A Family Affair: Examining the Impact of Parental Infidelity on Children Using a Structural Family Therapy Framework

Infidelity has a permeating impact on social systems, but no system is more impacted by infidelity than the nuclear family. This paper examines the impact of parental infidelity on the family using a structural family therapy (SFT) framework. Conceptualizing and treating infidelity from an SFT approach provides a systemic understanding of how interactions between the parental units about infidelity impact parent–child dynamics. Clinical recommendations are outlined for couple and family therapists to help families find healthy and adaptable ways to create and maintain structures that minimize the harmful impact of infidelity on the family system.     

AN ISLAMIC APPRAISAL OF MINDING THE GAP

The neglect of psycho‐spiritual needs of patients as they traverse the modern healthcare system has been a featured theme in medical literature over the past decade. This literature, which often highlights in‐patient palliative care, as well as acute and critical care settings, influences practice guidelines and protocols of doctors and nurses. In this essay, I review some of the pertinent issues raised in the literature and examine the validity of placing an ethical perspective on this issue. I also compare Islamic theocentric perspectives with secular, non‐theistic perspectives on restoring psycho‐spiritual care for patients. I then develop a framework for pastoral intervention based on aspects of the Islamic tradition and elaborate this framework by addressing clinical contexts and cases. The essay is an exposition based upon a review of the modern medical literature, an analysis of some of the traditional Islamic written sources, and the observations of the investigator, a practicing physician and an American Muslim.     

‘You were not born here,so you are classless,you are free!’ Social class and cultural complex in analysis

The unconscious impact of differences in culture and social class is discussed from the perspective of an analyst practising in London whose ‘foreign accent’ prevents patients from placing her within the social stratifications by which they feel confined. Because she is seen by them as an analyst from both ‘inside’ and ‘outside’ the British psycho‐social fabric and cultural complex, this opens a space in the transference that enables fuller exploration of the impact of the British social class system on patients’ experience of themselves and their world. The paper considers this impact as a trans‐generational trauma of living in a society of sharp socio‐economic divisions based on material property. This is illustrated with the example of a patient who, at the point of moving towards the career to which he aspired, was unable to separate a sense of personal identity from the social class he so desperately wanted to leave behind and walk the long avenue of individuation. The dearth of literature on the subject of class is considered, and the paper concludes that not enough attention is given to class identification in training.     

Applying a Family Resilience Framework in Training,Practice, and Research: Mastering the Art of the Possible

With growing interest in systemic views of human resilience, this article updates and clarifies our understanding of the concept of resilience as involving multilevel dynamic processes over time. Family resilience refers to the functioning of the family system in dealing with adversity: Assessment and intervention focus on the family impact of stressful life challenges and the family processes that foster positive adaptation for the family unit and all members. The application of a family resilience framework is discussed and illustrated in clinical and community‐based training and practice. Use of the author's research‐informed map of core processes in family resilience is briefly noted, highlighting the recursive and synergistic influences of transactional processes within families and with their social environment. Given the inherently contextual nature of the construct of resilience, varied process elements may be more or less useful, depending on different adverse situations over time, with a major crisis; disruptive transitions; or chronic multistress conditions. This perspective is attuned to the diversity of family cultures and structures, their resources and constraints, socio‐cultural and developmental influences, and the viability of varied pathways in resilience.     

Understanding social suffering: a phenomenological investigation of the experience of inequality

As global market conditions erode traditional forms of solidarity, there is evidence of psychological disturbance among a number of social groups as a direct result. This paper investigates this issue among a disadvantaged working‐class group in South Yorkshire (England) and argues that understanding emerging forms of social suffering requires both a social and a person‐centred approach that transcends normal clinical/psycho‐analytic accounts. The attempt here is to create well‐founded terms of reference that will support investigators who seek to embed agents' case histories in a social‐psychological framework as they set about illuminating social pathologies. The paper attempts to trace the contours of pathology holistically by following its traces as they are manifest in everyday experience and articulated in conversation; thus putting agents' everyday perceptions of the data at the heart of this account. Copyright © 2005 John Wiley & Sons, Ltd.     

Family Therapy and Childhood-Onset Schizophrenia: Pursuing Clinical and Bio/Psycho/Social Competence

Childhood-onset schizophrenia is perceived as more complicated because of its complexity, pervasive duration, and impact on individual and family functioning. Viewing the symptoms of childhood schizophrenia as creating a bio/psycho/social competence within which the therapist and family must interact may help contribute to treatment success. Competent family therapists working within this culture should be knowledgeable about the characteristics of childhood-onset schizophrenia, aware of their own biases towards psychosis, and skillful in its treatment. Guidelines are provided to help therapists identify their attitudes about schizophrenia and understand appropriate skills for treating the disorder.     

Structural Family Therapy and Autism Spectrum Disorder: Bridging the Disciplinary Divide

ABSTRACT

Applied Behavior Analysis (ABA) is an evidence-based practice approach for the treatment of individuals with autism. The systemic effects of autism suggest that family therapy would considerably enhance the treatment of individuals with autism. Marriage and family therapy (MFT) training does not routinely include exposure to autism beyond the associated diagnostic criteria. Structural Family Therapy (SFT) is a systemic model that is familiar to those trained in family therapy and appropriate for the needs of families affected by autism. Therefore, the authors have used SFT as a foundation for supervising MFT trainees working in an autism treatment setting.     

Can we Build on Social Movement Theories to Develop and Improve Community‐Based Participatory Research? A Framework Synthesis Review

A long‐standing challenge in community‐based participatory research (CBPR) has been to anchor practice and evaluation in a relevant and comprehensive theoretical framework of community change. This study describes the development of a multidimensional conceptual framework that builds on social movement theories to identify key components of CBPR processes. Framework synthesis was used as a general literature search and analysis strategy. An initial conceptual framework was developed from the theoretical literature on social movement. A literature search performed to identify illustrative CBPR projects yielded 635 potentially relevant documents, from which eight projects (corresponding to 58 publications) were retained after record and full‐text screening. Framework synthesis was used to code and organize data from these projects, ultimately providing a refined framework. The final conceptual framework maps key concepts of CBPR mobilization processes, such as the pivotal role of the partnership; resources and opportunities as necessary components feeding the partnership's development; the importance of framing processes; and a tight alignment between the cause (partnership's goal), the collective action strategy, and the system changes targeted. The revised framework provides a context‐specific model to generate a new, innovative understanding of CBPR mobilization processes, drawing on existing theoretical foundations.     

Revisiting an era in Germany from the perspective of adolescents in mother‐headed single‐parent families

Much of the documented work on families headed by single mothers is based on empirical evidence from North America and a few Anglo‐Saxon countries. Many researchers consider single‐mother families to be at a disadvantage because of nonsupportive family policies. This paper uses data from a social context that differed hugely in this respect—the German Democratic Republic (GDR). The GDR provided extensive state support to single‐mother families and, thus, was vastly different from other countries. Based on a literature review and using Hill's family stress theory, this paper is based on the hypothesis that adolescents living in mother‐headed single‐parent families and those living with their biological parents would have near‐similar social outcomes (display of psychosomatic symptoms, perception of stress, display of delinquent behaviour, life satisfaction, academic self‐efficacy, and academic grades) and family‐related outcomes (relationship with parents and perception of family environment). Further, it was hypothesized that adolescents from stepfather families would display more negative social and family‐related outcomes when compared with respondents from the other two family types. The sample comprised 1302 adolescents (M  =  13.82 years, SD  =  1.88) who were recruited from the city of Leipzig in the year immediately following German unification, 1991. Respondents reported on measures of psychosomatic symptoms, stress, delinquency, life satisfaction, academic achievement, and family‐related variables. ANCOVAs, with a control for income adjusted for household size, indicated adolescents from single‐mother families to have very similar experiences to respondents living with their biological parents on all measures except for their assessment of family environment. Adolescents living in stepfather families reported the least favourable experiences. Results are indicative of a social context in Germany that, despite unification and the early hardships for single‐mother families, still provided these families with more opportunities than constraints.     

Subjectivity,Not Personality: Combining Discourse Analysis and Psychoanalysis

Mainstream psychology can often be criticized for turning the liberal concerns of psychologists into conservative practices focusing on the individual. In the United Kingdom, the discursive turn in social psychology has been marked by an audacious body of work critical of cognitive attempts to theorize the social. A particular psycho‐discursive strand has emerged, which combines discourse analysis and psychoanalytic theory in an attempt to change both the subject of, and the subjectivity (re)produced by, mainstream psychology. This paper reviews three different psycho‐discursive approaches: (i) Hollway and Jefferson's Free Association Narrative Interview method; (ii) Billig's Psychoanalytic Discursive Psychology; (iii) Parker's Lacanian excursions into social psychology. In these psycho‐discursive approaches, ‘subjectivity’ replaces personality as the key theoretical construct where the social forms part of who we are and these approaches seem to offer social psychologists the theoretical tools to start to appreciate how individual personality and social context are intimately connected.     

Fortalezas Familiares Program: Building Sociocultural and Family Strengths in Latina Women with Depression and Their Families

The purpose of this article is to describe Fortalezas Familiares (FF; Family Strengths), a community‐based prevention program designed to address relational family processes and promote well‐being among Latino families when a mother has depression. Although depression in Latina women is becoming increasingly recognized, risk and protective mechanisms associated with children's outcomes when a mother has depression are not well understood for Latino families. We begin by reviewing the literature on risk and protective psychosocial mechanisms by which maternal depression may affect Latino youth, using family systems theory and a developmental psychopathology framework with an emphasis on sociocultural factors shaping family processes. Next, we describe the theoretical basis and development of the FF program, a community‐based 12‐week intervention for Latina immigrant women with depression, other caregivers, and their children. Throughout this article, we use a case study to illustrate a Latina mother's vulnerability to depression and the family's response to the FF program. Recommendations for future research and practice include consideration of sociocultural processes in shaping both outcomes of Latino families and their response to interventions.     

Direct and Mediating Effects of an Anxiety Sensitivity Intervention on Posttraumatic Stress Disorder Symptoms in Trauma-Exposed Individuals

Anxiety sensitivity (AS), or fear of anxious arousal, is a higher-order cognitive risk-factor for posttraumatic stress disorder (PTSD) composed of lower-order physical, cognitive, and social concerns regarding anxiety symptoms. Brief and effective interventions have been developed targeting AS and its constituent components. However, there is limited evidence as to whether an intervention aimed at targeting AS would result in reductions in PTS symptoms and whether the effects on PTS symptoms would be mediated by reductions in AS. Furthermore, there is no evidence whether these mediation effects would be because of the global or more specific components of AS. The direct and indirect effects of an AS intervention on PTS symptoms were examined in a sample of 82 trauma-exposed individuals (M age = 18.84 years, SD = 1.50) selected based on elevated AS levels (i.e., 1 SD above the mean) and assigned to either a treatment (n = 40) or an active control (n = 42) condition. Results indicated that the intervention led to reductions in Month 1 PTS symptoms, controlling for baseline PTS symptoms. Furthermore, this effect was mediated by changes in global AS and AS social concerns, occurring from intervention to Week 1. These findings provide an initial support for an AS intervention in amelioration of PTS symptoms and demonstrate that it is primarily reductions in the higher-order component of AS contributing to PTS symptom reduction.     

An Embodied‐Socio‐Psychological Perspective in Health Psychology?

The author introduces an alternative perspective to the biopsychosocial model in health psychology. In the first part of her article, she presents the major critiques levelled at mainstream research in health psychology. In the second part, she reviews fundamental studies on the place of emotions in corporeality, then studies that are more psycho‐socially oriented and focus on the relationship between health and the social. This literature review shows the necessity of an alternative perspective. The Embodied‐Socio‐Psychological (ESP) perspective which is presented here is based on a historico‐cultural and developmental approach, drawing from Wallon and Vygotsky’s work and supported by current research in neuroscience on mirror neurons as well as by early interaction psychology. The ESP perspective enables accounting for the articulation between embodied emotional development and the development of superior psychological functions within the social and cultural field; during the crisis of serious illness, this articulation is strongly disrupted in its embodied emotional, embodied social as well as socio‐psychological foundations. This perspective proposes going beyond a notion of the ill human being as a juxtaposition of BPS variables, in order to account for the complementary, indissociable and complex articulation of the corporeal, the social and the psychological. It refers to a theoretical approach that is clearly psychological and no longer anchored in a biomedical definition.     

The Impact of Cancer on Psychological and Social Outcomes

Cancer is now the biggest cause of mortality worldwide. Although the debilitating physical symptoms of cancer have long been known, the psychological and social impacts of cancer have become the subject of examination only relatively recently. The psychological outcomes that have been examined are primarily negative emotional variables, e.g., anxiety, but emerging research has focused on positive emotional variables, e.g., post‐traumatic growth, or cognitive outcomes. In this article, we provide a synthesis of reviews that have addressed the psychosocial impact of cancer. The framework for this synthesis is provided by a conceptualisation in which the presence of cancer impacts on psychosocial outcomes either directly or via mediating variables, including physical symptoms and treatment, and that this effect may be moderated by several variables, some characteristic of the person with cancer (demographic or personality‐related variables) and some characteristic of their environment (social support and medical variables). We also briefly examine the impact of cancer on the broader family unit following cancer diagnosis, treatment, survivorship and bereavement. We conclude that the heterogeneity of the cancer experience highlights the need for theoretically driven research and consistency in measurement approaches to determine mechanisms by which cancer exerts influence on psychosocial outcomes. This would allow development and delivery of targeted psychological interventions and a clearer delineation of the roles of the various parties, including clinical psychologists, family members and policymakers.     

Trauma exposure and post-traumatic stress symptoms among Syrian refugee youth in Jordan: Social support and gender as moderators

This study assessed relations between exposure to trauma and post-traumatic stress (PTS) symptoms, and whether perceived social support from family and friends and gender moderated these associations. Syrian refugee youth (N = 418, 55.0% female) attending public schools in Jordan participated. Boys reported more age-adjusted PTS symptoms than girls. Analyses revealed that family support and gender moderated the association of trauma on PTS symptoms. For males, the benefits of family support were most evident under conditions of high traumatic stress exposure, while for females, benefits of family support were evident when no loss or injury to family members had been reported. Support from friends was not helpful for either gender. School- or family-based interventions designed to treat PTS symptoms need to consider the different needs of boys and girls, particularly within the Syrian Muslim cultural context.     

Integrating family therapy in adolescent depression: an ethical stance

Adolescent depression, particularly where suicidal behaviour is involved, is a complex and pressing mental health problem and demanding for families, therapists and services alike. This article reviews the evidence-based literature for adolescent depression including family therapy approaches. It suggests an integrative treatment approach that includes individual psychological treatment like CBT, medication where required and a family therapy intervention is supported by the literature. The focus of the latter is psychoeducation, building resilience and hope, enhancing communication, reducing relational conflict between parents and adolescents and addressing attachment and relationship issues. A systemic framework for integrating family therapy in the evidence- based treatment of adolescent depression is described. This is based on an ethic of hospitality towards different languages of therapy, which is illustrated by a detailed example from family therapy practice.     

Rethinking NIMBYism: The role of place attachment and place identity in explaining place‐protective action

The ‘NIMBY’ (Not In My Back Yard) concept is commonly used to explain public opposition to new developments near homes and communities, particularly arising from energy technologies such as wind farms or electricity pylons. Despite its common use, the concept has been extensively critiqued by social scientists as a useful concept for research and practice. Given European policy goals to increase sustainable energy supply by 2020, deepening understanding of local opposition is of both conceptual and practical importance. This paper reviews NIMBY literature and proposes an alternative framework to explain local opposition, drawing upon social and environmental psychological theory on place. Local opposition is conceived as a form of place‐protective action, which arises when new developments disrupt pre‐existing emotional attachments and threaten place‐related identity processes. Adopting a social constructivist perspective and drawing on social representation theory, a framework of place change is proposed encompassing stages of becoming aware, interpreting, evaluating, coping and acting, with each stage conceived at multiple levels of analysis, from intrapersonal to socio‐cultural. Directions for future research and potential implications of the place‐based approach for public engagement by energy policy‐makers and practitioners are discussed. Copyright © 2009 John Wiley & Sons, Ltd.     

Is domestic violence a gender issue? Views from a British city1

Domestic violence involves the abuse, whether emotional, physical, sexual and/or economic, of one or more family (or ex‐family) members by another family member within the home or wider domestic context. It is typically associated with increasing entrapment, injury, medical complaints, psycho‐social problems and (sometimes) unsuccessful help‐seeking. Research evidence demonstrates that domestic abuse is prolific, prolonged, impacts physically, emotionally and economically upon women and children in particular, over the long‐term including well after they are ‘safe’ from the perpetrator. Furthermore, such abuse is widespread and happens all over the world. The findings reported here are from an observational population survey conducted in one British city to assess awareness of domestic violence. While there appears to be a broadly held and well‐informed definition of what actions constitute domestic violence and why it occurs, there are striking differences in perspective concerning public awareness of the frequency of domestic violence and knowledge of its importance as a safety issue indicating that it is still not seen generally as a serious social problem. Copyright © 2004 John Wiley & Sons, Ltd.     

Culture,context and society – The underexplored potential of critical realism as a philosophical framework for theory and practice

This article explains how the meta‐theoretical framework of critical realism addresses methodological issues of concern to social psychologists and social scientists. The article outlines key tenets of critical realism – its notion of the stratified nature of reality and generative mechanisms as powers in natural and social objects that cause things; its notion of knowledge of reality as stratified rather than only empirical; its acceptance of epistemological but not judgmental relativism; and its monist ontology. The article then introduces realist social theory to provide a framework for understanding the society–person connection. It explains how issues relating to culture, context, and society raised in the indigenous psychology English literature might be addressed from a critical realist perspective. Some implications arising from adopting a critical realist perspective in research practice are outlined and social psychologists and social scientists are encouraged to explore the potential of critical realism as a meta‐theoretical framework and new paradigm.     

The lived experiences of individuals with Tourette syndrome or tic disorders: A meta‐synthesis of qualitative studies

There is a growing body of qualitative literature describing the lived experiences of people with tic disorders (TDs). The aim of this paper was to conduct a systematic review of this literature, synthesizing the perspectives of individuals on their experiences. Meta‐synthesis methodology was utilized to review and draw together findings from 10 articles, from which key concepts were extracted, and over‐arching themes generated. Six themes were identified to encompass the experience of TDs, including (1) cultural, semantic issues of the condition; (2) negative experiences in organizations and treatment; (3) the value and negative impact on interpersonal relationships; (4) personal identity in the constant presence of TDs; (5) concerns for the future; and (6) strategies to control and manage the observable presence of tics. Adaptive coping strategies were found to encompass continuous social adaptation, strategies to manage tics and social perceptions, self‐acceptance, advocacy, and support from others. The results highlighted the significant role of social and cultural issues related to understanding and stigma, which underpinned many of the lived experiences. Implications for clinical practice in supporting individuals with TDs were also highlighted.