Human Sexuality Education in Marriage and Family Therapy Graduate Programs

Given the likelihood that marriage and family therapists will encounter clients with sexual concerns, it is important to know how graduate training programs are preparing future clinicians to work with this domain of life. Sixty‐nine marriage and family therapy (MFT) program directors completed an online survey to examine how sexual health education is integrated into graduate training programs. Findings indicate that while the majority of program directors value sexuality curriculum, and most programs require at least one course in this area, there are barriers to privileging sex topics in MFT graduate programs. Barriers include few MFT faculties with expertise in human sexuality and marginalized sexual health topics. Implications for training MFT graduate students and their work with future clients are discussed.     

The treatment of sexual problems in marital and family therapy

With the proliferation of new research data and clinical practice techniques for dealing with sexual dysfunction, many family and marital therapists whose patients express sexual complaints experience the need to integrate this knowledge into their practice. For many couples and therapists, the rapid treatment approaches to sexual difficulties are inappropriate or ineffectual, yet the current literature addresses itself to either sex therapyper se or marital therapy and rarely deals with an integration of the two. This paper presents guidelines for assessing the sexual difficulties in the context of the relationship and outlines techniques for addressing the sexual difficulties directly while maintaining a more traditional marital therapy approach.     

TWENTY YEARS AND STILL IN THE DARK? CONTENT ANALYSIS OF ARTICLES PERTAINING TO GAY,LESBIAN, AND BISEXUAL ISSUES IN MARRIAGE AND FAMILY THERAPY JOURNALS

To what extent do marriage and family therapy journals address gay, lesbian, and bisexual issues and how does this coverage compare to allied fields? To answer these questions, a content analysis was conducted on articles published in the marriage and family therapy literature from 1975 to 1995. Of the 13,217 articles examined in 17 journals, only 77 (.006%) focused on gay, lesbian, and/or bisexual issues or used sexual orientation as a variable. Findings support the contention that gay, lesbian, and bisexual issues are ignored by marriage and family therapy researchers and scholars.     

The Doctoral Education of Professional Marriage and Family Therapists

The professional practice of marriage and family therapy (MFT) scholarship is regulated at the master’s level in the United States. Consequently, contemporary curricular issues have largely been focused on what is to be achieved within the master’s degree, with an emphasis on clinical practice. We consider here what value may and should be added through the doctoral degree in marriage and family therapy. Doctoral programs are the developmental stage wherein we should seek to transmit the specialized knowledge and skills germane to MFT scholarship and practice in diverse settings, e.g., clinical and research intensive university, family law, health care, child development and education, child welfare, juvenile justice, faith based, and business. However, underlying this specialty education are three transcendental goals: sophistication of family systems scholarship, socialization into the profession of MFT, and cultivation of professional maturity.     

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.     

农村留守女童性安全与性教育问题

近年来，随着外出务工人员的日益增多，农村留守女童数量也急剧上升。由于缺乏必要的监护及性安全教育，不少留守女童成为性侵害的对象。农村留守女童性安全与性教育问题成为舆情分析的焦点。从留守女童性侵案件呈现出的三大特征，即性侵主体多元化、性侵手段多样化、性侵意识淡漠化，可以看出农村留守女童性安全问题情势不容乐观。究其原因，突出地表现在三个方面：亲子教育的缺失影响到性知识的传授、监护人缺乏性安全防范与教育的意识以及学校性安全教育的重视力度较为薄弱。因此，要整合学校、家庭和社会力量，对农村留守女童系统而科学地实施性安全教育，以期能够促进她们身心健康和谐发展。     

Brief Family Therapy: A Critique of Kinston and Bentovim

There has been a growing interest in the use of brief family therapy with children. Despite this increased interest, research into the effectiveness of this approach appears to have lagged behind clinical practice. The present paper critically reviews a study by Kinston and Bentovim (1978) which could be viewed as typical in the area of brief family therapy. Analysis of Kinston and Bentovim's investigation revealed serious methodological deficiencies and raised some important clinical issues in brief family therapy studies. These include the importance of training in family therapy, the use of a consistent theoretical framework, and flexibility in the application of techniques. On the basis of this review, recommendations are made that future investigations of brief family therapy follow the guidelines necessary for valid psychotherapy research.     

The State of Sex Research in MFT and Family Studies Literature: A Seventeen‐Year Content Analysis

The ability to conceptualize and treat sexual problems has been widely accepted as a crucial skill to master the MFT training. However, clients’ sexual relationships are often ignored by clinicians because of a lack of experience or training, or personal discomfort. In this content analysis, we review sex and sex therapy research within MFT and family studies journals since the turn of the century. Of the 13,919 articles published within the 15 journals, 137 focused on sexuality or sex therapy. The articles were divided into five themes: sexual and relational health, sexual diversity, treatment and contributors of sexual dysfunction, sex therapy practices, and sexual education and development. Implications for clinical practices, sex therapy integration, and future research are discussed.     

Ethical Considerations in Sex Therapy

The most ethical sex therapy is that which cures the symptom and improves the marital relationship in the briefest time at the least cost. Neither insight therapy, nor direct sexual interaction with the client satisfy these criteria. Examples are given of effective ethical therapies, useful in male and female sexual dysfunctions.     

Assessment in Marriage and Family Therapy: A Review of Clinical Updates for Family Therapists

This article presents information from an integrative literature review that examined assessment processes presented to marriage and family therapists in Clinical Updates for Family Therapists, Volumes 1 (2005), 2 (2006), and 3 (2007). The study was based on the concern that marriage and family therapy is losing its systemic relational focus as practitioners must comply with diagnosis models using the Diagnostic and Statistical Manual of Mental Disorders. Using integrative literature review methods, similar to qualitative research, 54 articles were deconstructed to identify assessment tools and diagnostic processes being presented as best practice. Of the 54 articles, 96% identified the importance of having a family or couple relational perspective for working with individuals with mental disorders; however, only 54% provided any explanation to how this could be accomplished. These findings suggest a need to increase the identification of unique, relational assessment practices in articles that offer best practice techniques in marriage and family therapy.     

Training family therapists to work with children and families: a modified Delphi study

This study examined child inclusion issues and training marriage and family therapists (MFTs) to treat children. This modified Delphi study utilized a panel of experts, and gathered data through questionnaires and qualitative interviews. Panelists believe children should participate in family therapy sessions for both child and adult problems, except when parents are discussing sex or sensitive issues. Child-focused courses should emphasize developmental issues, engaging techniques, theoretical issues, play therapy theory, MFT treatment for child disorders, and specific child/family problems. Panelists suggest numerous child-focused references, but reached consensus for only one. Key therapist attributes and skills were identified. Deductive and inductive training methods and the role of supervision were highlighted. Although therapist playfulness and creativity were emphasized, few play techniques were included in the final profile.     

Incorporating sexual orientation into MFT training programs: infusion and inclusion

Many authors have questioned the preparedness of family therapists to deal with sexual minority clients. Even though the Commission on Accreditation for Marriage and Family Therapy Education (COAMFTE) has called for the integration of sexual orientation into the curriculum of marriage and family therapy training programs, the subject continues to be marginalized. The purpose of this article is to encourage trainers to examine their programs' curricula for evidence of heterosexist bias and introduce ways that they might integrate issues related to same-sex affectional and sexual orientations into their programs via the classroom and the clinic.     

Integrating a Trauma Lens into a Family Therapy Framework: Ten Principles for Family Therapists

This paper aims to show how a trauma lens can be incorporated into existing family therapy practices, changing how therapists perceive presenting problems and therefore the issues and sites of intervention. After reviewing the family therapy literature concerning trauma and defining different types of trauma, the paper discusses how traumatic memories differ from ordinary memories. Ten principles for practice are described to guide therapists in integrating the trauma lens into their family therapy practice. Three case studies are used to illustrate these principles.     

What's the Use of Family Therapy?

This paper, a plenary address to the Australian Family Therapy Conference, is concerned with the role of family therapy in society and the abuse of professional power. It is argued that family therapy is part of the medicalisation of marriage and the family, through which problems are defined — often inappropriately — as relationship problems and experts (therapists) are created. Aspects of professional power are identified; its pursuit is not in the interests of families, especially those with greatest needs. Proposals to tackle these obstacles are made regarding practice and training in therapy, and the management of professional power.     

Fundamentals of Theory and Practice Revisited: Sex Therapy: Historical Evolution,Current Practice. Part I

This is the first of a two‐part series, and provides a contextual history of major trends in sex therapy, notably the psychoanalytic, behavioural and medical models, as well as detailing the family therapy contribution to the field. Part 2 will present the outline of a first interview, and use it to demonstrate a systemic model which explores the interrelationship between the symptom, the presenting person(s), the ‘sexual’ as part of the relationship, the biological, the broader cultural view of sexuality — and the therapist's framework and thinking. Case studies are used as illustration.     

A Curriculum for Graduate-Level Marriage and Family Therapy Education*

The Delphi technique of refining group opinion was used to develop a graduate level marriage and family therapy curriculum. Opinions were synthesized from a national panel of 20 AAMFT Approved Supervisors and 25 training directors of graduate-level marriage and family therapy programs. Three rounds of questionnaires were employed and 101 content areas met the criteria for inclusion into the final curriculum. Discussed are the similarities and differences of this curriculum and the current “model” AAMFT curriculum. It is hoped that the curriculum devised from this study will lead to the continued rethinking, refinement, and evolution of marriage and family therapy education.     

Measuring the Effect of Sexual Health Education Training in Professionals: Structure of the Sexual Health Education for Professionals Scale (SHEPS) Among Marriage and Family Therapy Graduate Students

Marriage and family therapists and sexual health therapists are likely to receive training in graduate school that prepares them to encounter sexual concerns among clients, but there are few standard ways to assess the efficacy of this training. The Sexual Health Education for Professionals Scale (SHEPS) was developed to address this deficit. In this preliminary study, 163 marriage and family therapy graduate students completed the SHEPS prior to starting a graduate course in assessing and treating sexual concerns. Exploratory factor analyses indicate that the SHEPS subscales have good psychometric properties. The Skills and Knowledge subscales have factors labeled Typical Clients, Special Clients, Conservative Clients, and Ethically Complicated Clients. The Attitudes subscale had factors called General Sexual Attitudes, Valuing Sexual Health Training, Open to Providing Sexual Help, and Conservatism. This new instrument may be used to assess education and training of sexual health and marriage and family therapists. Larger sample sizes and longitudinal studies are needed in future.     

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.     

Using Masturbation in Sex Therapy

Abstract

Masturbation may be useful in treating hypoactive sexual desire disorder. To examine this possibility, the current study examined the relationships between masturbation, sexual desire, sexual fantasy, and dyadic sexual activity. The relationships between masturbation and other constructs were also examined: overall sexual dysfunction, relationship satisfaction, life stress, and sexual attitudes. Mediational analyses suggest several causal pathways between masturbatory desire, masturbatory frequency, sexual fantasy, sexual desire, and sexual activity. Developing a model of masturbation may help illustrate its role in sexual functioning and highlight its potential role in sex therapy.