Relational safety and liberating training spaces: an application with a focus on sexual orientation issues

This article describes and discusses a teaching case of a clinical training situation involving a gay marriage and family therapy student working with a same-sex affectional couple. The conceptual pillars of this teaching case, relational safety and liberating spaces, are advanced as illustrations of how the student developed his voice in the training process. Pivotal moments in this process are discussed, as are implications for training and personal and professional growth.     

Crisis management during "live" supervision: clinical and instructional matters

In this article, we illustrate two examples of "live" supervision with marriage and family therapy trainees whose clients presented in the therapy room in immediate crisis. The case examples, one a client with suicidal thoughts and the other a parent who had struck her child, demonstrate how the university-based therapy team managed the recursive clinical and supervision processes that unfolded during the sessions. We present the case examples from the perspective of both supervisees and supervisor, discussing how our different experiences of the supervision unfolded in real time. Case discussion and reflections later in the article illustrate the need for an open, transparent, dialogical process throughout supervision. A case is made for supervisory participants to create alternative formats in which multiple supervisory voices can be heard.     

A FAMILY THERAPY INTERNSHIP IN A MULTIDISCIPLINARY HEALTHCARE SETTING: TRAINEES' AND SUPERVISOR'S REFLECTIONS

Family therapy doctoral students from American Association for Marriage and Family Therapy-accredited programs are required to complete a full-time clinical internship. The literature provides little information about these internship experiences. Two doctoral-level marriage and family therapists summarize their professional and personal experiences in their internships located within a multidisciplinary healthcare setting. In addition, their supervisor reports on her experiences working with marriage and family therapy doctoral interns. We hope that this case report will stimulate all interns and their supervisors to provide feedback to their internship sites and graduate programs about their clinical training and the extent to which the programs prepared them for their marriage and family therapy careers in the larger health and mental health community.     

Teaching accountability: using client feedback to train effective family therapists

The AAMFT Task Force on Core Competencies (Nelson et al., 2007) proposed that marriage and family therapy (MFT) educators teach and provide evidence of trainee competence beyond coursework and accrued clinical hours. This article describes the integration of a systematic client feedback protocol into an MFT-accredited program's curricula to address the call for outcome-based learning. Outcome management (OM) provides a framework for teaching and assessing trainee effectiveness. Continuous incorporation of client feedback embodies collaborative, strengths-based, integrative, and diversity-centered program values. Students learn a system for being accountable to clients, the profession, and service communities.     

A graduate course in marriage and family enrichment

Legislation aimed at decreasing the divorce rate and the resurgence of interest in marriage and family enrichment have propelled educators to consider how well they are training new therapists in the preventive approaches to therapy. In this article, we present a graduate course to educate students about the enrichment movement and skill- and competency-based approaches to family intervention. We provide a general outline for teaching the course as well as specific resources and guidelines that can be of value to all marriage and family therapy practitioners.     

Trainee multicultural case conceptualization ability and couples therapy

Previous literature on the assessment of multicultural counseling competence has been concerned only with counselors' abilities when working with individual clients. We expanded this line of research by investigating trainees' multicultural case conceptualization ability in the context of working with couples. Despite the fact that trainees self-reported a high level of multicultural competency, trainees were largely inattentive to racial factors in their case conceptualization responses to vignettes involving both African American and European American clients presenting for couples therapy. On the whole, despite didactic, clinical, and extracurricular training in multiculturalism, marriage and family therapy trainees did not sufficiently incorporate cultural factors into their clinical case conceptualizations. We discuss implications for teaching, practice, and future research.     

Family Social Work: The Past and the Present

SUMMARY

It is easy to blame the dysfunction of a family member on his or her behavioral patterns. I use the title, “It's the Relationship, Stupid!” not to talk down to family therapists, but to remind myself that the source of dysfunction is usually family relationships, especially the marriage relationship. This article gives several case studies for practical application of therapy techniques that focus on developing the “WE” of the family unit. One practical technique that I developed is a communication typology. The married couple (and family members) are divided into “Painters” and “Pointers.” This typology explains much of the conflict and mis-communication that leads to the breakdown of the “WE.” This article also presents dysfunction within the individual as a relationship problem and introduces the concept of the “spirit” of the individual as expressing the relationship the person has with self.     

Arranged Marriages as Support for Intra‐ethnic Matchmaking? A Case Study on Muslim Migrants in Germany

This article discusses the behavioural and institutional mechanisms that guide the matchmaking process of arranged marriages 1 amongst Muslim migrants in Germany and clarifies how this practice may influence ethnic homogamy. The focus is on general characteristics of arranged marriages rather than differences between diverse ethnic groups. The methodology is qualitative due to the sensitive and complex topic and the current state of research. Typically, the whole family is deeply involved in the process of arrangement, which consists of three stages (pre‐engagement, engagement, marriage). Thereby, the extension of parental scope of action by means of institutionalized admission procedures turns out to be vitally important. In consideration of the fact that mate selection takes place at the pre‐engagement stage, it is the most crucial. Furthermore, differences to other partner‐choosing processes are at their most distinct at this point, being responsible for the identification and labelling of this model as an arranged marriage. Selection criteria are mainly determined by the reputation of the marriage candidate and her/his family along with cultural features (such as belonging to a particular religious group, ethnicity or nationality). In our study, preferences for a cultural homogenous match were the most dominant ones. This inclination may cause the tendency towards transnational marriages when there are no suitable marriage candidates to be found in Germany.     

MAKING MULTICULTURALISM RELEVANT FOR MAJORITY CULTURE GRADUATE STUDENTS*

The revised accreditation standards for marriage and family therapy programs (Manual on Accreditation, 1988) require that the curriculum reflect an emphasis on “issues of gender and ethnicity as they relate to marital and family therapy” (p. 13). Training approaches that are described in the professional literature tend to emphasize an understanding of ethnic minorities while deemphasizing the trainee's own ethnic and cultural roots. As such, training lacks dynamic integrity for the white, middle-class trainee. This paper describes a rationale for addressing the ethnic and cultural background of all family therapy trainees and provides training activities to accomplish this end.     

Most and Least Meaningful Learning Experiences in Marriage and Family Therapy Education

Marriage and family therapy educators increasingly emphasize training competencies. What we know less about is what makes family therapy education meaningful to marriage and family therapy (MFT) graduate students and what does not. In this study, through an Internet survey, we explored the most and least meaningful learning experiences of 68 MFT graduate students and recent graduates of Commission on Accreditation for Marriage and Family Therapy Education—accredited programs. We used thematic analysis to identify and illustrate resulting themes, which included the importance of experiential and personal components to learning, the professor‐student alliance, tying theory to practice, and the experiences of students with their clients, among others. We discuss the implications of these findings to support family therapy education and offer tentative suggestions for formative discussions both within and across programs. Video Abstract is found in the online version of the article .     

Use of simulated clients in marriage and family therapy education

Knowledge of how one should manage suicidal, homicidal, child maltreatment, and domestic violence situations is paramount in the training of marriage and family therapists (MFTs). Simulated patient modules were created to help clinical faculty address these crisis situations in a protected learning environment. The modules were implemented by the MFT faculty in collaboration with the Office of Clinical Skills Assessment and Education at East Carolina University's Brody School of Medicine. Qualitative data over the course of 2 years revealed six thematic domains regarding therapists' performance, therapists' emotions, the simulation experiences, and lessons learned. Educational, clinical, and research recommendations include tools to implement simulation exercises into marriage and family therapy programs as well as suggestions to assess for teaching effectiveness.     

Narratives and self-identity in later life: Two rural American older women

Older adults often draw on memories to construct stories about themselves that help them to retain and validate their self-identities, doing this within the cultural contexts that have shaped their lives. In this paper, we examine the life history narratives of two working class, rural American older women and the ways in which those narratives are similar despite one major difference: one has dementia. In both cases, major themes that are consistent with gender-based, working class, rural American cultural values are dominant, including closeness of family, hard work, ties to the land, and religious faith. In the first case, she reconstructs memories of her life in accordance with dominant cultural and personal values, downplaying the ways in which her experiences were “out of step” with these values. In the second case, her sense of identity remains and is expressed through her co-constructed memories although she is experiencing cognitive loss.     

Expanding Systems Thinking: Incorporating Tools from Medical Sociology into MFT Education and Research

The field of marriage and family therapy has historically focused on dynamics within family systems, and at times the role of social and cultural factors external to the family. To date, however, little scholarship has examined how therapists themselves are embedded within a mental healthcare system. The purpose of this article is to demonstrate how structural components of the mental healthcare system shape the practice of therapy. We draw from the field of medical sociology to illustrate how three dominant structures—managed care, diagnosis, and evidence‐based models—are intertwining and mutually reinforcing systems that have significant and long‐term implications for systemic therapists and researchers. We recommend incorporating a sociological understanding of such structures into MFT education and research.     

Working with African American clients: considering the "homeplace" in marriage and family therapy practices

In this article, we discuss perspectives on the "homeplace" that are important to consider in marriage and family therapy involving African American clients. The homeplace comprises individual and family processes that are anchored in a defined physical space that elicits feelings of empowerment, rootedness, ownership, safety, and renewal. Critical elements of the homeplace include social relationships that shape individuals' and families' sense of social and cultural identity. We draw on our ethnographic and clinical research with African American families in urban and rural settings to describe typical schisms between therapists and African American clients when communicating about the homeplace. We also explore the impact of homeplace disruptions on experiences of "yearning." Recommendations for integrating a homeplace perspective into therapy practices are provided.     

Family Social Work Practice: Onward to Therapy and Policy

ABSTRACT

In a recent article published in the Journal of Family Social Work McNeece (1995) argued that family therapy has no interest in or relevance for social policy interventions. Through the presentation of several arguments he constructs an irreconcilable dichotomy between policy and practice, suggesting that therapeutic interventions are responsible for pulling resources away from the development of effective social policy interventions. This paper challenges the dichotomy between policy and practice and presents an alternative view concerning the relationship between social policy and family therapy. The increasing importance of family policy in family therapy is summarized and a new trend within marriage and family practice, policy as practice, is discussed. Current family practice literature and personal case examples are used to provide alternative viewpoints to three main points that were presented by McNeece concerning family therapy practice, and the therapy/policy interface. Finally, the current practice context of managed care is used to illustrate the interdependence of practice and policy, and the need for a new understanding concerning family practice.     

Sexual addiction and marriage and family therapy: facilitating individual and relationship healing through couple therapy

In recent decades there has been an increase in literature regarding sexual addiction as well as a growing number of clients presenting in therapy with problems related to their sexual behaviors (including internet sexual addiction). This article (a) presents a synthesis of the research on the impact of sexual addiction on the addict, the partner, and the couple; (b) outlines the process of healing for each based on the research synthesis; and (c) discusses the role of marriage and family therapy in facilitating both individual and relationship healing from sexual addiction. Implications for future research in sexual addiction, generally, and in marriage and family therapy, specifically, are presented.     

An Open-Systems Approach to Teaching Family Therapy*

Through systems concepts are increasingly employed in family and marital therapy, they are usually employed in a limited way, excluding some aspects of the total system. Systems ideas are applied most fully to the nuclear and extended family of the referred patient, and increasingly to the therapist's family of origin. The interface between the influence of the family of origin of the professional and difficulties in his practice is also scrutinized, though more often in a teaching and supervisory context than during therapy. The relationships among the therapist's family of origin, his marriage and family of procreation, and his professional work are more often neglected, and the influence of all three on the dynamics of institutions, training programs and staff groups is least often explored. The authors, a married couple who work together professionally, occupied fin-several years a crucial leadership role in developing the first multi-disciplinary teaching programs in the London area, bringing together key teachers from all the main institutions, with widely differing theoretical orientations, in a group which now forms the Institute of Family Therapy (London). This paper describes their attempt to facilitate a more consistently open-systems approach which appeared to stimulate unusually rapid growth, learning, and group cohe-siveness.