Marriage and Family Therapists’ Perspectives on Treating Overweight Clients and Their Weight-Related Behaviors

Marriage and Family Therapists (MFTs), undoubtedly, will be working with clients who are overweight and are working on their weight-related behaviors (WRB). Yet, little is known about MFTs' approach with this population. Our purpose was to survey MFT students, faculty, and licensed clinicians about their current practices, training, beliefs, and theoretical perspectives of working with clients who are overweight and WRB. One-hundred eight participants completed an electronic mixed-method survey. Participants reported that they were not trained to work with overweight clients on WRB, but strongly believed they should be. Contextual differences, implications for training, and future research are discussed herein.     

Therapist Response to Clients’ Partner Abuse: Implications for Training and Development of Marriage and Family Therapists

This qualitative study explored ecosystemic influences on therapists’ responses to partner abuse. Research questions focus on aspects of personal and professional development of attitudes and belief systems surrounding partner abuse. In-depth interviews with seven therapy trainees indicate that family of origin experiences, clinical experiences, and therapist developmental processes affect values, beliefs, and clinical reactivity to cases involving partner abuse. Implications for therapists’ self-work, clinical training, and the process of supervision are addressed.     

Marriage and Family Therapists’ Ability to Diagnose Asperger’s Syndrome: A Vignette Study

The purpose of this study was to determine the degree to which AAMFT clinical members can accurately diagnose Asperger’s Syndrome. 171 AAMFT clinical members were surveyed using a vignette methodology. Participants were asked to read the vignette and provide a diagnosis for the child in the vignette. Four out of five participants were unable to correctly diagnose the vignette child with Asperger’s Syndrome. Analyses found that the ability to correctly diagnose Asperger’s Syndrome did not vary based on the participants: gender, years of clinical experience, or specialized clinical population (e.g., individuals, couples, families, children). Thomas Stone Carlson is an associate professor and Christi McGeorge is an assistant professor in the couple and family therapy program at North Dakota State University. Sarah Halvorson is a graduate of the couple and family therapy program at North Dakota State University and is in clinical practice in Illinois.     

Families with a Member with Mental Retardation and the Ethical Implications of Therapeutic Treatment by Marriage and Family Therapists∗

In this article, ethical issues related to the treatment of families with a member with mental retardation are discussed. The history of psychotherapeutically treating the community with mental retardation and accompanying concerns, such as dual diagnosis and diagnostic overshadowing, are discussed. Ethical considerations of the informed consent and assent process are discussed and applied to more modern areas of confidentiality, treatment goals, and individual sexuality. Marriage and family therapists are encouraged to bring clarity and balance to the process of informed consent and assent when working systemically with the population with mental retardation and their families.     

The Impact of Clients’ and Therapists’ Characteristics on Therapeutic Alliance and Outcome

Journal of Contemporary Psychotherapy - This article investigates distances between therapists and their clients in their experience of the therapeutic alliance across the duration of the...     

Marriage and Family Therapy Graduate Students’ Satisfaction with Training Regarding Religion and Spirituality

Marriage and family therapists are likely to encounter religious or spiritual clients in their career and thus are encouraged to be aware of their clients’ religious and spirituality. This awareness is often fostered within graduate training programs. This study aims to examine graduate students’ incorporation of religion and spirituality in therapy and their satisfaction with the quality and amount of training programs’ adherence to religion and spirituality. A sample of 135 graduate students from American Association for Marriage and Family Therapy accredited programs completed the survey. Findings showed that graduate students with greater levels of religiosity and spirituality were more likely to perceive it important to address religion/spirituality in therapy and to perceive there is a need for religious/spiritual education. When controlling for religious and spiritual orientations, overall regression results revealed that not having a course on religion and spirituality and perceiving a need for religious/spirituality in education predicted lower satisfaction with the amount and quality of current training surrounding these dimensions. Implications demonstrate the need to address religious/spiritual concepts in the curriculum, supervision, and in marriage and family therapy training.     

Therapists’ Responses to Religious/Spiritual Discussions with Trauma Versus Non-trauma Clients

This research explores therapists’ reactions to discussions of religion and spirituality in secular psychotherapy. We used a mixed method design including qualitative and quantitative components to examine data from 14 mental health professionals. Therapists acknowledged the importance of, and outlined reasons for, engaging in religious/spiritual discussions. They provided examples of the diverse ways in which their own views on religion/spirituality have an effect on their therapeutic work. Therapists view attention to religion/spirituality in trauma therapy as necessary. They see an emphasis on religion/spirituality within the treatment of traumatized clients as possessing distinctive qualities in comparison to their treatment of other populations.     

Family Involvement in a Whole-School Bullying Intervention: Mothers’ and Fathers’ Communication and Influence with Children

Research indicates that involving families in school efforts to prevent and manage bullying behaviour is essential to success. Parents can influence their children's involvement in bullying situations by modelling positive social behaviour, offering advice about appropriate responses to bullying, and encouraging help-seeking. This paper reports family-related findings from the three-year group randomized control trial of the Friendly Schools Friendly Families (FSFF) intervention, which provided training and whole-school, classroom and family resources to build the capacity of schools to prevent bullying victimization and perpetration. Over 1400 parents and carers of Grades 2, 4 and 6 school students completed a survey at baseline and two post-tests. Parents exposed to the FSFF parent component received resources about ways to reduce bullying, build parenting skills and enhance parent–child communication; they also completed home activities with their children; and were encouraged to engage with their children’s school to reduce bullying. Mothers and fathers reported significant increases in the frequency of discussions with their child about bullying. Mothers were more likely than fathers to give pro-social, passive and help-seeking advice compared to fathers, who were more likely to encourage their child to ‘fight back’. The intervention improved fathers’ perceptions of their influence on children’s responses to being bullied. These results highlight the importance of working with both male and female caregivers when addressing children’s bullying behaviour. The findings also demonstrate that a parent intervention can have a positive impact on parent–child communication about bullying when it is an integral part of a whole-school approach.     

Christian Pastors’ Perspectives and Insights on the Practice of Family Therapists Referring LGB Clients: Exploring the Role of Religion

Abstract

This qualitative study explored Christian pastors’ perceptions and insights for family therapists who refuse to work with lesbian, gay, and bisexual (LGB) clients by consistently referring them. Twenty-one pastors from diverse Christian traditions were interviewed. Thematic analysis identified the following themes related to the pastors’ perceptions of the practice of referring LGB clients: (1) Best Interest of the Client and Therapist, (2) Discriminatory Practice, and (3) No Referrals will be Provided. The following themes represent pastors’ advice for family therapists: (1) Develop a Well-Thought-Out Referral Plan; (2) Be Accountable for Your Own Beliefs; and (3) Engage in Conversations.     

Exploring Master Therapists’ Use of Power in Conversation

Various theoretical approaches to therapy place different emphases on the use of power in therapy. In this study, we explore six master therapists’ use of power via communicational control for theoretical consistency. Results indicate that all therapists, regardless of their stance on power, use the role of therapist to exert power in an initial therapy session. Master therapists, in general, did appear to be theoretically consistent with their stated philosophies of therapy. Suggestions for future studies exploring power therapists have are included.     

Family Therapy with Couples and Individuals with Parkinson’s Disease

Family therapists are increasingly called upon to work with individuals and families with medical issues, but often do not have sufficient background on the issue to be most helpful. The purpose of this paper is to help family therapists understand Parkinson’s Disease (PD) and its impact on the individual and his or her family. PD is the second most prevalent neurodegenerative disorder in the United States, following Alzheimer’s disease (Hirtz et al., Neurology 68:326–337, 2007). According to the Parkinson’s Disease Foundation, approximately 60,000 individuals are diagnosed with PD every year, and approximately one million Americans are currently living with PD. In this paper, we provide an overview of PD based on research and the second author’s many years of providing services for individuals with PD, as well as offer specific recommendations for providing family therapy using narrative, solution-focused and emotionally focused therapy based on the first author’s work as a family therapist with individuals, groups, and couples dealing with PD.     

Developmental Changes in Discrepancies Between Adolescents’ and Their Mothers’ Views of Family Communication

Prior work indicates that adolescents perceive the family more negatively than do their parents. These discrepant views comprise some of the most robust observations in psychological science, and are observed on survey reports collected in vastly different cultures worldwide. Yet, whether developmental changes occur with these discrepant views remains unclear. In a sample of 141 adolescents and their mothers, we examined 1-year developmental changes in discrepancies between parents’ and adolescents’ views of family functioning. We focused on discrepant views about a relatively covert domain of family functioning (i.e., internal views of open communication) and a relatively overt domain of such functioning (i.e., views about observable communication problems). We observed significant developmental changes in discrepant views for open communication, but not for communication problems. These findings have important implications for research examining links between discrepant views of family functioning and whether these discrepancies serve as risk or protective factors for adolescent psychosocial functioning.     

The Importance of Spirituality in Couple and Family Therapy: A Comparative Study of Therapists’ and Educators’ Beliefs

The purpose of this study was to explore the differences between the beliefs of couple and family therapists (CFTs) and CFT educators in accredited training programs regarding the importance of spirituality in their personal and professional lives. The results suggest a significant difference between the two populations, with clinicians reporting a higher level of agreement regarding the overall role of spirituality in their personal and professional identities compared to CFT faculty members. However, both therapists and educators reported similar levels of agreement in regard to the need for education related to integrating spirituality and its role in clinical practice. Implications for CFT training programs are discussed.     

Therapists’ experiences with internal representations of clients

Fourteen therapists were interviewed via telephone regarding their experience of “carrying around” their clients with them between sessions (i.e. internal representations, or IRs, of clients), a phenomenon about which little empirically based knowledge exists. Data were analyzed using consensual qualitative research. Findings indicated that overall, therapists have IRs infrequently, most often have IRs of clients struggling with severe or challenging presenting problems, and do receive some training about IRs. When describing a specific IR experience, therapists typically noted a strong therapy relationship, and stated that the IRs typically had specific triggers. The IRs generally consisted of feelings about the client, and typically consisted of thoughts about the client or the felt presence of the client. The IRs generally yielded positive effects, typically both personally and professionally, and were typically discussed with supervisors/consultants. Implications for research, training, and practice are presented.     

Marriage and Family Therapy Students’ Change in Multicultural Counseling Competencies after a Diversity Course

Attention to diversity is required in Commission on Accreditation for Marriage and Family Therapy Education-accredited programs, yet not much research exists regarding the effectiveness of graduate training on therapists’ multicultural counseling competencies. In this study, 12 students enrolled in a masters-level diversity class were given pre- and post-tests of their multicultural counseling competencies. Results showed that students significantly increased their multicultural awareness, knowledge, and skills after completing the diversity class. The discussion includes implications for educators who seek to improve students’ multicultural counseling competencies.     

Client Aggression Towards Therapists: Is It More or Less Likely with Transgendered Clients?

ABSTRACT

It is well known that clients occasionally threaten or assault their therapists. No studies to date have attempted to systematically measure client aggression by transgender patients towards clinicians. One of the major questions of this study was to determine if clients with gender dysphoria have greater levels of aggression towards therapists than non-gender dysphoric clients. One hundred and fourteen professional therapists who are members of the Harry Benjamin International Gender Dysphoria Association responded to a questionnaire that addressed aggression by both transgender and non-transgender clients. Transgender clients were shown to commit significantly less acts of aggression than did non-transgendered clients (p = 0.0094). Within the relatively small subgroup of transgender clients that did commit acts of aggression, male-to-female transgender clients were significantly more likely to do so than female-to-male clients (p = 0.002). While the transgendered client undergoes significant suffering in violating inviolable gender boundaries, this suffering, in general, does not translate into acting out behaviors directed towards their therapists.     

Are We Prepared? Recommendations for Couple and Family Therapists Engaging with Young Generations on Social Media

Social media is a salient aspect of most people’s lives in the United States. Younger generations (e.g., Gen Z) are among some of the most likely to engage with social media and have mental health concerns. Mental health providers are beginning to use social media to engage with prospective clients. However, there is a lack of guidance on how to maximize the utility of social media engagement for couple and family therapists (CFTs). This paper reviews the current literature on therapists’ professional presence on social media and younger generations’ expectations around social media competency. Recommendations for how CFTs can effectively engage with younger generations through social media are provided. A discussion of professionalism, accessibility, demonstrating aligned values, branding CFT, and gaining a reputation of cost effectiveness are emphasized. Future directions for studying the phenomenon of therapists using social media to engage with an online audience are included.

     

Marriage and Family Therapy Students’ Views on Including Weight Bias Training into Their Clinical Programs

Discussions about diversity rarely focus on overweight, obesity, and bias about body size (i.e., weight bias). These discussions allow students to develop self-awareness about how their biases can affect their clinical work, as well as the challenges and subsequent bias clients may face in their everyday lives and from clinical providers. One consequence of the rising prevalence of overweight and obesity in the United States is the increase in the level of weight bias and discrimination towards individuals who are overweight, which has been documented among mental and healthcare professionals. Thus, it is imperative that training programs integrate weight bias as a part of diversity training. The authors will review weight bias in mental and healthcare professions, and describe several trainings focused on self-awareness about weight bias. The purpose of this study was to pilot and evaluate a training program for marriage and family therapy (MFT) students about developing self-awareness around weight bias and working with clients who are overweight. Following the program, focus groups were conducted to explore participants’ experiences, learning, and feedback on the content and delivery method. Focus Group methodology was used to guide the analysis process. Four themes emerged: training program feedback, challenges for the MFT field, self-of-therapist, and etiology of weight loss/gain. Implications for MFT training programs are discussed.     

Facilitating Family Communication About Predictive Genetic Testing: Probands’ Perceptions

The responsibility of informing relatives that predictive genetic testing is available often falls to the proband. Support is required during this process, however the perceived utility of genetic counseling and other strategies to facilitate communication have not been explored. We investigated the experiences of 12 individuals with hereditary nonpolyposis colorectal cancer (HNPCC) in a semistructured telephone interview. Respondents informed their immediate family about the availability of genetic testing, however many more-distant relatives were not directly informed. Respondents were mostly satisfied with the way they told family members about testing and had mixed views about the usefulness of genetic counseling. Gender differences were observed, with most men expressing a need for guidance or support in communicating to relatives. Letters and booklets were thought to enhance the quality of information but the provision of further aids is unlikely to increase the number of relatives made aware of predictive testing by the proband.