Beyond the Binary: Trans‐Negotiations in Couple and Family Therapy

Dualistic notions about gender and sexuality have permeated the field of couple and family therapy. These binary constructions have been limiting for everyone, especially those who fall outside the male/female dichotomy. This article examines the impact of these binary notions, especially on transgender and gender‐creative individuals, couples, and families. Current theory and research in the field as they relate to gender identity, sexuality, and gender minority stress in couples and families are presented. Case examples are used to illustrate affirmative approaches to treatment issues such as coming out, safety, grief and loss, redefining relationships, and social/medical transitions that may arise for transgender or gender nonconforming (TGNC) individuals, couples, and families.     

Family therapy with delinquents: a critical review of the literature

A critical review of the theoretical and outcome studies on family therapy with delinquents is presented. Assessment of the theoretical developments reveals that families of delinquents may be distinguishable from other families by their interactional sequences and processes. The available outcome studies within the field indicate that family therapy is viable for interventions with this population, with behavioral, structural, strategic, and communication approaches receiving the most support, but more specific and robust evidence is still needed. Trends in the research and critical issues are identified and used to provide suggestions for future research and practice.     

Engaging high risk families in community based intervention services

Involving high risk families in community based intervention services constitutes a major challenge facing service delivery in the fields of mental health and substance abuse. Mental health and substance abuse programs typically experience high rates of failure to enroll families in services, as well as high rates of drop-outs from treatment. With family-based intervention programs, those involving all the members of the family or household participation by the entire family is a key to having a successful program. The NIDA funded Youth Support Project tests such a home and family based Family Empowerment Intervention in a randomized field trial which targets families of juvenile offenders. This intervention is delivered three times a week by paraprofessionals who are supervised by a licensed clinician. We discuss the guiding principles and success of our enrollment activities and discuss their implications for other family-based services.     

Family Systems and Ecological Perspectives on the Impact of Deployment on Military Families

The scope of sustained military operations in Iraq and Afghanistan has placed great demands on the Armed Forces of the United States, and accordingly, military families have been faced with deployments in more rapid succession than ever before. When military parents fulfill occupational duties during wartime, military children and families face multiple challenges, including extended separations, disruptions in family routines, and potentially compromised parenting related to traumatic exposure and subsequent mental health problems. Such challenges can begin to exert a significant toll on the well-being of both individuals and relationships (e.g., marital, parent–child) within military families. In order to respond more effectively to the needs of military families, it is essential that mental health clinicians and researchers have a better understanding of the challenges faced by military families throughout the entire deployment experience and the ways in which these challenges may have a cumulative impact over multiple deployments. Moreover, the mental health field must become better prepared to support service members and families across a rapidly evolving landscape of military operations around the world, including those who are making the transition from active duty to Veteran status and navigating a return to civilian life and those families in which parents will continue to actively serve and deploy in combat zones. In this article, we utilize family systems and ecological perspectives to advance our understanding of how military families negotiate repeated deployment experiences and how such experiences impact the well-being and adjustment of families at the individual, dyadic, and whole family level.     

Formal Lessons Improve Informal Educational Experiences: The Influence of Prior Knowledge on Student Engagement

Educational experiences can be influenced by novel experiences, yet educators often overlook the influence novelty exerts on students. This quasi-experimental study manipulated prior knowledge before a zoo field trip for 210 urban 7^th-grade students from 2 schools, 1 comprised mostly of low-socioeconomic status (SES) families and 1 comprised mostly of middle-SES families. Students participated in 1 of 2 preparatory lessons, only 1 of which previewed field trip-related content, thereby increasing prior knowledge for half the students from each school. Prior knowledge significantly increased learner engagement, measured through attentiveness, from both schools, but in different types of behaviors. Students from the low-SES school demonstrated more attentiveness if their preparatory lesson previewed field trip material than if it was unrelated to the field trip. Students from the middle SES school displayed the same level of attentiveness in both conditions (and overall higher than the low-SES students). This study highlights complexities associated with prior knowledge and reveals strategies to help improve engagement levels for students visiting informal learning environments.     

REACTION OF EMPLOYEES TO PERFORMANCE APPRAISAL INTERVIEWS AS A FUNCTION OF THEIR PARTICIPATION IN RATING SCALE DEVELOPMENT

A substantial amount of research has been conducted on the performance appraisal feedback interview. The purpose of the present field study was to see whether employee involvement in the development of rating scales used in the feedback interview affected ratees' perceptions of the interview. Behaviorally anchored rating scales (BARS) were developed for five job families in a midwestem hospital. A participation group consisted of employees from each of the job families who were involved in all phases of BARS construction. A nonparticipation group involved an equal number of employees from each of the job families who were not involved in the BARS development. The results showed that participation in BARS construction led to favorable perceptions regarding the performance appraisal interview process as well as positive outcomes.     

Coparenting Interventions for Fragile Families: What Do We Know and Where Do We Need To Go Next?

With a large and growing share of American families now forming outside of marriage, triangular infant–mother–father relationship systems in “fragile families” have begun to attract the interest of family scholars and clinicians. A relatively novel conceptualization has concerned the feasibility of intervening to support the development of a sustained and positive coparenting alliance between mothers and fathers who have not made an enduring relationship commitment to one another. At this point in time, there are very few published outcome studies of programs explicitly conceived to help build coparenting alliances in such families. This article reviews what we currently know from this evolving field of study, and from those related responsible fatherhood and marriage and relationship enhancement (MRE) initiatives that included any explicit targeting, strengthening, and assessment of fragile family coparenting in their designs. We summarize lessons learned thus far from Access and Visitation (AV) programs for non‐residential fathers, from MRE programs for low‐income, unmarried couples, and from newer programs for fragile families directly designed to target and support coparenting per se. We close with recommendations for charting this important new family process terrain.     

The Art of Recruitment: The Foundation of Family and Linkage Studies of Psychiatric Illness

Family and linkage studies of psychiatric illness involve special benefits and challenges in the field of scientific investigation. The success of a family or linkage study is dependent on the recruitment process. The most informative and reliable method of data collection in this field of investigation is through direct interviews with as many family members as possible. Although there are circumstances when direct interviewing is not possible, there are other circumstances, such as refusal of relatives to participate, that deserve closer scrutiny. The complexities involved in the recruitment process while conducting medical investigations have been explored in the literature. However, special issues relevant to the recruitment process merit further exploration for working with families in the context of family and linkage studies of psychiatric illness. Careful understanding of this critical topic may minimize the incidence of family nonparticipation in such research endeavors. This article addresses these issues as they relate to recruiting individuals and their families in this field of investigation. These issues include the role of attitudes, values and beliefs, family interaction and the identification of influential members, informal communication networking, informed consent while promoting the research, and ethical concerns.     

Intergenerational continuity and discontinuity in Mexican-origin youths' participation in organized activities: insights from mixed-methods

Motivation theories suggest that parents are an integral support for adolescents' participation in organized activities. Despite the importance of parents, the field knows very little about how parents' own experiences in activities influence the participation of their adolescent children. The goals of this study were to examine (a) the patterns of intergenerational continuity and discontinuity in parents' activity participation during adolescence and their adolescents' activity participation, and (b) the processes underlying each of these patterns within Mexican-origin families. Qualitative and quantitative data were collected through three in-depth interviews conducted with 31 seventh-grade adolescents and their parents at three time points over a year. The quantitative data suggested there was modest intergenerational continuity in activity participation. There were three distinct patterns: nine families were continuous participants, seven families were continuous nonparticipants, and 15 families were discontinuous, where the parent did not participate but the youth did participate in activities. The continuous participant families included families in which parents valued how organized activities contributed to their own lives and actively encouraged their adolescents' participation. The continuous nonparticipant families reported less knowledge and experience with activities along with numerous barriers to participation. There were three central reasons for the change in the discontinuous families. For a third of these families, parents felt strongly about providing a different childhood for their adolescents than what they experienced. The intergenerational discontinuity in participation was also likely to be sparked by someone else in the family or an external influence (i.e., friends, schools).     

Families and family psychology at the millennium. Intersecting crossroads

This introduction to the International Perspectives section presents a global overview of various issues and trends that families and family psychologists confront at the beginning of the 21st century. These are presented in broad strokes so that a kaleidoscopic intermingling of pieces emerges. Some predictions are included about new and expanding directions the field of family psychology is likely to take in coming decades. The need for additional research to field test criteria sets for emerging relational diagnosis and to evaluate which are the most efficacious therapeutic interventions is highlighted (F. W. Kaslow, 1987, 1995b). This section also includes 3 other articles on various aspects of family psychology by leading psychologists from 3 diverse countries and continents--the Virgin Islands (R. Dudley-Grant, 2001), Israel (E. Halpern, 2001), and Japan (K. Kameguchi, 2001). Each is representative of the larger region in which each author teaches and practices. These articles are intended to present a collage of some of the problems families are experiencing, future trends, and a call to action for psychologists to intervene to prevent and ameliorate family distress. Each author describes the history and current status of family psychology in his or her country and relates key dilemmas to what is happening on the world scene.     

Parentification and Maternal HIV Infection: Beneficial Role or Pathological Burden?

Parentification, along with parenting and child adjustment, were examined in 23 9-through 16-year-old youth from families affected by maternal HIV infection and 20 same-age peers whose mothers were not infected. Children whose mothers were HIV-positive reported to more often engage in parental role behaviors, relative to children of HIV-negative mothers. This difference remained even after controlling for the effects of current drug use, number of adults per child in the household, and marital status. Findings revealed a beneficial relationship between parentification and both child adjustment and parenting, particularly among families affected by maternal HIV infection. When relationships were examined separately by HIV status, the pattern of results suggested that parentification, which involves increased emotional closeness, rather than role-related tasks, which may involve increased responsibility of household maintenance, seems to foster an association with concurrent positive parenting and child adjustment among families coping with HIV/AIDS. Directions for future research, including the need for methodological advances in the field are discussed.     

Critical consciousness, accountability, and empowerment: key processes for helping families heal

Families are inextricably embedded within their larger sociopolitical contexts, an observation acknowledged by many theorists. The field of family therapy is working on its translation into comprehensive and effective approaches for helping families change. This article illustrates the use of the Cultural Context Model to help families change, guided by the linked foundational concepts of accountability, critical consciousness, and empowerment. The authors support their discussion of theory with examples illustrating the ways in which social patterns connected to race, gender, class, and sexual orientation shape the dilemmas that family members encounter, as well as their access to solutions.     

Evidence-based practice in family therapy and systemic consultationChild-focused problems

Evidence for the effectiveness of family therapy and family-based interventions from critical literature reviews and controlled trials is considered for families with children and adolescents who present with various difficulties. The evidence supports the effectiveness of family therapy as an effective treatment either alone or as part of a multimodal or multisystemic treatment programme for child abuse and neglect, conduct problems, emotional problems and psychosomatic problems. Implications for practice, training and continuing professional development in the field of family therapy are discussed.     

Beyond home-based family intervention: A multi-family approach toward change

A growing specialty area in the mental health field involves working with emotionally disturbed youth and families-at-risk by providing services in the context of the home environment. A review of the literature provides documentation for family systems, social learning, and ecological interventions with at-risk families receiving home-based intervention but there is an absence of material on the use of multi-family groups with this population. The purpose of this article is to outline the implementation of a multi-family therapy (MFT) component for home-based programs serving at-risk families. Advantages and disadvantages when using MFT are also addressed.The authors are grateful to Linda Pannell for her helpful comments on drafts of this article.     

For the new family therapist: A glossary of terms

Abstract

Traditional psychodynamic terms used in describing, diagnosing, and treating individual patients have proven less than helpful in working with families. In an attempt to alleviate this difficulty, and as an aid to the newcomer in the field of family therapy, this glossary of terms is presented. This glossary is not meant to be all-inclusive. Rather, its purpose is to provide the new family therapist with an introduction to the language of the field, an armamentarium from which to work, and to provide a basis of knowledge that is usually not accumulated by the new family therapist until he or she has worked with a number of families over a period of time.     

Global Mental Health: A Call for Increased Awareness and Action for Family Therapists

Global mental health (GMH) is an emerging field that focuses on the need for culturally sensitive mental health services in low‐ and middle‐income countries (LMICs). While many new initiatives have been established worldwide to understand GMH needs and to provide care in LMICs, family therapists have primarily worked with families in high‐income countries. The few existing family‐based initiatives in GMH focus on psychoeducation and are typically not based on general systems theory. However, emerging trends in family therapy may enable family therapists to impact mental health issues in LMICs. These trends, which are shared interests of both family therapy and GMH, include collaborative care, a growing emphasis on the importance of culture in understanding and treating mental health issues, recognition of the ability of families to support or impede recovery from mental illness, and the use of strength‐based and evidence‐based treatments. This paper describes ways for family therapists to become active in the GMH community.     

Family reconciliation as a response to adolescent crises

Concern for adolescents who act in dangerous, life-threatening ways has heightened dramatically in recent years. Many of these adolescents appear to come from nuclear families isolated from their kinship systems. Without the mediating effects of kin, the adolescent transition can become a major crisis. Kinship systems remain cohesive when members can reconcile their beliefs about essential aspects of family functioning with the demands for adaptation during major life transitions. Reconciliation is lost when members believe that kin can no longer be trusted to insure their well-being. Kinship fragmentation ensues as family members leave the field or are excluded. Isolated nuclear families then rapidly lose the resilience to respond to life transitions without resorting to extreme, maladaptive solutions. The Systemic Crisis Intervention Program (SCIP) uses the opportunity of the crisis precipitated by the adolescent's life-threatening behavior to alter family myths that have led to network fragmentation. Crisis teams mobilize and meet with kin in four-hour gatherings to foster reconciliation and kinship system reintegration.     

Professional Politics and the Concepts of Family Therapy, Family Consultation, and Systems Consultation

At a time when an increasing number of professionals are calling themselves "family therapists," many teachers and theorists in this field are troubled that the term "family therapy" no longer adequately characterizes the concepts or activities of the field. Recently, clinical, political, and economic circumstances have emerged that suggest the need for alternatives to the role of "family therapist." By adding the roles of family consultant and systems consultant, we can open up new options for ourselves and our clients. During initial contacts with families, agencies, and other professionals, we can heighten our therapeutic potential by proceeding with consultative stocktaking, not starting with therapy. Family consultation also can assist in redirecting therapy when a new problem or an impasse develops, in focusing on competency rather than on pathology, and in engaging constructively with families that have a physically or mentally ill member.     

A Review of Family Therapy in Residential Settings

This article provides an overview of the history of family involvement in residential treatment as well as a synthesis of the research showing family-centered interventions and outcomes for youth in residential settings. There are many methods for engaging families in residential treatment that are discussed in the literature; however, there is a significant gap as the field has not yet identified specific family therapy approaches that demonstrate efficacy in working with youth and their families in this particular setting. A review of the literature over the past 10 years will highlight the emerging family therapy models being utilized in this setting, which include multiple-family group intervention, family-directed structural therapy, and narrative family therapy. The article will also include a discussion of three major, well-established theoretical approaches that have been found to be effective in working with youth with conduct issues and show promise in treating youth and families in the complex setting of residential treatment: brief strategic family therapy, multi systemic therapy, and functional family therapy.     

Caregiving for children through conflict and displacement: a pilot study testing the feasibility of delivering and evaluating a light touch parenting intervention for caregivers in the West Bank

A child's adjustment to wartime stress is reliant not only on individual responses and qualities, but very significantly on the availability of support that they may receive from their parent or caregivers and quality of relationships. Strengthening parental support has the potential to be valuable. A pilot two-arm randomised controlled trial investigated the feasibility of delivering and evaluating the “Caring for Children Through Conflict and Displacement” intervention with caregivers in the West Bank. Feasibility to recruit and train non-specialist staff on-the-ground to screen families for eligibility, collect outcome data, deliver the intervention and to recruit and retain families in the study were examined. Research staff and intervention facilitators were successfully appointed in the field, screened participants and delivered the intervention to 120 caregivers, collecting outcome measures pre-and post-delivery. All families completed the outcome measures, with very little missing data. This indicated that the intervention can be delivered feasibly and evaluated with families in this humanitarian context. Preliminary outcome data showed promise that the intervention may have the potential to both improve family functioning and reduce children's problem behaviour. Implications of family-focused initiatives, particularly within a conflict/post-conflict context for the prevention of several negative health and social outcomes directions, are discussed.