Creating Culturally Responsive Family Therapy Models and Research: Introducing the Use of Responsive Evaluation as a Method

Models of marriage and family therapy (MFT) typically reflect Western values and norms, and although cultural adaptations are made, many models/frameworks continue to be inappropriate or inadequate for use with non‐Western cultures. Worldwide, therapists are examining ways of using MFT models in a culturally sensitive manner, especially when working with clients who are seen as having minority status or perceived as “other” by the dominant group. This essay suggests the use of responsive evaluation as a theoretically consistent methodology for creating and evaluating culturally responsive therapies. This approach rigorously evaluates each unique client/therapist context, culture, power, needs, and beliefs. We describe responsive evaluation and discuss how each component addresses the research needs of examining culturally responsive family therapies. A case illustration is offered delineating the process of conducting culturally responsive therapy with a Cambodian sample using solution‐focused and narrative therapy.     

Personal Reflections of A Family Therapist*

In this informal paper I discuss my personal evolution as a family therapist, developments in the field, the politics of a systems approach in conventional settings, resistances to family and marital therapy by other professionals, some still puzzling aspects of family therapy, whether family or marital therapy works and what do we mean by working, directions my own work has taken, some comments about the nature of family life, the satisfactions and frustrations and stresses of being a family therapist, some hidden agendas of family therapy practices, how one's own personal family relationships affect and are affected by this kind of work, the casualties among family and marital therapists, and, finally, whether family therapists should have family therapy for themselves and their own families.     

The Cultural Imperatives of Professionalism: Who's Protecting Whom?

What does it mean to be a professional therapist? This paper explores some of the personal and cultural pressures that influence how we see ourselves as professional therapists. It then explores how these pressures impact upon our capacity to protect children and ourselves.     

Partners in the Spiritual Dance: Learning Clients’ Steps While Minding All Our Toes

We present four case illustrations highlighting the complex interplay of therapists’ and clients’ spirituality in therapy. Complexity, in these cases, results from (a) degrees of similarity and difference, both real and perceived, between clients’ and therapists’ spiritual beliefs and practices; (b) degrees of spiritual disclosure; (c) characteristics of the therapeutic relationship; and (d) geographic and cultural influences. Practicing therapists and therapist training programs can benefit from addressing how therapist and client spirituality intersect and influence therapy, how both similarity and difference present obstacles and opportunities, and how ambiguity and assumptions can contribute to misunderstandings. We believe that both the therapist’s and the client’s spiritualities are key influences in therapy that can contribute to the frustration, and the growth, of clients and therapists alike.     

THE CLIENT'S INTERVIEW OF THE THERAPIST

This paper presents a framework for thinking about interactions between client and therapist systems in terms of the participants' personal explanatory systems and models of reality. The therapist's contribution to forming structures throughout the therapy is examined. The elements of a covert interview of the therapist performed by the client system are described. A model is presented for training therapists to think systemically about client/therapist fit in the context of the client's interview. A case presentation illustrates the value of the interview.     

Gender Socialization,Countertransference and the Treatment of Men with Eating Disorders

Knowledge about the treatment of eating disorders is largely based on the experience of women with these disorders. The motivations, beliefs, vulnerabilities and developmental factors that cause and perpetuate eating disorders in men are often gendered. Engaging men in therapy and helping them build and sustain motivation requires therapeutic sensitivity to the impact of these gendered factors. Therapists’ sensitivity to these factors inevitably activates personal experiences with gender and provides an important source of information about patients’ experiences. This article focuses on how gender socialization and internalized views of masculinity affect client, therapist and the co-created therapeutic relationship. Male and female therapists can use awareness of gender influences to improve their ability to detect and communicate their gendered countertransference reactions. The article concludes with a discussion of how gendered assumptions and emotional reactions can affect treatment team interactions and treatment program protocols.     

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.     

Therapists’ Assessment and Treatment of Internet Infidelity Cases

In this study, we investigated through an Internet survey of 508 practicing marriage and family therapists which treatment decisions varied by gender of the client and background variables of therapists. The subjects responded to several typical Internet infidelity scenarios. We varied the gender of the person initiating the infidelity for half of one sample. We also asked the family therapy participants to respond to how they might assess and treat each presenting problem. They also evaluated problem severity, prognosis of the case, number of sessions necessary for treatment, and the extent to which a therapist would focus individually or relationally. Results indicate that there were differences in how therapists assessed and treated clients based on client gender, therapists’ age, therapists’ gender, how religious therapists reported they were, and the extent of therapists’ personal experience with infidelity.     

Working With a Deadly Serious Problem — An Interview With Brian Cade

Brian Cade is an internationally respected family therapist, noted for his work with teams and the one-way screen, for the creative use of metaphor and humour, and strategic interventions. Yet our interview, squeezed into a lunch-break in the middle of a workshop held in Adelaide in September 1984, touched none of these. Instead we talked of the nuclear issue and beneath this discussion ran basic questions all therapists should ask of themselves — What is the appropriate role of the therapist? Should a therapist's own strong values have a place within therapy? And how can the therapist make an impact on society?     

Compassion fatigue in marriage and family therapy: implications for therapists and clients

Given that marriage and family therapists are exposed to a wide range of circumstances that leave them uniquely vulnerable to experiencing compassion fatigue, it is important to examine the stresses and hazards they face and what those consequences mean for both themselves and clients. It is essential that they identify how compassion fatigue negatively affects the therapeutic relationship and overall treatment outcome as well as that of the personal life of the family therapist. The marriage and family therapist is responsible and ethically obligated to identify and implement ways in which he or she can prevent and remedy compassion fatigue.     

Cultural Attunement in Therapy With Mexican‐Heritage Couples: A Grounded Theory Analysis of Client and Therapist Experience

There is a need for culturally attuned approaches for couple therapy with Mexican/Mexican‐Americans. This qualitative grounded theory study utilized interviews with 11 client couples of Mexican heritage and 14 marital and family therapists to shed light on how Latino and non‐Latino therapists co‐construct positive experiences of cultural attunement with Mexican and Mexican‐American couple clients. Analysis identified a model of cultural connection through personal engagement with four interrelated phases: (a) mutual invitation, (b) shared engagement, (c) expanding personal connection, and (d) creating cultural connections. Clients in this study valued professionalism and expertise of the therapist, but felt attuned to and respected when therapists demonstrated humility, shared personal stories and emotion, and engaged in a collaborative process.     

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.     

Encounter with Soul

For Americans in the new Millennium, there is a revival of interest in spiritual matters. Simultaneously, attention to spirituality in the social work profession is a cutting edge theme. Social work has a holistic focus on person-in-environment, acknowledging the psychological, emotional, physical and social aspects of the individual. The spiritual is also a defining aspect of each individual. Bidden or unbidden, therapists are confronted daily with the manifestations of the spiritual yearning of their clients while also being confronted with their own spiritual attitudes. The endeavor to understand the human dilemma must include the spiritual dimensions of both therapist and client. This article defines the author's therapeutic attitude as it is informed by social work training, personal life experience, and spiritual religious beliefs. Several case examples are included.     

Straight therapists working with lesbians and gays in family therapy

This article uses a cultural literacy model to sensitize straight marital and family therapists (MFTs) to work with gays, lesbians, and their families. While most MFTs number gays and lesbians among their clients, differences in sexual orientation between therapist and clients are often insufficiently addressed, closing off therapeutic possibilities. Marital and family therapists are asked to systematically assess homophobic and heterosexist assumptions in both personal attitudes and professional theory and practice and to educate themselves about gay culture and family life. The role of disclosure, trust, and collaborative meaning making in creating a therapeutic relationship that is culturally sensitive, clinically effective, and ethically responsible is examined.     

DIFFERENT AND SAME: FAMILY THERAPY WITH ASIAN-AMERICAN FAILIES

This paper is written for non-Asian family therapists who must deal with an increasing number of Asian-American client families. Unlike some writers in fthe field who advocate that client and therapist have the same ethnic background, the authors belive that cultural sensitivity can be learned. Several culturally important values are described, and suggestions on how to orient treatment to fit this client population are offered. A Detailed case example illustrates the treatment issues involued.     

Expertosis: Is it Catching?

In this plenary address a therapist talks about her experiences of culture, gender, the loss of her daughter, and the impact this has had on her values and beliefs which are reflected in both her personal and professional life. Her paper challenges dominant discourses and the tyranny of expert knowledge.     

Collaborative Influence

Collaborative therapists acknowledge their role in influencing clients and the outcomes of therapy. But the word ‘influence’, for many new to the collaborative therapies, can be mistakenly connoted as an undue exercise of therapist power. From a dialogic and social constructionist perspective, this article reflects on how therapists can be influential in collaborative ways. Negotiating ‘shared intentionalities’ with clients, while privileging their preferences in meaning‐making and change—as part of respecting their primary authorship over their lives—assists therapists to employ their influence in ways that stay collaborative. Furthermore, by regarding client ‘resistance’ and misunderstanding as instructive, therapists can enhance their efforts to stay collaborative.     

Creating the Next Wave of Family Therapy

This article is an exploration of family therapy in Australia based on interviews with seven leading Australian family therapists: Max Cornwell, Carolyn Quadrio, Ron Perry, Laurie MacKinnon, Brian Stagoll, Banu Moloney and Jim Crawley. It explores the attributes and qualities of what makes a good family therapist and seeks to understand how the next generation of therapists can generate a new enthusiasm for family therapy.