Marriage and family therapists working with couples who have children with autism

Current research about families and couples who have children with autism is discussed using the Double ABCX model as a guide. A case study is presented along with recommendations for therapists who work with couples who have children with autism. Marriage and family therapists are encouraged to use the Double ABCX model as both an assessment tool as well as for intervention. More research and effective therapists in this area are needed in order to keep up with the rising rates of families that include children diagnosed with autism.     

Re-examining child welfare's response to ICWA: Collaborating with community-based agencies to reduce disparities for American Indian/Alaska Native children

Many state and county child protection systems (CPS) are attempting to reduce the documented disproportionality in out of home placement rates for American Indian/Alaska Native children. This article presents a case example of collaboration between Colorado CPS and an urban American Indian family services agency that was intended to impact this disproportionality. The Denver Indian Family Resource Center created and evaluated a family preservation model that includes both direct services to Native families and CPS-level systemic interventions designed to reduce out-of-home placement. Direct services addressed family stressors and caregiver substance abuse and mental health issues, and incorporated Native cultural values. Systemic interventions focused on collaborative partnerships and provided CPS with practical ways to comply with the Indian Child Welfare Act. Agency data showed an increase in the number of children remaining at home or with extended family. Statewide data showed a decrease in the disparity ratio for placement of Native children compared to White children.     

Spiritual assessment in marital and family therapy: a methodological framework for selecting from among six qualitative assessment tools

Emerging professional and cultural developments underscore the importance of spiritual assessment. Most marriage and family therapists, however, appear to have received little training on the topic. Consequently, this article overviews a complementary family of six recently developed qualitative assessment approaches or tools, an initial brief assessment tool and five comprehensive assessment tools, and presents a methodological framework for using the six tools. To help decide whether or not a comprehensive assessment is warranted after conducting an initial brief assessment, two general guidelines are offered. Suggestions for selecting the appropriate comprehensive assessment tool are also presented, and summarized graphically in the form of a decision tree. The overall methodological framework is designed to be congruent with the recent spiritual assessments recommendations issued by the Joint Commission on Accreditation of Healthcare Organizations (JCAHO), the largest healthcare accrediting organization in the United States.     

Establishing the Preliminary Validity of Spiritual Eco-Maps with Native Americans

The use of validated instruments is particularly important with populations of color such as Native Americans. Drawing upon the concept of social validity, this mixed method study validates an existing qualitative spiritual assessment instrument—spiritual eco-maps—using a sample of recognized experts in Native American culture (N = 50). The study identifies: (1) the degree of cultural consistency, strengths, and limitations of the spiritual eco-map concept, and (2) how the questions designed to help operationalize the concept might be improved to be more valid, relevant and consistent with Native culture. The results suggest that spiritual eco-maps are relatively consistent with Native American culture as long as they are operationalized appropriately. The paper concludes by providing a more culturally valid question protocol along with suggestions for administering the instrument in a culturally competent manner.     

Family Assessment and Intervention Using an Interactive Art Exercise

The authors have developed a family-centered interactive art exercise from a synthesis of clinical tools used by attachment theory and family art therapists. The exercise aims to facilitate assessment and treatment of families with younger children (two to eight years) at a tertiary referral child and family psychiatric facility, by observing how a family collectively as well as individually sets about planning and completing an art task. Art exercises allow for both verbal and non-verbal communication. The exercises are deliberately kept simple in order to span a range of developmental abilities, and allow the therapist/s to observe from behind a one-way screen, so as to be less intrusive in the family dynamics. Although developed for assessment with a specific population, the exercise is likely to be useful in other clinical situations and has been used as a treatment tool by the authors.     

FAMILY THERAPY WITH INTELLECTUALLY AND CREATIVELY GIFTED CHILDREN

Few family therapists have expertise in the psychology of giftedness, and little research has been conducted to determine the effectiveness of family therapy with talented children and their families. The purposes of this paper are: (1) to provide family therapists with information on the unique psychosocial stressors associated with giftedness and (2) to stimulate further research and development on the efficacy of family therapy in alleviating distress and actualizing potential in gifted and talented children and their families. The paper provides a critical overview of the existing research literature on gifted children and their families. First, current conceptualizations of giftedness are described. Then the research literature on the characteristics of intellectually and creatively gifted children and their families is reviewed with an emphasis on the endogenous (individual) and exogenous (systemic) factors that can create or exacerbate psychosocial problems. Finally, we suggest an eclectic, eco-systemic approach to three common concerns that bring gifted children and their families to therapy.     

Video Game Use as a Tool for Assessing and Intervening with Identity Formation and Social Development in Family Therapy

Because video games are becoming such an integral part of our culture, modern family therapists are more likely than ever to encounter families with members who play them. It is easy to overlook video game use in terms of its potential as a therapeutic tool, particularly if a therapist possesses only limited knowledge of the medium. Using existing literature and my experience as a lifelong gamer, I provide family therapists with a background of the major video game genres and explain how video games can aid in the assessment of factors such as identity formation and social development. I also provide a systemic case example, recommendations for practice, and a table for quick reference to highlight potential videogame‐based family therapy interventions.     

INFLUENCES ON THEf INCLUSION OF CHILDREN IN FAMILY THERAPY BRIEF REPORT

This study examined factors that influence family therapists to include children in or exclude them from therapy sessions. We hypothesized that therapist comfort, child problem type (internalizing vs. externalizing), family composition (one- vs two-parent families), and presenting problem (child-oriented problem vs. adult-oriented problem) affect therapists' inclusion of children. A survey of clinical members of AAMFT found that half of the therapists excluded children on the basis of their comfort and that those who felt more comfortable were more likely to include children in sessions. Therapists included children more frequently in cases of an internalizing vs. an externalizing child, more with single-parent than two- parent families, and more often when the presenting problem focused on a child than on an adult. Implications of the findings are discussed.     

Depression,the Family,and Family Therapy

The potential contribution of family therapists to the treatment of depression remains underdeveloped. Family therapists need to articulate how changes in family functioning might benefit depressed persons, as well as how other problems in the families of depressed persons tend to go unrecognised. Furthermore, family therapists need to be alert to how undetected depression in adults and children may interfere with their ability to meet their goals with families who seek therapy for other persons. This article provides family therapists with (1) an overview of the nature and experience of depression; (2) an introduction to antidepressant medication; (3) a summary of research findings relating depression to its family context and (4) a brief overview of developments in the marital and family treatment of depression.     

Factors predicting placement of urban American Indian/Alaskan Natives into out-of-home care

American Indian/Alaskan Native children have disproportionately been placed into out-of-home care compared to White children in the child welfare system. What were the factors that child protective services (CPS) workers considered when deciding to remove a child from the home? Utilizing data from the National Survey of Child and Adolescent Well-Being, this study examined out-of-home care factors for 2215 urban American Indian/Alaskan Native (AI/AN) and White children. In the urban sample, children from White families were younger and were more likely to be investigated for lack of supervision, while AI/AN families were investigated for physical neglect. In the placement regression models, urban AI/AN children came from homes where caregivers had greater alcohol, drug and mental health problems. Decisions by CPS workers to place AI/AN children may have been influenced by racial bias. A CPS system that acknowledges culture and race may reduce overrepresentation in placement. Efforts to work with AI/AN families prior to a child's removal may prove to be beneficial and less expensive.     

Therapeutic Assessment with Children in Family Therapy

Therapeutic Assessment with Children (TA‐C) is a brief semi‐structured intervention in which psychological assessment is used to help families with children and adolescents to change. In this paper we introduce the TA‐C model, describe its semi‐structured format and exemplify how it can be applied by family therapists.     

THE VOICES OF CHILDREN: PREADOLESCENT CHILDREN'S EXPERIENCES IN FAMILY THERAPY

Although family therapists often include children in therapy sessions, they rarely consider the child's wishes regarding participation or ask children for their impressions of therapy. In this study, 16 children between the ages of 5 and 13 who had participated in at least four family therapy sessions were interviewed to determine their perspectives on the experience. The children made it clear that they wished to be involved in a meaningful way in therapy and that they wanted to come to sessions even when they were not the focus. Feedback from these children is used to suggest ways family therapists might enhance their effectiveness with families with children.     

African American Therapists Working With African American Families: An Exploration of the Strengths Perspective in Treatment

With the exception of Hill's (1971, 1999) work, historically much of the literature on African American families has focused more on pathology than strengths. This study used interviews with 30 African American psychotherapists, self-identified as employing a strengths perspective with African American families, to investigate which strengths they identified in the families and how they use those strengths in therapy. Themes emerging from data analysis confirmed the continued importance of the five strengths Hill noted. In addition, two new strengths were identified by the participants: a willingness of a greater number of families to seek therapy, and the importance of family structure. Strategies used in engaging the families in therapy and practice implications for family therapists are discussed.     

The Impact of Historical Trauma and Mistrust on the Recruitment of Resource Families of Color

ABSTRACT

The Multiethnic Placement Act of 1994 and the Interethnic Adoption Provisions of 1996 (MEPA-IEP) require states to diligently recruit “potential foster and adoptive families that reflect the ethnic and racial diversity of children in the state for whom foster and adoptive homes are needed” (42 U.S.C. §622b(3)(9)). Nationally, 53% of the children in foster care and 55% of the children waiting to be adopted are children of color (Adoption and Foster Care Analysis and Reporting System, 2014). Recruitment of resource families of color has historically presented challenges. This article critically examines the diligent recruitment efforts of an urban county targeting Black/African American, Latino, and Native American communities through a critical race theory lens. Although there was an overall increase in resource families, the racial and ethnic representation of resource families to children in care within the county improved for Latinos yet declined for Black/African Americans and Native Americans. Theoretically, these results indicate that the historical mistrust of communities of color toward the child welfare system is a barrier to successful recruitment of resource families from these communities.     

Action-oriented evaluation of an in-home family therapy program for families at risk for foster care placement

The purpose of this study was to conduct an action-oriented evaluation of an in-home family therapy program serving families deemed at risk for the placement of children in foster care. In this study, feedback was solicited from both clients and therapists. Results indicate "duality" associated with several aspects of in-home family therapy, including the opportunity to observe families in their own homes versus the vulnerability some families feel when therapy is conducted in-home; therapists suggesting that sufficient training is required for in-home family therapy to be effective versus clients' opinions that therapists' lived experiences are more relevant; and the importance of the therapeutic alliance versus feelings of abandonment upon termination. Implications for researchers and practitioners are discussed.     

Spiritual ecomaps: a new diagrammatic tool for assessing marital and family spirituality

This paper develops a new diagrammatic spiritual assessment tool, the spiritual ecomap, for use with individuals, couples, and families. While a genogram portrays a family's history over time, a spiritual ecomap provides a valuable supplement by depicting a family's current relationships to critical ecological systems in space. The spiritual ecomap is based upon an anthropological framework conceptualized in the spiritual formation tradition and can be used with families from diverse spiritual traditions. I use a case study to familiarize the reader with the instrument, and offer suggestions for its application.     

Are the Children Playing Quietly? Integrating Child Psychotherapy and Family Therapy

Over many years, family therapy training programs have not included the engagement of children under seven. John Byng-Hall wrote in 1986 that family therapists could learn about understanding young children from child psychotherapists. It has long been my practice to include young children when working with families. This article describe ways of working that include young children's play as relevant information. I hope to encourage other child psychotherapists and family therapists to find better ways of integrating skills.     

Systemic Therapeutic Approaches with Sexual Minorities and Their Families

Abstract

GLBTQ families encompass very diverse forms, all of which are interwoven with other differences such as class, race, ethnicity, religious and spiritual beliefs. This article will familiarize the reader with some challenges faced by families of sexual minorities and how different family therapy approaches might be applied. Training issues for therapists are identified and future areas for development are discussed.     

Family Therapy for Child and Youth Mental Health: A Scoping Literature Review

Early intervention in childhood years is an important part of successful therapies for children and adolescents living with or at risk of mental illness. Family therapy acknowledges the role of family relationships, interactions, and family systems in child and youth mental health. To explore the effectiveness and delivery of family therapy in order to inform current family therapy practice in Australian public mental health services, a scoping literature review mapped key concepts of the past 11 years of family therapy research. Current gaps were noted within the following key concepts: family therapy settings and definitions, the influence of family factors on outcomes, transparency of intervention methods, and the training of family therapists. Further research could be undertaken to address current gaps in the literature, specifically: assessment and intervention processes; typical length of time for a series of family sessions; frequency of sessions; and theoretical foundations linked with most effective outcomes, as identified by clinicians, children, and their families. This research would provide a better understanding of best practice and evidence‐based family therapy practices that work for children and their families to inform family therapy practice in Australia and beyond. This scoping literature review identified that there is a noteworthy variation in the way brief family therapy is provided, both in terms of the duration and frequency of sessions, as well as the theoretical underpinnings employed. Further research is warranted to explore different service contexts and brief versions of family therapy delivery and the outcomes for the children and their families.     

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.