CONTEMPORARY FAMILY THERAPY最新文献

Family members of a loved-one with an alcohol use disorder (AUD) experience much stress and other adverse impacts, especially those that are frontline caregivers and therefore most proximal to AUD. Previous research has shown such family members experience altered functioning of the prefrontal cortex in response to images of their loved-one, and these responses have similarities to brain responses to alcohol cues for a person with AUD. The current study aimed to expand this research by examining whole-brain functional activation of family members’ brains. Functional magnetic resonance imaging (fMRI) was used to measure activation responses of 10 family members with a loved-one with diagnosed AUD, as well as that of 10 control group participants, during an event-related research paradigm. Results from Generalized Linear Modeling (GLM) indicated significant activation in the left hippocampus and left amygdala for family members of an AUD loved-one, and this activation was significantly greater than that of a control group. These two subcortical regions play a role in the reward network and their activation found in this study may be associated with a reward-based “approach” response – drawing further parallels between the functioning of the impacted family member’s brain and that of the brain of someone with AUD. This understanding influences how clinicians might provide services to family members of those with AUD.

Extant literature guiding therapists’ work with female torture survivors is scant. The study presented here engaged nine providers who specialize in this work in a qualitative inquiry regarding clinical presentations unique to this clientele, including the impact(s) that torture has on their a priori and future relationships with intimate partners, family members, and others in their immediate community(ies). The manners in which survivors’ experiences with torture influences therapy processes (e.g., transference, attention to culture, pairings with extra-therapeutic factors), therapists’ attendance to self-of-the-therapist and supervision foci, and specific suggestions and advice for novice therapists preparing to engage in this type of work were also explored. Clinical- and research- implications of study findings are put forth in conclusion.

Past research has indicated the factors that prevented Asians/Asian Americans from seeking mental health services. However, few studies examined their experiences in receiving mental health services. This study utilized a convenience sample with a non-identifying online survey. As part of the larger survey, this analysis concentrated on addressing two open-ended questions that inquired about the obstacles and challenges that the participants encountered while receiving therapy and the strategies they employed to overcome these challenges. Using qualitative methods to analyze the data, four themes emerged to describe the obstacles Asian/Asian American clients experience in mental health services, including a lack of trust in therapy and therapists, lack of cultural understanding by therapists, language barrier, and challenges related to access and resources. Results are discussed along with best practices and clinical implications for therapists working with Asian/Asian American individuals, couples, and families.

This phenomenological study explored the lived experiences of six Black women who survived Intimate Partner Violence (IPV) through the frameworks of Toxic Black Femininity (TBF), Post-Traumatic Slave Syndrome, and Intersectionality to understand how coping with ongoing systemic racism influences meaning making of IPV experiences and help-seeking behaviors. Participants discussed how narratives within Black families and churches influenced how they coped with the trauma symptoms resulting from their IPV victimization and navigate relationships now. Specifically, participants’ experience of TBF and associated adherence to racial and gendered norms and stereotypes showed up as: 1) a felt pressure to portray strength, 2) rationalize the abuse, 3) advocate for their partner’s needs but not their own, and 4) blame themselves for the abuse. Further, when participants sought help, they: 1) avoided actions that could lead to police involvement due to fear of police brutality against their male partners, 2) had their hurt minimized due to white expectations of Blackness, 3) heard narratives from family and religious systems that reinforced TBF and their decision to stay in the harmful relationship, and 4) turned their frustrations with the lack of helpful support systems into advocacy. These findings highlight the intergenerational transmission of survival skills and narratives that have been passed down to Black women since the time of slavery and how systemic racism and TBF keep these narratives in play.

This study examined the association between attachment styles (avoidance and anxiety) and marital satisfaction in 202 couples from Northeast India. Dyadic Response Surface Analysis (DRSA) tested for nonlinear effects of similarity in attachment on marital satisfaction. The Actor-Partner Interdependence Model (APIM) examined linear actor and partner effects. Results revealed a positive association between moderate avoidance similarity and husbands’ marital satisfaction, with no significant effect for similarity in anxiety. Interestingly, husbands’ anxious attachment positively predicted wives’ marital satisfaction, challenging traditional attachment theory. These findings highlight the importance of considering cultural context and gender differences when examining attachment and marital satisfaction. The clinical implications for married couples are discussed.

Many studies have looked at the conflict resolution styles individuals bring into marriage, but scant evidence exists in the area of the conflict resolution strategies developed over time by long-term couples. This study introduces the idea of jointly negotiated conflict resolution strategies (JNCRS) in long-term couples. For the study, 1112 individuals married 40 + years born in 48 countries were recruited. Semi-structured in-depth interviews were conducted with 180 individuals (90 couples), and 932 coupled individuals responded to an online survey. Interpretive phenomenological analysis (IPA) and content analysis were used in this qualitative study. Six of the primary JNCRS employed by couples are discussed: listen, avoid conflict, communicate well, compromise, resolve quickly, cool down. Three of these—listen, avoid conflict, and communicate well—encompassed 43% of the strategies proffered. Negotiation of JNCRS involved change over time, acknowledging conflict styles based on parental modelling, acknowledging cultural influences, and acceptance. Couple therapists can use this evidence in their work with distressed couples to discuss the content and process of jointly negotiated conflict resolution strategies for each unique relationship situation.

While 10 million U.S. adults experience suicidal thoughts and 1.7 million attempt suicide annually, candid, truthful endorsement of assessment items related to suicidal ideation (SI) can be inhibited by stigma, shame, and embarrassment and a fear of involuntary hospitalization. Suicidal ideation in, and suicide attempts by, family members increase the suicide risk among other members by several times, and so accurate detection of SI is crucial for couple and family therapists. To address concerns about stigma and false negatives in screening for SI, a 19-item subtle screening of suicidal ideation (SSSI) was developed from a pool of 32 “proxy” items tapping psychological pain, emotional intelligence, and negative alterations in mood and cognitions. A demographics form, a measure of suicidal ideation, measures of anxiety, depression, and traumatic stress, and versions of the Beck Hopelessness Scale and the Interpersonal Needs Questionnaire were also used for data collection. Principal components analysis and reliability, correlation, and multiple regression procedures on data from a non-random, diverse sample of adults (N = 306) provided evidence of excellent reliability (α = .93) and convergent and discriminant validity for the SSSI. The three-dimensional SSSI accounted for 54.9% of the variance in a direct measure of suicidal thoughts, and a Receiver Operator Characteristic curve identified a cut-off score of 35 with a sensitivity of .937 and specificity of .81, indicating the instrument successfully identifies those with and without suicidal thoughts. Clinical implications and future research are discussed.

Portugal has approximately 8,000 children with life-limiting conditions. A need to psychological support has been identified, so an innovative online intervention study for families was developed. The aim is to explore potential effects of three intervention programs on the psychological experience of parents, grandparents and siblings respectively. The pilot study has a quasi-experimental, before-after study design with a mixed methods approach. Family members were allocated, not-randomly, to a comparison group or an experimental group. 12 parents, 6 grandparents and 6 siblings were included in this study. Semi-structured interviews and questionnaires were used pre- and post-intervention. For parents, significant improvements were found in the Coping Health scores. The anxiety also decreased, and all participants described a more positive perspective towards the illness, hope and more skills development. The grandparents reduced their anxiety, stress and depression in a clinically relevant way. In the qualitative feedback, grandparents began to recognize their resilience and joy. Pilot results also indicate positive responses from siblings, related to perception of normality in family context, and a lower trait anxiety. Despite the positive outcomes, the small sample size needs to be considered. Further studies would be required to confirm these findings.

Previous research on African Americans’ engagement in family therapy has focused on barriers to treatment. This qualitative study examines the experiences of African Americans who choose to attend family therapy. We utilized a pattern second cycle coding process to analyze survey data from 39 African American adults who attended family therapy. The findings generated five themes that describe the participants’ experiences that brought them to family therapy, (1) life experiences that led to family therapy, (2) perceptions of therapy, (3) positive experiences that encouraged participants’ use of family therapy, (4) factors that caused participants hesitancy in attending family therapy, (5) change in perception concerning family therapy. The final theme was generated by exploring participants’ perceptions of family therapy before and after engaging. Thirty-four participants reported positive beliefs about therapy after receiving family therapy. In addition, participants’ coping mechanisms before entering therapy are detailed to provide insights into how they managed issues before deciding to engage in family therapy. We offer recommendations for engaging African Americans in family therapy and implications for future research.

We examined the prevalence of relationship undermining statements by therapists treating couples, as reported by clients, and the association of these statements with outcomes. Participants (n = 270) reported on recollections of their therapist saying that they were incompatible, that therapist could not help them, that the relationship was beyond repair, that divorce was the best or most realistic option, or told one of partners that the other had a personality problem, or proposed individual therapy instead ofcouple therapy. Findings showed a prevalence rate of 10-28% across these fiveundermining statements; 40% of clients reported at least one statement. Undermining statements were associated with poorer outcomes and shorter duration of coupletherapy. We suggest that some therapists treating couples lack a systemic/relationship framework and set of skills, which leads them to become frustrated and pessimisticwith difficult couple cases. We offer implications for the training of couple therapists.