CONTEMPORARY FAMILY THERAPY最新文献

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.

The multiple benefits of family-based treatment (FBT) used in substance use disorder (SUD) treatment include increased treatment engagement, better treatment outcomes, and cost-effectiveness compared to other behavioral health treatment modalities. However, the prevalence and types of FBTs offered among SUD treatment facilities are largely unknown. The present study used data collected during 2009–2010 from 325 treatment centers in the United States to (1) explore the prevalence in the utilization of FBT in SUD treatment, and (2) identify differences between treatment facilities that do and do not offer FBT. Results indicated that the adoption of FBT was negatively associated with the percentage of clients who were unemployed or involved in the criminal justice system at time of intake, and positively related to the number of hours of individual therapy and treatment center emphasis on utilizing the 12 Steps. Additionally, the majority of treatment centers that followed the American Society of Addiction Medicine (ASAM) clinical guidelines offered FBT. Lastly, the percentage of families involvement was negatively associated with centers’ proportion of revenues from Medicaid (i.e., health insurance for those with limited income) and positively associated with treatment center revenues from private insurance. The impact of having FBT in SUD treatment centers is discussed.

This study examined the development of the therapy alliance over the first six sessions of couple therapy using a dyadic latent growth curve. The role of relationship adjustment, symptom distress, and attachment to alliance development were also examined. Participants were 165 couples in a treatment-as-usual setting. The alliance increased over the first six therapy sessions for males and females with males following a curvilinear pattern of growth. Additionally, female relationship adjustment was related to initial alliance levels for females while symptom distress was related to female alliance development. Male attachment avoidance and female attachment anxiety were related to male initial alliance. Couple therapists need to pay attention to intake level of female adjustment, symptom distress, and attachment—along with male attachment, as these are related to alliance development. Therapists should also be mindful that female and male alliance follow a different developmental trajectory.

Finding effective interventions and best practices for families during the divorce or separation process has been prevalent for many years due to the continuous impact that divorce has on families and the greater society. To meet the needs of the community, two mental health professionals developed and facilitated a parent education course targeting the reduction of coparental conflict. Due to the unique attributes of the course, researchers began a quantitative study of the program by having participants complete pre- and post-surveys. The final sample for this study consisted of 212 parent participants. Findings from the data are reported along with implications for facilitators, program developers, mental health providers, and future researchers.

Anxiety is very pertinent to systemic family therapy (SFT), however, there is little research that seeks to understand people’s experiences with anxiety symptoms and how they impact people’s lives and relationships. The aim of this study was to examine the trending hashtag #ThisIsWhatAnxietyFeelsLike—a commonly used hashtag related to anxiety—to look more closely at how users talk about their anxiety symptoms on Twitter and how these symptoms influence people’s interactions and relationships with others. We used a qualitative thematic analysis to analyze 1318 relational tweets posted with this hashtag that occurred between February 2017 and February 2018 and uncover themes related to experiences with anxiety. The analysis revealed six core themes: (a) deflated self in relation to others and their perceptions; (b) fear, worry and avoidance behaviors that influence relationships; (c) negative emotional responses leading to feeling misunderstood, lonely, and like a failure; (d) social triggers; (e) anxiety management strategies; and (f) things for others to avoid.

Although structural strategic family therapy (FT) is an evidence-based approach for adolescent behavior problems, manualized family therapy models have not been widely adopted in usual care due to the training and implementation resources required. This article presents a competency framework for utilizing family collaboration with adolescent cases. It begins by discussing challenges to implementing FT in routine care and presents the core elements strategy, then introduces three “branches” that together constitute a continuum of family involvement—family collaboration, family skills training, and systemic family therapy—and describes the rationale and procedures for focusing on competency guidelines for family collaboration specifically. It then describes the basic techniques and competency guidelines for six core elements of family collaboration: family systems outreach, adolescent ecosystem, location of self, goal setting, family participation, caregiver consultation, family session management. It concludes by discussing future directions for this framework and the development of additional competencies for the other branches. While further research is necessary to test the efficacy of the treatment branches and accompanying competency standards, this article presents an innovative approach to involving family members in care that includes accessible competency guidelines.