Family Therapy with Unmarried African American Mothers and Their Adolescents

Almost two-thirds of African American births are to unmarried mothers, and these single parents are among the most economically vulnerable in the United States. The effects of chronic stressors such as poverty can compromise the ability of these mothers to parent effectively, particularly during the developmental period of adolescence, typically a stressful phase of parenting. This article describes a multidimensional family therapy (MDFT) approach to working with African American adolescents who have drug and/or behavior problems. It is maintained that addressing the intrapersonal functioning of African American single mothers is vital if they are to re-establish the attachment bonds necessary for the maintenance of essential parental influence in the lives of their adolescents. Through systematic attention to the parent as an individual, leading to a balance between self-care and care for others, parental supervision is more easily achieved and relational impasses between parent and adolescent more equitably resolved.     

Utilization of Individual versus Family Therapy Among Adolescents with Severe Emotional Disturbance

Service utilization patterns among children with severe emotional and/or behavioral disturbances are described for 89 children and families, interviewed at two time points across a 6-month period. Children received a greater number of individual therapy sessions than family therapy sessions, and children significantly decreased their levels of internalizing and externalizing behaviors. Family therapy was associated with decreases in internalizing behaviors when children reported outcomes. Individual therapy was not associated with changes in either internalizing or externalizing behaviors regardless of reporter. Symptom severity did not dictate whether children were provided individual or family therapy. Recommendations for individualized treatment plans are offered.     

A Review of Family Therapy as an Effective Intervention for Anorexia Nervosa in Adolescents

This review examines family therapy as an effective intervention for Anorexia Nervosa (AN) in adolescents. An electronic and manual literature search was conducted. Studies pertaining to family therapy in the treatment of AN and specifically, the Maudsley Method/Family-Based Treatment were identified. A limited number of randomized control trials exist implicating family therapy. Of the existent studies, methodological limitations pertaining to small, homogeneous sample sizes are evident. Despite the limited number of studies, family therapy appears to illustrate probable efficacy. Additional research and funding are necessary to fully support family therapy in the treatment of AN in adolescents.     

Culturally Competent Family Therapy with Latino/Anglo-American Adolescents: Facilitating Identity Formation

On two occasions separated by one year, Chinese adolescents (N = 2,758) responded to instruments measuring their perceived parent-adolescent trust (i.e., paternal trust of the child and the child's trust of the parent) and other dimensions of parent-child relational qualities (satisfaction with parental control, readiness to communicate with the parent, and global satisfaction with the parent-child relationship). Results showed that perceived parent-adolescent trust was concurrently and longitudinally related to other dimensions of parent-child relational qualities. Multiple regression analyses suggest that the relations between perceived parent-adolescent trust and different dimensions of parent-child relational qualities over time were bidirectional in nature. Relative to perceived paternal trust of the adolescent child, adolescent child's trust of their parents exerted a stronger influence on different dimensions of parent-adolescent relational qualities, particularly in the father-adolescent dyad. While the influence of the child's readiness to communicate with the parents on parent-adolescent trust was weak in the father-adolescent dyad, the influence of global satisfaction with the parent-adolescent relationship on parent-adolescent trust was weak in the mother-adolescent dyad. The implications of the present findings on parent education and family therapy are discussed.     

Scene-Based Psychodramatic Family Therapy With Troubled Adolescents and Parents: A Pilot Study

Scene-Based Psychodramatic Family Therapy (SB-PFT) is an innovative treatment used with troubled adolescents and their parents to improve family relationships and reduce adolescents’ problematic behavior. It integrates the principles of family therapy, psychodrama, and multiple-family group methodology. This research is a pilot study to obtain empirical evidence on the SB-PFT therapeutic process by gauging the perception of change of troubled adolescents and their parents, and assess the perceived helpfulness of its methodology and techniques. Ten multiple-family intervention groups were drawn up, with 110 participants (63 adolescents and 47 parents), and we adopted a qualitative methodology with focus groups, using an inductive analysis of 290 active constructions of participant narratives. Concerning perception of change, the adolescents reported mainly gaining in social support, prosocial attitudes, keys to problem solving, and expression of emotions due to the treatment. The parents perceived improvement in social support, keys for educational practices, emotional well-being, and expression of emotions due to the treatment. Regarding the perceived helpfulness of methodology and techniques, both adolescents and parents highlighted the usefulness of the group methodology for gaining social support, relativizing the problem, and expressing emotions. Additionally, participants referred to role-playing and mirror techniques as the most useful techniques. In conclusion, this first study on SB-PFT presents and describes its treatment for troubled adolescents and their parents. The participants’ positive perception of their personal and relational change after treatment should serve to promote further studies with quantitative methodology in order to verify the effectiveness of SB-PFT treatment.     

A Conceptual Model and Clinical Framework for Integrating Mindfulness into Family Therapy with Adolescents

Individual and group‐based psychotherapeutic interventions increasingly incorporate mindfulness‐based principles and practices. These practices include a versatile set of skills such as labeling and attending to present‐moment experiences, acting with awareness, and avoiding automatic reactivity. A primary motivation for integrating mindfulness into these therapies is compelling evidence that it enhances emotion regulation. Research also demonstrates that family relationships have a profound influence on emotion regulation capacities, which are central to family functioning and prosocial behavior more broadly. Despite this evidence, no framework exists to describe how mindfulness might integrate into family therapy. This paper describes the benefits of mindfulness‐based interventions, highlighting how and why informal mindfulness practices might enhance emotion regulation when integrated with family therapy. We provide a clinical framework for integrating mindfulness into family therapy, particularly as it applies to families with adolescents. A brief case example details sample methods showing how incorporating mindfulness practices into family therapy may enhance treatment outcomes. A range of assessment modalities from biological to behavioral demonstrates the breadth with which the benefits of a family‐based mindfulness intervention might be evaluated.     

Therapist Interventions Associated with Productive Emotional Processing in the Context of Attachment-Based Family Therapy for Depressed and Suicidal Adolescents

Productive emotional processing is considered a key change mechanism in attachment-based family therapy (ABFT). This study examined the impact of attachment-based family therapy therapist interventions aimed to promote productive emotional processing of primary adaptive emotions in a sample of 30 depressed and suicidal adolescents who had participated in a larger randomized clinical trial. Results of sequential analyses revealed that relational reframes and therapists’ focus on primary adaptive emotions were associated with the subsequent initiation of adolescents’ productive emotional processing of primary adaptive emotions. In contrast, interpretations, reassurances, and therapists’ focus on adolescents’ rejecting anger toward their parents were all followed by the discontinuation of adolescents’ emotional processing that had already begun. Finally, therapists’ general encouragement of affect and focus on adolescents’ unmet attachment/identity needs were associated with both the initiation of adolescents’ productive emotional processing, and with the discontinuation of such processing once it had already begun. Theoretical and clinical implications are discussed.     

Therapy with Women in the Later Stages of Life

This paper addresses the importance of a creative spiritual evolution for the woman in later stages in her life, the unique difficulties she faces in pursuing this aspect of her being, and the clinician's role in helping her meet this life challenge and opportunity. In the ongoing process of self-creation, relevant models and symbols become important sources of direction and inspiration. However, for the aging woman, Western culture and religion offer few nourishing images and the quest for spiritual and creative growth can become a lonely and frightening one. As clinicians, we can help to change this experience by working with clients to identify, generate and integrate symbols and psychological paradigms that will energize the realization of evolving need and potential.     

Family Therapy in China

This paper aims to provide an overview of the family therapy in mainland China, by analyzing its development, current situation and future directions. The authors argue that the history of family therapy can be understood as three stages: introductory stage from 1985 to 1994, “blossoming” stage from 1995 to 2004, and “fast growing” stage from 2005 to present. In every stage, we can see clear differences in each of the following fields: training (including training programs in universities and workshops held by companies or institutes), academics (including research articles, professional books and conferences), and general public environment (including media and policies). We also outline the development of China’s first university system family therapy training program as an example and evidence of family therapy’s significant present and future development in mainland China. Based on this, we highlight some points for future improvement in family therapy in mainland China, including developing indigenous theories and practice models, reinforcing training and research programs in university systems, and improving accreditation standard for all family therapists.     

Family Therapy in Romania

The article outlines the development of family therapy in Romania. Family therapy has a relatively brief history in this country, only beginning with the first training programs in the early to mid 1990s. However, as far as the number of professional associations is concerned, it is well represented on the map of psychotherapy approaches. There are several opportunities for training in family therapy. The accreditation of the training programs and the certification of the graduates of these programs is clearly regulated by law. From the legal point of view psychotherapy is considered a specialization of psychologists rather than an independent profession. The authors offer a brief overview of the history of family therapy in Romania, its present position in the health and social care system, the context of training, accreditation standards, the network of professional organizations and some of the possible future directions for family therapy. Finally, recently produced Romanian films are suggested as a medium for getting acquainted with the complex dilemmas faced by contemporary Romanian families.     

The Effects of a Multiple Family Therapy on Adolescents with Eating Disorders: An Outcome Study

Multiple Family Therapy (MFT) has gained increasing popularity in the treatment of eating disorders and many programs have been developed over the past decade. Still, there is little evidence in the literature on the effectiveness on MFT for treating eating disorders. The present study examines the effects of a particular model of Multiple Family Therapy on eating disorder symptoms, quality of life, and percentage of Expected Body Weight (%EBW) in adolescents with eating disorders (ED). Eighty‐two adolescents with ED, aged between 11 and 19 years, were assessed before and after treatment using the Eating Disorders Inventory 2 (EDI‐2), the Outcome Questionnaire 45 (OQ‐45) and %EBW. Results showed a significant increase in %EBW between the beginning and end of treatment, with a large effect size. 52.4% of patients achieved an EBW above 85%. Symptoms relative to all EDI dimensions (except for bulimia) significantly decreased during treatment. The three dimensions related to quality of life assessment also improved over the course of MFT. At the end of treatment, 70.7% of patients had a total OQ‐45 score below clinical significance. This study suggests that Multiple Family Therapy may benefit adolescents with eating disorders, with improvement on several outcome measures (%EBW, ED symptoms, and quality of life). However, the lack of a comparison group entails caution when drawing conclusions.