Contemporary Psychotherapy: Moving Beyond a Therapeutic Dialogue

Psychotherapy was developed as a means of using words to heal emotional pain. Although a therapeutic dialogue can be helpful to many clients, some people need a more action-based intervention. Psychotherapy may be enhanced by adapting several therapeutic procedures that have been found effective in physical therapy. Where physical therapy can help clients learn to manage chronic physical pain, psychotherapy can help clients learn to manage chronic emotional pain. Both physical therapy and psychotherapy can help to facilitate awareness, flexibility, strength and endurance in order to maximize the clients functional ability.     

Evaluation of Service‐Learning‐Infused Courses With Refugee Families

This study evaluated the impact of service‐learning‐infused courses on multicultural competence and social justice advocacy skills among counseling students. The project, in which students acted as job coaches for refugee families, was integrated into 1st‐ and 2nd‐year counseling courses. Results indicated an increase in multicultural knowledge and advocacy skills, with greater changes reported among 1st‐year students. Implications for counselor training, including placement of service‐learning projects within the counseling curriculum, are discussed. Este estudio evaluó el impacto de cursos con elementos de aprendizaje por medio del servicio en la competencia multicultural y las habilidades de defensoría de justicia social entre estudiantes de consejería. El projecto, en el cual los estudiantes proporcionaron orientación laboral a familias de refugiados, estaba integrado en cursos de consejería de primer y segundo año. Los resultados indicaron un aumento del conocimiento multicultural y las habilidades de defensoría, con mayores cambios comunicados por los estudiantes de primer año. Se discuten las implicaciones para la formación de consejeros, incluyendo la inserción de projectos de aprendizaje por medio del servicio en el currículum de consejería.     

Mentalization‐based Therapeutic Interventions for Families

This article attempts to bridge two seemingly different and yet related worlds, the intra‐psychic and the interpersonal, by viewing systemic practice(s) through a mentalization‐based lens. It is argued that in therapy there needs to be a deliberate, conscious and consistent focus on mentalizing. The emerging mentalization‐based therapy for families is an innovative approach and a distinctive model which is systemic in essence, deriving its ideas and practices from a variety of diverse systemic approaches, yet enriching family work by adding mentalizing ingredients.     

Two Families: The Origins of a Therapeutic Crisis

The treatment by individual and family therapy of a hospitalized young woman is presented as it reflects the historical and current family dynamics of the patient and her individual psychotherapist. The contribution of these factors to a therapeutic crisis is discussed.     

Voices of Dialogue and Directivity in Family Therapy With Refugees: Evolving Ideas About Dialogical Refugee Care

In this article, we reflect on our evolving ideas regarding a dialogical approach to refugee care. Broadening the predominant phased trauma care model and its engaging of directive expertise in symptom reduction, meaning making, and rebuilding connectedness, these developing dialogical notions involve the negotiation of silencing and disclosure, meaning and absurdity, hope and hopelessness in a therapeutic dialogue that accepts its encounter of cultural and social difference. In locating therapeutic practice within these divergent approaches, we argue an orientation on collaborative dialogue may operate together with notions from the phased trauma care model as heuristic background in engaging a polyphonic understanding of coping with individual and family sequelae of forced displacement. This locating of therapeutic practice, as informed by each perspective, invites us to remain present to fragments of therapeutic positioning that resonate power imbalance or appropriation in a therapeutic encounter imbued with a social context that silences refugees’ suffering. In a clinical case analysis, we further explore these relational complexities of negotiating directive expertise and collaborative dialogue in the therapeutic encounter with refugee clients.     

Educational Cultural Brokers and the School Adaptation of Refugee Children and Families: Challenges and Opportunities

Canadian schools are utilizing services previously provided by settlement and community-based agencies to ensure the successful school adaptation of refugee children and families. This study examined the role of educational cultural brokers during the adaptation. Research queries addressed include strategies that cultural brokers use to facilitate the adaptation of refugee children in school settings, and opportunities and barriers to cultural brokering that exist in educational settings. A qualitative case study of eight educational cultural brokers was employed, using focus groups, critical incidents, document review, and semistructured interviews. Results suggest brokers engage in micro- and macrolevel activities through six brokering roles, with each role encompassing challenges and opportunities at the school, agency, and community level. This paper discusses aspects of these roles that have relevance for practice and policy for both cultural brokers and other providers of school-based services to refugee families.     

Treatment Engagement: Building Therapeutic Alliance in Home-Based Treatment with Adolescents and their Families

Client engagement is an essential yet challenging ingredient in effective therapy. Engaged clients are more likely to bond with therapists and counselors, endorse treatment goals, participate to a greater degree, remain in treatment longer, and report higher levels of satisfaction. This study explored the process of engaging high-risk youth and their parents in a unique home-based family therapy intervention. Qualitative interviews were conducted with 19 families who completed family therapy sessions that included a core component aimed at increasing treatment engagement. Parents’ and youths’ perceptions of engagement suggest the importance of developing therapeutic alliance with therapists, who facilitated building a shared alliance among family members. Implications for improving client engagement are discussed within the context of alliance building with the therapist and among family members.     

Therapy with Families in China: Cultural Factors Influencing the Therapeutic Alliance and Therapy Goals

Rapid economic and social development in China is producing opportunities for a better standard of living for many families but also is associated with significant stress. Family therapy is one of the forms of mental health services that have become increasingly available. Western-derived models of family therapy are being used and adapted to meet the cultural traditions and needs of Chinese families. This article describes a variety of Chinese cultural factors that can influence the establishment of therapeutic alliances with family members (communication styles, collectivist values, family roles, and structure) and those that can shape family therapy interventions by addressing contextual factors affecting Chinese families (economic development, migration patterns, academic pressure, and changing gender roles for women). Suggestions are offered for using cultural sensitivity to address these factors tactfully to build strong therapeutic alliances and help families cope with significant life stresses.     

Building an Expanded Therapeutic Alliance: A Task Analysis with Families Trapped in Parental-Adolescent Conflict

Parental-adolescent conflict is part of the normal developmental cycle of families, but when it occurs in a dysfunctional way, it is associated with the appearance of various harmful conditions for the family system and for the adolescent in particular. Family therapy is one of the main options for psychotherapeutic intervention in these cases and has ample evidence of its effectiveness. The success of this intervention is conditioned to the construction of an adequate therapeutic alliance with the family, but the process of this task has not been clarified yet. The present study is a task analysis, the purpose of which was to create a heuristic model of how an expanded alliance may be built in these kinds of cases. The model was revised and improved from the intensive analysis of six cases. The resulting model can be a useful guide for family therapists in that it describes the specific client and therapist behaviors involved in balancing the alliance, as well as the potential obstacles and suggested ways to resolve them.     

A Review of the Use of Trauma Systems Therapy to Treat Refugee Children,Adolescents, and Families

ABSTRACT

Children and adolescents within refugee families face adverse childhood experiences emanating from multiple sources. These traumatic events can begin with persecution within their country of origin, during the migration process, and within their re-settled countries. More specifically, these children and their families are more prone to the four core stressors being: traumatic, acculturative, isolative and resettlement stress. Trauma Systems Therapy for Refugees (TST-R) is a promising treatment model to address child and adolescent mental health disparities revolving around direct and vicarious trauma. In TST-R, the treatment team systematically targets the needs of the child, while collaborating with cultural brokers from the refugee community, their school, and family unit. Researchers have used TST-R as an intervention for reducing trauma symptoms in Somali, Somali-Bantu, and Bhutanese children, adolescents, and their families. We review the strengths and limitations of this model. Further research is needed to determine its applicability to other communities within the United States and abroad.     

Dialogue with a Bishop

Pastoral Psychology -     

The Afghan Refugee Client

With the advent of political turmoil in Afghanistan, increasing numbers of Afghan refugee families have been coming to the United States. Both the children and the adults perceive school as the primary resource for their successful transition into U.S. society. The school counselor is in a position to guide Afghan clients by providing them with necessary educational and career information. The historical isolation of Afghanistan and its remote location geographically make this rich and ancient culture unknown to many Americans. This culture has certain significant and unique characteristics that affect the way in which Afghans may adjust. The author describes aspects of the Afghan culture most relevant to counseling the Afghan refugee family or individual.     

Living in with Normal Families

Connie Hansen participated in my project, “Methodology for Studying Family Interaction,” in the mid 1960s. One of the purposes of that project was to compare several groups of families, including “normals.” Connie suggested that it might provide a rich source of data if she were to “live in” with a few of the “normal” families and observe them day to day on their own territory. (A year or so before, Dr. Jules Henry had given a talk to the MRI staff about living-in with “schizogenic” families, and I believe that Connie had discussed her idea with him.) Connie was an experienced family therapist — she was one of Virginia Satir's first students — and a most perceptive observer. She lived with three “normal” families for a week each during 1966–67; she was excited by the wealth of material and exhausted by the experience. She tried to develop a group of central themes from her data and gave me a preliminary draft of a paper in 1969. It clearly contained a number of important observations about the complexities and subtleties of family systems and some beginning attempts at conceptualization. She struggled for years to clarify and elaborate on her material. Several times she sent me portions and fragments of new drafts, each with additional insights, but she was never satisfied with her efforts. It seems a fitting tribute to Connie — she died early in 1979 — to attempt to put together her various drafts. We wanted to publish this very important material in a readable form and yet still preserve the immediateness, enthusiasm, and vividness of her observations. I hope, that if she were to read it, she would not be overly critical of this final draft. JULES RISKIN, M.D. It is a special privilege for me to participate in this posthumous publication of Connie Hansen's unique contribution to the further knowledge of family interaction. She died before the material could be published. I feel particular gratitude to the young woman who entered my first training program in 1961 at the Mental Research Institute. This was a time when such training seemed “far out” and was regarded as “probably only a fad.” She was willing to face the risks inherent to her professional standing by choosing to do this training. It was this same courage together with her imagination and curiosity and her willingness to document her experience without judging it that resulted in the article now being published. Farewell, Connie, and thank you for your presence in my life. VIRGINIA M.SATIR