Navigating post-trauma realities in family systems: Applying social constructivism and systems theory to youth and family trauma

Trauma affecting youth and families takes a variety of forms, from random one-time events such as accidents and natural disasters to chronic and highly personal trauma from child abuse or intimate partner violence. Though trauma has received increasing attention in theory and intervention research over the last several decades, the prevailing theories and treatments have limitations due to a linear perspective focused on the trauma problems of the individual. This is particularly concerning given the high dropout rates for trauma-focused treatments and the complexities of intergenerational trauma that cannot be adequately conceptualised at the level of the individual. To inform and improve family-based treatment of youth and family trauma, this paper proposes a theoretical framework informed by social constructivism and systems theory. Social constructivism upholds that reality is constructed through communication as an adaptive process for survival, with multiple potential realities possible. Systems theory promotes a non-linear view of causality within a system, such that the structure and properties of a system determine outcomes more than the inputs that go into the system. Together, the principles of these meta-theories contradict the orthodox focus on traumatic events causing trauma symptoms, and instead imply that family-based treatment should focus on helping families shift assumptions and dynamics that sustain the problem in the present. The joint application of a social constructivism–systems theory framework for trauma introduces several new principles to inform family-based treatment: (a) post-trauma realities; (b) mutual survival; (c) power–justice balance; and (d) adaptive reorganisation. The implications of these principles for youth and family trauma treatment will be discussed. Future intervention development and research should consider these principles in the ongoing effort to improve family therapy for youth and family trauma.     

Walk-in Together: A pilot study of a walk-in online family therapy intervention

Many Australians are requiring mental health care, including families, leading to long wait times in order to access support. Walk-in therapy reduces barriers to mental health support services by providing support at the time that families seek help. This paper presents a proof-of-concept study investigating the acceptability and short-term effectiveness of an online walk-in family therapy service, Walk-in Together (WIT). Part 1 of the paper describes the experiences of 44 family members from 22 families who presented to a public family therapy clinic for a virtual walk-in family therapy session. The session was conducted by a team of three experienced family therapists. Family members' experiences were sought pre-session, post-session, and at 6 weeks follow-up via survey and interview. Part 2 of the paper explores therapist perceptions (n = 7) of the WIT approach, through thematic analysis of semi-structured interview data. Post-session feedback showed 85% of family members found WIT to be helpful and 50% were optimistic about their future as a family after their WIT session. Six weeks post-session it was revealed that WIT supported planning for families in equipping them to move forward with 88% of family members reporting that they knew what to do after the session. All therapists uniformly experienced the model as offering a timely and beneficial service, suitable for diverse presentations and constellations of families. These preliminary results suggest the significant utility of this WIT intervention as a well-received and helpful service for families, who valued the easy access and rapid therapeutic response afforded by the online, walk-in delivery model. This proof-of-concept paper suggests the potential for further development and growth of WIT, as well as other mental health support services using a walk-in, telehealth model to meet the rising demand for therapeutic support for families in distress.     

Effectiveness of the Coral Tree Family Service family inpatient unit: a longitudinal study exploring change in family functioning

Child mental health disorders represent a major burden to public health in Australia due to high prevalence rates, the widespread impact across domains, and the potential for difficulties to persist into adolescence and adulthood. Extensive evidence exists for the use of parent management training and cognitive behavioural therapy to treat difficulties experienced by children; however, a proportion of children do not benefit as expected from these treatments. The use of complementary therapeutic approaches and variations to the mode and intensity of existing intervention is warranted; family inpatient units represent a unique example of this. The aim of this study is to evaluate the effectiveness of a well-established Australian inpatient unit that admits the whole family, for children aged 12 years and younger referred with mental health, behavioural, or emotional difficulties. This study's longitudinal within-subject study design utilised routinely collected outcome data from the systemic clinical outcome and routine evaluation, 15 item (SCORE-15)—a valid and reliable measure of family functioning—from a sample of 980 participants attending the Family Residential Program. This study reported significant improvement in family functioning across all outcome variables between baseline and post-intervention, with no variables returning to pre-intervention levels at follow-up. Clinically significant changes in overall family functioning showed that 37% of participant scores moved from the clinical range at baseline to the nonclinical range post-intervention. This study represents the first empirical evaluation of the Family Residential Program, and the reported results provide compelling evidence for the program to effect improvement in family functioning for families with long-standing and severe difficulties. Poor rates of questionnaire completion following intervention frequent the literature base of family inpatient units, with low post-intervention (56%) and follow-up (12%) rates evident in this study. This study uniquely contributes to the growing evidence base of family inpatient units using rigorous evaluation methods.     

A sociology of bullying: Placing youth aggression in social context

In this paper we review the sociological literature on peer aggression among adolescents and demonstrate how it can form the basis of a new subfield in sociology on the subject of bullying. Although sociologists have mostly avoided the term bullying in classic works on adolescent aggression, these studies suggest that institutional social control, status hierarchies and social inequalities provide important social context for youth aggression. While historically they have not been in dialog with each other, when taken together sociological research on youth status relations and social networks, systemic bias, school culture and social ecology can lay the foundation of a sociology of bullying. We suggest that if sociologists see this work as shedding light on issues of bullying, they can begin to play a larger role in the shaping of the national conversation on bullying and influence anti-bullying programs in schools to take better account of the social dimensions of bullying.     

Family functioning and emotion socialization in Chinese two-parent households: A person-centered approach

The current study adopted cluster analysis as a person-centered approach to identify patterns of Chinese families’ functioning and parents’ emotion socialization responses and investigate their associations with children's emotion regulation and behavioral outcomes. Both parents residing in the same family were included to explore joint contributions of mothers and fathers within the family system. Participants were 204 Chinese two-parent (mother and father) households of 5- to 10-year-old children (M_age = 7.43 years, SD = .81; 98 girls). Both parents filled out online questionnaires about their perceptions of family functioning (cohesion, adaptability) and endorsement of responses to children's negative emotions (supportive, nonsupportive). Mothers also reported children's lability/negativity, emotion regulation, problematic behaviors (internalizing, externalizing) and prosocial behaviors. Five clusters were identified: poor-functioning/dismissing, well-functioning/coaching, engaged fathers, engaged mothers, and balanced/diffuse. Overall, poor-functioning/dismissing families had children with the lowest functioning and well-functioning/coaching families had children with the most optimal outcomes. The other three clusters were moderate in terms of child functioning with children of engaged fathers having less optimal outcomes than the other two. The nuanced variations among clusters and meaning of results are discussed in relation to Chinese cultural contexts. Findings support the utility of a person-centered approach for illuminating how parents’ socialization practices interconnect holistically within dynamic family systems.     

Gender Asymmetry in Family Migration: Occupational Inequality or Interspousal Comparative Advantage?

This paper examines gender inequality in the determinants of job‐related long‐distance migration among married dual‐earner couples during the 1980s and 1990s. The analysis tested the structural explanation, which attributes gender asymmetry in family migration to structural inequality in the labor market, and the comparative advantage explanation derived from relative resource theory. The analysis used individual‐ and family‐level data from 5,504 Panel Study of Income Dynamics families, occupation‐level data from the 1980–2000 U.S. Decennial Censuses Integrated Public Use Micro Samples, and discrete‐time event history models. Gender differences in the determinants of family migration were not explained by gender differences in occupational characteristics, but the results partially support the relative resource theory by illustrating the conditioning influence of interspousal comparative advantage.     

“Families” in International Context: Comparing Institutional Effects Across Western Societies

We review comparative evidence of institutional effects on families in Western societies. We focus on 2 key aspects of family life: gendered divisions of labor and people's transitions into, within, and out of relationships. Many individual‐level models assume the effects are robust across countries. The international evidence over the past decade suggests instead that the socioeconomic and policy contexts strongly influence the significance and even direction of individual effects. A growing body of evidence also highlights important differences across social groups and family forms within countries. The pattern of relative gender, class, and other group equality varies across countries, as do related family experiences and outcomes. We conclude with suggestions for future comparative family research.     

Family Risk and Resilience in the Context of War and Terrorism

War and terrorism are exerting increasing force on world affairs, with growing implications for families and the scholars who study them. In this review, I consider the implications of mass violence for families, with particular emphasis on families with members serving in the U.S. military and families around the world who live where mass violence occurs. Mass violence poses significant threats to mental health and family functioning, but individuals and families also display striking levels of resilience.