Sitting In: The Experience of Learning and Practicing Family Therapy through Being a Co-Therapist in Hong Kong

This article explores family therapy trainees’ subjective experiences of working as cotherapists with a supervisory-level therapist in a Chinese context, regarding their perceptions of and positioning in it and also their opinions on the benefits and/or pitfalls of cotherapy. Individual interviews with a total of six cotherapists revealed three themes: (1) Cotherapy was perceived as an experiential learning journey that evolved from anxiety and excitement to empowerment and nurturing; (2) a collaborative master–apprentice relationship of openness, trust, and mutual respect was developed with both sides’ interactive effort, which included common commitment and concern for the client, the supervisor’s awareness and explicit address of the role hierarchy, principle setting prior to the cooperation, and honest pre- and-postsession sharing and discussion; (3) the dual-purpose supervisor–trainee cotherapy brought direct benefits for all involved parties and for others. The findings have useful implications for integrating treatment and training for optimal training/learning outcomes and for advancing knowledge transfer from senior to junior and from academia to the field, with reference to local cultural characteristics.     

How Does Family Connectedness Contribute to Youths’ Health? The Mediating Role of Coping Strategies

Family connectedness has important implications for adolescents’ well-being, contributing to their physical, psychological, and social health. However, little is known about the mechanisms underlying these effects. The present longitudinal study examined the process by which family connectedness, as perceived by adolescents, predicted greater positive and fewer negative health behaviors in adolescents over time. In particular, we sought to determine whether adaptive and maladaptive coping strategies mediated the link between family connectedness and adolescents’ self-reported health status. Data were obtained from 1,774 New Zealand adolescents aged 10–17 years, who completed a self-report survey three times at one-year intervals. With longitudinal mediation path models, we tested whether maladaptive and adaptive coping strategies at T2 functioned as mediators between family connectedness at T1 and overall health, vitality, sleep sufficiency, body satisfaction, substance use, and self-harm at T3. Findings revealed that family connectedness predicted greater levels of adaptive coping, which, in turn, predicted better health indicators but not decreases in ill-health indicators. Furthermore, family connectedness predicted lower maladaptive coping, which, in turn, predicted higher levels of positive health outcomes and fewer negative health outcomes. Results showed that the positive effect of family connectedness on adolescents’ health occurred through increased use of adaptive coping strategies, decreased use of maladaptive coping strategies, or both. These results have important implications for practitioners working with adolescents and parents, as well as for health promotion program developers.     

The Relationship Between Social Support and Family Relationships Among Low-Income Couples Attending Relationship Education

Results are mixed for relationship education (RE) interventions with low-income couples. For couples who experienced positive changes, it is not clear what aspects of program models contributed to change. Many low-income couples attend government-funded RE with limited access to social and community resources. Program models often provide related resources complimentary to RE skill-building. We examined the relationship between income, social support, and family functioning for low-income, ethnically diverse couples (N = 856) who attended RE, as well as the mediating effects of social support on family functioning outcomes. Analyses included three separate dyadic models that examined associations among constructs at baseline and immediately following the RE intervention. Results demonstrated relationships between participants’ reported social support and family functioning such that (a) social support was associated with baseline family functioning for both men and women; (b) men’s baseline social support was influenced by women’s baseline family functioning; and (c) men’s and women’s social support change score had a positive influence on their own family functioning change score. However, social support was not a significant mediator of change in family functioning. Implications for RE practice and research are also discussed.     

《周易》家人卦的家道要旨

《周易》家人卦的家道理论体系,由立家之道、安家之道和兴家之道构成,且三位一体而又层层递进。立家之道,源于“阴阳变易”之化生原理,宏于“阴顺阳威”;付之践行,始于“闲邪未蒙”,功在“厉威勿纵”,誉于“顺德利贞”。安家之道,据于“允执厥中”的象位原理,适于“中正合宜”;履之于家,固于“持守正道”,毅于“谨遵中德”,成于各安角色。兴家之道,基于“民安国泰”的系统法则,旨在“家齐国治”;行之于家,寓于“王假有家”,系于交感互爱,遵于唯变所适。整个家道理论体系是一个系统有机统一的整体,极具系统性与辩证性。     

The Role of Family Functioning in Bipolar Disorder in Families

Investigated the association between family functioning and conflict and their links with mood disorder in parents and with children's risk for bipolar disorder. Participants were 272 families with a child between the ages of 5-17 years. Parents' history of psychiatric diagnoses and children's current diagnoses were obtained via semi-structured interviews. Parent report on the Family Assessment Device and the Conflict Behavior Questionnaire measured family functioning and conflict, respectively. Results revealed a small but significant indirect pathway from parental diagnosis of mood disorder to child bipolar disorder through impaired family functioning, via increased family conflict. Parental mood disorders were also significantly related to other negative outcomes in children, including unipolar depression and oppositional defiant disorder. Associations between parent diagnoses and family functioning changed depending on youth age, but not youth sex.     

Breathing life into family processes: introduction to the special issue on families and asthma

This introduction to the special issue dedicated to families and asthma proposes that the study of asthma highlights general systems topics such as integration of individual needs into the group, developmental trajectories of risk and resilience, supportive and destructive patterns of interaction, and the cultural adaptation of family therapy. It briefly introduces papers in the special issue and concludes that asthma can serve as an exemplar in the study of family health due to its comorbidity with mental health problems, potential to affect multiple members of the family, disproportionate influence on low-income and minority families, and multiple avenues for intervention.     

Incorporating family therapy into asthma group intervention: a randomized waitlist-controlled trial

Asthma psychoeducational programs have been found to be effective in terms of symptom-related outcome. They are mostly illness-focused, and pay minimal attention to systemic/familial factors. This study evaluated a novel asthma psychoeducation program that adopted a parallel group design and incorporated family therapy. A randomized waitlist-controlled crossover clinical trial design was adopted. Children with stable asthma and their parents were recruited from a pediatric chest clinic. Outcome measures included, for the patients: exhaled nitric oxide (eNO), spirometry, and adjustment to asthma; and for the parents: perceived efficacy in asthma management, Hospital Anxiety and Depression Scale anxiety subscale, Body Mind Spirit Well-being Inventory emotion subscale, and Short Form 12 health-related quality of life scale. Forty-six patients participated in the study. Attrition rates were 13.0% and 26.0% for the active and control groups, respectively. Repeated-measures ANOVA revealed a significant decrease in airway inflammation, as indicated by eNO levels, and an increase in patient's adjustment to asthma and parents' perceived efficacy in asthma management. Serial trend analysis revealed that most psychosocial measures continued to progress steadily after intervention. Significant improvements in both symptom-related measures and mental health and relationship measures were observed. The findings supported the value of incorporating family therapy into asthma psychoeducation programs.     

Testing the Biobehavioral Family Model in pediatric asthma: pathways of effect

This study uses a laboratory-based multiinformant, multimethod approach to test the hypothesis that a negative family emotional climate (NFEC) contributes to asthma disease severity by way of child depressive symptoms, and that parent-child relational insecurity mediates the effect. Children with asthma (n = 199; aged 7-17; 55% male) reported parental conflict, parent-child relational security, and depressive symptoms. Parent(s) reported demographics, asthma history, and symptoms. Asthma diagnosis was confirmed by clinical evaluation and pulmonary function tests, with disease severity rated by an asthma clinician according to NHLBI guidelines. Family interactions were evoked using the Family Process Assessment Protocol, and rated using the Iowa Family Interaction Rating Scales. Path analysis indicated a good fit of data to the hypothesized model (chi2[1] = .11, p =.74, NFI = .99, RMSEA = .00). Observed NFEC predicted child depression (beta = .19, p < .01), which predicted asthma disease severity beta = .23, p < .01). Relational security inversely predicted depressive symptoms (p = -.40, p < .001), and was not a mediator as predicted, but rather an independent contributor. The findings are consistent with the Biobehavioral Family Model, which suggests a psychobiologic influence of specific family relational processes on asthma disease severity by way of child depressive symptoms.     

Gender differences in severity of writing and reading disabilities

Gender differences in mean level of reading and writing skills were examined in 122 children (80 boys and 42 girls) and 200 adults (115 fathers and 85 mothers) who showed behavioral markers of dyslexia in a family genetics study. Gender differences were found in writing and replicated prior results for typically developing children: Boys and men were more impaired in handwriting and composing than were girls and women, but men, who were more impaired in those writing skills, were also more impaired in spelling than women. Men were more impaired than women in accuracy and rate of reading passages orally, but boys were not more impaired than girls on any of the reading measures. Males were consistently more impaired than females in orthographic skills, which may be the source of gender differences in writing, but not motor skills. Population-based studies that report gender differences in reading in children with dyslexia may be confounding reading and writing disorders—the latter being the true source of gender differences in both children and adults with dyslexia.