Intervention Strategies for Parent Coordinators in Parental Alienation Cases

Families characterized by parental alienation present problems that are extremely difficult to resolve through conventional methods of family therapy. Court appointed parenting coordinators (P.C.) are in the very best position to make effective interventions in these cases. The authors use genograms to illustrate the difficulties of establishing normal visitation and re-negotiating binuclear families in five different cases: (1) Divorced family, minimal conflict, (2) Divorced family, conflicted relationship, (3) Divorced family, child in alignment with mother, (4) Divorced family, child estranged from father, and (5) Divorced family, parental alienation. The authors then use the genograms to suggest interventions for PC's in five areas: (1) Creating a buffer zone to facilitate crossing the co-parental boundary, (2) Helping the child separate from the enmeshment with the alienating parent, (3) Blocking intrusions from the alienating parent, (4) Strengthening the bond with the targeted parent, and (5) Weakening the coalition around the alienating parent-child dyad.     

Genograms in counselling practice: A review (Part 1)

Genograms are an important clinical tool for many counsellor, therapists and other health care professionals and can be used for assessment, gathering information on family relationships and exploring themes in counselling practice. This article reviews the recent literature on genograms and examines the efficacy and use of this tool from a number of perspectives including the use of genograms in health care, psychological counselling and in genetic counselling. The predictive value, and future development of the use of the genogram in counselling are also discussed.     

You must leave before you can cleave: A family systems approach to premarital pastoral work

We advocate the use of a family systems approach to premarital pastoral work, involving exploration of the families of origin of the intended spouses. Family systems theory argues that a marriage is like a merger of two corporations, each having its own stockholders; thus, adequate preparation for marriage involves coming to terms with the realities of one's family of origin and that of one's intended spouse. Exploratory techniques include genograms, house tours, family photo albums, and discussions of the rules and rituals in the respective families. Leaving father and mother is the central prerequisite to marriage.Dr. Mitchell is Professor of Pastoral Care and Theology, Eden Theological Seminary, 475 E. Lockwood Ave., Webster Groves, Missouri 63119. Dr. Anderson is Associate Professor of Pastoral Theology, Wartburg Theological Seminary, 333 Wartburg Place, Dubuque, Iowa 52001.     

Spirituality-Focused Genograms: Keys to Uncovering Spiritual Resources in African American Families

This article invites therapists to explore the spiritual resources of African Americans through the use of spirituality-focused genograms. Spiritual issues can be considered in the context of family dynamics, as well as cultural factors including gender, socioeconomic status, language, geographic origins and issues of racism and oppression. Examples of the use of spirituality-focused genograms in therapy are presented.     

Genograms in counselling practice: Constructing a genogram (part 2)

In Genograms in counselling practice: a review (part 1), recent literature on the use of genograms was reviewed and the efficacy and utility of genograms in counselling practice was examined. This paper outlines how a family genogram is constructed in a counselling setting. An approach to introducing the relevance of a genogram to the client is described as is the method of gathering and using information. The therapeutic use of genograms is also discussed.     

How Therapists Discuss Causality with Families in an Integrated Family Management and Therapy Service, a Qualitative Study with Focus Groups

Family therapy (FT) and family management (FM) approaches to psychosis have been distinguished by their understanding of causality. FM holds a biological understanding which could have negative consequences for the person with psychosis. FT, with its focus on interactions, has been criticised for its potential for implying that families are to blame for their relative’s psychosis. Although these two approaches have been integrated, the manner in which causality is discussed in family sessions within an integrated approach has not been researched. Qualitative research was conducted with clinicians working in an established integrated family intervention service to explore how they discuss causality. Four focus groups were conducted and a framework approach to thematic analysis used. Four themes developed from the analysis: how a shared understanding of causality is constructed; the use of an ‘explorative conversational’ therapeutic style to discuss causality; factors that limited the exploration of causality; and the challenges of working with issues of blame. The stress-vulnerability model, genograms, interactional-cycles and formulation were identified as useful tools to develop a shared understanding of causality. The therapeutic style of ‘explorative conversation’–based in FT, integrated with the stress-vulnerability model–based in FM, was identified as key to the integrated model and clinicians felt these two aspects addressed the criticisms that have been levelled at each approach. Complex family problems, abuse and illicit drug use were factors that challenged causality discussions. Families feeling blamed/blaming themselves and attempts to transform blame made up a dominant theme of the research.     

The Emergence of Eric: Co-Therapy in the Treatment of a Family with a Disabled Child

This paper focuses on the problem of socialization of the disabled child within his family. For the family of the disabled child, socialization is doubly challenging; the family must teach its child not only how to be human, but also how to be disabled in the larger society. Often families of disabled children need help in enhancing their child's participation in family life — a critical aspect of socialization. One highly effective means of assisting families in this task is the use of family therapy. A case study is included to illustrate the use of family interviewing with a congenitally blind adolescent boy. Two therapists — a rehabilitation counselor (who is blind) from a state agency serving blind children^a and a social worker from a child guidance agency^b— collaborated in working with the family, which included a mother, father, their congenitally blind thirteen-year-old boy, and his two sighted brothers. The authors conclude that the child's family is the most potentially powerful resource for the successful habilitation of the disabled child into larger society and postulate family treatment as an effective means of attaining this end.     

The Colored, Eco-Genetic Relationship Map (CEGRM): A Conceptual Approach and Tool for Genetic Counseling Research

The Colored Ecological and Genetic Relational Map (CEGRM) [pronounced see-gram] is a conceptual approach and tool for presenting information about family and nonkin relationships and stories about inherited diseases in a simple, understandable form. It combines information that can be derived from pedigrees, genograms, ecomaps, and social network analysis in a single, or series of, pictorial maps based on colors and shapes. The CEGRM is based on a social systems perspective, particularly emphasizing social exchange and resource theories. The CEGRM should be particularly useful in genetic counseling research with members of suspected cancer-risk families or families with other late-onset inherited diseases. A genetic counseling client comes with a social history and context as well as a genetic one. Client decision-making in terms of reproductive plans, therapeutic intervention, lifestyle behavior and sharing or withholding of genetic information frequently becomes enmeshed with preexisting psycho-social relationships among biological kin, affinal kin (in-laws) and fictive kin (friends who act as family). The CEGRM makes it easier to compare different types of social interactions between the client and his/her significant others and among family members on the same dimensions.     

The Family Diagram and Genogram: Comparisons and Contrasts

The family diagram and its derivative the genogram are widely used in marriage and family therapy, other mental health disciplines, and family medicine. After a brief history of the origins of the family diagram and genogram, several different areas are compared in order to help distinguish differences between family diagrams and genograms. The results of these evaluations illustrate some similarities in format and symbols due to a common history, but distinct differences in purpose, theoretical basis, rationale for data collection, and interpretation guidelines. Divergent theoretical perspectives explain the differences between family diagrams and genograms. The family diagram is intertwined with Bowen family systems theory, while the genogram emphasizes how the nuclear family interacts within multiple contextual levels. The family diagram and genogram are not synonymous; rather, they are distinctly different methods of family assessment.     

Parent–Child Conflict Profiles in Chinese American Immigrant Families: Links to Sociocultural Factors and School‐Age Children's Psychological Adjustment

Research suggests that parent–child conflict is a salient family process in Asian immigrant families and often a stressful experience for Asian American youth due to value discrepancies between Asian and Western cultures. The present study examined ratings of parent–child conflict across conflict topics from parents' and children's perspectives in a sample of Chinese American immigrant families with school‐age children (N = 239; age = 7.5–11 years). Latent profile analyses identified three parent‐rated conflict profiles and four child‐rated conflict profiles. Parent and child conflict profiles were unrelated to each other and differentially related to family sociocultural factors and children's psychological adjustment. Parents' moderate conflict profile scored highest on parent‐rated child behavior problems and had the highest household density and lower parent Chinese orientation. Children's moderate‐specific and high conflict profiles scored higher on child‐reported behavior problems than the low conflict profile. These results highlight the need to assess family conflict from both parents' and children's perspectives and target parent–child conflict communication as a pathway to prevent or reduce behavioral problems in Chinese American children of immigrant families.     

Systemically-Based Psychotherapeutic Techniques in Genetic Counseling

The uses of systemically-based psychotherapeutic methods in genetic counseling are discussed in the context of the origin of genetic counseling, the definition of genetic counseling, and the adjustments that one must make in order to implement these methods. Selected systemic methods which can be readily incorporated into genetic counseling are presented: use of genograms to explore family attitudes and beliefs about genetic risk, communications skills, and applications of family of origin work in genetic counseling. The need for research regarding the methodology and process of genetic counseling is presented with discussion of the need for theories of practice for genetic counseling.     

Interpersonal Psychotherapy—Adolescent Skills Training With Youth From Asian American and Immigrant Families: Cultural Considerations and Intervention Process

Although research has identified effective evidence-based depression prevention interventions for diverse youth, little is known about how the intervention process unfolds with immigrant family youth. This study utilized a qualitative approach to explore cultural and clinical differences in the implementation of Interpersonal Psychotherapy–Adolescent Skills Training (IPT-AST) in two schools, one serving youth from primarily immigrant, Asian American families and the second, youth from mostly nonimmigrant, non-Hispanic White families. A total of 131 IPT–AST sessions were audio recorded, transcribed, and coded for presence and patterns of cultural and clinical constructs. Results revealed that sessions with immigrant family youth were more likely to contain discussions of interpersonal problems characterized by estrangement, goals of spending time together with important others, mentions of emotion suppression and academic achievement expectations, conversations about acculturation, differences in value orientation, and discomfort with implementing new intervention skills. Dialogue from interventionist and youth exchanges is presented to illustrate how these themes emerged and were addressed by interventionists in a culturally responsive manner. The study highlights how IPT–AST with immigrant family and Asian American youth may unfold differently compared to youth from nonimmigrant families. Implications of findings for providers are discussed.     

Coalitions and Family Problem Solving with Preadolescents in Referred,At-Risk,and Comparison Families

This study tested the hypothesis that the mother-father coalition, parent-child coalitions, and parental warmth expressed toward the child are associated with family problem solving in families with a preadolescent child referred for treatment of behavior problems (n = 30 ), families with a child at-risk for conduct disorder (n = 68 ), and a sample of comparison families (n = 90 ). Referred and at-risk families displayed less effective problem solving. A regression analysis, which controlled for gender of the child, family structure, family income, marital satisfaction, and severity of child problems, showed that strong parental coalitions were linked to low levels of family problem solving in at-risk and referred families. Parent-child coalitions had little apparent impact while parental warmth was highly correlated with better family problem solving. The results may be interpreted as evidence for a tendency for parents in at-risk and referred families to “scapegoat” a preadolescent during family problem-solving sessions. This may undermine progress on family problem solutions and may complicate family-based prevention and treatment programs that use family problem-solving sessions.     

Improving partnerships with families and carers in in‐patient mental health services for older people: a staff training programme and family liaison service

In spite of policies advocating the involvement of families in the care of mental health service users in the UK, there are few examples of initiatives to develop staff confidence and skills in partnership working. This article describes a whole team training initiative and family liaison service to promote family inclusive working on in‐patient wards for older people in Somerset, UK. A three‐day staff‐training programme is described and training outcomes are reported. Staff report a substantial increase in confidence and family meetings held. A pre‐and post‐ training case note audit shows increased consideration of the needs of families. To further increase face to face meetings with families a family liaison service has been established, whereby a staff member with systemic family therapy training joins ward staff to hold family meetings as part of the assessment/admission process. Evaluation of this service has shown it to be effective with positive feedback from families and staff.     

Pyramidal training for families of children with problem behavior

The pyramidal training model was extended to multiple family members of children with behavior disorders. Three primary caregivers were taught to implement individualized treatments for problem behavior. They were then taught how to use various instructional strategies (e.g., prompting, feedback) to teach 2 other family members to implement the treatment. Results showed that pyramidal training was effective in increasing caregiver implementation of treatments across three families.     

The use of children's drawings in multiple family group therapy

This paper describes the advantages, difficulties and techniques of including young children in multiple family group therapy (MFGT). Multiple family group therapy consists of weekly sessions where three or more families meet conjointly with a therapist or cotherapists. Clinical vignettes demonstrate how to use children's drawings with parents to improve family communication. The efficiency of MFGT is compared to family therapy or individual therapy. The effective use of this modality with some children under 10 years is discussed.This research was supported in part by Alcohol, Drug Abuse, and Mental Health Administration Psychiatry Education Branch Grant MH 13882 from the National Institute of Mental Health.     

Assessment of the Use of Spiritual Genograms in Counselor Education

Spiritual genograms collect and organize family information of a religious or spiritual nature. The authors explored the use of the spiritual genogram in counselor education. Graduate counseling students were assigned to construct and present a spiritual genogram within a course titled “Counseling and Spirituality.” An assessment of the quality of the students' learning experiences was conducted. Narrative responses were gathered from 32 advanced and postgraduate students enrolled in 1 of 4 classes over a 2‐year period. The results verified the benefits of this constructivist and experiential learning process. Implications for counselor development and further research are discussed.     

ICTs and Family Functioning: A Study on Portuguese Families with Adolescents and Emerging Adults

Nowadays, information and communication technologies (ICTs) represent an integral part of contemporary family life, introducing changes in families’ functioning. Positive, negative, and mixed aspects of this influence were identified. The present study intends to understand the relationship between ICTs and family functioning among participants from two different family life cycle stages. A total of 157 Portuguese families (307 participants from 97 families with emerging adult children and 169 from 60 families with adolescents) completed measures about the use of ICTs (an adaptation of SEFT/ETEF©) and family functioning (SCORE-15). The number of ICTs and problems related to their use were higher in families with adolescent children. The use of a higher number of ICTs was related to a better level of family functioning in both family groups. However, according to the multiple regression model, the problematic situations related to ICTs use only seem to predict a worse level of family functioning in families with adolescent children. Also, parents and children of each group differed in the number of ICTs used. Some limitations, implications for family therapy, and future research directions are discussed.     

Is elevated risk of child maltreatment in immigrant families associated with socioeconomic status? Evidence from three sources

In this study we tested whether children from Dutch‐immigrant families are at increased risk for maltreatment, and if so, what factors could explain this risk. Three data sources from the second Netherlands Prevalence Study of Maltreatment of Youth (NPM‐2010) were used to answer these questions. First, 1127 professionals from various occupational branches (sentinels) were asked to report each child (including some background information on the child and family) for whom they suspected child maltreatment during a period of three months. Second, we included the 2010 data from the Dutch Child Protective Services and third, 1759 high school students aged 11–17 years filled out a questionnaire on their experiences of maltreatment in the past year. We found that children from traditional immigrant families with a relatively long migration history in the Netherlands (Turkish, Moroccan, Surinamese, and Antillean) and from nontraditional immigrant families (African [except Morocco], Eastern European, Central Asian, and South and Central American; often refugees) were at increased risk for child maltreatment compared to native Dutch families. However, in the professionals’ and CPS data this risk disappeared for the traditional immigrant families after correction for educational level of the parents and for step‐parenthood. Within the group of families with low education or step‐parents, the risk for child maltreatment was similar for traditional immigrant families as for native Dutch families. Nontraditional families remained at increased risk after correction for sociodemographic and family factors. In conclusion, we found that children from both traditional and nontraditional immigrant families are at increased risk for maltreatment as compared to children from native Dutch families. For the traditional immigrants this risk could partially be explained by socioeconomic status. This implies that socioeconomic factors should be taken into account when outlining policies to fight child maltreatment.