How Do the Professional Lives of Family Therapists Affect their Private Relationships: A Qualitative Study

This article is based on a qualitative research project about how the professional lives of family therapists affect their private relationships. The overarching research question was: How does your professional work as a family therapist affect your private relationships? To answer this question, semi‐structured qualitative interviews were conducted with four therapists from two different Family Counseling Services. Through the use of interpretative phenomenological analysis, three main findings were identified: (1) family therapists’ knowledge and values are a basis for interpersonal encounters; (2) participants describe resonance in relation to clients’ stories; and (3) therapists can be challenged in managing confidential knowledge particularly where they belong to the same communities as clients. The study also explores societal expectations and discourses that accompany the role of therapist, which can affect therapists’ freedom of movement in their private lives. These issues are discussed in relation to family therapy theory and relevant research.     

The Strengths of Rural Social Workers: Perspectives on Managing Dual Relationships in Small Alaskan Communities

Social workers are advised to avoid dual relationships; however, this recommendation is not realistic for rural social workers. Using qualitative analysis, this study examines the perspectives of 10 rural social workers in Alaska who are long-term members of their community. From the data, four themes emerged: (1) Rural social workers cannot avoid dual relationships, (2) Healthy dual relationships can have benefits for clients, (3) Social work and other professional education helps rural social workers manage complex situations, and (4) Rural social workers use complex critical thinking and have developed advanced skills to negotiate dual relationships.     

A Brief Report on the Ethical and Legal Guides For Technology Use in Marriage and Family Therapy

Marriage and family therapists (MFTs) use ethical codes and state licensure laws/rules as guidelines for best clinical practice. It is important that professional codes reflect the potential exponential use of technology in therapy. However, current standards regarding technology use lack clarity. To explore this gap, a summative content analysis was conducted on state licensure laws/rules and professional ethical codes to find themes and subthemes among the many aspects of therapy in which technology can be utilized. Findings from the content analysis indicated that while there have been efforts by both state and professional organizations to incorporate guidance for technology use in therapy, a clear and comprehensive “roadmap” is still missing. Future scholarship is needed that develops clearer guidelines for therapists.     

Reflexive Research Ethics for Environmental Health and Justice: Academics and Movement-Building

Community-engaged research on environmental problems has reshaped researcher-participant relationships, academic-community interaction, and the role of community partners in human subjects protection and ethical oversight. We draw on our own and others' research collaborations with environmental health and justice social movement organizations to discuss the ethical concerns that emerge in community-engaged research. In this paper we introduce the concept of reflexive research ethics: ethical guidelines and decision-making principles that depend on continual reflexivity concerning the relationships between researchers and participants. Seeing ethics in this way can help scientists conduct research that simultaneously achieves a high level of professional conduct and protects the rights, well-being, and autonomy of both researchers and the multiple publics affected by research. We highlight our research with community-based organizations in Massachusetts, California, and Alaska, and discuss the potential impacts of the community or social movement on the research process and the potential impacts of research on community or social movement goals. We conclude by discussing ways in which the ethical concerns that surface in community-engaged research have led to advances in ethical research practices. This type of work raises ethical questions whose answers are broadly relevant for social movement, environmental, and public health scholars.     

Protecting persons in family therapy research: an overview of ethical and regulatory standards

Family therapists are expected to engage in ethical and responsible research, while maintaining rigorous ethical standards and adhering to federal regulations that require protection for research participants. We present a short historical overview of the significant events and ethical controversies leading to the formulation of current regulations in human subject research and review. Federal regulations and guidelines, including issues of informed consent, special populations, and conflict of interest are reviewed. A short list of recommendations to assist family therapists in staying abreast of contemporary research protocol is provided.     

What we value: A Delphi study to identify key values that guide ethical decision-making in public relations

This study recommends that the Public Relations Society of America expand its professional values list to include respect and trustworthiness. This addition also shows the value this study's public relations participants place on mutually beneficial relationships with their clients/employers, customers, communities, and society as a whole. The findings contribute to the growing attention to and value of relationship management theory for effective public relations.     

Living with dementia in rural and remote Scotland: Diverse experiences of people with dementia and their carers

There is a lack of research into people's experiences of using services as dementia sufferers themselves, or because they care for someone with dementia, in rural areas. This article explores their experiences in the context of rural Scotland, drawing on data gathered from both people with dementia and their carers. Our research suggests that understanding the nuanced and co-constituted experience of dementia in rural communities is a pre-requisite for improving service provision. The paper explores the way in which participants linked their experiences to their spatial location in rural areas. Our findings suggest that participants used a narrative of idealised rurality which linked together interwoven and overlapping social networks, a physical relationship with place and a sense of self sufficiency. However, the participants’ stories also highlighted the diversity in experiences as service users between places, suggesting a disjunction between the generalising narrative of the rural idyll and their particular situations. These findings extend the literature on rural mental health issues and on the experience of dementia in particular, in turn helping to inform place and person centred policies.     

Professional Relationship Boundaries: A Social Work Teaching Module

Social workers are often challenged by the complex and ever‐changing dynamics within their relationships with clients, and struggle to find ethical responses within professional boundary grey zones where boundaries with clients can be difficult to identify, yet easy to cross. Social work educators attempt to prepare students for these complex situations, yet in the United States research reveals rates of social work boundary violations that lead one to question the efficacy of social work ethics education. This article describes the educational competencies and instructional strategies that comprise an adaptable course module which was developed in response to this challenge, and intended to increase students' self‐awareness, motivation and professional judgment‐making abilities related to their professional boundaries. The educational competencies for this course include the abilities to: identify boundary violations, apply critical thinking skills to complex professional relationship contexts, increase awareness of self and other, and initiate prevention strategies. In contrast to traditional approaches to education, this article describes instructional strategies that are based on adult‐learning principles, which have the purpose of effectively and creatively teaching topic areas in such a way as to produce behavioural change. These course topic areas include a ‘Professional Relationship Boundaries Continuum’ conceptual framework, boundary violation impacts, personal boundary vulnerabilities, blurring boundary indicators, and risk‐minimizing strategies.     

DEVELOPMENTAL LESSONS OF SEASONED MARITAL AND FAMILY THERAPISTS: A QUALITATIVE INVESTIGATION

Little has been published regarding the development of therapists during their professional careers. This qualitative research study explored the development of seasoned marriage and family therapists (MFTs) in order to identify important events and themes in their personal and professional lives. The main developmental theme that emerged was the integration of their personal and professional selves. Information gained from this study might be useful in understanding the self of the therapist within training and supervision and might partially provide a map of the possible transitions facing MFTs along their developmental journey.     

The Ethical Practitioner in Formation: Issues of Courage,Competence and Commitment

This article reports on a small study exploring students' accounts of ethically difficult situations. Participating students were studying professional qualifying programmes in social education and social work at three higher education institutions in Finland, France and the UK. Variations in how students describe ethically difficult situations are noted—including whether they feature the student as an active moral agent facing a difficult ethical decision and the extent to which they utilise recognisably ‘ethical’ language and concepts. The types of situations reported as ethically difficult are identified as focusing on: the difficulties of challenging service users and colleagues; the power and responsibility of the worker; and defining the boundaries of the professional relationship. Similar types of situations were raised by students in the different countries, although there is some variation in how they describe their ethical difficulties and the specific concerns they raise. Implications for teaching include the need to develop skills and qualities in students that enable them to recognise the ethical dimensions of difficult situations and to develop the courage to act on their decisions.     

Books Received

In addition to acting as teachers, social work educators can play many other roles in relation to their students—including sexual partner, friend, therapist, or employer. Combining the role of instructor with one of these other roles may lead to ethical violations and dilemmas. This article urges educators to consider their power differential and the potential for harm to their students before entering a dual relationship. It reviews the NASW Code of Ethics and relevant literature about dual relationships in practice and in academia; discusses examples of dual relationships in social work education; and formulates questions for educators to use in assessing ethical practice.     

The Impact of Family Therapists’ Adult Attachment Styles on Their Career Choice and Approach to Therapy: An Interpretive Phenomenological Analysis

Attachment theorists have highlighted the role of the therapist in providing a ‘secure base’ for therapy. This raises the question of how therapists with insecure as well as secure attachment styles manage the integration of their personal experience and their therapeutic work. This study explored the relationship between family therapists’ adult attachment styles, influences on their career choice and their approach to therapy. Participants’ (n = 11) attachment styles were previously assessed using the self-report Experiences in Close Relationship questionnaire. Three participants were assessed as having a ‘secure’ attachment style; three were ‘preoccupied’, three ‘fearful’ and two ‘dismissing’. They were interviewed about their practice and the impact of past or current relationships on their development as therapists. Interpretive Phenomenological Analysis was used to analyse the verbatim accounts into cluster of master themes and subthemes. The analysis identified two master themes: understanding one’s self and the impact of family of origin experiences, and the integration between personal experiences and therapeutic work. There were differences in responses relating to the therapists’ attachment styles. Therapists with ‘secure’ adult attachment styles were aware of their challenges and able to utilise their experiences in their practice and respond sensitively to their clients. Conversely, those with ‘insecure’ styles have difficulties in mentalisation and in using counter-transference responses in their practice. We suggest that family therapists, social workers and others engaged in therapeutic work with families should undertake an exploration of the ‘self’ of the therapist in the context of their own family relationships and adult attachment styles as part of their training and continuing professional development.     

Working with ‘The Welfare’ in Child-at-Risk Cases

This paper, the second in a series concerned with family therapy in cases involving children at risk of abuse, focuses on how to establish a workable relationship between therapists and child protection professionals and child protection professionals and parents. After overviewing the difficulties faced by therapists in working with ‘the Welfare', we propose guidelines to overcoming common obstacles to successful case management, concluding that therapy often fails when therapists attempt to deal with intrafamilial issues long before external relationships are resolved.     

Secondary Trauma: How Working with Trauma Survivors Affects Therapists

Secondary trauma, a relatively recent topic that has emerged in the field of social work, includes the emotional and psychological effects that working with traumatized clients has on therapists. Secondary trauma can seriously impact therapists' personal and professional well-being. Trauma therapists face major ethical dilemmas if their reactions to being traumatized enter into the therapeutic relationship, exposing clients to psychological harm or possibly re-traumatization. As many graduate programs in social work and social service agencies are still unaware of this phenomenon, recommendations are made for how to introduce the topic as priority and how to cope with and prevent secondary trauma.     

ETHICAL DILEMMAS IN FAMILY THERAPY

A review of the literature in the area of ethical dilemmas facing family therapists revealed that there were a number of issues facing family therapists which are not included in the Principles for Family Therapists (1984) of the American Association for Marriage and Family Therapy. Seventy-five family therapists from across the nation responded to a questionnaire which asked what ethical dilemmas they face and how helpful the ethical guidelines are with these dilemmas. Results indicate that family therapists are encountering dilemmas which are not included in the Principles, significantly more often than those that are included. The ethical principles were found to be helpful for those ethical dilemmas attended to by the Principles.     

Ethical dilemmas faced by family therapists

This study explores the reactions of 202 randomly selected clinical members of the American Association for Marriage and Family Therapy (AAMFT) to a variety of ethical dilemma situations which examine what family therapists are doing in their work when confronted with these difficult situations. Eight of the issues studied have been discussed in the literature and eight are included in the AAMFT's Ethical Principles for Family Therapists (1984). In addition to showing how clinical members responded to dilemmic vignettes that reflect these dilemmas, results indicated that family therapists are facing these dilemmas, have a high rate of consensus of what they would and would not do in each situation and almost all the situations were seen as being ethically significant by the majority of respondents.     

AAMFT ETHICAL CODE: "DUAL RELATIONSHIPS"

The current American Association for Marriage and Family Therapy (AAMFT) Code of Ethical Principles prohibits an apparently wide, but vaguely defined, range of nonsexual, and presumably nonromantic dual relationships between therapists and clients, supervisers, employees and students. We suggest that this extension of the dual relationship prohibition is undesirable, for a variety of reasons. The most important of these is that attempting to make relationships simple by legislation, rather than dealing with inevitable complexity, prepares students poorly for the work they must do. Instead, we propose that training and supervision include serious emphasis on relationship complexity, and issues of exploitation and power, within the therapy relationship and within the training program or supervision itself.     

Correlates of physical activity in a community sample of older adults in Appalachia

Although much has been learned about the global determinants of physical activity in adults, there has been a lack of specific focus on gender, age, and urban/rural differences. In this church-based community sample of Appalachian adults (N = 1,239), the primary correlates of physical activity included age, gender, obesity, and self-efficacy. Overall, 42% of all participants and 31% of adults age 65 years or older met recommended guidelines for physical activity, which suggests that most participants do not engage in adequate levels of physical activity. Of participants who met physical activity guidelines, the most common modes of moderate and vigorous activity were walking briskly or uphill, heavy housework or gardening, light strength training, and biking. These particular activities that focus on building self-efficacy might be viable targets for intervention among older adults in rural communities.     

Ethics and family therapy: the case management of family violence*

All family therapists, and especially Milan-style systemic therapists, have been trained to take a neutral stance regarding family issues, based on a circular causality model of family interaction. Therefore, when therapists deal with family violence, their ability to perceive individual responsibility for unethical behavior is weakened or suppressed. In fact, this ability is the primary tool in developing effective treatment planning in cases of family violence: The actively physically abusive man needs to be in individual and/or group therapy, not conjoint or family therapy. The ethical judgment of the therapist is what determines the limits of family therapy.