Family Therapy with East Indian Immigrant Parents Rearing Children in the United States: PARENTAL CONCERNS,THERAPEUTIC ISSUES,AND RECOMMENDATIONS

The paper focuses on East Indian immigrant parents and some of the post-immigration difficulties they experience in their attempts to rear culturally East Indian children within the United States cultural context. Concerns specific to parenting children in the US, and therapeutic issues East Indian immigrant parents bring to therapy are presented and discussed. Effective therapy with East Indian immigrant families requires that therapists be flexible in their therapeutic approaches with these families, and become more knowledgeable about the varieties of East Indian families, their cultural beliefs, values, and norms. Recommendations for culturally effective therapy are offered.David A. Baptiste, PhD, is Senior Psychologist, New Mexico Corrections Department, and in the private practice of Marital and Family Therapy, 2709 Sim Ave. Las Cruces, NM 88005 (DAB2709@aol.com).*The author is an immigrant from Guyana, South America, an Indian diaspora country. The experiences and observations discussed here are culled from 30 years of clinical practice in several US locations with a variety of East Indian Families from the Indian subcontinent and other diaspora countries.     

Depicting Caribbean Theological Libraries

Theological libraries in the Caribbean have suffered from invisibility, so this study aims to bring these libraries to the fore. It presents key features of the libraries and seeks to determine if these are influenced by the libraries’ denominational affiliation, geographic location, and size. Geographically speaking, the target area was twenty-nine Caribbean territories. Data was gathered using a questionnaire containing mainly open-ended questions in English and Spanish, which was mostly administered face-to-face. The general results are offered first: the number of libraries found, their geographic location—whether in the English, Spanish and Dutch-speaking Caribbean—their denominations, and their size. These results are followed by a more detailed presentation focusing on classification schemes, subject headings, automation, and staffing at the supervisory level. The findings are then analyzed by denomination, location, and size. The article ends with a discussion of the results, comparing theological libraries in the Caribbean with theological libraries in the United States, Asia, and Europe. The study concludes that denomination and location have not affected the findings; but size has to some extent. Also, in some areas, Caribbean theological libraries resemble those in North America, while in others they resemble those in Asia and Europe.     

Family therapy with Spanish-heritage immigrant families in cultural transition

Increasing numbers of Spanish-heritage immigrant families in the United States are beginning to seek therapy for family conflicts related to their adapation to the new country/culture. This paper focuses on the difficulties experienced by these families and presents issues specific to therapy with them. Effective therapy with these families requires that therapists focus on clarification of the differential adaptation rates of family members and facilitate a resolution of the family's transitional conflicts(s). Six cases involving such families are presented.David A. Baptiste, Jr., PhD, is a Psychologist and Marital and Family therapist in the counseling center at New Mexico State University and in private practice, Las Cruce, NM.Revision of a paper presented to the International Round Table for the Advancement of Counseling, Annual Conference, Utrech, The Netherlands, July, 1985. The author expresses appreciation to Judith Landau-Stanton for her helpful review of an earlier draft of this paper.     

Sexuality,Intimacy, and Recovery

Human sexuality is an inseparable part of the yearning for intimacy, merging, and touch, both for people in general and for those with severe mental disorders. The exploration and acceptance of sexuality and the yearning for intimacy are vital to the recovery process of people with severe mental disorders. Despite this importance, therapists appear to disregard sexual issues in therapy with people with severe mental disorders. This article discusses the sexuality difficulties of these patients resulting from their personal history and examines the difficulties of therapists and therapeutic institutions in dealing with these patients’ sexuality-related issues.     

Change: How do we recognize it?

The paper seeks to examine the working assumptions that guide us as therapists engaged in the attempt to facilitate change in families. It summarizes a piece of preliminary research based on the responses of a group of therapists working in different agencies. A questionnaire on change was developed and given to the therapists followed by a group discussion.
The results suggest that therapy teams, and families, have common sense ideas about:

• the beginning, and end of a period of change;

• types of change—those falling into four categories; of behavioural, structural, communication and experiential.

Our results suggest that difficulties in therapy may be associated with a failure amongst the therapists in a team to negotiate their mutual assumptions about change. In addition the process of therapeutic change is seen as involving a negotiation between the family and the therapists about what will count as change.
The data were gathered from a group of therapists attending a local meeting of the Association for Family Therapy in Plymouth.     

Immigrant Stepfamilies

Immigration and remarriage are two stressful events that impact on family's functioning and well being. This article examines the effects on families of experiencing both of these transitions simultaneously. A case illustration is presented and implications for practice and for future research are discussed. The article is based on the clinical experience of the writer as well as on her study of stepfamilies from diverse cultural backgrounds.     

Family therapy and outcome: Relationships between therapist and family styles

This study examined therapeutic outcome for a group of 175 clinic families divided into levels of family competence and style, and, later, into seven clinical groupings. The division into these groups was based on the level of rated Competence and Style determined by using the Beavers Systems Model. Therapists also rated their level of Openness/Sharing Strategy, Power Differential, and Partnership with the family at the third session. Results indicate that more competent families who fared well in therapy had therapists who formed a partnership, disclosed strategy, and employed a minimal power differential with the family. The most disturbed families, and those with a Centrifugal style, did better with therapists employing a high power differential and lower levels of openness and partnership. The study also presented the distribution of individual diagnoses by family groups. Implications for family therapists, including the value of family assessment, are provided.     

Assessing Parenting Behaviors in Euro–Canadian and East Asian Immigrant Mothers: Limitations to Observations of Responsiveness

The use of parenting measures that are developed for use with Western families without testing their validity among families from non-Western cultural backgrounds may not be appropriate. Similar parenting behaviors may affect child outcomes in different ways across different cultures. This study examined the cross-cultural validity of an observational Maternal Responsiveness coding system and of self-reports of lax/inconsistent parenting in Euro–Canadian (n = 23) and East Asian immigrant mothers (n = 23) of 4- to 7-year-old sons. In Euro–Canadian mothers, observed parenting responsiveness was associated with less lax/inconsistent parenting and fewer child behavior problems. In East Asian immigrant mothers, however, observations of greater responsiveness were not related to reports of lax/inconsistent parenting, and were associated with greater child behavior problems. Implications for the use of these parenting measures across culture groups are discussed.     

Immigrant Families’ Perception of the Causes,First Manifestations,and Treatment of Autism Spectrum Disorder

Compared to families from their host country, families from immigrant backgrounds who have a child with autism spectrum disorder (ASD) tend to experience greater difficulties in accessing, using, and complying with intervention services for their child. This disparity may be partially accounted for by cultural differences in how families perceive the causes and symptoms of ASD as well as their treatment priorities. The present study sought to document these perceptions in immigrant families living in a Canadian city. Forty-five parents from Latin America, Africa, Western and Eastern Europe, the Caribbean, East Asia, and the Middle East participated in a semi-structured interview. These data were examined qualitatively through thematic analysis to first document all parents’ perceptions, then to contrast mothers’ and fathers’ responses, and finally to examine common themes as a function of country of origin. The most frequently mentioned causes of ASD were environmental factors such as vaccines and diet. Moreover, some participants did not know the cause of their child’s ASD. The majority of parents cited the absence of speech as one of the first symptoms noted in their child. Priorities for intervention varied: mothers tended to prioritize speech therapy, whereas fathers favored support in school. Taken as a whole, these findings highlight the need to implement informational programs for these families.     

Aging families: The personal, permanent group

Later life families present a very special instance of group psychotherapy with older adults. This paper describes the challenges faced by later life families, including major life events to which multiple family members must adapt, and the increasing dependency of some elderly members. A developmental framework for later life problems is offered as a therapy frame useful to families. Key aspects of therapy process with later life families are also presented. Goals, strategies, structures of therapy, and the therapist’s role are all shaped by the long and intimate history of the members of this special form of group.     

What we say we do: results of the 1997 UK Association of Family Therapy Members Survey

This study represents the first UK national survey of family therapists and systemic practitioners. The aim was to provide demographic information of systemic practitioners/family therapists and also to describe their clinical practice. The sampling frame used was the UK Association of Family Therapy membership list and all members were sent a postal questionnaire. The response rate was 33% with 495 out of 1500 questionnaires returned. Among the major findings were: systemic practitioners/family therapists are most likely to work for an NHS trust, to use family therapy techniques/systemic ideas predominantly, and to treat a broad range of client issues. They are also most likely to work with families, and therapy is relatively short term (five to eight sessions) regardless of whether they treat families, couples or individuals. Most family therapists/systemic practitioners use some measure of outcome, although frequently this will be feedback from clients. Supervision is sought by the majority of AFT members. In spite of some methodological limitations, the study provides interesting insights into the training and practice of UK family therapists and systemic practitioners which appears to differ in some respects from our American colleagues. It also provides a baseline for future surveys, making it possible to describe the developments of family therapy and systemic practice in this country.     

Leaving home: later stages of treatment

While the Leaving Home approach has greatly enhanced the work of many therapists struggling to help troubled young adults and their families, a more thorough consideration of the difficulties that often arise in the later stages of Leaving Home treatment is still needed. This paper examines the ways in which the function of the symptom and difficulties with life-cycle transitions may lead to problems in the later stages of treatment. Common manifestations of later-stage problems, including loss of therapeutic focus and failure of parents to follow through on plans are examined. Direct and indirect strategies for addressing these problems are identified and guidelines for their use presented.     

Medical or relational language? Problem and goal formulation in family therapy with adolescents conducted in a psychiatric outpatient setting

The constructionist view assumes that therapy participants' maps of understanding depend on the institutional context and their personal perspectives. The purpose of this study was to investigate the initial maps of difficulties reported by family members starting family therapy. 106 families that were referred to a psychiatric institution for outpatient family therapy were asked open-ended questions regarding the context of the referral, and goal and problem formulation for the therapy. The data were analysed via the consensual qualitative research-modified (CQR-M) method, and comparisons between groups were performed. The obtained results show a diversity of perspectives. Of interest was the predominance of medical language in describing the problem and relational language in describing the goal of therapy. An analysis of differences between mothers, fathers, adolescent patient and their siblings was also performed. The findings highlight the complexity of notions that families start family therapy with and may help therapists navigate through the therapeutic contract formulation process.     

Practising family therapy in India: how many people are there in a marital subsystem?

Systemic therapy would appear to be a viable form of treatment for people who exist in cultures that contain complex, extended family systems, such as those found in India. The practice of family therapy in India has evolved from Western concepts. These concepts appear to offer Indian therapists relevant and practical ways of working with families. However, some of these concepts need modifying before they can be used in an Indian context. Indian families may have very different worldviews and ideas of 'self' compared to families in the West, leading to different family organization. The situation can be further complicated by the cultural norms of therapists themselves. Therapists in India are often highly educated, come from upper-middle-class families and have been exposed to different cultures. They increasingly share many of the values of their counterparts in the West. At the same time, they retain aspects of their own cultural heritage, which is also the dominant culture for a large number of the families with whom they work. Thus, not only must Indian family therapists seek to work in culturally appropriate ways; they must also tolerate their own internalized conflicts regarding differing cultural norms. With the use of clinical data, this paper describes some of the personal and professional problems experienced by an Indian family therapist working with Western constructs of family organization.     

Police Families: Stresses,Syndromes, and Solutions

Law enforcement families experience a variety of both commonplace and unique stressors. This article discusses the main forms of police family stresses and crises and offers a range of practical solutions that family therapists can use to help these families cope and thrive. Especially with this kind of population, the emphasis is on both direct clinical services and a coaching-style, self-empowerment model that therapists can productively utilize in helping officers and their families to help themselves.     

Should I give advice? A systemic view

Giving advice is considered from i he viewpoint of Milan systemic family therapy, and the possibility of its always being a therapeutic error is discussed. The beliefs of both professionals and clients concerning advice are examined. What can systemic therapists do if families ask for advice, and when is direct advice useful? Effects on therapists and families of giving advice are discussed as well as ways of limiting possible damage to the process of therapy. Questioning techniques are considered as an alternative that allows families to discover their own solutions.     

Latino immigrant parents’ experiences raising young children in the absence of extended family networks in Canada: Implications for counselling

Latinos account for 10% of newcomers to Canada, and most are families with young children under the age of 10. In their homelands, Latinos are supported in the parenting process by extended family networks due to the cultural value of familism. Migration to Canada disrupts extended family care-giving, as only one’s spouse and dependent children are allowed to accompany the principal immigration applicant. The purpose of this qualitative study was to explore Latino immigrant parents of young children’s experiences of parenting in Canada in the absence of their extended families, and how they adjust to this new lived reality. An ethnically mixed sample of 10 parents (5 mothers and 5 fathers) participated in semi-structured interviews, which were analysed via thematic analysis. Emerging themes suggested a perceived “uploading” of parental responsibility after migration, producing fear, worry, sadness, loneliness and burnout. These experiences resulted in the negotiation of new parenting partnerships with unanticipated positive outcomes: increased nuclear family cohesion and increased father involvement in childrearing. Parents also described how new support networks were established in surprising ways, such as through interfaces with the health care system. Interventions for facilitating the successful adaptation of Latino parents in a similar predicament are discussed.     

Couple and family therapists’ experiences with Telehealth during the COVID-19 pandemic: a phenomenological analysis

In designing this study, we aimed to obtain a rich, phenomenological understanding of the experiences of couple and family therapists who transitioned their practice to telehealth due to the COVID-19 pandemic. Twelve experienced therapists from the U.S., Spain and Australia were interviewed in depth about their experiences of this transition, particularly how they developed and maintained therapeutic alliances in a virtual context with couples and families suffering pandemic-related hardships. The qualitative analysis identified 40 themes reflecting participants’ initial impressions of telehealth and their positive and negative reactions and adjustments to practicing remotely. Upon overcoming some initial wariness about providing services virtually, many participants described advantages to this way of working with families. Indeed, participants were creative in adjusting to this novel therapy modality, finding new ways to connect emotionally with their clients, to work meaningfully with children, to assess in-session dynamics, and to ensure their clients’ privacy and safety. Notably, several participants commented on the relatively slower development of alliances with new cases and the challenge of repairing split alliances between family members. Many of these difficulties were described as due to having minimal access to their clients’ raw emotions and the inability to use typical systemic interventions, such as moving family members around physically. Participants also reflected on being a “participant observer” to the upheaval caused by the pandemic, a distressing experience they shared with the families in their care.

     

Engaging refugee families in therapy: exploring the benefits of including referring professionals in first family interviews

The possible benefits of including referring professionals in the first family interviews are being explored as a way to engage refugee families in therapy. Families in exile confront a number of problems related both to premigration traumatic exposures and to present adaptation processes. Refugee clients and the referring professionals in the larger system frequently see the problems and their solutions quite differently. This situation may often result in unclear working alliances in a context of therapy. We will describe first family interviews in which referring professionals are interviewed about their reasons for referrals, and where the families are invited to discuss these considerations. The conversations permit families, referrers, and therapists to reflect upon differences in positions and perspectives. Their experiences suggest that agreements or contracts based on these joint interviews are less ambiguous and more clearly formulated than contracts based on interviews with families alone. Finally, these experiences are discussed as a potentially valuable approach in a cross-cultural context.