A Re-Examination of the Current Status and Future of Family Therapy in India

Marital and family counseling has existed in India for many decades. However, the formalized discipline of marital and family counseling/therapy has its theoretical foundation in the West. The purpose of this paper is to present an overview of the need for and the current status of the practice of marriage and family therapy (MFT) in India. Based on our limited experiences we have attempted to prognosticate the future of the profession of family therapy in India by proposing a number of salient issues that we think would be useful discussion points as the development and advancement of family therapy in India is considered.     

On Becoming a Profession: The Growth of Marriage and Family Therapy in India*

The practice of couple and family therapy has a long history in India. This article tracks some of the people, places, and contexts associated with the growth of marriage and family therapy (MFT) as a profession in the Indian context. Two of the authors outline their own introduction to MFT and work within this field in different cities in India in the last two decades. Based on their professional experiences and a pilot study conducted in Chennai, the authors document the needs of providers in the areas of systems-based therapy training and the practice of MFT. The role of the Indian Association for Family Therapy (IAFT) and suggestions for the future growth of the field are also highlighted. Mudita Rastogi, PhD, Professor, Illinois School of Professional Psychology, Argosy University, 1000 Plaza Drive Schaumburg, IL 60173 (MuditaRastogi@hotmail.com). Rajeswari Natrajan, PhD, Assistant Professor, Alliant International University, 2500 Michelson Drive, Suite 250, Irvine, CA 92612-1548. Volker Thomas, PhD, Associate Professor, Purdue University, 1200 West State Street, Fowler Memorial House, Purdue University, West Lafayette, IN 47907-1269. *Portions of this paper are based on Rajeswari Natrajan’s dissertation at Purdue University. **Rastogi and Natrajan share first authorship for this paper.     

焦虑障碍的系统式家庭治疗

焦虑障碍是最常见的心理障碍之一.其具有症状重、病程慢、复发率高、社会功能明显缺损等特点,给个人、家庭和社会造成了巨大的负担.家庭环境因素在焦虑障碍的发病、转归和预后方面都起到重要作用.本文介绍了国内外关于焦虑障碍患者家庭特点和家庭互动模式的研究结果.系统式家庭治疗作为一种家庭治疗模式,具有其独特的治疗理念和方法,国内外研究结果表明系统式家庭治疗用于焦虑障碍具有良好疗效.今后,还应该运用更加多元化的研究方法探讨中国焦虑症家庭动力学特点和家庭功能,并采用更加严格的随机对照设计,进一步证实系统式家庭治疗对焦虑障碍的治疗效果.     

焦虑障碍的系统式家庭治疗

焦虑障碍是最常见的心理障碍之一.其具有症状重、病程慢、复发率高、社会功能明显缺损等特点,给个人、家庭和社会造成了巨大的负担.家庭环境因素在焦虑障碍的发病、转归和预后方面都起到重要作用.本文介绍了国内外关于焦虑障碍患者家庭特点和家庭互动模式的研究结果.系统式家庭治疗作为一种家庭治疗模式,具有其独特的治疗理念和方法,国内外研究结果表明系统式家庭治疗用于焦虑障碍具有良好疗效.今后,还应该运用更加多元化的研究方法探讨中国焦虑症家庭动力学特点和家庭功能,并采用更加严格的随机对照设计,进一步证实系统式家庭治疗对焦虑障碍的治疗效果.     

Families Leaving Family Therapy After One or Two Sessions: A Multiple Descriptive Case Study

A multiple case study design was used to discover something of the experiences of families, therapists, and members of the reflecting team of the first and or second session of family therapy in an attempt to answer questions regarding why families drop out after only one or two sessions. It was found that the families attending these sessions found them to be ineffective in assisting them to re-author the stories of their lives. There many reasons for this being the case.     

Integrative Family Therapy

This paper describes an integrative approach to marital and family therapy in which psychodynamic (particularly object relations), family systems, and behavioral (particularly cognitive–behavioral) theory are blended in a flexible and tailored therapeutic approach. Human personality in its most significant contexts is a consistent focus. Background factors in the development to the approach and illustrative case materials are included.     

Family Therapy in France: A Brief Overview

The major issues in contemporary family therapy in France are described: Difficult beginnings, the practice of family therapy today, training and professionalisation, organization for family therapy, journals and publishing, and perspectives for family therapy in France.A psychiatrist, Head of Hospital Psychiatric and Mental Health Center near Paris (Ville Evrard. France 93330) and a family therapist     

Textbooks in Accredited Marriage and Family Therapy Programs

Although choices of required textbooks are important decisions in developing a course curriculum, faculty in marriage and family therapy training programs have few convenient resources to guide curriculum development. This article presents results of a survey of textbook selections of accredited marriage and family therapy programs within a regional affiliate of AAMFT. The five programs surveyed listed 108 different titles used in their curriculum. Only 12 texts were used by two programs, and only one text was used by more than two programs. This article presents the textbook selections by the six curricular areas of COAMFTE accreditation standards. The wide variety of textbooks used by programs leads us to conclude that no consensus exists about what textbooks best represent the core knowledge of marriage and family therapy. The body of knowledge taught in accredited marriage and family training programs reflects a distinct and autonomous body of knowledge.     

家庭治疗在我国临床实践中的应用

家庭治疗作为心理治疗领域的“第四势力”,将个体置于关系之中去考察其心理问题,通过改变家庭成员围绕症状所表现出来的交往方式,从而达到治疗症状的治疗方法。该疗法的研究与实践很快渗透到心身疾病,成瘾、抑郁、强迫、精神分裂症等许多领域,在临床实践中得到广泛的使用并取得了较好的效果。     

Unheard Voices: Experiences of Families Living with HIV/AIDS in India*

This study was aimed at understanding the impact of HIV on the family system in the Indian context. A sample of 20 families caring for a relative living with HIV/AIDS (PLWHAs) was recruited from a HIV counseling clinic at the National Institute for Mental Health and Neuro Sciences and a respite home for PLWHAs in Bangalore City in southern India. Qualitative data were collected from these families using a semi-structured interview guide and recorded in the form of narratives. Analysis of these data revealed the following themes: Stigma and discrimination; disclosure; changes in family functioning; financial difficulties; fears of the family; and helplessness. Each theme was presented in detail and implications for intervention to help these families and their PLWHAs discussed. V.A.S. Krishna, PhD, MPE, Fogarty Funded Post Doctoral Fellow, Department of Psychiatry, Washington University School of Medicine, St. Louis, MO 63108 (krishnavas@epi.wustl.edu). Ranbir S. Bhatti, PhD, Professor of Family Therapy, Montfort College, Bangalore, Former Professor and Head, Department of Psychiatric Social Work, National Institute of Mental Health and Neuro Sciences (NIMHANS), Bangalore, India 560029 (ranbirbhatti@yahoo.com). Prabha S. Chandra, MD, Additional Professor, Department of Psychiatry, National Institute of Mental Health and Neuro Sciences (NIMHANS), Bangalore, India 560029 (prabhachandra@rediffmail.com). Srilatha Juvva, PhD, Reader, Department of Family and Child Welfare, Tata Institute of Social Sciences (TISS), Mumbai, India 400088 (juvvas@tiss.edu). *The authors would like to thank all the PLWHAs and their family members for volunteering to be part of this study. Post-doctoral Fellowship support for Dr. V.A.S. Krishna from Fogarty Grant—TW05811 (LB Cottler, PI).     

Family Therapy Study Group: The Mumbai Experience

Family therapy training in India is not provided in a systematic manner. Only one institution, the National Institute of Mental Health and NeuroSciences at Bangalore, offers this training, in the form of a three-month program. Consequently, a workshop on basic skills in Family Therapy was conducted in February 2003, at Mumbai, by a trained family therapist from Bangalore. The workshop resulted in founding the Family Therapy Study Group (Mumbai), a non-registered body, in March 2003 so that learning could continue to occur. The group meets once a month for two hours and has had 18 such meetings at this writing. This paper describes the objectives, activities, significant achievements, and future plans of the study group.     

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.     

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.     

Fostering Client Creativity in Family Therapy: A Process Research Study

Creativity has been shown to enhance problem solving, and to increase flexibility and adaptability—qualities associated with positive therapeutic outcomes. Literature related to therapist and/or client creativity is primarily anecdotal. Empirical literature addressing how therapists can facilitate the creativity of their clients in family therapy is scarce. In this study, the researchers used process methodology to code the behavior of therapists and clients in 31 videotaped family therapy sessions. Results show a significant positive correlation between interventions that induce positive affect and the creative client behaviors of optimism and playfulness.     

Marital Conflict Among Parents: Implications for Family Therapy with Adolescent Conduct Disorder

Conduct disorder is associated with several causative and maintaining factors, with family functioning being an important one. This is especially true in the Indian context, where a lot of the problem behaviors manifested by adolescents with conduct disorders are in the family context. Marital relationship of the parents is a key aspect of family functioning, affecting a number of other dimensions of family functioning, including adolescent adjustment. The paper highlights the role of parents’ marital conflict in the emergence and maintenance of adolescent conduct problems. The importance of family therapy in managing adolescent conduct disorder is discussed through case examples from India. Shalini Anant, MPhil, PhD Scholar, Department of Clinical Psychology, National Institute of Mental Health and Neuro Sciences (NIMHANS), Bangalore 560029, India. Ahalya Raguram, PhD, Additional Professor, Department of Clinical Psychology, NIMHANS, Bangalore 560029, India. Address correspondence to Shalini Anant (shalinianant@gmail.com).     

Continued Evolution of Family Therapy: The Last Twenty Years

There have been numerous accounts of the history and major trends and issues in family therapy during the field's first three decades in the literature (see for example: Broderick & Shrader, 1981; Framo, 1972; Guerin, 1976; Kaslow, 1973, 1977, 1980; Nichols, 1986, 1999 for some varied depictions, written from each respective author's unique lens). Viewed as a set, packaged with different, yet interrelated contents, they offer a multihued portrait of the emerging field during its infancy, childhood, and adolescence. Now it is time to move on and look at the adulthood era as it has unfolded.     

Myth and Legend in Family Therapy: Maintaining the Distinction Between the Sacred and Secular in Family Process

Family therapy has blurred the distinction between the sacred (myth) and the secular (legend) with resultant ethical implications, and has also created problematic cross-cultural considerations with its use of “myth.” The objectives of this paper are (a) to briefly introduce the evolution of the concept of “myth” in folklore; (b) to identify specific problems resulting from the current utilization of the term “myth” by family therapists; and (c) to demonstrate how appropriate usage of the concepts “myth” and “legend” from folklore theory radically decreases the confusion created in comparison to the present reliance on the term “myth” alone. Kimberly Ann Holle, MS, MSW, LSW, LCDC -III, CADC, graduated from the College of Social Work, The Ohio State University, in June, 2005. Ms. Holle now resides in Columbus, Georgia, USA (kimmers.1212@aol.com).     

Work and Family Conflict: An Often Overlooked Issue in Couple and Family Therapy

Despite the systemic interaction, family-based journals, as well as intake and assessment forms most frequently used by couple and family therapists (CFTs), have given a limited amount of attention to the issue of work and family conflict. Moreover, a review of the literature indicated that many CFTs perceive themselves as inadequately prepared to assist couples and families with work and family conflict. Addressing this apparent limitation, the present study identified various work stressors that contributed to family conflict (WFC), and the family stressors that contributed to work conflict (FWC). Results revealed significant predictors of WFC and FWC. Implications for CFTs and recommendations for changes in academic training and supervision are provided. The authors would like to thank Dr. Gary Bischof, Associate Professor of Counselor Education and Marriage and Family Therapy program Director at Western Michigan University, for editorial comments made on a previous version of this paper.