The Disappearing Family: The Role of Counselors in Creating Surrogate Families

For most of the world the nuclear and extended family provide the psychological support needed to mature and deal with life's crises. In the United States the family is changing rapidly. The changes sharply limit the ability of the institution to provide the support and role models formerly available. This article documents the emerging issues counselors and clients need to face. It suggests the value of creating surrogate families to fill the void created by the disappearing family.     

Employing the Principles of Positive Behavior Support to Enhance Family Education and Intervention

Positive behavior support (PBS) is an evidence-based approach for supporting adaptive behavior and addressing behavioral challenges. It is critical that families have access to effective evidence-based behavior support practices for both intervention and prevention because they lead to better outcomes for families, and counter-productive family management practices have been shown to further escalate children’s behavioral challenges. PBS has been demonstrated to be effective with individual children with serious behavior challenges in family homes and features of PBS are evident in common family-based intervention approaches. Unfortunately, complete application of PBS in family contexts has not been fully explored or conceptualized. The purpose of this paper is to define the core features of PBS including lifestyle enhancement, assessment-based intervention, and comprehensive support plans (i.e., including strategies for prevention, teaching, and management). Examples of how the features of PBS are currently being employed within the field of PBS and within other evidence-based parent education and support programs are provided. Suggestions for how collaboration, assessment, data-based decision making, comprehensive intervention, and tiered approaches to service delivery may be used to enhance behavioral support for families are offered. Lastly, future directions for research and practice are recommended.     

A Closer Look at Religiosity Among Family Caregivers

This article addresses the relationships between the dimensions of religiosity and positive appraisal of caregiving among African American, Hispanic, and non-Hispanic Caucasian family caregivers for older adults. Data analysis of 69 subjects revealed a negative correlation between non-organizational religiosity and positive appraisal of care among African American caregivers and a positive correlation between organizational religiosity and positive appraisal of care among Hispanic caregivers. Findings from this analysis challenges the overall assumption that religiosity increases positive appraisal of caregiving. Rather, the nature and outcomes of family caregiving are different for various ethnic groups.     

Observed Family Interaction During Clinical Interviews: A Comparison of Families Containing Preschool Boys With and Without Disruptive Behavior

The clinical intake interview is an opportunity to observe family interactions and formulate hypotheses about their influence on presenting problems. In this study family interactions were assessed during an unstructured segment of a clinical intake. Families with disruptive preschool boys were compared with those having nonproblem boys. Mothers' and fathers' reports of marital satisfaction, parenting involvement, and child behavior problems were examined in relation to observed behavior during intake. Patterns of family interaction emerged which were consistent with previous research and with family systems theory. Clinic boys oriented more toward mothers than fathers and interacted more negatively with their fathers than did comparison boys. Implications for integrating the assessment of family interactions into clinical practice and research with behavior problem children are discussed.     

Observations about Family Interaction and the Effect of Therapy: Interviews with Families Eight Years after the Onset of Schizophrenia

This study focused on the development of and changes in the interaction within a family after the onset of schizophrenia in a family member. Special attention is given to the possible effects of various treatments on the interaction. Our method was a circular interview of all family members in a joint session 8 years after the onset of schizophrenia. We observed that changes in family interaction usually had taken place during the first year of the illness. Thereafter, family conditions and interactions seem to have remained relatively unchanged. On the other hand, in addition to actual family-centered therapy, all other treatment modes--individual therapy, medication, hospitalization--seemed to have acted as systemic interventions on the family level. Our observation that family interactions and models of therapy often had a surprisingly strong resemblance led us to consider the idea of their coevolution over the years and the possible significance of this. This article aims at calling the reader's attention to the manifold influences that the onset of schizophrenia and its various treatments seem to have had on family system.     

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.     

Creating a Secure Family Base: Some Implications of Attachment Theory for Family Therapy

The aim of this article is to make attachment research findings available in a form that family therapists can use. In attachment theory, parents are conceptualized as providing a secure base from which a child can explore. Family therapists, however, need a systemic concept that goes beyond the parent/child dyad. The concept of a secure family base is proposed, in which a network of care is made available for all family members of whatever age so that all family members feel secure enough to explore, in the knowledge that support is available if needed. Factors that contribute to the security or insecurity of the family base are outlined. The overall aim of therapy is to establish a secure family base from which the family can explore new solutions to family problems both during and after therapy. The role of the therapist is to help to resolve conflicts that threaten relationships, and to explore relevant belief systems that may be contributing to a sense of insecurity. The conceptual framework presented allows for an integration of family therapy techniques and ideas into a coherent whole. A new school of family therapy is not proposed.     

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.     

Predictors of Family Functioning Within Alcoholic Families

This study assessed the effects of various predictor variables on dimensions of functioning within alcoholic families. Participants were 173 college student volunteers from alcoholic families who completed a measure of family functioning, demographic questions, and questions related to experiences in their families of origin. Child abuse, spousal violence, parental divorce, length of time living with an alcoholic parent, parental marital status, and parental availability and predictability significantly affected family functioning, whereas frequency of parental drinking did not. Results suggest that quality of parental interactions with children is more important for functioning in alcoholic families than frequency of parental drinking.