| Sumario: | Second-order change is a central concept in Marriage and Family Therapy, but still remains poorly operationalized. We conducted a web-based modified Delphi study with 31 established faculty members currently teaching in COAMFTE-accredited Master's and Doctoral programs in the United States and in Canada to identify consensus regarding second-order change concepts, clinical operationalization, evaluation, and teaching principles. Numerous exemplars of first and second-order change were generated, but consensus on most items was low. Consensus was highest for pedagogy and low regarding concepts and clinical examples of first-order change and evaluation of second-order change. Results suggest clearer definitions and better measurement of systemic change are needed. Reprinted by permission of the publisher.
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