Family psychopathology: Cross training graduate marital and family therapy students in family assessment and psychiatric nosology

The structure of a course entitled Family Therapy with Major Psychopathology taught annually in the Mercer University Graduate Marriage and Family Therapy Program is presented. An epistemological presentation regarding the interface of psychiatric nosology and family systems assessment is discussed. Methods of diagnosing and assessing dysfunctional family systems are presented and training in individual psychiatric nosology is discussed, with particular attention given to family systems dysfunction as an etiological factor in the development of individual psychopathology. Learning techniques are discussed including lecture, discussion, case presentations, readings, and testing methods.     

Marriage and Family Therapists' Endorsement of Myths About Marriage

Marriage and family therapy training programs aim to provide students with research-based knowledge about marriage and divorce. A group of 223 California-based clinical members of the American Association for Marital and Family Therapy (AAMFT) was surveyed on their endorsement of 21 myths about marriage. Therapists provided correct responses to an average of 9.4 of these items. Endorsement of specific myths correlated with varying demographic, professional and family of origin variables. Implications for therapist training, practice, and future research are discussed.     

Family Therapy After the Divorce: Developing a Strategy

Family therapy with the whole family after a divorce has taken place provides a unique opportunity for intervention. Though the spouses have legally terminated their relationship, their parenting function remains. However, this reality is often clouded by the emotional conflicts generated by the divorce. Family therapy can be useful in facilitating life in the post-divorce period. A four-part model for intervention is described. The first task is to redefine the family as existentially including all members. Next, generational boundaries are firmed in order to reduce the parentification process, often intensified by the parent's physical absence. Third, the family needs to have a replay of the history of the marriage to correct developmental distortions and offer a changce to mourn the loss of the intact family. Finally, the therapists attempt to facilitate an emotional divorce. A case study is presented to elucidate the manner in which these steps unfold in treatment.     

The Field of Marital and Family Therapy

This article defines the emergence of marital and family therapy as a distinct clinical discipline and an area of clinical practice. Significant historical developments that shaped the field and the integrative aspects of family systems theory are described. The role of the American Association for Marriage and Family Therapy in professional credentialing and state and federal advocacy is reviewed, along with the contributions of the Commission on Accreditation for Marital and Family Therapy Education. These areas of development set the stage for recommendations for further interdisciplinary collaboration among the mental health disciplines.     

A Study of Jewish Identity Development and Its Relationship to Self-Esteem

Jewish college age students and adults completed measures of Jewish identity as well as self-esteem to determine whether Jews adhere to Atkinson et al. (1979) minority identity model, particularly as regards self-esteem. Participants were found to have diminished rather than enhanced self-esteem in the Resistance-Immersion stage. Diplomate in the American Association of Pastoral Counselors and an Approved Supervisor in the American Association for Marriage and Family Therapy. He is a Postdoctoral Fellow in the Clinical Psychology Program of the University of Connecticut.     

Families and family therapy in Germany

The author describes some of the effects of decades of life under a dictatorship for East Germans and the effects on family life and family therapy of changes following the recent reunification of Germany. A case example illustrates some intergenerational family problems associated with the changes. Contrasts are drawn between East and West Germany and family therapy's present stage of development is depicted in both parts of the reunified country. Germany has approximately 10,000 trained family therapists, a minority of whom work in private practice. The largest amount of family and couples therapy is performed in agencies.Portions of this material were first presented in a poster session at the American Association for Marriage and Family Therapy annual conference in Miami Beach, 1992.     

Book Reviews

Books reviewed in this article:
Lynn Hoffman, Family Therapy: An Intimate History
Ned L. Gaylin, Family, Self and Psychotherapy: A Person–centred Perspective
Roy Resnikoff, Bridges for Healing. Integrating Family Therapy and Psychopharmacology
John Sharry, Solution–Focused Groupwork
S.H. McDaniel, D.D. Lusterman and C. Philpot (eds), Casebook for Integrating Family Therapy: An Ecosystemic Approach
Carole Kayrooz, A Systemic Treatment of Bulimia Nervosa
George W. Burns, 101 Healing Stories. Using Metaphors in Therapy
Marcia Sheinberg and Peter Frankel, The Relational Trauma of Incest: A Family Based Approach to Treatment     

Emotionally Focused Family Therapy and Play Therapy Techniques

Emotionally Focused Family Therapy provides a framework for understanding children's behaviors in terms of attachment needs of comfort and support. However, when working with young children, play therapy is often developmentally preferred over “talk therapy.” By integrating play therapy techniques within an Emotionally Focused Family Therapy theoretical framework, therapists can help parents understand and meet their child's needs for affection and comfort. This article will discuss how play therapy techniques can be integrated with an Emotionally Focused Family Therapy theoretical framework for work with young children and their families.     

Non-suicidal Self-Injury (NSSI): A Case for Using Emotionally Focused Family Therapy

Non-suicidal self-injury (NSSI) is defined by engaging in self destructive behaviors specifically targeted toward the body without suicidal intent. It is a mental health phenomenon increasing in occurrence. Marriage and family therapists will need to know how to treat this clinical presentation, as it is gaining recognition as a diagnostic category in the 2013 Diagnostic and Statistical Manual used to identify mental illness. This paper provides background information about NSSI, and includes an argument for testing the treatment of this disorder with Emotionally Focused Family Therapy. A clinical example is included.     

Book Reviews

Books reviewed:
E. Jones and E. Asen, Systemic Couple Therapy and Depression
Alan Carr, Family Therapy. Concepts, Process and Practice
Torben Marner, Letters to Children in Family Therapy: A Narrative Approach
David Campbell, The Socially Constructed Organization
Gitte Haslebo and Kit Nielsen, Systems and Meaning – Consulting in Organizations
Christopher Clulow (ed.), Adult Attachment and Couple Psychotherapy, The 'Secure Base' in Practice and Research
C. Everett Bailey (ed.), Children in Therapy – Using the Family as a Resource     

Parental Divorce and the “Switching” of Religious Identity

This article examines the impact of parental divorce on the likelihood that an individual has changed their religious identify. Using data from the National Survey of Family and Households, we use a theoretical framework of family structure and community ties to test the hypothesis that religious mobility is more likely among children of divorce compared to those from intact families. Distinguishing between parental divorce in childhood and parental divorce in adulthood allows us to assess the impact of parental divorce on religious socialization. For individuals raised as either moderate Protestant, conservative Protestant or Catholic, parental divorce increases the likelihood of both switching to another religion and apostasy. The impact of divorce is particularly strong for Catholics and conservative Protestants, who are, in general, less likely to be religious mobile. These findings add religious disaffiliation to the set of likely sequelae of parental divorce. In addition, the results of the study highlight the need to consider the relationship between family structure and religious processes in a community context.     

Family Experience of Safe: A New Intervention for Families of Children with a Diagnosis of Autism Spectrum Disorder

Systemic Autism-related Family Enabling (SAFE) is a new intervention for families of children with a diagnosis of Autism Spectrum Disorder (ASD). SAFE responds to international and national recommendations for improved care and the reported needs of families. SAFE draws from Family Therapy techniques, Attachment Narrative Therapy and known preferences of individuals with autism. Twenty two families of a child with a diagnosis of ASD severity level 1 or 2 were recruited. The families attended five 3-hour sessions. Family members completed the Helpful Aspects of Therapy Questionnaire (HAT) after each session. Analysis of the HAT data revealed that adults and children experienced SAFE to be helpful which was elaborated in terms of the following themes: therapist as helping reflection, increased understanding, feeling closer, more confident to reflect and problem solve, improved communication and feeling less alone and isolated. The findings are discussed to consider how SAFE can be improved and implemented to offer support for families. SAFE is a good candidate to fill a gap in autism related care.

     

Contribution Patterns in Major U.S. Marital and Family Therapy Journals: 1992 Through 2002

The institutional sources of articles published between 1992 and 2002 in five major family therapy journals—the American Journal of Family Therapy, Contemporary Family Therapy, Family Process, Journal of Family Psychology, and the Journal of Marital and Family Therapy were reviewed. Noteworthy similarities and differences as compared to earlier reviews were found. While no single institution dominated in numbers of publications, six of the top 10 institutions found between 1980 and 1995 were also found to be within the top 10 most productive institutions between 1992 and 2002. Patterns and changes in contributions from international sources, as well as from institutions with a COAMFTE-accredited program are discussed. Contributions from private practitioners and clinicians are also addressed.     

Systems Techniques in Family Therapy: Two Pragmatic Approaches

Duhl, F.J. The Use of the Chronological Chart in General Systems Family Therapy. Journal of Marital and Family Therapy, 1981, 7, 361–373. Resnikoff, R.R. Teaching Family Therapy: Ten Key Questions for Understanding the Family as Patient. Journal of Marital and Family Therapy, 1981, 7, 135–142.     

Self-medication Hypothesis and Family Socialization Theory: Examining Independent and Common Mechanisms Responsible for Binge Drinking

For many, binge drinking behaviors start early and become a persistent pattern of use throughout the lifespan. In an effort to strengthen understanding of etiology, this study considered the mechanisms from the self-medication hypothesis and family socialization theory. The goal was to identify whether emotional distress is a potential shared mechanism that accounts for the development of binge drinking in different developmental periods. This study used the National Longitudinal Study of Adolescent to Adult Health (Add Health) dataset to examine binge drinking across time for n = 9,421 participants ranging in age from 11 to 18 (M = 15.39, SD = 1.62) at Wave I and ranging from 24 to 32 (M = 28.09, SD = 1.61) at Wave IV of the study. Using an autoregressive cross-lagged model, I examined how parent-child closeness, depressive symptoms, and binge drinking were related over three developmental periods. In examining cross-sectional and longitudinal relations, depressive symptoms were significantly related to binge drinking more often than parent-child closeness; however, results indicated the self-medication model may primarily account for concurrent drinking behaviors rather than long-term. The family socialization theory was indicated to account for some variability above and beyond the self-medication hypothesis. No indirect association between binge drinking and the parent-child relationship was detected through depressive symptoms, failing to support a shared mechanism between the two theories. The results provide support for a multifaceted assessment process for substance using clients, and support the use of Multisystemic Family Therapy, Multidimensional Family Therapy, and perhaps Attachment-Based Family Therapy.     

Book reviews

S. Walrond-Skinner (Ed.), Developments in Family Therapy, Theories and Applications since 1948
S. Box, E. Copley, J. Magagna and E. Moustaki (Eds). Psychotherapy with Families—an Analytic Approach
Judith Lask and Bryan Lask, Child Psychiatry and Social Work
A. Gurman and D. Kniskern (Eds), Handbook of Family Therapy
Kalman Flomenhaft and Adolph E. Christ (Eds), The Challenge of Family Therapy. A Dialogue for Child Psychiatric Educators
Alan S. Gurman (Ed.), Questions and Answers in the Practice of Family Therapy     

Book reviews

Book reviewed in this article: Sidney Bloch, Julian Hafner, Edwin Harari and George Szmukler, The Family in Clinical Psychiatry. Lynn Hoffman, Exchanging Voices: A Collaborative Approach to Family Therapy. Luigi Boscolo and Paolo Bertrando, The Time of Times: A New Perspective in Systemic Therapy and Consultation. Elsa Jones, Family Systems Therapy: Developments in the Milan Systemic Therapies. David R. Grove and Jay Haley, Conversations on Therapy.     

Managing Child Behavior Problems in Children With Autism Spectrum Disorders: Utilizing Structural and Solution Focused Therapy With Primary Caregivers

Previous therapeutic models for modifying and managing problem behaviors in children with an Autism Spectrum Disorder have, typically, focused on working directly with the diagnosed child. The exclusion of other family member involvement in treatment displayed a need for creating a systemic model for managing children's problem behaviors. This model proposes Solution Focused Brief Therapy (SFBT) and Structural Family Therapy (SFT) with a focus on the caregivers of children with ASDs to reduce parental stress, increase parental self-efficacy, and ultimately begin to manage child behavior problems.     

Divorce therapy: an in-depth survey of therapists' views

In-depth interviews were conducted with 21 highly experienced therapists on the criteria of a constructive divorce, the obstacles to achieving such a divorce, and the strategies and tactics of divorce therapy. The primary criterion of a constructive divorce was the successful completion of the process of psychic separation and the protection of the welfare of minor children. Therapy may focus on the decision to get divorced and/or the negotiation of the terms of a divorce settlement. Three types of therapeutic strategies were identified: reflexive intervention by which the therapist orients himself to the marital problems and attempts to gain the trust and confidence of the partners; contextual interventions by which he tries to promote a climate conducive to decision-making; and substantive interventions intended to produce resolution on terms the therapist has come to believe are inevitable or necessary. The nascent state of divorce therapy as an area of therapeutic specialization is noted. The problem of diagnostic criteria for divorce, the relationship between therapists and lawyers, the nature and consequence of therapist impartiality, and the degree to which therapists should mediate the terms of divorce are considered central issues meriting further study.     

军人婚姻关系恢复机制的探讨

随着社会的变化发展,离婚率日渐增长,军人婚姻关系也受到一定影响,离婚人数日益增多。家是社会的基础,是社会的细胞,特别是军人家庭,他们家庭的稳固与否不但对双方家庭影响巨大,同时也对国家、军队建设有比较深刻的影响。对军人婚恋关系恢复机制的探讨,加强对处于危机中的军人家庭的研究,有助于挽救其处于危机中的婚姻关系,建立和谐家庭,使其减少后顾之忧,更好地投入到部队的建设中去。