Stories for therapy: The right story to the right person at the right time

In the postmodern information era with its increasing complexity and demands on my time, I find storytelling increasingly attractive. The right story told to the right person(s) at the right time in the right way can powerfully define and shape both individuals and the systems into which they organize themselves. As interventions go, I find stories to be relatively high impact, low-risk, parsimonious, and user-friendly. This paper contains some of my favorite teaching stories and describes why and how I use them as both a family therapist and teacher of family therapy.     

The application of a domains‐based analysis to family processes: implications for assessment and therapy

Social domains are classes of interpersonal processes each with distinct procedural rules underpinning mutual understanding, emotion regulation and action. We describe the features of three domains of family life – safety, attachment and discipline/expectation – and contrast them with exploratory processes in terms of the emotions expressed, the role of certainty versus uncertainty, and the degree of hierarchy in an interaction. We argue that everything that people say and do in family life carries information about the type of interaction they are engaged in – that is, the domain. However, sometimes what they say or how they behave does not make the domain clear, or participants in the social interactions are not in the same domain (there is a domain mismatch). This may result in misunderstandings, irresolvable arguments or distress. We describe how it is possible to identify domains and judge whether they are clear and unclear, and matched and mismatched, in observed family interactions and in accounts of family processes. This then provides a focus for treatment and helps to define criteria for evaluating outcomes.     

Growing Points for Coparenting Theory and Research

Though the study of coparenting is still in its infancy, an explosion of coparenting research is in the wings. This paper identifies several emerging issues in coparenting theory and research to guide work in the years ahead, including issues in definition, conceptualization, and measurement; the interface between coparenting and adult development; and conceptual benefits that will accrue from studies of interadult coordination across diverse cultures and family systems. We emphasize that theory must lead empirical efforts, that across family systems the strongest coparental alliances are likely to be those in which the coparents both experience and provide support and solidarity for one another's parenting efforts with the children, and that measurement approaches need to be expanded so as to capture more comprehensively each family's organizational cooparenting structures and themes.     

Within-family reproductive technologies as a solution to childlessness due to infertility: Psychological issues and interventions

Patients choosing new reproductive technologies benefit from psychological consultation as they face unforeseen emotional and interpersonal sequalae from these procedures. This paper focuses on those patients who choose family members or close friends (i.e., known donors) to donate sperm or eggs or uteri in order to conceive and produce their babies. Medical family therapy offers these patients and families a framework from which to examine the biological, psychological, and interpersonal issues involved in these within-family solutions to childlessness due to infertility.This paper is a revision of a talk, Medical Family Therapy, Infertility, and the New Reproductive Technologies, given at the 1994 annual meeting of the American Psychological Association on August 4 in Los Angeles, CA, as part of the Mini-convention on Families panel on Clinical Issues in Families and Health.     

Family Support and Conflict: Prospective Relations to Adolescent Depression

The relations between family support, family conflict, and adolescent depressive symptomatology were examined longitudinally in a sample of 231 female and 189 male adolescents and their mothers. Structural equation models revealed that less supportive and more con-flictual family environments were associated with greater depressive symptomatology both concurrently and prospectively over a 1-year period. Conversely, adolescent depressive symptomatology did not predict deterioration in family relationships. Depressive symptomatology and, to a greater extent, family characteristics showed high levels of stability over the 1-year period. Counter to our expectations, the relations between family variables and depressive symptomatology were similar for boys and girls. The results suggest that the quality of family interactions is relevant for understanding the development of depressive symptoms in adolescents.     

焦虑障碍的系统式家庭治疗

焦虑障碍是最常见的心理障碍之一.其具有症状重、病程慢、复发率高、社会功能明显缺损等特点,给个人、家庭和社会造成了巨大的负担.家庭环境因素在焦虑障碍的发病、转归和预后方面都起到重要作用.本文介绍了国内外关于焦虑障碍患者家庭特点和家庭互动模式的研究结果.系统式家庭治疗作为一种家庭治疗模式,具有其独特的治疗理念和方法,国内外研究结果表明系统式家庭治疗用于焦虑障碍具有良好疗效.今后,还应该运用更加多元化的研究方法探讨中国焦虑症家庭动力学特点和家庭功能,并采用更加严格的随机对照设计,进一步证实系统式家庭治疗对焦虑障碍的治疗效果.     

Relationship of Attachment Style to Personality Factors and Family Interaction Patterns

This study investigated the relationships among attachment, personality style, and family interaction patterns. The results revealed that avoidant attachment style was associated with indirect affect expression as measured by somatic complaints, social isolation, family disengagement, and family conflict avoidance. Anxious/ambivalent style was associated with more overt expression of depression and anxiety. Family factors were not significantly related to either the anxious/ambivalent or secure styles. The implications and potential therapy benefits for use of attachment theory in family therapy and directions for future research are also addressed. Marci Leveridge, PhD, is a Licensed Health Service Provider and private practitioner in Oklahoma City. Cal Stoltenberg, PhD, is Professor, Counseling Psychology Program, University of Oklahoma, Department of Educational Psychology, 820 Van Vleet Oval, Room 321, Norman, OK 73019-2041 (cstoltenberg@ou.edu). Denise Beesley, PhD, is an Assistant Professor in the Counseling Psychology Program at the University of Oklahoma.     

焦虑障碍的系统式家庭治疗

焦虑障碍是最常见的心理障碍之一.其具有症状重、病程慢、复发率高、社会功能明显缺损等特点,给个人、家庭和社会造成了巨大的负担.家庭环境因素在焦虑障碍的发病、转归和预后方面都起到重要作用.本文介绍了国内外关于焦虑障碍患者家庭特点和家庭互动模式的研究结果.系统式家庭治疗作为一种家庭治疗模式,具有其独特的治疗理念和方法,国内外研究结果表明系统式家庭治疗用于焦虑障碍具有良好疗效.今后,还应该运用更加多元化的研究方法探讨中国焦虑症家庭动力学特点和家庭功能,并采用更加严格的随机对照设计,进一步证实系统式家庭治疗对焦虑障碍的治疗效果.     

Case Report: A Systems Approach to Genetic Counseling for Albinism

A systems approach to family therapy assumes that a person and his/her problems do not operate in a social vacuum but instead are imbedded in a social context. This context includes fairly small social systems such as a nuclear family and larger social systems such as school systems and cultural beliefs. A case of a girl with albinism born to a couple from India will be used to discuss how a systems approach might be useful in a genetic counseling setting.     

Irish norms for the SCORE‐15 and 28 from a national telephone survey

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 living in the Republic of Ireland and Northern Ireland completed the SCORE and brief measures of family and personal adjustment. Using receiver operating characteristic curve analyses, cut‐off points for the SCORE‐28 and 15 were found to identify families of children with significant emotional and behavioural problems. We also established 90^th percentile points and percentages of cases falling above each scale point for both versions of the SCORE. Confirmatory factor analyses showed that, for both versions of the SCORE, the data fit the three factor solutions found in previous studies. The SCORE scales also had significant correlations with measures of family, parental and child adjustment, and negligible correlations with socioeconomic variables and social desirability response set.     

A Systems Approach to the Treatment of Chemical Addiction

Therapists are increasingly considering chemical addiction from a family systems perspective. Effects of chemical dependency upon the family are discussed and intervention approaches aimed toward assisting the family as families redefine themselves and change their structure are considered. The integration of chemical dependency treatment and the family therapy is also discussed as it is practiced in an intensive outpatient program at a psychiatric hospital.     

Resilient Response to Battering

Spouse abuse remains an important social problem. Recent research has begun to explore resiliency in a variety of areas: Why, despite harsh life circumstances, do some people survive and later thrive after experiencing trauma? What are the processes associated with a successful departure from abuse? The authors worked with a local shelter to identify three groups of women: (a) those currently at the shelter; (b) those who had been away from an abusive relationship for at least one year; and (c) those who were identified by shelter staff as having demonstrated a resilient response to battering, and compared experiences and recommendations between groups and discuss clinical and service implications.     

Family-Focused Treatment for Childhood Depression: Model and Case Illustrations

Although the evidence base for treatment of depressive disorders in adolescents has strengthened in recent years, less is known about the treatment of depression in middle to late childhood. A family-based treatment may be optimal in addressing the interpersonal problems and symptoms frequently evident among depressed children during this developmental phase, particularly given data indicating that attributes of the family environment predict recovery versus continuing depression among depressed children. Family-Focused Treatment for Childhood Depression (FFT-CD) is designed as a 15-session family treatment with both the youth and parents targeting two putative mechanisms involved in recovery: (a) enhancing family support, specifically decreasing criticism and increasing supportive interactions; and (b) strengthening specific cognitive-behavioral skills within a family context that have been central to CBT for depression, specifically behavioral activation, communication, and problem solving. This article describes in detail the FFT-CD protocol and illustrates its implementation with three depressed children and their families. Common themes/challenges in treatment included family stressors, comorbidity, parental mental health challenges, and inclusion/integration of siblings into sessions. These three children experienced positive changes from pre- to posttreatment on assessor-rated depressive symptoms, parent- and child-rated depressive symptoms, and parent-rated internalizing and externalizing symptoms. These changes were maintained at follow-up evaluations 4 and 9 months following treatment completion.     

Understanding Thai Families: A Cultural Context for Therapists Using a Structural Approach

This article describes six cultural influences that affect Thai families: religious beliefs, rural and urban considerations, family relationships, societal values, masculine and feminine roles, and sexuality. A case study of a Thai family struggling with these issues and interventions from a structural therapy perspective is presented.     

二胎进行时:头胎儿童在向同胞关系过渡时的生理和心理变化及其影响因素

近年来,有关头胎儿童在面对母亲生第二胎时出现各种问题的新闻报道屡见不鲜。那么,是不是儿童在面对母亲生二胎时,都会出现如此消极的反应?会不会出现积极的反应呢?如果存在个体差异的话,那么面对第二胎的降临,哪些儿童更容易出现消极或者积极的变化?另外,是否有保护因素让头胎儿童更好地应对弟妹出生?是否有风险因素导致头胎儿童出现消极的结果?本项目拟开展3项子研究来回答上述这些问题。研究1分析在第二胎降临前后,头胎儿童的生理和心理变化轨迹;研究2分析调节头胎儿童生理和心理变化的个人因素(例如,气质和共情);研究3分析调节头胎儿童生理和心理变化的家庭层面的因素(例如,亲子关系与父母婚姻)。所获结果将为当前以及未来二孩家庭心理健康教育和咨询提供实证依据,具有重要的应用价值。     

How to Talk to Christian Clients About Their Spiritual Lives: Insights From Postmodern Family Therapy

Responding to literature calling for the integration of Christian spirituality and postmodern thinking, this article presents a more specific discussion of how postmodern family therapy approaches can be used to open therapy to the spiritual lives of Christian clients. In this article, postmodern family therapy approaches are described and the compatibility of postmodern family therapies and Christian thinking are examined. Finally, we see how a clinical practice based upon postmodern ideas can provide pastoral counselors with useful tools for talking with Christian clients about their spiritual lives. P. Gregg Blanton is Professor of Human Services at Montreat College. He is affiliated with the Pastoral Counseling and Growth Center in Asheville, NC.     

Work and Family Balance Among Dual-Earner Working-Class Mexican-Americans: Implications for Therapists

The ability to balance work and family demands can affect marital satisfaction, family cohesion, and job satisfaction. While most research in this area has utilized middle-class Anglo-American samples, the present investigation examined dual-earner, working-class Mexican- Americans. Positive relationships were found between work-family balance and satisfaction with marriage, family life and jobs with gender and acculturation showing moderating effects on some variables. Family therapists should be cognizant of the impact of work- family demands on marriage and family functioning even when working class minority families do not offer these issues as presenting problems.     

An Analysis of Schema Theory and Learning Theory as Explanations for Variance in Adolescent Adjustment to Divorce

Learning theory and schema theory were evaluated as possible explanations for the variance found in the adjustment of adolescent children of divorce. Self-report questionnaires were completed by first year Psychology and Economics students at Stellenbosch University. Participants completed Antonovsky's Life Orientation Questionnaire (measuring adjustment); Hudson's CAM and CAF questionnaires (measuring relationships with mother and father, respectively); and a set of questions measuring attitude to divorce; as well as a biographical questionnaire. Schema theory was not supported conclusively, as results showed only limited evidence for attitude to divorce acting as a mediator between the parent-child relationship and the child's adjustment. Results did, however, support learning theory as an adequate explanation for the positive correlations found between parent-adolescent relationships and adolescent adjustment. Knowledge of the importance of learning theory in explaining variance in adolescent adjustment to divorce can increase parents' awareness of their influence on their children's adjustment. This can also be used in the design of therapeutic programs for families going through divorce.     

Using a threat of divorce for maintaining family homeostasis within families in extreme distress (FED)

This paper describes a phenomenon of using a threat to divorce by families in extreme distress (FED) as a way of maintaining family homeostasis; that is, using a threat to divorce but never really implementing it. By relating to processes, such as social exchange and attachment, that often take place in the decision-making of divorce, we try to understand why those families choose to use the threat, thereby explaining this phenomenon. Using components of defining family boundaries, excitement and power struggle, we are thus able to better understand the existence of the phenomenon among FED.     

Familias Unidas: a family-centered ecodevelopmental intervention to reduce risk for problem behavior among Hispanic adolescents

This paper describes the theoretical and empirical foundations of Familias Unidas, a multilevel, family-centered intervention designed to prevent problem behavior in Hispanic adolescents. The main theoretical tenets for the intervention model; an ecological-developmental perspective, the centrality of ethnic and cultural themes, application of empowerment principles, and a family focus are reviewed. The literature on the risk and protective factors that provided the justification for the intervention's targeted mediators and the core clinical applications that are intended to alter them are discussed. Familias Unidas engages Hispanic immigrant parents into an empowerment process in which they first build a strong parent-support network and then use the network to increase knowledge of culturally relevant parenting, strengthen parenting skills, and then apply these new skills in a series of activities designed to reduce risks frequently found in poor, urban environments. The available evidence supporting the efficacy of Familias Unidas is summarized, as are future goals and a current, second-generation application of the intervention.