Marriage and Family Therapists' Comfort Level Working With Gay and Lesbian Individuals,Couples, and Families

As professionals, therapists should be prepared to work with a diverse population. The purpose of this study was to explore predictors of American Association of Marriage and Family Therapy Clinical Members' comfort level in working with gay and lesbian individuals, couples, and families. Results indicated that therapists' scores on the Support for Lesbian and Gay Human Rights Scale predicted their comfort level in working with gay and lesbian individuals, couples, and families. The challenge for training programs is to assist therapists-in-training and supervisors with self-exploration and to increase opportunities for interactions with gays and lesbians.     

Assessment of Parents,Couples, and Families in Dialectical Behavior Therapy

Family intervention in Dialectical Behavior Therapy (DBT) is a core part of multiple required functions of DBT, providing opportunities for skill training (including relationship-specific skills that are not covered in individual DBT), skill generalization, and direct intervention into the social and family environment. In order to intervene with parents, partners and other family members efficiently and effectively, therapists must first conduct a careful assessment. The core relationship transaction of emotion vulnerability/dysregulation and inaccurate expression leading to invalidating responses (and vice versa) is highlighted, as are the treatment targets in DBT with families, which inform assessment targets. Then, two core assessment procedures are explored, with clinical examples: (a) conducting “double chain” analyses, demonstrating how one person’s social or relationship responses affect the other’s emotional arousal (and vice versa); and (b) direct behavior observation of family interactions, which allow treatment targets to be identified efficiently. These two assessment strategies may also be combined. Implications for family interventions are discussed.     

Privileged Communication in Therapy: Special Problems for the Family and Couples Therapist

Misconceptions concerning the existence and scope of the legal privilege for communications in therapy are considered. Basic limitations on the protection afforded by the privilege are treated, as are some major specific exceptions and waivers, particularly as they raise special difficulties for the therapist who works with groups, couples, and families. Practical suggestions for the therapist and directions for policymaking by the helping professions are presented.     

Family and Couples Therapy in a Time of War

SUMMARY

In this article the issue of professional responsibility of couples and family therapists is raised with regard to the war in the Persian Gulf. Implications are discussed for families and couples coping with the stress of war and its aftermath.     

Diagnoses,Relational Processes and Resourceful Dialogs: Tensions for Families and Family Therapy

The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM‐5), given its psychiatric focus on mental disorders in individuals, presents families and family therapists with challenges. Despite considerable controversies over its adoption, the DSM‐5 extends a process of standardizing a language for human and relational concerns. No longer a diagnostic language of professionals alone, its use is medicalizing how mental health funders and administrators, as well as clients, respond to human concerns. For family therapists who practice systemically, particularly from poststructuralist and strengths‐based orientations, many tensions can follow when use of the DSM‐5 is expected by mental health administrators and funders, or by clients who present concerns about themselves or a diagnosed family member. In this paper, I explore how such DSM‐5 related tensions might be recognized, navigated, and negotiated in the practice of family therapy with clients, and with administrators and funders.     

Need for Family Therapy Services for Middle-Class Families in India

This qualitative study explored the needs of Indian middle-class families for family therapy services. Four focus group interviews were conducted with middle-class parents in Madras, India. Participants were introduced to the concept and practice of family therapy and were encouraged to take a more active role in supporting the services they suggested. Participants identified problems faced by Madras middle class families and five different types of services that they were aware of. Three categories of need for family therapy were identified from the narratives of the participants. Several themes fit in each of the three categories. Implications for clinical application 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.