An Infertility Primer for Family Therapists: II. Working with Couples Who Struggle with Infertility

The distress of infertility and its medical treatments are profound, and the effects reverberate in each partner, the couple dyad, and the couple's relationships with family, friends, and medical systems. Yet family therapists, like others in our society, are often uninformed or misinformed about the experience of infertility. While the legacies of infertility may be painful and enduring, they often remain unspoken, and hence may be overlooked in standard interviews. This article describes the experiences of couples struggling with infertility, most of whom have sought medical intervention, and it provides treatment interventions for guiding couples through this difficult and often uncharted terrain. Case vignettes derived from 2 years of this clinical research study are included.     

Healthcare Policy in the United States: A Primer for Medical Family Therapists

As family therapists increasingly practice in healthcare settings, they need to be aware of forthcoming changes in healthcare policy and the impact of these changes on their clinical work and the lives of their clients. In this paper, we provide a primer on healthcare policy for family therapists, which describes current and proposed changes in healthcare that will potentially revolutionize healthcare delivery for families. We describe three key initiatives: (1) Triple Aim; (2) the Accountable Care Organization; and (3) the Patient Centered Medical Home. We conclude with a discussion about future directions and healthcare policies that include families.     

Family Consulting: A New Role for Therapists

A new model for psychological practice entitled, "Family Consulting" is proposed. It is defined as a long-term, intermittent approach to working with families based on a developmental/non-pathological perspective. The specific format of intervention is described in detail. A brief review of the life-span perspective of development, the family life-cycle literature, and object relations family therapy, which serve as the building blocks of the model is provided. The role that family consulting can play in today's managed mental health care environment is discussed.     

Family Resilience and the Management of Fibromyalgia: Implications for Family Therapists

Fibromyalgia Syndrome (FMS) is one of the most troubling rheumatic disorders for patients, significant others, and the health care providers who treat them. Responses from 150 participants provided valuable information on the relationship between family resilience and the management of fibromyalgia. Self reported family stressors, strains, and distress were significantly associated with an increase in health problems/functional disability, whereas family hardiness and family social support were associated with a decrease. Family stressors and family strains were also positively associated with the frequency of medication use. Medical family therapy interventions that consider the familial context are recommended for treatment. Additional implications for clinical practice and future research are discussed. J. Cameron Preece, PhD, Sage Health Care, PLLC, 339 Allumbaugh Street, Boise, ID 83704. Jonathan G. Sandberg, PhD, Department of Marriage and Family Therapy, Syracuse University, Syracuse, NY 13244. (jgandbe@syr.edu) Special thanks go to Linda Stone Fish, PhD, for her support and guidance throughout the study.     

Searching for Family Therapy in the Rockies: Family Therapists Meet A Paleontologist

Family therapists use concepts germane to other academic disciplines. We recount four notions--context, explanatory metaphors, language conventions, and persistently refining knowledge--that family therapists and paleontologists each utilize. Revisiting family therapy's foundational concepts through the lens of another discipline reminds us of our theoretical beginnings, highlights those professional adaptations that we have made over the years, and offers us an opportunity to reinvigorate and expand our central organizing principles.     

Family Physicians and Family Therapists: Understanding the Interdependent Synergism

This article, written by a family physician and a family therapist, is designed to identify differences between these two cultures that may serve as stumbling blocks to successful meeting of occupants of these two worlds. With the differences identified and described, various notions and suggestions are offered in an effort to promote more successful bridging between these two groups. There is little question about the synergistic impact that can be engendered for recipients of their care should this bridging be successfully navigated. The present day realities in healthcare make this an idea whose time has not just come, but rather seems imperative.     

Termination: Legal and Ethical Considerations for Marriage and Family Therapists

Every Marriage and Family Therapist (MFT) must carefully plan how to initiate, convene, and terminate therapy. Determining how to ethically terminate therapy in a variety of therapeutic contexts can be challenging. Though termination is a common aspect of all therapeutic relationships, a lack of empirically based information on how to terminate therapy leaves practitioners alone in determining how best to end the treatment relationship. Furthermore, the subject of termination is discussed so scarcely in MFT literature that few authors have attempted to establish a standard for ethical termination. In the current climate of evidence-based services, predetermined session limits, and increased litigation for malpractice, MFTs must examine their termination procedures. This paper identifies the current available literature on termination and discusses the ethical and legal considerations for practicing MFTs as outlined by the AAMFT Code of Ethics (2004) American Psychological Association. 2004. Code of ethics., Washington, DC: Author.  [Google Scholar]. Directions and suggested methods for future research are set forth.     

Integration: Opportunities and Challenges for Family Therapists in Primary Care

Integration of behavioral and physical health is becoming critical for the overburdened primary care system. Policy changes are needed to accommodate integration nationally. Locally, medical and behavioral health providers are working together to create models that better fit their patients?? comprehensive needs while respecting the clinical, operational, and financial constraints of the current system. Family therapists trained to work in medical settings have an opportunity to emerge as clinical, research, and administrative leaders in this context. However, a paradigm shift is crucial to adapting their systemic orientation to interactions between individual patients, providers, staff, and healthcare and support systems. This article provides family therapists with: (1) an overview of the basic structure and barriers of integration, (2) suggestions on how to deliver quality care despite barriers at the local level, and (3) examples of key advocacy efforts representing possible entryways on a larger scale.     

Media Coverage of Child Sexual Abuse: An Opportunity for Family Therapists to Help Families and Communities

The recent media coverage of child sexual abuse charges involving priests is likely to trigger various needs among the public for professional services. Family therapists should prepare to respond effectively to the high anxiety that these media stories trigger. Family therapists with expertise in human sexuality should use such reports to promote a fuller understanding of all aspects of sexuality for individuals and families. Professionals can integrate much needed aspects of sexuality education in dealing with the mass media, in crisis intervention for persons at risk, and in therapy that centers on child or adult experiences of sexual abuse.     

A Profile of Chinese Family Therapists

It is helpful for professional organizations, policy makers and regulators, third-party payers, and clients to have access to empirical data about family therapists and the practice of family therapy. Nevertheless, there is no such data available in China. This study attempts to fill this gap by profiling Chinese family therapists. A questionnaire was designed and delivered to family therapists and trainees. A total of 117 questionnaires were collected and analyzed. The findings show that the majority of Chinese family therapists are female, in the age range of 31–40 years, hold master’s degrees, and attend continuous training programs that last 20–40 days over 2–3 years and short-term workshops for family therapy training. They are mainly motivated by the need for personal growth in their career choice. Most of them work in the institutional setting. They have worked in the counseling field for 6.6 years on average, and they have practiced family therapy for an average of 3.4 years. They perform counseling for 9.2 h per week, and 4 h involve working with families. They received an average of 30.6 h of family therapy supervision in the past year. They mainly see individuals and families with adolescents, and their approach is eclectic. This paper compares the findings in China with findings from North America, discusses possible reasons for differences in the findings, and provides suggestions for future development and studies of family therapy in China.     

Rural Marriage and Family Therapists: A Pilot Study

Marriage and family therapists practice in more than a third of the rural counties in the United States. However, little is known about the practice patterns of marriage and family therapists who practice in rural settings. This pilot study examined the clinical practice and community involvement of a sample of licensed marriage and family therapists in rural Texas. The results contribute to a small but developing body of research about a relatively unknown group of practitioners.     

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.     

Training Family Therapists in a Multicultural Setting

Authors describe a multicultural training model for family therapists and psychologists at a traditionally conservative Afrikaans speaking university in South Africa. Black psychologists are now receiving high priority in a masters degree program that leads to professional registration licensure because of the needs of the population. The authors emphasize the importance of being able to think multidimensionally and creating a context in which students can do the same in such contexts.