Clinical Guidelines for Working With Stepfamilies: What Family,Couple, Individual,and Child Therapists Need to Know

This article draws on four decades of research and clinical practice to delineate guidelines for evidence‐informed, clinically sound work with stepfamilies for couple, family, individual adult, and child therapists. Few clinicians receive adequate training in working with the intense and often complex dynamics created by stepfamily structure and history. This is despite the fact that stepfamilies are a fundamentally different family form that occurs world‐wide. As a result many clinicians rely on their training in first‐time family models. This is not only often unhelpful, but all too often inadvertently destructive. The article integrates a large body of increasingly sophisticated research about stepfamilies with the author's four decades of clinical practice with stepfamily relationships. It describes the ways in which stepfamilies are different from first‐time families. It delineates the dynamics of five major challenges stepfamily structure creates: (1) Insider/outsider positions are intense and they are fixed. (2) Children struggle with losses, loyalty binds, and change. (3) Issues of parenting, stepparenting, and discipline often divide the couple. (4) Stepcouples must build a new family culture while navigating previously established family cultures. (5) Ex‐spouses (other parents outside the household) are part of the family. Some available data are shared on the impact of cultural and legal differences on these challenges. A three‐level model of clinical intervention is presented: Psychoeducational, Interpersonal, and Intrapsychic/Intergenerational Family‐of‐Origin. The article describes some “easy wrong turns” for well‐meaning therapists and lists some general clinical guidelines for working with stepfamily relationships.     

Psychotherapy With African American Men: What We Know and What We Need to Know

African American men are at an increasingly high risk of experiencing psychological disturbances. Strategies for establishing effective therapeutic relationships with these clients are provided in the literature. Notably absent are empirical data pertaining to the effectiveness of psychotherapy with African American men. This article reviews the literature on psychotherapy and proposes an agenda for the next decade of research with African American male clients.     

Sexuality and Perimenopause: What Counselors Need to Know

Perimenopause, which recently has been recognized as separate from menopause, affects approximately 22 million U.S. women. It is a time when women are at greater risk for emotional, relationship, and sexual problems. The authors describe the symptoms of perimenopause, discuss the resulting psychosocial and sexual impact, and present treatment implications for counselors.     

Long Working Hours and Well-being: What We Know,What We Do Not Know,and What We Need to Know

Despite a widespread belief in both the academic and public policy literatures that working long hours is deleterious to health and well-being, our critical review of this large and complex literature fails to support a robust direct causal effect of work hours on either physical or mental well-being outcomes. Large-scale epidemiological studies, many of which are prospective and include objective health outcome measures, support a statistically significant association between long work hours and coronary heart disease and depression, but the effect sizes are very small. Moreover, there is an absence of true longitudinal studies that assess the consistency of working long hours over time and its relationship to well-being. Our review suggests that the effects of working long hours are nuanced in that they may vary considerably for different working populations based on gender, age, working conditions, and other factors. Primary and meta-analytic studies suggest that such moderator effects are plausible, yet rigorous testing of these remains to be done. We conclude with suggestions for specific moderator effects that seem worth investigating in future research.     

Residual Effects of Slavery: What Clinicians Need to Know

Marriage and family therapists grapple with the intersection of societal influence and African American clients’ presenting problems. Questions include: what impact has the historical trauma of slavery had on African Americans and what are the clinical implications of this trauma? This paper reviews the literature on the various residual effects of slavery (RES) within the African American community. A case vignette and a broad discussion of therapeutic techniques will be used to highlight the clinical implications of RES.     

Human Nature: What We Need to Know about Ourselves in the Twenty-First Century

The Western worldview that now dominates the planet embodies beliefs about human nature that are inconsistent with our evolutionarily evolved natures. Its "logic" at best ignores and at worst creates the symptoms of the modern world, which if uncorrected predict severe crises in coming centuries: population growth, environmental destruction, economic collapse, and increasing social violence. In contrast, there are numerous communities today creating alternative solutions based on different understandings of human nature and human needs: cooperation rather than competition; meaningful social identity; and respect for and trust in the autonomous behavior of all persons. There exist optimistic future models.     

Millennials at Work: What We Know and What We Need to Do (If Anything)

There are a lot of opinions about who Millennials are, what they think and value, and how they will behave as they grow older and gain more experience in the workforce. The relatively sparse empirical research published on Millennials is confusing at best and contradictory at worst. As noted in this article and others in this special issue, however, there are a few topics including work attitudes, long-term health outcomes, and personality factors on which we have reasonably solid data to inform us about current and likely future behavior of Millennials. We address the importance of context for understanding behavior of people in different generations, a subject often missing from the discussion of generational similarities and differences. There are implications for practitioners of what we know and for how context affects behavior. We make suggestions for how practitioners can use the data available to inform decisions they make about working with Millennials. Finally, we discuss the importance of new directions of research on generational differences to help both practitioners and the research community better understand the realities of generational similarities and differences and rely less on urban myths or stereotypes.     

What Colleagues Need to Know About the Cost of Independent Social Work

No abstract available for this article.     

Immigration as a Dynamic Experience: Personal Narratives and Clinical Implications for Family Therapists

This is a reflective account of the experiences of the authors who immigrated to the United States from India at different developmental, historical, political, and social stages. Although their culture-of-origin was the same, the meaning and experience of immigration was different for each author. The narratives show a natural continuum of experiences based on their developmental stage during immigration, reasons for immigration, and the historical context of both India and the US at the time of immigration. A common theme is the ambivalence experienced by them in their process of creating a physical and psychological home in a different culture.     

Breast Cancer Survivors Coping with Lymphedema: What all Counselors Need to Know

The purpose of this study was to promote greater understanding among counselors and other helping professionals regarding the stressors associated with lymphedema, how women cope with the stressors, and the role of social support. An intensive qualitative study was conducted; data were analyzed using a consensual qualitative research approach. The results suggest that coping with lymphedema is complex and pervasive. Implications for counselors who work with cancer survivors who experience lymphedema are discussed.     

What is Working,What is Not,and What We Need to Know: a Meta-Analytic Review of Business Ethics Instruction

Requirements for business ethics education and organizational ethics trainings mark an important step in encouraging ethical behavior among business students and professionals. However, the lack of specificity in these guidelines as to how, what, and where business ethics should be taught has led to stark differences in approaches and content. The present effort uses meta-analytic procedures to examine the effectiveness of current approaches across organizational ethics trainings and business school courses. to provide practical suggestions for business ethics interventions and research. Thus, the primary questions driving this research are as follows: (1) what course characteristics moderate the effectiveness of ethics instruction?, and (2) have ethics education and training efforts improved? Findings suggest that professional, focused, and workshop-based training programs are especially effective for improving business ethics. However, results also reveal considerable problems with many of the criteria used to evaluate the effectiveness of business ethics interventions. Practical suggestions for course design and evaluation in business ethics efforts are discussed along with future research needs.     

Relocation and Well-Being in United Methodist Clergy and Their Spouses: What Pastoral Counselors Need to Know

The well-being of relocated, male Florida Annual Conference United Methodist clergy and clergy spouses (N = 124) was compared with that of nonrelocated male United Methodist clergy and clergy spouses (N = 153). Results revealed no significant differences in well-being between relocators and nonrelocators. Clergy spouses exhibited significantly lower well-being than did clergy. Perceptions of relocation, stress level, and coping resources were significant predictors of clergy well-being. However, only stress level and coping resources predicted spouse well-being. Qualitative analysis of participants' responses revealed that pastoral counselors should address issues such as grief, powerlessness, loneliness, and clergy family reluctance to seek counseling services.     

What Employment Counselors Need to Know About Employment Discrimination and the Civil Rights Act of 1991

Under Title VII of the Civil Rights Act of 1964 there are two theories of liability for employment discrimination: disparate treatment and disparate impact. While disparate treatment deals with the adverse treatment of a specified employee, disparate impact deals with discrimination against a class of individuals. The Civil Rights Act of 1991 modified the law to allow plaintiffs to more readily bring a discrimination case. This article reviews the major components of the Civil Rights Act of 1964, the Civil Rights Act of 1991, and a proactive approach to using equal opportunity law in employment counseling.     

Family Physicians and Family Therapists: Understanding the Interdependent Synergism

This article, written by a family physician and a family therapist, is designed to identify differences between these two cultures that may serve as stumbling blocks to successful meeting of occupants of these two worlds. With the differences identified and described, various notions and suggestions are offered in an effort to promote more successful bridging between these two groups. There is little question about the synergistic impact that can be engendered for recipients of their care should this bridging be successfully navigated. The present day realities in healthcare make this an idea whose time has not just come, but rather seems imperative.     

At the Heart of the Pregnancy: What Prenatal and Cardiovascular Genetic Counselors Need to Know about Maternal Heart Disease

In the last decade, an increasing number of cardiac conditions have been shown to have a genetic basis. Cardiovascular genetic counseling has emerged as a subspecialty aiming to identify unaffected at-risk individuals. An important sector of this at-risk population also includes expectant mothers, in whom unique clinical challenges may arise. Genetic counselors, especially those in cardiovascular and prenatal settings, have an opportunity to identify and assist women who may benefit from cardiovascular care during pregnancy. This paper provides basic management and genetic evaluation principles for affected women, as well as guidance on identifying those who are at risk. We provide considerations for cardiac surveillance in pregnancy and the post-partum period. Finally, key psychosocial issues that appraise how to best provide support to at risk women as they make informed decisions are discussed. We propose that a team approach including cardiology, maternal fetal medicine, and genetic counseling best serves this patient population. Ongoing questions addressing an evidence based approach to cardiovascular genetic conditions in pregnancy still remain. Thus, well-designed research protocols are essential to mark progress in this area.