Transactional pathways of transgender identity development in transgender and gender-nonconforming youth and caregiver perspectives from the Trans Youth Family Study

Background: A growing body of research has examined transgender identity development, but no studies have investigated developmental pathways as a transactional process between youth and caregivers, incorporating perspectives from multiple family members. The aim of this study was to conceptualize pathways of transgender identity development using narratives from both transgender and gender-nonconforming (TGN) youth and their cisgender (nontransgender) caregivers.

Methods: The sample included 16 families, with 16 TGN youth, ages 7 to 18 years, and 29 cisgender caregivers (N = 45 family members). TGN youth represented multiple gender identities, including trans boy (n = 9), trans girl (n = 5), gender-fluid boy (n = 1), and girlish boy (n = 1). Caregivers included mothers (n = 17), fathers (n = 11), and one grandmother. Participants were recruited from LGBTQ community organizations and support networks for families with transgender youth in the Midwest, Northeast, and South regions of the United States. Each family member completed a one-time, in-person semistructured qualitative interview that included questions about transgender identity development.

Results: Analyses revealed seven overarching themes of transgender identity development, which were organized into a conceptual model: Trans identity development, sociocultural influences/societal discourse, biological influences, family adjustment/impact, stigma/cisnormativity, support/resources, and gender affirmation/actualization.

Conclusions: Findings underscore the importance of assessing developmental processes among TGN youth as transactional, impacting both youth and their caregivers.     

The Use of a Child-Based Acceptance and Commitment Therapy Curriculum to Increase Attention

Acceptance and Commitment Therapy (ACT) is a treatment that integrates mindfulness and acceptance training with behavior change processes. One of the core processes in ACT is contact with the present moment which involves shifting attention to what is happening here and now, contacting both internal and external stimuli. An experimental and control group were used to determine the impact ACT had on attention. ACT participants (M?=?5.4, SD?=?9.8) showed fewer inaccuracies on the CPT-X task compared to the control group (M?=?19.75, SD?=?16.1) at posttest F(1, 38)?=?11.49, p?=?.02, ηp²?=?.232. Results of the current study demonstrate participation in the use of an ACT curriculum for children to help increase attention outcomes.     

Secondary migration and relocation among African refugee families in the United States

The purpose of this study was to understand the secondary migration and relocation of African refugees resettled in the United States. Secondary migration refers to moves out of state, while relocation refers to moves within state. Of 73 recently resettled refugee families from Burundi and Liberia followed for 1 year through ethnographic interviews and observations, 13 instances of secondary migration and 9 instances of relocation were identified. A family ecodevelopmental framework was applied to address: Who moved again, why, and with what consequences? How did moving again impact family risk and protective factors? How might policies, researchers, and practitioners better manage refugees moving again? Findings indicated that families undertook secondary migration principally for employment, affordable housing, family reunification, and to feel more at home. Families relocated primarily for affordable housing. Parents reported that secondary migration and relocation enhanced family stability. Youth reported disruption to both schooling and attachments with peers and community. In conclusion, secondary migration and relocation were family efforts to enhance family and community protective resources and to mitigate shortcomings in resettlement conditions. Policymakers could provide newly resettled refugees jobs, better housing and family reunification. Practitioners could devise ways to better engage and support those families who consider moving.     

Guidelines for classifying evidence-based treatments in couple and family therapy

Guidelines for Evidence-Based Treatments in Family Therapy are intended to help guide clinicians, researchers, and policy makers in identifying specific clinical interventions and treatment programs for couples and families that have scientifically based evidence to support their efficacy. In contrast to criteria, which simply identify treatments that "work" and have been employed in the evaluation of other psychotherapies, these guidelines propose a three-tiered levels-of-evidence-based model that moves from "evidence-informed," to "evidence-based," to "evidence-based and ready for dissemination and transportation within diverse community settings." Each level reflects an interaction between the specificity of the intervention, the strength and readth of the outcomes, and the quality of the studies that form the evidence. These guidelines uniquely promote a clinically based "matrix" approach in which the empirical support is evaluated according to various dimensions including strength of the outcomes, the applicability across cultural contexts, and demonstration of specific change mechanisms. The guidelines are offered not only as a basis for understanding the evidence for diverse clinical approaches in couple and family therapy within the systemic tradition of the field, but also as an alternative aspirational model for evaluating all psychotherapies.     

"Don't lock me out": life-story interviews of family business owners facing succession

This qualitative study used a grounded theory methodology to analyze life-story interviews obtained from 10 family business owners regarding their experiences in their businesses with the goal of understanding the complexities of family business succession. The grounded theory that emerged from this study is best understood as a potential web of constraints that can bear on the succession process. Coding of these interviews revealed four key influences, which seem to have the potential to facilitate or constrain the family business owner's approach to succession. Influence 1, "The business within," captures intrapsychic dynamics of differentiation and control. Influence 2, "The marriage," addresses how traditional gender roles shape succession. Influence 3, "The adult children," examines the role of having a natural (accidental, organic, passively groomed) successor. Influence 4, "The vision of retirement," captures the impact of owners' notions of life post-succession. Family therapists frequently encounter family systems in which the family business is facing succession. Even if succession is not the presenting problem, and even if the business owner is in the indirect (rather than direct) system, this research reminds clinicians of the importance of the family's story about the family business. Therefore, clinical implications and recommendations are included.     

Collaborative helping maps: a tool to guide thinking and action in family-centered services

This article highlights "disciplined improvisation" as a metaphor for community-based work with multi-stressed families. It introduces Collaborative Helping maps as a tool that both helps workers think their way through complex situations with families and provides a structure to support constructive conversations between workers and families about challenging situations. The article illustrates this map through a clinical vignette and uses interviews with workers to highlight ways in which the map can both enhance worker thinking and support constructive conversations between workers and families about problems that could easily divide them and lead to polarization and escalating tension.     

Developing an outcome-based assessment for family therapy training: the Rochester Objective Structured Clinical Evaluation (ROSCE)

This paper addresses a growing need for cost-effective, outcome-based assessment in family therapy training. We describe the ROSCE, a structured, evidence-informed, learner-centered approach to the assessment of clinical skills developed at the University of Rochester Medical Center. The ROSCE emphasizes direct observation of trainees demonstrating clinical competencies. The format integrates both formative and summative assessment methods. It can readily be adapted to a wide variety of educational and training settings.     

Facilitating relational empowerment in couple therapy

Couples in distressed relationships often get caught up in power struggles, "Power Over" interactions that are informed by both neurobiology (e.g., the fight-flight reaction) and by cultural assumptions (e.g., competition, individualism, and patriarchy). This article seeks to widen the discourse about power by highlighting "Power To" and "Power With." Power To includes the ability to self-regulate, to read and manage one's own emotions, and to have voice while respecting the other's voice. Power With reflects the couple's commitment to conurture the relationship through empathy, respect, and generosity. Power To and Power With are proposed to constitute relational empowerment, the ability to navigate one's inner world and the interpersonal realm. The neurobiology of both couples' reactivity and relational empowerment are considered. Techniques are offered to facilitate Power To and Power With, interventions that interrupt couples' cycles of reactivity and allow them to make more thoughtful choices. Emotion regulation and empathy are particularly important skills of relational empowerment, and examples are offered to increase these capacities in couple therapy. The therapeutic perspective offered in this article challenges cultural practices and assumptions that keep intimate partners polarized in power struggles, and explores how relational empowerment can foster an egalitarian, mutually respectful relationship.     

Developing the therapeutic relationship: from 'expert' professional to 'expert' person who stutters

This article looks back over the years and identifies some of the most influential thinkers, writers, and researchers who have had a profound effect on the way the therapy at the Michael Palin Centre for Stammering Children in London has evolved. It tracks the changes that have occurred in theoretical perspective, treatments offered, and the delivery of therapy. In particular this author is interested in the changing nature of the therapeutic relationship between professionals and people who stutter (PWS), and describes the way it has developed from the “expert professional” towards a more collaborative relationship that recognises the “expert patient”. It was inspired by a book written in 1902 by Mr Beasley, a person who stammered. After several unsuccessful attempts to find a ‘cure’ he found his own solution to his stuttering and then used what he had learned to help many others. Much of what he wrote was well ahead of his time and reminds us, the professionals, of the importance of listening to and taking account of the views of PWS in therapy and designing treatment that meets the needs of the individual. This article also looks briefly at evidence based practice (EBP) and the issues involved in measuring outcomes that reflect the complex and individual nature of the problem. Finally the importance of the research in developing the knowledge and skill base of clinicians as well as PWS is acknowledged and discussed and the way ahead signposted.Educational objectives: The reader will learn about (1) the early history and development of stuttering therapy, (2) the influence of a variety of psychotherapeutic approaches, (3) the relevance of designing therapy to meet the needs of the PWS, and (4) discuss the role of ‘common’ factors in EBP.     

Mother and father adjustment during early parenthood: the roles of infant temperament and coparenting relationship quality

We explored how parent gender, infant temperament, and coparenting dynamics worked together to shape mothers’ and fathers’ depressive symptoms, stress, and parental efficacy during early parenthood. We were interested in the coparenting relationship as a context that shapes how parents respond to their infant's temperamental qualities. Participants were 139 couples who had recently given birth to their first child. Parent reports of temperament were collected when the infant was 4–8 months old and reports of coparenting and parent adjustment were collected at 13 months. Two-level random intercept models revealed interactions between temperament and coparenting, highlighting the family system as a context for how men and women adapt to their parenting role. There was little evidence for mother–father differences in these associations.