Family Phone Therapy in University Counseling and Psychological Service Centers: A Family Systems Approach

Abstract

This paper offers family phone therapy as a method for student mental health practitioners to overcome the obstacle of geographic distance between students and their families when family therapy is the treatment of choice. The issues of confidentiality, triangulation, diversionary conversation, and mixed communication, which present unique concerns when engaging in family phone therapy, are introduced and strategies to deal with them are discussed. A case example is presented to demonstrate the utility of family phone therapy in dealing with problems that students who use university mental health services can typically experience. Finally, implications of dealing with students' developmental tasks from an individual or family systems perspective are discussed.     

Pathways Among Marital Distress,Parental Symptomatology,and Child Adjustment

A community sample of 295 mothers, fathers, and children (M age = 11.14 years, SD = 2.32 years) rated marital distress, maternal and paternal psychological symptoms, and child adjustment. The predicted direct relations between these family and child variables were demonstrated for both fathers and mothers. Tests of pathways among these variables were conducted for separate but complementary mediation models. Maternal and paternal symptoms mediated the association between marital distress and child adjustment. Marital distress mediated the link between fathers’ symptoms and child adjustment, but the direct pathway between mothers’ symptoms and child adjustment remained. Pubertal status was modestly related to higher levels of family stressors. Joint implications of marital distress and parental symptoms for child adjustment are discussed.     

Book Reviews

Book Reviewed in this article: Beavers, W. Robert. Psychotherapy and growth: A family systems perspective. Clanton, G. & Smith, L. G. Jealousy. Erickson, Gerald D. & Hogan, Terrence P. Family Therapy—An introduction to theory and technique. Scanzoni, John H. The black family in modern society. Sholevar, G. Pirooz, (Ed.). Changing sexual values and the family. Stein, Edward V., (Ed.). Fathering: Fact or Fable? Sugar, Max (Ed.). The adolescent in group and family therapy.     

The Division of Labor in Lesbian,Gay, and Heterosexual New Adoptive Parents

Little research has investigated the division of child care and housework in adoptive or lesbian/gay parent families, yet these contexts “control for” family characteristics such as biological relatedness and parental gender differences known to be linked to family work. This study examined predictors (measured preadoption) of the division of child care and housework (measured postadoption) in lesbian (n = 55), gay (n = 40), and heterosexual (n = 65) newly adoptive couples. Same‐sex couples shared child care and housework more equally than heterosexual couples. For the full sample, inequities in work hours between partners were associated with greater discrepancies in partners' contributions to child care and masculine tasks; inequities in income between partners were related to greater discrepancies in contributions to feminine tasks. Participants who contributed more to child care tended to contribute more to feminine tasks. These findings extend knowledge of how labor arrangements are enacted in diverse groups.     

Common Developmental Tasks in Forming Reconstituted Families*

Developmental tasks common to the formation of a reconstituted family are described, particularly the continued mourning of the old family; the formation of a solid marital relationship despite the difficulties presented by past failures and the presence of children; formation of sibling alliances across family lines. A treatment case is described which illustrates one family's process of achieving these developmental tasks.     

Family group conferences: from Maori culture to decision-making model in work with late modern families in Norway†

Models and methods within social work and child protection services are disseminated across cultural and national borders. The family group conference (FGC), with its origins in traditional Maori culture, is one example of this. The application of this model presupposes an ‘extended family’. Based on sociological theory, we highlight and problematise the explicit inattention to relevant cultural differences. The assumed existence of the extended family is implied in the direct translation of the term. The family in late modern society is often described as diversified, elective and shifting. We argue that FGC is relevant to such families. In our conclusion, we point out that despite changes, the family remains associated with traditional family values as solidarity and joint obligations, responsibilities and continuity. FGC vitalise traditional family values and facilitate for modern families performing traditional family practices. From our exploration of discourses and analyses on how FGC may be transformed from supporting Maori traditional culture to become a decision model in a CPS of a society such as Norway, we find there is a compliance with two fundamental factors: the late modern family's negotiating practices and the revitalisation of traditional family values.     

Paradox and a Systems Theory Approach to a Case of Severe School Phobia**

A recent case of severe school phobia treated by the author and a colleague is discussed. Systemic assessment indicated high resistance to change. Our initial paradoxical strategy utilising a “therapeutic triangle” is outlined, designed to bind the family into arguing in favour of change. With the lessening of resistance, direct interventions were utilised, combined with re-framings preventing the family developing a rationale that would allow them to escape change.     

Preparation for Adoptive Parenthood with a Special-Needs Child

ABSTRACT

Mothers of 86 adopted special-needs children were surveyed regarding the tasks they undertook to prepare for parenthood. They engaged in tasks related to learning about the child most often and stated participating in training to be adoptive to be most helpful. Overall preparedness, more so than either the number or type of adoption preparation tasks (APTS) completed prior to the adoptive placement, was found to be positively associated with assessment of child and family functioning. Implications of these findings for the delivery of adoption preparation programs are discussed.     

A Contribution to the History of Family Therapy in Australia and New Zealand: A Bibliometric Perspective*

The content of the first ten volumes of The Australian and New Zealand Journal of Family Therapy is analysed to provide a picture of the major themes and subject matter addressed in its formative years using the techniques of bibliometrics and content analysis. A methodology is developed for measuring the prevalence of subject content in the journal which could have application in other fields. The interdisciplinary character of family therapy is demonstrated by the diversity of cited end-of-article journal references. A list of most-cited journals is provided. The characteristics of authorship are discussed with respect to geographic dispersion, institutional affiliation, seniority and gender. The issue of collaborative authorship is discussed in relation to the patterns of co-authorship observed in this period, 1979–1989. The analysis identifies signs of the emergence of family therapy as a discrete field. The paper concludes also that there are positive signs of maturation of the journal. It offers some pointers about directions for the journal in the next phase ofits development.     

Life satisfaction linked to different independence-from-parents conditions in Italian emerging adults

ABSTRACT

The transition toward adulthood in Italy lasts longer than in other countries with respect to living with the family of origin, starting work, and gaining economic independence. This study aimed to analyse the transition to adulthood in Italian youths by exploring these developmental tasks. The first aim was to analyse gender and age differences in these developmental tasks. Given that these tasks are not necessarily achieved at the same time, the second aim was to establish if it might be possible to identify different clusters of individuals according to their residential, economic and employment conditions. The third aim was to explore life satisfaction in different clusters. 191 Italian emerging adults (65 males) aged 20–30 years (M?=?24.40) completed the Satisfaction with Life Scale and a specific questionnaire assessing residential independence, economic autonomy, and job stability. Results showed no gender differences in the three developmental tasks. However, older participants reported a higher level of independence. Cluster analysis identified three different groups: ‘totally dependent’, ‘partially independent’ and ‘totally independent’ from parental family, differently composed in terms of partnering. These groups do not differ in life satisfaction levels. Results are discussed focusing on different independence-from-parents conditions that characterize Italian emerging adults.     

Is Work-Family Policy Use Related to the Gendered Division of Housework?

Researchers have proposed that work-family policy use may either reinforce or challenge the existing gendered division of labor within couples, but results from prior studies have been inconclusive. Using data from a regional survey of work and family life, we extend this research by focusing on how housework is divided within couples and by differentiating between traditionally female- and male- typed housework tasks. Results show that among dual-earning women, policy use is not related to share of female- or male-typed tasks. Among dual-earning men, policy use is positively related to share of female-typed tasks and negatively related to share of male-typed tasks. These findings suggest that work-family policy use does not reinforce the gendered division of housework.

Multicultural Considerations in the Application of Child Protection Laws

Professionals exercise a great deal ofdiscretion in the application ofmandatory reporting laws and child welfare laws. This paper examines the subjective factors that influence the decisionmaking process from labeling an incident as possible abuse or neglect through the disposition stage. Multicultural issues that affect each stage of the process are discussed. Areas of disparate treatment of minorities are considered. Disparate treatment stems from biased and unequal application of the laws in some cases, or when standards are applied and interventions made that are insensitive to the cultural context of the family. Potential consequences of failing to consider culture in applying child protection laws are biased reporting, errors in assessing perceived risk, ineffective interventions) and increased out-of-home placements. The need for a culturally sensitive approach to assessment and intervention is emphasized.. Areas for future research are recommended.     

Medical Family Therapists in Action: Embracing Multiple Roles

Medical family therapy (MedFT) is a growing area of interest within the field of marriage and family therapy. Its practice necessitates a shift from conventional family therapy practices to include diverse ways of providing care. Literature highlights approaches for patients with specific illnesses and for particular healthcare contexts. Less is understood about frameworks for treating patients with different illnesses across settings. Contributing to the growing discourse surrounding MedFT, we present a role‐based practice framework that identifies six consistent roles, Therapist, Brief Interventionist, Health Coach, Patient Advocate, Consultant to Health Professionals, and Trainer specific tasks associated with each. We describe the skills needed to perform each role and describe how we move fluidly between roles to provide comprehensive care.     

Multidimensional Family Therapy: A Science‐Based Treatment System

MDFT is a family‐based intervention for adolescent substance abuse and associated mental health and behavioural problems (Liddle, 2010). Integrative in several ways, MDFT uses an ecological or contextual conceptual framework to understand the developmental tasks of teens and their families. Research‐derived knowledge about risk and protective factors, and proximal causes, correlates and contributors to adolescent drug and related problems inform clinical thinking and interventions with every case. A multisystems approach, MDFT assesses and intervenes in four areas: (1) the adolescent as an individual and a member of a family and peer network; (2) the parent(s), both as individual adults and in his or her role as mother; father or caregiver; (3) the family environment and family relationships, as manifested in day‐to‐day family transactional patterns; and (4) extrafamilial sources of influence such as peers, school and juvenile justice. Interventions are made within and coordinated across domains. Progress in one area or with one person has implications for and use in others. Individual meetings with parent(s) and teen set the stage for family sessions, and family meetings may offer content and new outcomes that need to be brought to extrafamily meetings with juvenile justice or school personnel. MDFT was developed and tested as a treatment system rather than a one‐size‐fits‐all approach. A treatment system offers different versions of a clinical model that vary according to factors such as clinical sample characteristics (older versus younger adolescents, juvenile justice involved versus no involvement in juvenile justice systems), and treatment parameters (type of clinical setting and treatment dose).     

Change and Paradox in Family Therapy

This paper shows that when the interpersonal context in a family alters, solutions which have previously been successful may paradoxically increase the family's difficulties rather than resolve them. Therapy minors this process, in that when the family system is flexible, “commonsense” interventions may be effective, whereas with a rigid dysfunctional family system therapeutic interventions may be necessary which, among other things, paradoxically imply that no change is required. Some concepts derived from Watzlawick, Weakland and Fish are redefined and the mathematical group theory used by these authors is replaced by system theory in combination with the theory of logical types. A “behaviour disorder” family is used to illustrate the paradoxical mode of symptom development and also the use of a number of paradoxical therapeutic interventions. Possible reasons for the therapeutic power of these interventions are discussed; the concept of first and second order therapeutic paradoxes is introduced.     

Multicultural considerations in the application of child protection laws

Professionals exercise a great deal of discretion in the application of mandatory reporting laws and child welfare laws. This paper examines the subjective factors that influence the decisionmaking process from labeling an incident as possible abuse or neglect through the disposition stage. Multicultural issues that affect each stage of the process are discussed. Areas of disparate treatment of minorities are considered. Disparate treatment stems from biased and unequal application of the laws in some cases, or when standards are applied and interventions made that are insensitive to the cultural context of the family. Potential consequences of failing to consider culture in applying child protection laws are biased reporting, errors in assessing perceived risk, ineffective interventions, and increased out- of- home placements. The need for a culturally sensitive approach to assessment and intervention is emphasized. Areas for future research are recommended.     

School Refusal An Empirical Study and System Analysis

The empirical, clinical and theoretical literature on School Refusal is reviewed. A study is reported in which a comprehensive group of forty severe school refusers was compared with a matched control group. They differed on a wide range of variables. The school refusing children were more depressed, anxious, introverted, neurotic, over protected and less intelligent. Their parents' educational attainment and levels of intelligence were lower; they were older and had larger families; father's occupational status was lower and he was often absent from home. The results are discussed. A three level system theory interpretation is presented:

• (i) child;
• (ii) family;
• (iii) beyond the family.

Some therapeutic implications are offered.     

Inter-rater Agreement Indices for Multiple Informant Methodology

This paper addresses the potential applications of multiple informant methodology (MIM) to family research. The MIM is used when data on the same unit of analysis are collected from more than one informant, and when the researchers’ purpose requires a dyadic or group level of analysis. The MIM relies on inter-rater agreement (IRA) indices, which are needed to both estimate agreement among informants and aggregate scores from different informants. This review describes the main IRA indices: reliability within-group index (r_WG), agreement within-group index (a_WG), average deviation indices (AD_M and AD_Md), intra-class correlation coefficient (ICC), and random group index (r_WG). For each index, we describe the aim, application contexts, formula(s), ranges, cutoffs, requirements to apply the index, and its possible application to family research.     

Evaluation of the Stress Adjustment and Adaptation Model Among Families Reporting Economic Pressure

ABSTRACT

This research evaluates the Stress Adjustment and Adaptation Model (double ABCX model) examining the effects resiliency resources on family functioning when families experience economic pressure. Families (N = 128) with incomes at or below the poverty line from a rural area of a southern state completed measures of perceived economic pressure, family hardiness, social support, and the McMaster Family Assessment device. The family resiliency model was evaluated using regression and two path analyses. Results of the model evaluation indicate that when family resiliency resources are introduced economic pressure is not a significant stressor influencing family functioning. Family resiliency is a key to the healthy functioning of the family unit moderating distress and decreasing the negative effects associated with economic pressure. Implications for social work practice to enhance family resiliency using community and personal supports are discussed.     

Communicative Correlates of Satisfaction,Family Identity,and Group Salience in Multiracial/Ethnic Families

Guided by the Common Ingroup Identity Model ( S. L. Gaertner & J. F. Dovidio, 2000 ) and Communication Accommodation Theory ( C. Shepard, H. Giles, & B. A. LePoire, 2001 ), we examined the role of identity accommodation, supportive communication, and self‐disclosure in predicting relational satisfaction, shared family identity, and group salience in multiracial/ethnic families. Additionally, we analyzed the association between group salience and relational outcomes as well as the moderating roles of multiracial/ethnic identity and marital status. Individuals who have parents from different racial/ethnic groups were invited to complete questionnaires on their family experiences. Participants (N = 139) answered questions about relationships with mothers, fathers, and grandparents. The results of the multilevel modeling analyses are discussed in terms of implications for understanding multiracial/ethnic families and family functioning.