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.     

Therapist and Family Values in a Cultural Context

In this article the author discusses the nature, complexity, meaning, and function of values, their presence in the family counselor or therapist as well as in the family in treatment, and the consequences for treatment of the interplay between those two value systems. A brief conceptualization of values is offered, followed by (a) a discussion of family language as a key to identifying salient values, (b) where values are experienced, (c) timing as a value in counseling, (d) the relationship between therapy and the ideology of cultural relativism, (e) midwestern American farming family values thai illustrate an ethnographic approach to family assessment and intervention, and if) therapist values and the professional values of family therapy as a social movement. A number of vignettes from the author's work with families and supervision of family medicine residents in family counseling illustrate the theoretical and methodological issues that are raised.     

Cultural Competence When Working With American Indian Populations: A Couple and Family Therapist Perspective

This article focuses on treating the underrepresented American Indian and Alaska Native population in therapy. The lack of literature on this topic may impede the ability of couple and family therapists (CFTs) to work effectively with members of this group. Issues such as the underutilization of therapy, dropout rates, culturally syntonic joining and assessment, religion, and spirituality are discussed. In addition, potential boundary issues of gift giving and community integration are explored. Finally, cultural strengths are addressed so they may be clinically integrated with this unique population.     

The Benefits of Interprofessional Collaboration for a Pharmacist and Family Therapist

Abstract

Medical family therapists (MedFTs) and pharmacists in the context of interdisciplinary collaboration will be discussed. In an effort to build and reflect on their own professional experiences, recognizing the need to address wellbeing from a multitude of perspectives, and with the goals of improving access to care by identifying potential partnership opportunities between the two professions, the authors synthesized findings from pertinent articles using Medline and PsycInfo. This paper will illuminate the precise roles of MedFTs and pharmacists, how they fit into the interdisciplinary healthcare team, and anticipated facilitators and barriers in this undertaking to enhance patient care.     

Family Therapy for Substance Use among Sexual Minority Youth: A Review of Treatment Options

Abstract

Substance use disorders are nearly twice as common among sexual minority youth (SMY) as among their heterosexual peers. Most applied literature about this population suggests interventions on either the individual or community level, and the benefits of family therapy for this population are often overlooked. The present literature review (a) outlines clinical knowledge related to sexual minority youth and substance use (e.g., prevalence rates, contributing factors), (b) discusses the importance of clinical self-awareness around these topics, and (c) outlines clinical behaviors and interventions from literature that may be employed when working with substance-using SMY and their families.     

Navigating Critical Theory and Postmodernism: Social Justice and Therapist Power in Family Therapy

The family therapy field encourages commitment to diversity and social justice, but offers varying ideas about how to attentively consider these issues. Critical informed models advocate activism, whereas postmodern informed models encourage multiple perspectives. It is often not clear how activism and an emphasis on multiple perspectives connect, engendering the sense that critical and postmodern practices may be disparate. To understand how therapists negotiate these perspectives in practice, this qualitative grounded theory analysis drew on interviews with 11 therapists, each known for their work from both critical and postmodern perspectives. We found that these therapists generally engage in a set of shared constructionist practices while also demonstrating two distinct forms of activism: activism through countering and activism through collaborating. Ultimately, decisions made about how to navigate critical and postmodern influences were connected to how therapists viewed ethics and the ways they were comfortable using their therapeutic power. The findings illustrate practice strategies through which therapists apply each approach.     

Observations on Loss and Family Development

This article examines the role of death and loss in family developmental processes. Aspects of family development are described, followed by an exploration of the impact of loss on family functioning and development. We present a typology of initial family response styles to the death of a member as well as some immediate and longer-term patterns of adaptation after a loss. The article concludes with a case example and a discussion of multigenerational sequelae of unresolved bereavement in family systems.     

A Framework for Optimizing Work–Life Balance Practices in Australia: Perceived Options for Employee Support

Drawing from institutional theory, this study explored work–life balance (WLB) practices in Australian small and medium enterprises. Data were obtained from a sample of 219 managers. The authors identified organizational characteristics associated with the adoption of 4 groups of WLB practices using a causal model. Of the 3 models tested, the final model supported a conceptual framework that included 4 domains: flexible work options, leave programs, support benefits, and care arrangements. The findings suggested that organizational characteristics—namely, industry type and location—affected WLB practices. Implications for theory and practice are discussed along with avenues for future research.