Factors Associated with Engagement in Family Therapy

Thirty-eight families who continued in conjoint family therapy were compared on a variety of antecedent variables to 13 families who dropped out. Three potentially important predictors of continuance in family therapy were found: (a) which spouse initiated the search for treatment; (b) the level of authoritarianism in the spouses; and (c) family socioeconomic status. Families that dropped out of treatment tended to be of lower socioeconomic status and contained spouses who had more highly authoritarian attitudes as measured by the California F Scale ( 1 ). Families that contained a severly disturbed member had a poor rate of engagement in treatment, but if both spouses in such a family were low in authoritarianism, the engagement rate was 100 per cent. When both spouses initiated the search for treatment, engagement was also nearly perfect. The difficulty in engaging families from the lowest socio-economic class may be attributed partly to the authoritarian attitudes of the husband.     

Predictors of Client Attrition in a University-Based Community Counseling Clinic

The purpose of this study was to investigate how symptom distress, social role, interpersonal relationships, gender, age, number of supports, and education level predict client attrition in a community sample. Using binary logistic regression and cross-sectional data, the authors examined the predictive impact of 8 variables on adult client attrition in a university-based community counseling clinic. Results indicated that education level, interpersonal relationships, and number of supports significantly predicted attrition. In this sample, gender, age, symptom distress, social role, and race did not significantly predict attrition. Implications for clinical assessment and counseling practice are discussed.     

Family Therapy with a Multiparental/Multispousal Family

This article examines therapy with a Bedouin-Arab family from the Negev, Israel, which consisted of 69 members: a husband, 8 wives, and 60 siblings. The husband, who lived with his youngest wife, paid little attention to his other wives and their children. There was considerable competition, hostility, and jealousy among the wives; no communication between the co-wives or the children of different wives; and a variety of behavioral and psychosocial problems among family members. I describe the varied strategies and systems involved in family therapy. The main strategies were to establish good relationships among the co-wives and to build a coalition among them, including the youngest wife, through group therapy in a medical clinic. A secondary strategy was using the children's problems to get the husband involved in the therapy. With improvement of the children's functioning, and with reduced intra-subfamily hostility, the husband's relationships with his children and wives improved.     

Using a Session Feedback Form in Cognitive Therapy with Children

This article presents a new written form for eliciting session feedback from children. The importance of session feedback is discussed and the specific written form is presented. Clinical applications and advantages of the session feedback form are also reviewed. Additionally, the uses of the session feedback form in supervision are explained. Finally, cautions and limitations are outlined.     

Implementation of DBT-Informed Therapy at a Rural University Training Clinic: A Case Study

University training clinics offer state-of-the-art treatment opportunities for clients, particularly for underserved and underinsured client populations. Little has been published regarding the implementation of Dialectical Behavior Therapy (DBT) in settings such as a university training clinic, which may face challenges in utilizing such a comprehensive treatment. This single-case study describes the application of a DBT-informed treatment with a female BPD client, highlighting how the modifications made can ease implementation in a rural university training clinic. Data collected from DBT diary cards document minimal time demands required for the use of between session-coaching, along with clinically meaningful changes in suicidality and misery ratings, and effective DBT skill use. A discussion of the unique components and contributions of this case to informing potential DBT modifications within university clinics are presented.     

Enhancing Family Therapy with Analytical Psychology

In a postmodern era of changing values and competing world views this article suggests that analytical psychology can enter the epistemological debate and speak to contemporary family therapy. Key concepts and contributions are examined and highlighted with an emphasis on their relevance for enhancing the field of family therapy. Individuation is discussed in light of Jung's analytical treatment stages, which include confession, explanation, education, and transformation. The relevance for family therapy is illustrated throughout the article as each treatment stage is explicated. Jung's emphasis on the spiritual is also discussed with implications for the importance of recognizing and attending to issues of spirituality in family therapy.     

Associated Factors of Suicide Among University Students: Importance of Family Environment

The aim in this study was to underline the importance of family environment as a significant associate of suicide probability among university students. For this aim 226 Turkish university students completed Suicide Probability Scale, Family Environment Questionnaire, Beck Depression Inventory, and Positive and Negative Affect Scale. As a result of the formulated regression analysis, after controlling for the 51% of the total variance accounted for by the control variables (i.e., gender, age, living with family versus away from family, and Grade Point Averages) and mood related variables (i.e., depressive symptoms, and positive and negative affect), family cohesion still emerged as a significant associate of the suicide probability. These findings underline the importance of family relations as a risk factor of suicide among university students.This work has been supported by the Turkish Academy of Sciences, in the framework of the Young Scientist Award Program. (TG-TUBA-GEBİP/2002-1-11).     

Exploring the Use of Family Therapy with Adults with a Learning Disability

Clients with a learning disability have received little attention so far from psychotherapeutic services. Systems thinking seems to have obvious potential for this group, given the stresses which such a disability puts on the client and his family and the variety of different organizations with which they become involved. This paper describes the use of family therapy within a clinic setting and considers similarities to and differences from general family therapy practice. Ways of overcoming communication difficulties are highlighted, as is the need to redress the power imbalance within the therapeutic situation.     

Parent-Child Interaction Therapy With a Spanish-Speaking Family

There is relatively little information on the treatment effectiveness of child behavior-management programs with Spanish-speaking populations. Though there are several empirically supported treatments available in English, research on the applicability of these programs in Spanish is virtually nonexistent. This single-case study discusses the application of Parent-Child Interaction Therapy (PCIT) with a Spanish-speaking mother-child dyad to address the child’'s externalizing behavior problems. Both observational and parent self-report data are presented. Results suggest that PCIT was effective in increasing positive parent behaviors, decreasing child behavior problems, and reducing parental stress level. Implications for future clinical and research work with Spanish-speaking families are discussed.     

Family Therapy with Families of Holocaust Survivors

This is a clinical review of 7 families of Holocaust survivors who presented for treatment because of problems with an adolescent of the third generation. In 3 cases the problem was anorexia, and the remaining 4 had various clinical presentations, mostly related to separation-individuation issues. A common thread in the narratives that unfolded was that the trauma of the grandparent/survivors had been transmitted across subsequent generations to exercise significant influence on the children and grandchildren. Often, a more recent death or separation crisis had been the catalyst for these difficulties or a trigger that activated the Holocaust trauma. An outline of the therapeutic intervention is presented; it was based on a combination of systemic, structural, strategic, and psychodynamic approaches. It is suggested that open acknowledgment of the transgenerational issues played a critical role in moving families toward a more differentiated outcome.     

Therapist Interventions Associated with Productive Emotional Processing in the Context of Attachment-Based Family Therapy for Depressed and Suicidal Adolescents

Productive emotional processing is considered a key change mechanism in attachment-based family therapy (ABFT). This study examined the impact of attachment-based family therapy therapist interventions aimed to promote productive emotional processing of primary adaptive emotions in a sample of 30 depressed and suicidal adolescents who had participated in a larger randomized clinical trial. Results of sequential analyses revealed that relational reframes and therapists’ focus on primary adaptive emotions were associated with the subsequent initiation of adolescents’ productive emotional processing of primary adaptive emotions. In contrast, interpretations, reassurances, and therapists’ focus on adolescents’ rejecting anger toward their parents were all followed by the discontinuation of adolescents’ emotional processing that had already begun. Finally, therapists’ general encouragement of affect and focus on adolescents’ unmet attachment/identity needs were associated with both the initiation of adolescents’ productive emotional processing, and with the discontinuation of such processing once it had already begun. Theoretical and clinical implications are discussed.