2005
beliefs, particularly with respect to issues of cultural diversity
and gender roles. Of the 15 final skills agreed upon in the
focus group, 8 had some elements based on a relational or
personal characteristic of the therapist and 7 were based on
systemic concepts and restructuring skills. The focus group
also placed special emphasis on two essential skills during
their discussion: the novice therapists’ ability to provide a
vision of hope for change to the family and their willingness
to take direction in supervision.
The dichotomy of relational versus structural family tech-
niques found in this present study mirrors the issues regarding
common elements across theories of therapy that result in
effective outcomes. Feminist approaches to family therapy
have advocated a relational model that demystifies the pro-
cess of therapy and emphasizes the equalization of power
between the therapist and clients. This collaborative stance
reflects an incorporation of the clients’ perspective into the
therapy, builds on the strengths and capabilities of the family
members, addresses their special needs, and leads to greater
flexibility in the treatment process (Hare-Mustin, 1998; Rob-
inson & Howard-Hamilton, 2000; Sprenkle, Blow, & Dickey,
1999). Sprenkle et al. (1999) are emphatic in that “most evi-
dence we have centers on the quality of the therapeutic rela-
tionship/alliance” (p. 353) and that common factors across
models need greater attention in training and practice. From
these perspectives, relational skills are a necessary compo-
nent across all models, and emphasis should be placed on
developing the therapeutic relationship within which goals,
tasks, and specific techniques of intervention are dimensions
of the dynamic alliance.
Implications for Research
Given the small number of participants and the absence of
any men on the panel, the findings from this study must be
viewed with some caution. Replication of this study with a
larger and more diverse group of practitioners and supervi-
sors using the SFT model will provide a broader and possibly
more complex picture of essential skills needed by novice
therapists. The struggle regarding integration of the relational
elements into the structural model may represent a post-
modern development in the applied setting. Qualitative
research studies that explore the phenomenology of SFT with
practitioners might yield important data illustrating the grass-
roots evolution of the model with implications for training
and supervision. Additionally, studies are needed to explore
the nature of supervisory frameworks that promote profi-
ciency in the integration of the SFT model and the common,
nontechnique variables to further a consistent therapeutic
agenda.
Implications for Clinical
Preparation and Training
Recent literature identifies common factors and
nontechnique variables underlying effective therapy (Hub-
ble, Duncan, & Miller, 1999) thereby supporting a trend in
family therapy toward a “postmodern understanding of the
limits of unitary perspectives” (Sprenkle et al., 1999, p. 330).
This movement away from distinct family therapy models
toward integrative approaches would require that significant
attention to these common factors is necessary in academic
preparation and supervision. The data from this study that
support the relevance of relational skills in the application of
SFT may appear to echo the relevance of common factors as
core factors in effective family therapy. That is, the therapeu-
tic relational experience is considered an intervention in its
own right and as the means through which other interventions
are conceived and conducted. From this perspective, students
need preparation in integrative approaches that incorporate
components from methodologies across individual, dyadic,
family, and broader systemic domains. Furthermore, by
emphasizing both relational and structural elements in
clinical training, the dichotomy between these two aspects
may be resolved.
However, Simon (2004) cautioned that when assimilating
aspects from one theoretical context into another, the result
may be a “watered-down species of psychotherapy integra-
tion” (p. 254). Alternatively, integrative models that create
schemes or frameworks for expanding and amplifying thera-
peutic strengths require a thorough exploration of each
model’s conceptual underpinnings and a coherent integration
of those concepts (Fraenkel & Pinsoff, 2001; Simon, 2004).
Thus, the challenge for SFT trainers and supervisors is to dif-
ferentiate between the superficial and atheoretical grafting of
techniques into a structural model and a more substantial
exploration of truly integrative models, as illustrated by the
participants in this study.
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Denyse B. Doerries, Ph.D., is a behavior specialist and codirector
of the Training and Technical Assistance Center (T/TAC) at the Col-
lege of William and Mary. She also has a limited private practice
working with families with children who have disabilities.
Victoria A. Foster, Ph.D., is an associate professor and the faculty
director of the New Horizons Family Counseling Center at the Col-
lege of William and Mary.