Values and Ethics in Family Therapy

This article is an introduction to this special issue on values and ethical issues in family therapy. The author discusses the historical context for the rising interest in these issues in family therapy, describes the rationale for this special issue, and presents a framework for analyzing the core values of the prominent models of family therapy. The ethical debate over use of paradoxical techniques in family therapy is used as an illustration of a values clash between different models of family therapy.     

A Comparison of the Effectiveness of Values Clarification Presented as a Personal Computer Program versus a Traditional Therapy Group:

Eight adolescent inpatients were assigned to two groups equated as much as possible by matching the subjects for age, sex, and diagnosis. The experimental group viewed an individual self-paced computer program on values clarification, and the control group attended a single group therapy session covering identical content. Pretesting and posttesting was done using the Tennessee Self-concept Scale and the Internal-External Control Scale. No significant differences were found using these tests as measures of effectiveness, but on the post-treatment attitude survey, subjects in the computer group reported greater perceived effectiveness than those in the control group. The computer program was well accepted and not related to prior exposure to computers. Subjects completed the computer program in less than half the time required to present the material in the therapy group.     

Changes in the Hierarchy of Value References Associated With Flying in Space

ABSTRACT One hundred twenty‐five astronaut autobiographies, interviews, and oral histories were content analyzed and scored for references to values ( Schwartz, 1992 ). The current study extended methods tested in 2 pilot studies of space veterans from many nations, of both sexes, and with different experiences within the history of human spaceflight. Value references reflected a high degree of concern with individualism, with Achievement, Enjoyment, and Self‐direction ranked highest. There were relatively few value differences across demographic categories, demonstrating the impact of the spaceflight experience. After returning, the astronauts showed increased concern with Universalism, Spirituality, and Power (social recognition), a broadened set of references to values oriented toward the collective good.     

Values in Family Therapy Practice and Research: An Invitation for Reflection

Values have been shown to be a pervasive part of both marriage and family therapy (MFT) clinical practice and research. Yet, many therapists and researchers remain unclear about how values affect their work. This article examines the influence of Western philosophical assumptions and therapy traditions in light of current understandings of values in therapy. The influence of values in MFT research processes is similarly examined. Implications for how family therapy professionals can be more reflective and sophisticated in their understanding of values in clinical practice and scientific inquiry are discussed. Suggestions for addressing values in MFT training also are given.     

Truth Values and the Value of Truth

This paper explores the ways in which truth is better than falsehood, and suggests that, among other things, it depends on the kinds of proposition to which these values are attached. Ordinary singular propositions like It is raining seem to fit best the bivalent scheme of classical logic, the general proposition It is always raining is more appropriately rated according to how often it rains, and a practically vague proposition like The lecture will start at 1 is appropriately rated according to its nearness to exactness. Implications for logic of this rating system are commented on.     

Conceptual Clarification and the Task of Improving Research on Academic Ethics

What does the term academic ethics mean? How does this term relate to others in the academic integrity literature, such as research misconduct? Does conceptual confusion in the study of academic ethics complicate development of valid analyses of ethical behavior in an academic setting? The intended goal of many empirical projects on academic ethics is to draw causal conclusions about the factors that lead to faculty or students possessing or disregarding academic integrity. Yet, it is not clear that scholars using the concept academic ethics are measuring the same phenomenon when they use associated concepts, such as responsible conduct of research. The purpose of this paper is to develop a taxonomy of concepts for the empirical study of academic ethics. Based in research on comparative analysis of democracy, another normatively preferable but multifaceted concept, I argue for a taxonomy of concepts for the study of academic integrity that reduces problems of “conceptual stretching” and challenges to the validity of empirical research in this field.     

Cognitive-Behavioral Therapy With Chinese Americans: Research, Theory, and Clinical Practice

In this article, we discuss how to conduct cognitive-behavioral therapy with Chinese Americans. We present an integration of theory, research, and clinical practice to help mental health practitioners understand how Chinese culture may potentially influence the CBT treatment process for Chinese immigrants. Several recommendations are provided as to how to adapt and modify CBT to better meet the therapeutic needs of Chinese American clients. A case example demonstrates how cultural modifications of CBT can lead to effective psychotherapy outcomes for Chinese American clients.     

Some Notes on the Use of Family Sculpture in Therapy

Therapists learning to use family sculpture as a tool often find difficulty in exploiting the technique to its fullest. This article, designed to encourage therapists to take the risks involved in using a technique new to them, describes how the author and his cotherapists used sculpture in three cases in different ways. In each case, the author explains how the therapists made the choices involved in directing the therapeutic process. He suggests that even when a sculpture itself seems to have failed to produce useful information, it can elicit from clients signals that will indicate opportunities for effective use of other techniques and that a sculpture, once used, can be restaged to reinforce client behavior change.     

Notes on the Existential Psychotherapist as a Host in Couples Therapy

EMOTIONALLY FOCUSED COUPLE THERAPY WITH TRAUMA SURVIVORS: STRENGTHENING ATTACHMENT BONDS. Susan M. Johnson. New York: Guilford, 2002, 228 pp., $30.00 (hardcover). Reviewed by Connie Salts.

COUPLES IN CONFLICT. Edited by Alan Booth, Ann Crouter, and Mari Clement. Mahwah, NJ: Lawrence Erlbaum Associates, 2001, 304 pp., $59.95 (hardback). Reviewed by Kyle D. Killian.

CONFLICT AND DECISION-MAKING IN CLOSE RELATIONSHIPS. Erich Kirchler, Christa Rodler, Eric Holzl, &; Katja Meier. Philadelphia, PA: Taylor &; Francis, 2001, 272 pp., $62.95 (hardcover). Reviewed by Anna K. Hultquist.

CLOSE ROMANTIC RELATIONSHIPS: MAINTENANCE AND ENHANCEMENT. Edited by John Harvey and Amy Wenzel. New Jersey: Lawrence Erlbaum, 2001, 400 pp., $89.95 (hardback), $37.50 (paperback). Reviewed by Mark Odell.

A CLINICIAN'S GUIDE TO MAINTAINING AND ENHANCING CLOSE RELATIONSHIPS. Edited by John Harvey and Amy Wenzel. New Jersey: Lawrence Erlbaum, 2002, 342 pp., $79.95 (hardback), $36.00 (paperback). Reviewed by Mark Odell.

BEYOND THE MYTH OF MARITAL HAPPINESS: HOW EMBRACING THE VIRTUES OF LOYALTY, GENEROSITY, JUSTICE AND COURAGE CAN STRENGTHEN YOUR RELATIONSHIPS. Blaine Fowers. San Francisco, CA: Jossey-Bass, 2000, 241 pp., $25.00 (hardback). Reviewed by Roy Bean.     

Dialectical Behavior Therapy With Prolonged Exposure for Adolescents: Rationale and Review of the Research

Among adolescents, interpersonal trauma has been associated with severe post-traumatic stress disorder (PTSD) and impairments across multiple domains of functioning (e.g., Derosa, Amaya-Jackson & Layne, 2013; Ford, Courtois, Steele, van der Hart, & Nijenhuis, 2005; van der Kolk, 2005). Such difficulties can include high-risk behaviors such as active suicidality (Middlebrooks & Audage, 2008) and nonsuicidal self-injurious behavior (NSSI; Hu, Taylor, Li, & Glauert, 2017). While there have been many advances in the treatment of trauma, treatment dropout for adolescents seeking trauma-informed treatment is predicted by diagnostic comorbidity and complexity (Sprang et al., 2013), as well as the number of traumatic events endorsed (Wamser-Nanney & Steinzor, 2016). Many traumatized adolescents with high-risk behaviors are referred to Dialectical Behavior Therapy (DBT-A). However, DBT-A does not yet include a specific, evidence-based protocol for treating PTSD, without which treatment gains may not be sustained for traumatized adolescents (Harned, Korslund, & Linehan, 2014). While Prolonged Exposure (PE) is indicated as the gold-standard treatment for PTSD and has proven effective for adolescents (PE-A; Foa, McLean, Capaldi, & Rosenfield, 2013), it has not yet been validated with adolescents who are actively suicidal. However, PE has successfully been integrated within DBT for adults with co-occurring Borderline Personality Disorder and PTSD (e.g., DBT-PE; Harned et al., 2014). Based upon this model, the current paper proposes the integration of DBT-A and PE-A to treat adolescents with interpersonal trauma who also present with high-risk behaviors. The paper discusses anticipated complications related to adapting this model for adolescents and provides direction for future research.     

One- to Three-Session Therapy With Children and Families

Individuals or families occasionally “leave therapy” after only one or several sessions, claiming to have gotten what they needed. Although such experiences are often considered treatment failures, there is growing evidence that such brief contacts can in fact produce changes as thorough and meaningful as those seen in long-term treatment. The few studies exploring such brief encounters suggest the long-range effectiveness of one-session treatment across diagnostic categories. Examples of one- to three-session treatment in the individual and family therapy literature are cited. Three of the author's cases are described, illustrating one style of intervention. Is such treatment merely palliative, or can it deal with “underlying” causal issues? How can significant change occur within the structure of one to three hours? These issues are discussed within the framework of psychoanalytic and family systems theories of symptom formation and symptom maintenance.     

Toward the Clarification of the Construct of Depersonalization and its Association With Affective and Cognitive Dysfunctions

Little consensus or systematic research exists regarding the symptoms that constitute depersonalization and its association with affective and perceptual dysfunctions. A scale was constructed to measure depersonalization experiences reported in the literature and four items representing psychotic symptoms. Five factors representing different types of depersonalization emerged: Inauthenticity, Self-Negation, Self-Objectification, Derealization, and Body Detachment. Based on the factors, scales were constructed; these scales have internal consistency ranging from .78 to .84. Each of these factor scales was factorially distinguishable from psychosis and correlated between .48 and .58 with the Jackson and Messick (1972) Feelings of Unreality Scale, suggesting divergent and convergent validity. Inauthenticity, the most frequent and pervasive form of depersonalization experience, was best predicted by a cognitive style featuring intense, critical examination of self and others. In contrast, Self-Objectification was best predicted by thought disorganization and perceptual distortion and was experienced somewhat infrequently by relatively few subjects. All forms of depersonalization were associated with depression, except Inauthenticity.     

Motives and Values to Achieve: Different Constructs With Different Effects

ABSTRACT Motives to achieve and values associated with achievement were conceptualized as distinct and independent personality constructs, one nonconscious, the other conscious, each predictive of a different type of achievement-related behavior It was hypothesized that (a) motive and value measures would be uncorrelated, (b) motives would predict “operant” or spontaneous behaviors while values would predict “respondent” or stimulus-driven behaviors, and (c) motives and values would interact such that subjects with high values relating to achievement would perform better than those with low values, but only when their motives were also high Hypotheses (a) and (b) were strongly supported m two studies, and Hypothesis (c) was supported in Study 2 In that study, the motive for achievement was a particularly strong predictor of operant math performance among those subjects who valued achievement as opposed to affiliation The findings suggest that nonconscious (motive) and conscious (value) measures are both useful in different cases–the former for predicting “real” (doing) activity, the latter for predicting self-report (thinking) responses Questions concerning how motives and values might combine to predict different kinds of behavior are addressed     

Notes on the Tenacity of Therapeutic Presuppositions in Process Research: Examining the Artfulness of Blamings in Family Therapy

In their recent contribution to the Journal of Family Therapy , Frosh et al . apply discourse analytic methods to the study of 'process' in family therapy. While we welcome this contribution, we suggest that the authors' reading of the data has been affected by a number of fundamental presuppositions, which have led them to neglect the skilful rhetorical work taking place in the session. In this paper, we have undertaken an alternative analysis of the data, examining its rhetorical features and suspending judgement on the efficacy of the therapeutic project and on the truth status of statements made by participants in the session. While acknowledging that our microanalytic method has some shortcomings, we contend that attention to the situated and strategic nature of 'therapy talk' has exposed the primacy of notions of responsibility and blame in family work, and has shown how these issues are artfully negotiated by therapist and family in the cut and thrust of the therapeutic interview.     

Comparing Values and Methods in Psychodynamic and Cognitive-Behavioral Therapy: Commonalities and Differences

To determine the underlying values and methods in cognitive-behavioral and psychodynamic therapy and to address the implications of those values and methods for integrating the two therapies, the Process Value and Methods Survey was sent to members of The Association for Advancement of Behavior Therapy (cognitive-behavioral sample) and Division 39 of American Psychological Association (psychodynamic sample). Members were asked to endorse items based on their ideal understanding of their respective orientations. A Principal Components Analysis (PCA) of the combined samples yielded six components for values, of which four were significant according to orientation. A second PCA, for therapeutic methods, yielded six components, five of which were significant according to orientation. In both PCAs, components significant for an orientation were consistent with the corresponding constructs of that orientation. The relationship between method and value components as well as how value components may be related to clinical practice and psychotherapy integration is discussed.