Family Therapy with Families of Holocaust Survivors

This is a clinical review of 7 families of Holocaust survivors who presented for treatment because of problems with an adolescent of the third generation. In 3 cases the problem was anorexia, and the remaining 4 had various clinical presentations, mostly related to separation-individuation issues. A common thread in the narratives that unfolded was that the trauma of the grandparent/survivors had been transmitted across subsequent generations to exercise significant influence on the children and grandchildren. Often, a more recent death or separation crisis had been the catalyst for these difficulties or a trigger that activated the Holocaust trauma. An outline of the therapeutic intervention is presented; it was based on a combination of systemic, structural, strategic, and psychodynamic approaches. It is suggested that open acknowledgment of the transgenerational issues played a critical role in moving families toward a more differentiated outcome.     

Community Family Therapy with Military Families Experiencing Deployment

The length and frequency of deployments in the current wars in Iraq and Afghanistan are associated with increased vulnerability for both part- and full-time military families who stand to benefit from systems-oriented practice by marriage and family therapists. Community Family Therapy (CFT) is a modality designed to promote resilience both within and beyond the four walls of the therapy room, facilitate family connections in the community, and empower them for local leadership. The effects of deployment on families are summarized and CFT principles are adapted as a framework for intervention with this population.     

Need for Family Therapy Services for Middle-Class Families in India

This qualitative study explored the needs of Indian middle-class families for family therapy services. Four focus group interviews were conducted with middle-class parents in Madras, India. Participants were introduced to the concept and practice of family therapy and were encouraged to take a more active role in supporting the services they suggested. Participants identified problems faced by Madras middle class families and five different types of services that they were aware of. Three categories of need for family therapy were identified from the narratives of the participants. Several themes fit in each of the three categories. Implications for clinical application are discussed.     

Of Families and Other Cultures: The Shifting Paradigm of Family Therapy

This essay proposes that family therapy is currently undergoing a paradigm shift as a result of the ascendance of an epistemological focus absent in the foundational works that gave rise to the field's dominant clinical approaches. While systemic metaphors for the family are based on mechanistic, biological, and linguistic models primarily concerned with how the world is (ontology), postmodernism's social constructionist leanings give primacy to meaning, interpretation, and the inter-subjectivity of knowledge (epistemology). Thus, the metaphor of the family as a system is gradually being subsumed by a metaphor that construes families as interpretive communities, or storying cultures. It is suggested that this largely implicit transformation be made explicit in order to explore more fully the clinical implications of the new epistemology.     

Utilizing Movies in Family Therapy: Applications for Individuals,Couples, and Families

Movies, like books, can be useful and inexpensive interventions in therapy. The advantages of using movies in therapy are discussed, as well as guidelines for integrating movies as intervention. In addition, the authors conducted a survey of clinicians in order to collect their suggestions for utilizing particular movies with particular presenting problems. Results of the survey are included in the appendix.     

Describing Latinos Families and Their Help-Seeking Attitudes: Challenging the Family Therapy Literature

Latinos comprise a diverse ethnic group in the United States, yet central concepts describing Latinos persist. The purpose of this study was to assess the degree to which Latinos agree with the statements found in the marriage and family therapy (MFT) literature used to describe Latinos and Latino families, as well as their help-seeking attitudes and experiences. Research questions were derived from five constructs used to describe Latinos: familism, personalism, sense of hierarchy, spiritualism, and fatalism (Ho in Family therapy with ethnic minorities. Sage, Newbury, CA, 1987; Ho et al. in Family therapy with ethnic minorities, (2nd ed.). Sage, Thousand Oaks, CA, 2004). Overall, participants agreed with most of the statements pertaining to familism and personalism. However, mixed results were found for the constructs related to sense of hierarchy, spiritualism, and fatalism, as well as for participants’ help-seeking attitudes and behaviors. Latinos in this sample sought mental health professionals. However, MFTs were not sought as frequently as psychiatrists, psychologists, and clergy.     

Measuring Family Therapy Outcome in a Clinical Setting: Families That Do Better or Do Worse in Therapy

This study examined several important family and therapist characteristics as they related to treatment success. A total of 434 families entering family therapy at a sliding-fee clinic in Dallas, Texas were rated (on the Beavers Interactional Competence and Style Scales), and completed several self-report family assessment instruments (Self-Report Family Inventory, FACES III) prior to beginning therapy. The therapists, trainees from various disciplines, had been trained in the Beavers Systems Model. Overall, 75% of the families showed at least some improvement. Those that fared best in therapy were more competent at the outset. While number of therapy sessions was associated with greater gains, there were some families that made great gains in fewer than six sessions. There were important demographic qualities that did not discriminate between greater- vs. lesser-gain families, including income level, ethnicity, therapist gender, and family size. A regression analysis indicated that functional rather than demographic variables were more important in predicting therapy outcome.     

Diagnoses,Relational Processes and Resourceful Dialogs: Tensions for Families and Family Therapy

The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM‐5), given its psychiatric focus on mental disorders in individuals, presents families and family therapists with challenges. Despite considerable controversies over its adoption, the DSM‐5 extends a process of standardizing a language for human and relational concerns. No longer a diagnostic language of professionals alone, its use is medicalizing how mental health funders and administrators, as well as clients, respond to human concerns. For family therapists who practice systemically, particularly from poststructuralist and strengths‐based orientations, many tensions can follow when use of the DSM‐5 is expected by mental health administrators and funders, or by clients who present concerns about themselves or a diagnosed family member. In this paper, I explore how such DSM‐5 related tensions might be recognized, navigated, and negotiated in the practice of family therapy with clients, and with administrators and funders.     

Assessing Family Coordination in Divorced Families

Posttraumatic stress disorder (PTSD) and partner relationship difficulties commonly co-occur among Veterans of Operations Enduring Freedom and Iraqi Freedom (OEF-OIF). This study reports upon results for six male OEF-OIF Veterans with PTSD and their female relationship partners who completed cognitive-behavioral conjoint therapy for PTSD (CBCT for PTSD), which is a treatment that targets reductions in PTSD and couple distress. Case- and group-level data supported reductions in Veterans' PTSD symptoms and female partners' relationship distress. These findings suggest that CBCT for PTSD may be a promising intervention for OEF-OIF Veterans' PTSD and their partners.