AAMFT Master Series tapes: an analysis of the inclusion of feminist principles into family therapy practice

Content analysis of 23 American Association for Marriage and Family Therapy Master Series tapes was used to determine how well feminist behaviors have been incorporated into "ideal" family therapy practice. Feminist behaviors were infrequent, being evident in fewer than 3% of time blocks in event sampling and 10 of 39 feminist behaviors of the Feminist Family Therapist Behavior Checklist. These eminent therapists most often dealt with empowerment of male clients and management of power differentials in the therapeutic relationship in a relatively feminist manner, but they tended to hold women responsible for family issues, endorsed traditional rather than egalitarian relationships, and overlooked how the social context affects families. Several of the therapists were blatantly sexist in their treatment of female clients, communicating disrespect of and pathologizing them. The few tapes portraying effective incorporation of feminist principles in family therapy indicate that a handful of behaviors are key to this approach.     

Clients as Teachers: Reciprocal Influences in Therapy Relationships

The value of the continuing education industry for therapists is questioned, as is the usefulness of therapy books and journal articles, as a means of engaging therapists in life‐long learning. Instead, it is argued that our clients are our best teachers and that therapists learn most effectively from their clients. Drawing on research studies with prominent theoreticians and therapists, and on case studies from clinical work, a number of important themes are identified as ways in which therapists are influenced by their therapeutic encounters with their clients. The themes explored in this article include: (1) intimacy and high emotional arousal with clients as we witness profound change; (2) being challenged by clients; and (3) allowing for boundary ‘crossings’ in order to develop more flexible ways of working with clients. The implications for professional development are discussed.     

Making Difference Matter: An Exploration of Culture and Identity in the Therapeutic Domain

This paper examines a number of dimensions which the author believes are pivotal to a feminist perspective in working with clients from linguistically and culturally diverse communities. Definitions of culture and identity are examined in the context of power, followed by a discussion of the therapist's relationship with her/his frameworks of knowledge. Finally, the place of ethics is considered, drawing on a recent analysis of democracy. Through this discussion and analysis, therapists may reflect more fully on their own culture and identity, without which it is not possible to do therapy which can bridge cultural difference.     

Three Journeys Toward The Reflecting Team

The experience of familiestrainee and supervisory therapists involved in reflecting team work are explored through the metaphor of ‘journey’ and by asking a small number of our colleagues and clients about their experiences. Ideas gained from this approach are tentatively used to raise some questions about the reflecting team specifically and the current direction of family therapy. More rigorous research into this area is invited.     

Therapeutic change in Colombian families dealing with violence: therapists, clients, and referring systems in conversation

There is a gap in the Marriage and Family Therapy literature regarding clients', therapists', and family judges' theories of change in relational therapy for family violence. We conducted in-depth interviews with eleven court-referred families, their therapists, and two family judges in Bogota, Colombia. Interviews focused on their expectations of therapy outcomes, their understanding of change, and their evaluation of individual and relational therapy outcomes. We followed a grounded theory approach to data analysis. Analyses showed that therapists, family judges, and clients hold different expectations and theories regarding therapeutic change. Findings are discussed based on existing research on clients' and therapists' ideas about change. Implications for future research and practice are presented.     

From Knowing to Doing: Guidelines for Socioculturally Attuned Family Therapy

Family therapists know that clinical concerns are not separate from larger sociopolitical contexts. Attunement to clients’ sociocultural experience is foundational to good practice, yet few guidelines integrate attention to the larger societal processes or address social equity. The purpose of this article is to help therapists move from knowing about sociocontextual issues to doing socioculturally attuned practice. We offer an overarching framework that returns to Bateson and the roots of family therapy through a call for third order transformation. The approach is responsive to societal context and an analysis of power while working through enduring concepts of major family therapy models. Transtheoretical guidelines that can be integrated across practice models to promote third order change are illustrated with case examples.     

Complex Couples: Multi‐Theoretical Couples Counselling with Traumatised Adults Who have a History of Child Sexual Abuse

One of the major ways child sexual abuse can have an impact on individuals is in their later ability to have and maintain fulfilling couple relationships. Survivors may experience avoidance behaviours that become problematic in their adult intimate relationships. If couple therapists fail to focus on these traumatic imprints, the therapy may founder. This paper proposes that a multi‐theoretical approach enables the couple therapist to deal with the complex problems such couples present including sexuality and intimacy concerns. Such an approach integrates trauma theory, attachment theory, feminist principles, body‐oriented psychotherapy, and systemic couple therapy.     

Understanding the experience of Black clients in marriage and family therapy

Past research on Black clients' utilization of therapy focused on the barriers that prevent Black clients from attending therapy and the reasons for these barriers. However, few studies have been conducted that focus on how Black clients attending therapy actually experience these barriers. This study utilized both Likert and open-ended questions to examine the obstacles 16 Black clients face in their attempts to attend family therapy. The most frequently identified obstacles were related to concerns over family member response and cultural barriers to therapy. Participants also reported concerns about racial and/or cultural differences and a lack of understanding by non-Black therapists. The implications of this study addressed how to effectively meet the therapeutic needs of Black clients.     

Individualism and conformity in the 1950s vs. the 1980s

If the 1950s are remembered for conformity, the 1960s for rebellious individualism, and the 1970s for narcissistic individualism, images of the 1980s contain an ambiguous mixture of individualism and conformity, with similarities to the 1950s. But if the 1980s resemble the 1950s in some respects, are portraits of individualism and conformity in the later decade nevertheless different from their earlier incarnations? A comparative analysis of best-selling self-help books in the 1950s and the 1980s reveals the following changes: from “maturity” as a desirable end to an ever-changing self; from determinism about the self to antideterminism and constructionism; from institutional constraints and joys to interpersonal ones. These changes reflect the incorporation of ideas from the counterculture of the late 1960s and early 1970s, and may also stem from perceptions of a simultaneous increase in structural determinism and individual empowerment.     

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.     

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.     

Therapy with Transsexual Youth and Their Families: A Clinical Tool for Assessing Youth’s Readiness for Gender Transition

The World Professional Association for Transgender Health’s Standards of Care suggests a letter of recommendation be provided from a mental health professional if a transsexual desires hormone therapy or surgery. Therefore, transsexual clients have a unique dependence on therapists to obtain medical treatments needed to live life in their affirmed gender. Despite this need for therapeutic services, most therapists lack the training that is necessary to sensitively serve transsexual clients, particularly transsexual youth. While a published clinical assessment tool exists for therapists to determine readiness of adult transsexual clients for medical gender transition, no similar tool is available for therapists working with transsexual youth. This article discusses therapeutic issues specific to transsexual youth and families and presents a clinical assessment tool for determining transsexual youth’s readiness for medical treatments.     

Approaches to worker rehabilitation by occupational and physical therapists in the United States: factors impacting practice

Work-related rehabilitation services have changed in nature and scope since their inception in the late 1970s. A review of the literature reveals a large body of published data concerning the various approaches used by therapists in this practice area, but a limited number of comparison studies documenting the value of one approach over the other. This national survey of physical and occupational therapists in the US was conducted in 2002, and examined the prevailing trends in service provision, and factors that determine the nature of services provided to clients. Results indicate that services continue the move to onsite service provision and an emphasis on prevention, but that select services, such as onsite job analysis and comprehensive, inter-disciplinary programs are being used to a limited degree. Research that examines the relative contributions of selected work-related services to successful and efficient return to work outcomes is necessary to identify best practice approaches. Therapists and insurance providers should work more closely in exchange of data that will ensure optimal program design and funding.     

Analyzing Politics and Change in Women's Organizations

Research on women's political action too often passes over women's organizations that do not officially adopt a feminist ideology and do not explicitly set out to change gender power relations. Based on implicit notions that such women's organizations are nonpolitical (or less interesting), the research often supports a false dichotomy between feminist and nonfeminist organizations rather than illuminates women's common political ground. This study addresses women's collective action, politics and change by focusing on the case of Nicaraguan Mothers of Heroes and Martyrs - women who lost a son or daughter in the revolution or Contra War. Although some members in Matagalpa critiqued male domination, the organization itself did not set out to challenge the gendered division of labor; indeed, their collective demands relied upon and in many ways reinforced traditional gender identities. I argue that such movements are important to feminist political analysis. As I demonstrate in this article, an organization's lack of an official feminist ideology does not mean that individual members do not express interests, identities and ideals that challenge the gendered status quo. Such research, however, requires a nuanced approach, recognizing women as both accommodating and resisting gendered social structures. Thus, this study challenges the dominant feminist-feminine dichotomy by demonstrating that women's collective action is not only per se political (and politically important) but may also challenge as well as reinforce gendered power structures.     

Treatments for PTSD and Pathological Gambling: What Do Patients Want?

This study explored the treatment preferences of 106 people with posttraumatic stress disorder (PTSD), pathological gambling (PG), or both. It is the first know study of its type for this comorbidity. Sixteen different treatment types were rated, with a broad array of modalities including manualized psychotherapies, medication, self-help, alternative therapies, coaching, and self-guided treatments (use of books and computerized therapy). A consistent finding was that PTSD treatments were rated more highly than PG treatments, even among those with both disorders. Further, of the sixteen treatment types, the sample expressed numerous preferences for some over others. For example, among PG treatments, self-help was the highest-rated. Among PTSD treatments, psychotherapies were the highest-rated; and individual therapy was rated higher than group therapy. For both PG and PTSD, medications were rated lower than other treatment types. Non-standard treatments (i.e., computerized treatment, books, coaching, family therapy, alternative therapies) were generally rated lower than other types. Discussion includes implications for the design of treatments, as well as methodological limitations.     

Considering justice: an exploratory study of family therapy with adolescents

Feminist approaches to therapy with adolescents emphasize an empowering focus on the strengths of adolescents while simultaneously insisting that therapists become aware of their own biases toward today's adolescents. However, a review of the family therapy literature finds little mention of feminist approaches for addressing injustices (e.g., family scapegoating, negative societal views of adolescents, and gender oppression) that arise in family therapy with adolescents. Therefore, this study explores clinical approaches and resources suggested by a surveyed group of self-identified feminist family therapists. In addition, we also recommend several approaches and resources that will aid family therapists in creating a more just climate for family therapy with youth.     

Moving Up the Continuum of Hope: Developing a Theory of Hope and Understanding its Influence in Couples Therapy

For years therapists have suggested that hope is an important catalyst in the process of change. This study takes a grounded theory approach to address the need for a clearer conceptualization of hope, and to place interventions that increase hope within a therapeutic context so that therapists know how and when to use those interventions. Fifteen active and experienced marriage and family therapists from across the United States participated in hour-long phone interviews about hope in couples therapy. Moving Up the Continuum of Hope emerged as the core category from the grounded theory analysis of the data. This category represents a process, with general and specific conditions and consequences that increase a couple’s level of hope. This study serves as a foundation for future process research on couples therapy, as well as research on hope in other contexts (e.g., individual and family therapy) and with other perspectives (e.g., clients).     

DEVELOPING AN IDENTITY AS A FEMINIST FAMILY THERAPIST: IMPLICATIONS FOR TRAINING

Although feminists have profoundly influenced the field of family therapy, little has been written about the process by which these women came to identify themselves as feminist family therapists. This article reports the results of a qualitative research study that explored that process and suggests a model of feminist family therapy identity development. Implications for training programs are reveived.