The experiences of a group of general practitioners learning and attempting family therapy are described. Three principles for working with whole families — facilitation, formulation and focussing — are illustrated by case histories. Family therapy in general practice can be effective for patients and worthwhile for family doctors. PMID:7153974
This paper examines a case study of family play therapy in Israel. The unique contributions of play therapy are evaluated including the therapy's accessibility to young children, its richness and flexibility, its exposure of covert patterns, its wealth of therapeutic means, and its therapeutic economy. The systematization of the therapy attempts…
Zuk, Gerald H., Ed.; Boszormenyi-Nagy, Ivan, Ed.
Presented at a conference at which authors represented major theoretical positions in the field, most of the papers use family therapy as an important source of observations or ideas, or as a means to pinpoint methodological problems. Papers are grouped in sections as follows: four which introduce the reader to the field of specialization, provide…
Rosmann, Michael R.
A family therapy model, based on a conceptualization of the family as a behavioral system whose members interact adaptively so that an optimal level of functioning is maintained within the system, is described. The divergent roots of this conceptualization are discussed briefly, as are the treatment approaches based on it. The author's model,…
Wagenaar, Karin; Baars, Jan
This article describes how families are functioning in the Netherlands, and how family therapy is used in mental healthcare. In the open Dutch society, new ideas are easily incorporated, as exemplified by the rapid introduction and growth of family therapy in the 1980s. In recent decades, however, family therapy has lost ground to other treatment models that are more individually orientated, and adhere to stricter protocols. This decline of family therapy has been exacerbated by recent budget cuts in mental healthcare. In regular healthcare institutes family therapy now has a marginal position at best, although family treatment models are used in specific areas such as forensic treatments. In addition, the higher trained family therapists have found their own niches to work with couples and families. We argue that a stronger position of family therapy would be beneficial for patients and for families, in order to counteract the strong individualization of Dutch society. PMID:22515464
Kameguchi, Kenji; Murphy-Shigematsu, Stephen
Reviews the development of family psychology and family therapy in Japan, tracing the origins of these movements, explaining how these fields were activated by the problem of school refusal, and describing an approach to family therapy that has been developed to work with families confronting this problem, as well as preventive programs of family…
Tuerk, Elena Hontoria; McCart, Michael R.; Henggeler, Scott W.
This article summarizes and illustrates the collaboration strategies used by several family therapies. The strategies used within multisystemic therapy (MST) are emphasized because it has demonstrated high rates of treatment completion and favorable outcomes in multiple clinical trials. Many of the collaboration strategies in family work are common to other forms of evidence-based psychotherapy (e.g., reflective listening, empathy, reframing, and displays of authenticity and flexibility); however, some strategies are unique to family systems treatments, such as the identification of strengths across multiple systems in the youth’s social ecology and the maintenance of a family (versus a child) focus during treatment. A case example illustrates collaboration and engagement in the context of MST. PMID:23616297
Keeney, Bradford P.; Ross, Jeffrey M.
Presents a cybernetic view of brief family therapy. Includes a historical discussion of the key ideas underlying brief family therapy, a cybernetic model of therapeutic change, and a clinical case for exemplification. (Author/JAC)
Tse, Samson; Ng, Roger M K; Tonsing, Kareen N; Ran, Maosheng
Family therapy views humans not as separate entities, but as embedded in a network of relationships, highlighting the reciprocal influences of one's behaviours on one another. This article gives an overview of family demographics and the implementation of family therapy in Hong Kong. We start with a review of the family demographics in Hong Kong and brief notes on families in mainland China. Demographics show that the landscape has changed markedly in the past decade, with more cross-border marriages, an increased divorce rate, and an ageing overall population - all of which could mean that there is increasing demand for professional family therapy interventions. However, only a limited number of professionals are practising the systems-based approach in Hong Kong. Some possible reasons as to why family therapy is not well disseminated and practised are discussed. These reasons include a lack of mental health policy to support family therapy, a lack of systematic family therapy training, and a shortage of skilled professionals. Furthermore, challenges in applying the western model in Chinese culture are also outlined. We conclude that more future research is warranted to investigate how family therapy can be adapted for Chinese families. PMID:22515459
Breunlin, Douglas C; Jacobsen, Elizabeth
In this article, we examine the field of family therapy by drawing a distinction between two forms of practice: Whole Family Therapy (WFT), defined as treating the whole family, and Relational Family Therapy (RFT), defined as working with a subsystem of the family or an individual while retaining a systemic lens. Our thesis is that the practice of WFT has been in decline for some time and steps must be taken to keep it from becoming a defunct practice. We consider the trajectory of WFT and RFT throughout the development of family therapy through reference to the people, the literature, training, and practice patterns associated with family therapy. We remind the reader of the many benefits of WFT and suggest that today WFT is likely to be practiced in conjunction with RFT and individual therapy. Since training of family therapists today is largely located in degree-granting programs, we identify constraints to including WFT in such programs. We conclude by offering suggestions that can enhance a program's ability to train students in WFT. PMID:24948531
Kane, Connie M.
States that current literature suggests that dreams are seldom used by marriage and family therapists, yet dreams can be powerful tools in therapeutic treatment. Includes clinical examples that demonstrate the effective use of dreams in marriage and family therapy. Discusses the interface between dream interpretation and systems therapy. (MKA)
Lemmon, C R; Josephson, A M
It is a perpetual source of debate whether dysfunctional family communication and relationship patterns cause eating disorders or the stress associated with raising a child with an eating disorder elicits such problems. Regardless, family therapy is a necessary component of any comprehensive biopsychosocial approach to the treatment of eating disorders. A careful assessment of the entire family, including the identified patient; his or her parents and siblings; the parents' marriage and families of origin; the child's emotional, social, and physical development; parental regulation of developmental stages; and communication patterns is mandatory. Family therapy for eating-disordered patients attempts to facilitate the elimination of potentially life-threatening symptoms and begin a therapeutic process of change within the entire family. Research has shown significant support for the use of family therapy in this population, but well-controlled treatment outcome research remains somewhat limited. PMID:11449810
Doherty, William J.
Discusses the historical context for rising interest in values and ethical issues in family therapy, and presents framework for analyzing core values of prominent models of family therapy. Uses ethical debate over use of paradoxical techniques in family therapy to illustrate values clash between different models of family therapy. (Author)
Getz, Hildy G.
Describes how a family therapy perspective can be integrated into group as a treatment modality. Concepts from family therapy are illustrated through a description of a specific women's group and case study. Techniques from family therapy applied in group are derived from multigenerational, experiential/humanistic, and cognitive-behavioral…
Harvey, Rebecca G; Stone Fish, Linda
Trends in popular belief about same-sex relationships have undergone noteworthy change in the United States over the last decade. Yet this change has been marked by stark polarizations and has occurred at varying rates depending upon regional, community, racial, religious, and individual family context. For queer youth and their families, this cultural transformation has broadened opportunities and created a new set of risks and vulnerabilities. At the same time, youth's increasingly open and playful gender fluidity and sexual identity is complicated by unique intersections of class, race, religion, and immigration. Effective family therapy with queer youth requires practitioner's and treatment models that are sensitive to those who bear the burden of multiple oppressions and the hidden resilience embedded in their layered identities. We present case examples of our model of family therapy which addresses refuge, supports difficult dialogs, and nurtures queerness by looking for hidden resilience in the unique intersections of queer youths' lives. These intersections provide transformational potential for youth, their families and even for family therapists as we are all nurtured and challenged to think more complexly about intersectionality, sexuality, and gender. PMID:26283240
Abroms, Gene M.
Redefines the role of family therapy in terms of the reemergence of the medical model in psychiatry. In this biopsychosocial model the goal of family therapy is defined as the achievement of socialization. Describes the goals of psychotherapy, sociotherapy, and biotherapy and suggests they are combined in family therapy. (Author/JAC)
Zuk, Gerald H.
Family therapy is a method for resolving conflict in value systems. The family therapist has three role functions: the go-between, the side-taker, and the celebrant. The therapist selectively expresses values that disrupt and then repair destructive family interaction. Short-term therapy works best because it least violates value expectations…
Schweitzer, Jochen; Ochs, Matthias
The article deals with systemic-family therapeutic implications of differential diagnostics of school refusal behavior. Systemic therapy elements, that are useful in treatment of school phobia/school anxiety, and family interaction types, in which school refusal behavior occurs, are introduced. Finally two case studies of systemic family therapy are presented. PMID:12951914
This first-person account of a case study on family therapy discusses two latency-age boys who were referred for treatment. The assessment was that in both cases it was the family itself that was disturbed and needed treatment. The therapist worked with the first boy and his family together. The therapy model used was the "proper" family…
Wetchler, Joseph L.
Functional family therapy model assesses family behavior from perspectives of interactional process and functional payoffs for the individual family members. Illustrates that functional needs change as a result of development, and that by including a family life cycle perspective in the assessment process, clinicians will get a clearer picture of…
Apsche, J. A.; Ward Bailey, S. R.
This case study presents a theoretical analysis of implementing mode deactivation therapy (MDT) (Apsche & Ward Bailey, 2003) family therapy with a 13 year old Caucasian male. MDT is a form of cognitive behavioral therapy (CBT) that combines the balance of dialectical behavior therapy (DBT) (Linehan, 1993), the importance of perception from…
Zuk, Gerald H.
The truncated nuclear family consists of a two-generation group in which conflict has produced a polarization of values. The single-parent family is at special risk. Go-between process enables the therapist to depolarize sharply conflicted values and reduce pathogenic relating. (Author)
Sexton, Thomas L.; Alexander, James F.
Increases in delinquency and violence over the past decade are often rooted in a number of interrelated social problems that may originate within the family structure. The focus of this publication is the effectiveness of family intervention programs and chronicles one type of intervention, the Functional Family Therapy (FFT). FFT draws on a…
Frankel, Harvy; Frankel, Sid
This paper assesses the engagement of family therapy and family practice with families with children, who are living in poverty. It analyzes four promising models from two perspectives. The first perspective relates to critiques, which have been made of the practice of family therapy with families living in poverty; and the second relates to the…
Banyard, Victoria L.; Fernald, Peter S.
In this article, we describe a demonstration and discussion of an initial family therapy interview simulated by 4 student volunteers. Several concepts and principles fundamental to family therapy are illustrated: interview stages, one-person definition of a problem, systemic perspective, clear generation line, unified executive team, disengaged…
Apsche, Jack A.; Bass, Christopher K.
This article highlights the inclusion of Mode Deactivation Therapy as a treatment modality for families in crisis. As an empirically validated treatment, Mode Deactivation Therapy has been effective in treating a wide variety of psychological issues. Mode Deactivation Therapy, (MDT) was developed to treat adolescents with disorders of conduct…
Describes the initial evaluation phase of family therapy, which clarifies the circular interaction maintaining the symptom, the family structure, and its relationship to the therapist. Suggests using first sessions to collect data and organize it meaningfully. Presents phenomenological and mythical models of family functioning as guides for…
Doherty, William J.
Presents model that addresses issues of where to place parent and family education in the spectrum of professional services to families, and how to distinguish between education and therapy in work with families. Offers five-level model of involvement with families as an alternative to the dichotomous distinction between education and therapy.…
Scopetta, Mercedes A.; And Others
Research and clinical practice at the Spanish Family Guidance Clinic (Miami, Florida) has suggested that ecological structural family therapy might be a treatment of choice for Cuban immigrants. Such a treatment approach was found to be consistent with the values of this population and was particularly helpful in addressing special problems…
A multitude of empirical studies clearly demonstrates that the origin and course of eating disorders is closely linked to family factors. The influence is exerted in a direct way by conveying attitudes towards food, eating, weight, shape and appearance within the family and in a more indirect way by the family relationships. Families of bulimics differ from those of anorexics by a higher degree of conflict, impulsivity, expressiveness and by lower affective resonance and cohesion. Family therapy has proven to be effective in the treatment of eating disorders. A sketch of a family therapy describes the conflict oriented approach which includes behavioral elements in oder to stabilize the eating behavior and the weight. PMID:15918543
Presents integrative framework for combining central aspects of individual psychodynamics with structural family therapy in meaningful way. Explains how framework derives from developmental perspective. Presents case example to illustrate combined approach and demonstrate its utility. (Author/NB)
Roesler, T A; Savin, D; Grosz, C
A significant portion of children referred for psychiatric treatment have been sexually abused. One of the most difficult symptom manifestations to treat in young children is the management of anger. In this case, a 4-year-old boy was sexually abused by persons outside the family. He showed symptoms of regressive behavior including encopresis, enuresis, difficulty sleeping, fearfulness, recurrent nightmares, and had hyperalertness and frequent outbursts of anger. Treatment initially involved group therapy, with a concurrent parents' group. After experiencing little improvement in group therapy, the youngster was put in individual play therapy and family therapy. Family therapy proved essential in creating a safe environment for the patient where he could learn to regulate his affect and process his traumatic experience successfully. PMID:8407771
Filial therapy is a specific mode of child-centred play therapy. The parent or carer conducts structured weekly therapeutic play sessions with the child. The therapist provides coaching, detailed feedback, and support, but does not engage directly with the child. Filial therapy empowers parents and carers to become the agents of therapeutic change. Because parent and child work through problems together, children's attachments become more secure, and family relationships are enhanced. Filial therapy was developed in the 1960s by Louise and Bernard Guerney as an innovative form of child-centred play therapy for three- to 12-year-olds. It is a flexible mode of therapy with three main models currently in use, two of which are group models. Filial therapy is evidence-based. Empirical research has shown it to be effective for intact families, blended families, adoptive families, those with children in public (local authority) care, single parent families, and those in which grandparents or other relatives are the full-time carers. Research also shows it to be effective with families of different cultures and ethnicities. Filial therapy can help parents or carers help children who have experienced difficulties such as trauma and abuse, or who for other reasons have problems with behaviour, relationships and mental health. Filial therapy provides help over the long term and after the therapist has reduced or ended contact with a family. Once parents have learned the filial skills they can continue with play sessions for months, even years. They also naturally adapt the skills for use in every day life. PMID:18973091
O'Farrell, Timothy J.
Following a brief review of literature on marital and family treatment for alcohol problems, this paper describes two types of marital therapy frequently used with alcoholics and presents a brief overview of results from a study in progress comparing the two modalities. Behavioral marital therapy uses communication skills training, contracting,…
Zuk, Gerald H.
The author examines the three crises he feels family therapy has passed through in the last three decades, including the need to transcend its focus on schizophrenia and to deal with families differing widely in socioeconimic origin. The current challenge is the need for professionalization of the field. (Author)
Burgess, Thomas A.; Hinkle, J. Scott
Notes that Millon's biopsychosocial model asserts that socioenvironmental factors of parental or peer rejection may shape development of avoidant behavior but does not elaborate on how family system may perpetuate its existence once disorder has evolved. Presents brief overview of avoidant behavior and strategic family therapy case study.…
Beck, Michael J.
Patients' respiratory problems may interfere with their talking in therapy sessions. Interventions by the therapist must be based on an understanding of the underlying dynamics which produced the respiratory problem. (Author)
Background Due to the armed conflicts in the Balkans in the 1990s many families escaped to other countries. The main goal of this study was to explore in more detail the complexity of various family members’ experiences and perceptions from their life before the war, during the war and the escape, and during their new life in Sweden. There is insufficient knowledge of refugee families’ perceptions, experiences and needs, and especially of the complexity of family perspectives and family systems. This study focused on three families from Bosnia and Herzegovina who came to Sweden and were granted permanent residence permits. The families had at least one child between 5 and 12 years old. Method Family therapy sessions were videotaped and verbatim transcriptions were made. Nine family therapy sessions were analysed using a qualitative method with directed content analysis. Results Three main categories and ten subcategories were found - 1. Everyday life at home, with two subcategories: The family, Work and School/preschool; 2. The influence of war on everyday life, with three subcategories: The war, The escape, Reflections; 3. The new life, with five subcategories: Employment, Health, Relatives and friends, Limited future, Transition to the new life. Conclusions Health care and social welfare professionals need to find out what kind of lives refugee families have lived before coming to a new country, in order to determine individual needs of support. In this study the families had lived ordinary lives in their country of origin, and after experiencing a war situation they escaped to a new country and started a new life. They had thoughts of a limited future but also hopes of getting jobs and taking care of themselves and their families. When analysing each person’s point of view one must seek an all-embracing picture of a family and its complexity to tie together the family narrative. To offer refugee families meetings with family-oriented professionals to
Clarkin, J F; Glick, I D
Since its beginning some 25 years ago, family therapy has become a widely used madality. The field is developing its own theoretical foundations, training institutions, and body of outcome research; the authors review some of the changes, especially those of the last two or three years. One major development is the growing differentiation of family therapy models and techniques; related are increasing attempts to delineate selection criteria and to provide empirical data for special matches of problems and treatments. The field has moved from its early preoccupation with schizophrenia to concern with new target populations, such as families disrupted by divorce. Family therapy is also being used more often in the treatment of hospitalized patients and of substance abusers. The outcome research is growing in extent and sophistication; the positive results indicate a continuing prominent role for this modality. PMID:7106716
Sholevar, G P
Low levels of parental skill and cooperation are the prominent roots of arrested socialization, and a lack of appreciation for intimate and gratifying human relationships is evident in children with CD. The relational problems are exaggerated further by the child's observation of chronic parental discord and internalization of a family image constructed around intrafamilial conflict and isolation. Skills deficits in parental and marital communication and problem solving and conflicts in these relationships play significant roles in producing family dysfunction. The low level of parental differentiation and identity formation plays a fundamental role in family dysfunction by interfering with the development of an adequate self-image, self-esteem, and internal codes of behavior in the child. The transmission of parental antisocial tendencies to their children is facilitated by the low level of differentiation between parent and child. Family treatment should focus on enhancing cooperation between parents and children and between parents as co-parents and as a couple. Enhancing parent management skills can undermine the use of coercive, punitive, and impulsive interactions in the families. The higher divorce rate in parents of children with CD should be addressed with parents directly and early in treatment with the hope of mobilizing the rehabilitative and cooperative marital forces. In terms of future directions, family studies should address and incorporate the expanding knowledge of biologic and psychologic characteristics of children with CD and the possible impact of such characteristics in undermining family development and integrity. Such investigations should include the following information: The role of sustained and intense aggression in some children on family functioning and development. The possible role of diminished response to punishment and excessive search for gratification in children with CD. The role of the child with CD in promoting marital and
Hoyt, Michael F.; Gurman, Alan S.
Attention is called to disturbing developments in insurance reimbursement that threaten the practice of therapy involving more than one person. This can be seen as part of the movement to marginalize psychotherapy as first-line treatment and replace it with the inappropriate and excessive (and often exclusive) use of medication.
Long, Walter C
The family members of death row inmates undergo unique suffering that includes disenfranchised grief and intense psychological trauma. In Texas, where executions occur at a rate of 1 every 2 weeks, this class of trauma victims presumably is large, a fact that should generate public mental health concern. Yet the class remains virtually unknown to the therapeutic community. Very little has been done to address the trauma healing needs of death row families. This theoretical paper proposes that structural therapy designed to reengage attachment relationships and reempower family members' innate resources to emotionally regulate one another may provide one of the most effective means of helping this population survive trauma. PMID:21967176
Family therapy with the single, young adult can be successfully carried out using the Bowen family systems theory when the process is staged over time. The therapist who has gone back into his or her own family of origin can be of greatest help as a "coach" to the client in this ongoing process. The therapist assists the client in a process of orderly differentiation that enables the client to develop a more solid sense of self. Reactive distance and emotional cut-offs are modified as solutions to anxiety. More personal, flexible family, peer, and work relationships are promoted. The client's initial presenting problems diminish as he/she comes to terms with his/her ultimate aloneness and self-responsibility, and begins to accept family members as they are and relationships with them for what they can be. PMID:6917974
Hertlein, Katherine M.; Lambert-Shute, Jennifer; Benson, Kristen
Postmodernism has influenced family therapy in significant ways, from clinical work to family therapy research. Little has been written, however, on how to conduct postmodern research in a manner reflecting marriage and family therapy inquiries. The present study seeks to investigate doctoral students understanding of postmodern family therapy…
Rosenstock, Harvey A.; And Others
The case of a nine-year-old boy suffering from psycosomatic migraine headaches is discussed. The main article presents the case study and discusses the family systems approach which was successfully used in therapy. The following discussion deals with the psychosomatic personality. (HMV)
Cermele, Debra E., Ed.
In an effort to help practitioners deal with the great volume of current literature in the field of marriage and family therapy, this compilation attempts to present clinically relevant material in a user-friendly format. Topics selected for inclusion are believed to be up-to-date, informative, and clinically meaningful--as well as theoretically…
Nichols, William C.; And Others
Replicated Everett's (1980) survey of Approved Supervisors of American Association for Marriage and Family Therapy (AAMFT). Found significant differences in today's supervision including increase in female supervisors, shift toward systemic theoretical orientation, more supervisors in formal training settings, increase in video recording usage,…
Lask, Bryan; Roberts, Alice
Anorexia nervosa (AN) in childhood and adolescence has a poor prognosis. It is possible that this may in part be due to the fact that cognitive weaknesses that appear to be risk factors for its development and maintenance are not being targeted in treatment. Through its focus on these deficits, cognitive remediation therapy (CRT) has been shown to be a promising intervention for AN. Furthermore, family interventions are widely recommended for this patient population, but to date no studies have reported the use of CRT in a family setting. This paper presents a case series in which family-based CRT was a significant component of the management. It was well received by patients and their families and previously treatment resistant patients became more engaged with the entire treatment process. In addition, all patients receiving family-based CRT went on to make progress towards recovery. These initial clinical observations suggest family-based CRT is likely to be a useful addition to treatment for child and adolescent AN and justifies formal evaluation. PMID:24096368
Carson, David K.
Looks at the importance of creativity in the context of family therapy. Examines creative techniques such as family sculpturing, family art therapy, puppetry, family drawings, and psychodrama. Focuses on the concept of creativity in prominent theories of counseling (i.e., humanistic, Gestalt, cognitive psychology) and the relation of divergent…
Josephson, Allan M.
Objective: This article discusses the pedagogy of teaching family therapy in the new millennium. It draws on the strengths of "family systems therapy" but goes beyond it--suggesting a new paradigm, new terminology, and a new teaching perspective. It discusses the historical background of family therapy training, a scientific foundation for what…
Historically, family counseling grew from a focus on the individual to an emphasis on the importance of the entire family as the unit of treatment and the structure of the family as the key ingredient in family functioning. Strategic family therapy (SFT) has evolved from these traditional intervention approaches to the use of a brief, directive,…
Cole, Patricia M.; Johnson, Kit
The purpose of this article is to encourage family therapists to become more interested in family business practice. It does so in three ways: (a) highlighting the number of therapists already involved in family business issues; (b) showing the parallels between family business and family therapy by applying family business research findings to…
Resnikoff, Roy O.
Ten questions for understanding the family as patient are presented as one aspect of an overall teaching plan for family therapy. Seeing the family as patient is important in initial stages of evaluation and therapy. A case study of a large, overly close family is used as an illustration. (Author)
Dimitriou, Evangelos C.; Didangelos, Pavlos A.
Refers to the child-rearing practices and to the situation of family therapy in Greece. Maintains many children in Greece live in an overprotective, overcontrolling and overdemanding environment, which could promote emotional problems. Comparison of the efficacy of family therapy to that of individual therapy in a child guidance clinic suggests…
Regas, Susan J.; Sprenkle, Douglas H.
Describes the therapy, assessment, and education principles of Functional Family Therapy and applies them to the treatment of inhibited sexual desire, using a case illustration. Functional Family Therapy works at motivating the couple to want change, rather than providing an understanding of underlying causes of the problem. (JAC)
Micucci, Joseph A.
Presenting a developmentally grounded approach to treating a wide range of adolescent problems, this book shows how troubled teenagers and their parents can be helped to use family relationships as catalysts for growth and change. Case examples, practical discussions of the process of assessment and therapy, and straightforward clinical advice are…
What are the therapeutic limitations of systemic psychotherapy when working with families who hold religious fundamentalist beliefs? At a time of debate about religious fundamentalism, terrorism and radicalisation, where do family therapists position themselves when confronted by extreme beliefs in the therapy room? Research suggests that the increase in modernity within our society equates not just with an increase in secularisation, but rather an increase in pluralism. Contemporary models of family therapy pay explicit attention to issues of gender, culture, ethnicity, discrimination and societal contexts. The author, therefore, proposes that family therapists need to examine their position regarding religious fundamentalism in relation to the social constructionist relativist continuum and engage with uncomfortable questions about whether they believe that fundamentalism has essentially pathological roots. This article will explore whether the dualist position within some religious movements set against a more secular psychotherapeutic and psychiatric cultural milieu can invite a fundamentalised response from clinicians. The author draws on her own work with families who hold religious fundamentalist beliefs and enquires about ethics, transparency and collaboration within family therapy practice. This article invites complex ongoing challenging questions and debate. PMID:26712896
Doherty, William J.; And Others
Analyzes 13 models of family therapy according to their special emphases on the Family FIRO (Fundamental Interpersonal Relationship Orientation) model's dimensions of inclusion, control, and intimacy. Final conceptual analysis of models indicated that four family therapy models emphasized inclusion as a primary focus, four emphasized control, and…
Much of the development of family therapy as a discipline was an outcome of the clinical, training, and theory-building activities conducted at family institutes around the United States. Beginning in the 1960s, these institutes were the crucibles in which the concepts and practices of family therapy flourished. The author, a leader at one of the largest family institutes in the United States, discusses the role of family institutes in promoting the practice of family therapy, as well as the challenges of doing so. PMID:24785549
Pavlin, Saul; Rabkin, Richard
Two experienced family therapists discuss therapeutic style, involvement, techniques, methods, handling of sexual material, use of self and of cotherapists in family sessions. Issues, relating to the first session, family fights sessions, types of families, family systems, and termination are also detailed. (Author)
Rait, Douglas Samuel
Objective: This study describes the current state of family therapy training in a sample of child and adolescent psychiatry fellowship programs. Method: Child and adolescent psychiatry fellows (N = 66) from seven training programs completed a questionnaire assessing demographics, family therapy training experiences, common models of treatment and…
Szapocznik, Jose; And Others
Compared structural family therapy (SFT), individual psychodynamic child therapy (IPCT) and control condition for Hispanic boys (N=69) with behavior and emotional problems. Findings suggest that control condition was less effective in retaining cases than treatment conditions, and SFT was more effective than IPCT in protecting family integrity.…
Family Therapy Inst., Rugby, ND.
The report--over half of which consists of appendixes--describes the Family Therapy Institute, a statewide program in Rugby, North Dakota devoted to the deinstitutionalization of juvenile delinquent status offenders by means of short term intensive family therapy treatment. Among the aspects covered are a history of the philosophical approach…
This article outlines a graduate-level, one-time-only family therapy course that prepares counseling trainees to be competent at entry-level family therapy in the United States. The approach outlined addresses the training concerns of programs that significantly emphasize individual-focused paradigms and that have limited time to train counseling…
Williams, Lee M.
Notes that family therapy research and psychotherapy research in general have been criticized for their lack of relevance to clinical practice. Presents five-stage model, based on marketing and developmental perspective, that family therapy researchers can follow to increase relevance of their work for clinicians and other consumers of family…
Wendorf, Donald J.; And Others
Charts the development of the Family Therapy Consortium, a group that provides supervision and continuing education in family therapy and explores the peer supervision process at work in the consortium. The focus is on individual and group development, which are seen as complementary aspects of the same growth process. (Author/NRB)
Haddock, S A; Zimmerman, T S; MacPhee, D
In the past two decades, feminist scholars have challenged the field of family therapy to incorporate the organizing principle of gender in its theory, practice, and training. In this paper, we introduce a training, research, and therapeutic tool that provides guidance for addressing or observing gender and power differentials in the practice of family therapy. As a training tool, the Power Equity Guide helps trainees to translate their theoretical understanding of feminist principles into specific behaviors in therapy. Researchers and supervisors can use the Power Equity Guide to evaluate the practice of gender-informed family therapy. We also provide specific suggestions for its use by trainers, supervisors, therapists, and researchers. PMID:10776603
Roberts, Janine; Abu-Baker, Khawla; Diez Fernández, Cristina; Chong Garcia, Nelly; Fredman, Glenda; Kamya, Hugo; Martín Higarza, Yolanda; Fortes de Leff, Jacqueline; Messent, Philip; Nakamura, Shin-Ichi; Torun Reid, Fatma; Sim, Timothy; Subrahmanian, Chitra; Zevallos Vega, Roxana
Family therapists from 10 different countries (China, India, Israel including Palestinian citizens, Japan, Mexico, Peru, Spain, Turkey, Uganda, and the United Kingdom) describe systemic therapy in their contexts and current innovative work and challenges. They highlight the importance of family therapy continuing to cut across disciplines, the power of systems ideas in widely diverse settings and institutions (such as courts, HIV projects, working with people forced into exile), extensive new mental health initiatives (such as in Turkey and India), as well as the range of family therapy journals available (four alone in Spain). Many family therapy groups are collaborating across organizations (especially in Asia) and the article presents other ideas for connections such as a clearing house to inexpensively translate family therapy articles into other languages. PMID:25099431
GLICK, IRA D.; DULIT, REBECCA A.; WACHTER, EILEEN; CLARKIN, JOHN F.
The authors review recent controlled studies on the interrelationship of the family and its members with borderline disorder and propose a new model for understanding and managing this relationship. The focus of the model is on psychopathology, evaluation, and treatment of patient and family as they influence each other. In the authors’ view this illness originates in cerebral dysfunction, in the patient in combination with impaired relationships among family members. When the family is available, we believe that the treatment of choice is a multimodal approach involving family psychoeducation and family systems or dynamic intervention where possible, in combination with medications, individual psychotherapy, or both. PMID:22700254
Offering an alternative to clinician's prevalent focus on family dysfunction, this book draws upon extensive clinical and research experience to present a framework for therapeutic and preventive work with couples and families who are distressed, vulnerable, or at risk. The book identifies key interactional processes that enable family members to…
Chrzastowski, Szymon K
This article presents how genograms, a classic family therapy technique, can be used in the context of narrative therapy. Genograms create a unique opportunity to explore and re-tell family stories thus enabling their re-authoring. An important aspect of this process is that of tracking down family resources and wisdom. The graphic form of a genogram can be very helpful in distancing a person from the dominant narrations in her/his family. Additionally, genogram analysis is an excellent opportunity to conduct re-membering conversation and introducing the "club of life" metaphor. Finally, the creative approach to drawing genograms can be an invitation for family members to "play" with their family stories and, as a consequence, re-position their roles in these stories. The article completes the presentation of the family therapy case study which was inspired by narrative ideas and genogram analysis. PMID:21613367
Linesch, Debra; Aceves, Hilda C.; Quezada, Paul; Trochez, Melissa; Zuniga, Elena
This grounded theory study utilized art therapy techniques to explore the experiences of 8 Latino families that had immigrated to the United States. Focus group facilitators invited the parents and adolescent children in the families to share their acculturation experiences verbally and in family drawings. Emergent themes from each of three focus…
Wood, Jeffrey J.; Piacentini, John C.; Southam-Gerow, Michael; Chu, Brian C.; Sigman, Marian
Objective: This study compared family-focused cognitive behavioral therapy (CBT: the Building Confidence Program) with traditional child-focused CBT with minimal family involvement for children with anxiety disorders. Method: Forty clinically anxious youth (6-13 years old) were randomly assigned to a family- or child-focused cognitive-behavioral…
Zarski, John J.; And Others
Discusses home-based family therapy intervention programs, designed as a preventive strategy for multiproblem, at-risk families in mental health agencies. Maintains that a review of the literature reveals little information on clinical supervision, which is a major component of home-based family intervention. Focuses on providing an alternative…
Stinchfield, Tracy Anne
Research has indicated that traditional office-based family therapy services are not always effective with at-risk families and that there is an increasing trend toward home-based delivered services (W. Snyder & E. McCollum, 1999). In this qualitative study, the author explored experienced home-based family therapists' perceptions of the…
Paré, D A
This essay proposes that a family therapy founded on a contemporary, postmodern perspective demands an expanded range of metaphors for the family and the work of therapy. It describes a perspective that emphasizes a view of the family as a culture, as opposed to a system. A cultural perspective naturally addresses issues of meaning and language, narrative, politics, and practices of power-critical contemporary concerns not adequately encompassed by traditional systemic formulations. The essay explores the relationship between theory and metaphor, and contrasts the views of persons and of the family offered by the metaphors of culture and system. Case illustrations demonstrate how a cultural view effectively fashions an expanded therapeutic discourse, shifting the focus of family therapy from normative prescriptions for family "functionality" to issues of intercultural harmony. This shift in emphasis also extends to individual work, where the therapeutic task is construed as a peace-making between conflicting stories that intersect in the client's life. PMID:8804965
Erickson, Martin J.
Discusses some of the specific problems associated with the adoption of the family life-cycles (FLC) theory and paradigm in marriage and family therapy (MFT). Four ideas are offered as ways to "re-vision" the FLC paradigm in MFT in the areas of theory, research, and therapy. (Author/MKA)
Navarre, S E
The structural approach to family therapy offers a useful perspective to the nurse therapist working with families with various cultural backgrounds. Asian and Hispanic families are examined to illustrate using Minuchin's approach to family counseling. The rationale for the structural approach is explored, and specific therapeutic techniques for practice are described. Nurses who work with culturally diverse families might profit by using this approach. PMID:9883131
Cardona, Betty; Softas-Nall, Lia
In this interview, Patricia Arredondo shares with us her scholarship and expertise working with Latino families. Patricia talks about multicultural competencies, multicultural development as well as diversity assessment when working with Latino families. Dr. Arredondo has published widely on these topics and is the coauthor of "Counseling Latinos…
Malone, C A
This article has provided an overview of the complex relationship between family therapy and child and adolescent psychiatry. Emphasis has been placed on the fact that the controversy and polarization that earlier characterized the relationship have delayed, but not blocked, the full integration of family therapy into child and adolescent psychiatry. Child psychiatrists and family therapists have been able to move beyond dichotomous polemics to combine the two fields in clinical practice, which has led to meaningful convergence in research and services. Family research has yielded important new directions for clinical practice in the areas of attachment, alcoholism, conduct disorder, and schizophrenia spectrum disorders. It also has led to models of family continuity that have considerable potential for interrelating and possibly integrating different family therapy models. Family research also has uncovered family factors in the intergenerational transmission of psychopathology that can inform clinical practice. Convergence in the clinical domain has led to improved assessment and treatment across a wide range of child, adolescent, and family developmental, emotional, behavioral, and mental disorders. Finally, this article has reviewed the controversy over family systems therapy and the development of new directions in theory and practice to which this controversy has led. Despite the possibility that these new directions might lead to significant disruption and interference in the process of convergence, careful examination of the controversy and the new developments in practice suggests that rather than producing division between the two fields, the new developments, especially narrative therapy, are more likely to bring the two fields closer, particularly in the realm of interventive interviewing in family therapy. PMID:11449803
James, Kerrie; MacKinnon, Laurie
Critiques family therapy literature concerning incest. Identifies pervasive myths claiming that (1) fathers and mothers are pathologically disturbed or inadequate; (2) incest is caused by separation and loss; (3) family isolation or a rigid external boundary explains incest; and (4) incest serves a function in maintaining family organization.…
Laird, Heather; Vande Kemp, Hendrika
Explored the level of family therapist complementarity in the early, middle and late stages of therapy performing a micro-analysis of Salvador Minuchin with one family in successful therapy. Level of therapist complementarity was signficantly greater in the early and late stages than in the middle stage, and was significantly correlated with…
Johnson, Lee N.; Ketring, Scott A.
The role of the therapy alliance in therapy outcome for families dealing with child abuse and neglect was examined using the family as the unit of analysis. The alliance was tested as a moderator in relationship to posttreatment levels of symptom distress and physical violence. Results show that the bonds, goals, and tasks subscale scores are…
Sagatun, Inger J.
Examines the effects of a self-help program, Parents United, on families in which incest has occurred. Studied male incest offenders (N=56). Results indicated the program was successful in increasing participants' feelings of responsibility, and decreasing recidivism, but less successful in keeping the families together. (Author/JAC)
Fishman, H. Charles
Juvenile Anorexia Nervosa (AN) is a severe problem both in terms of presenting symptomatology and its tendency toward chronicity. Researchers have consistently shown that family-based approaches are superior to individual approaches for the treatment of juvenile AN. This article addresses the capacity deficit of trained family therapists to treat…
Moy, Caryl T.
The use of touch in therapeutic relationships is seldom dealt with as a practice issue except in a proscriptive way. To gather descriptive information on the use of touch in therapy, professional therapists (N=50) whose practice was largely family therapy were interviewed about the successful use of touch in their helping relationships. Interview…
Teufel, Emily Scudder
Through art therapy, children express symbolically what they will not or cannot express emotionally to those close to them, and some children have the added stress of family problems that are magnified due to the situation. Presents the case history of a nine-year-old girl in the terminal stages of leukemia whose artwork symbolized family unity.…
A "third force" in family therapy is outlined in this paper, which combines a phenomenological-humanistic approach with a highly active-directive attempt to help family members surrender their misperceptions of themselves and others and to make profound philosophic changes in their intrapersonal and interpersonal attitudes and behaviors. (Author)
Reviews pertinent literature on terroristic trauma and combines this information with the author's experience in treating adults, children, and family victims and survivors of recent terrorist attacks. Describes the psychological syndromes resulting from terrorism and discusses the relevant individual and family therapy modalities for treating…
de Castro, Sahily; Guterman, Jeffrey T.
Solution-focused therapy is proposed as a model for families coping with suicide. The nature and incidence of suicide is described along with a consideration of the effects that suicide has on families and prevailing treatment approaches. Three case examples illustrate the application. Implications are discussed pertaining to the theory, practice,…
Mooradian, John K.
This article describes a learning method that employed theatre students as family clients in an advanced social work practice course. Students were provided with an opportunity to integrate and apply their learning of theory, clinical skills, and professional conduct in full-length family therapy sessions that occurred in the classroom and were…
The vast majority of pet owners regard their companion animals as family members, yet the role of pets in family systems and family therapy has received little attention in research, training, and practice. This article first notes the benefits of family pets and their importance for resilience. It then examines their role in couple and family processes and their involvement in relational dynamics and tensions. Next, it addresses bereavement in the loss of a cherished pet, influences complicating grief, and facilitation of mourning and adaptation. Finally, it explores the ways that clients' pets and the use of therapists' companion animals in animal-assisted therapy can inform and enrich couple and family therapy as valuable resources in healing. PMID:19930434
Stewart, Catherine; Voulgari, Stamatoula; Eisler, Ivan; Hunt, Katrina; Simic, Mima
Existing randomized controlled trials of family therapy for treatment of bulimia nervosa in adolescence highlight the need for further development of treatments. This article describes the development of multi-family treatment for bulimia nervosa in adolescents aged 13-18. It outlines the theory guiding this development, the areas of need identified by previous studies, and the treatment that has been designed to meet these needs. Particular attention is given to the need to increase communication between family members, strategies to reduce high levels of criticism or hostility, and skills to manage emotion dysregulation and low tolerance for negative emotions. To these ends the program draws on the multi-family treatment for anorexia nervosa, cognitive behavioral therapy techniques, and dialectical behavior therapy. PMID:26010166
Beenken, Andrew; Mohammadi, Moosa
The family of fibroblast growth factors (FGFs) regulates a plethora of developmental processes, including brain patterning, branching morphogenesis and limb development. Several mitogenic, cytoprotective and angiogenic therapeutic applications of FGFs are already being explored, and the recent discovery of the crucial roles of the endocrine-acting FGF19 subfamily in bile acid, glucose and phosphate homeostasis has sparked renewed interest in the pharmacological potential of this family. This Review discusses traditional applications of recombinant FGFs and small-molecule FGF receptor kinase inhibitors in the treatment of cancer and cardiovascular disease and their emerging potential in the treatment of metabolic syndrome and hypophosphataemic diseases. PMID:19247306
Baldwin, Scott A.; Christian, Sarah; Berkeljon, Arjan; Shadish, William R.
This meta-analysis summarizes results from k = 24 studies comparing either Brief Strategic Family Therapy, Functional Family Therapy, Multidimensional Family Therapy, or Multisystemic Therapy to either treatment-as-usual, an alternative therapy, or a control group in the treatment of adolescent substance abuse and delinquency. Additionally, the…
Greenberg, G.; Ganshorn, K.; Danilkewich, A.
OBJECTIVE: To provide family doctors in busy office practices with a model for counseling compatible with patient-centred medicine, including the techniques, strategies, and questions necessary for implementation. QUALITY OF EVIDENCE: The MEDLINE database was searched from 1984 to 1999 using the terms psychotherapy in family practice, brief therapy in family practice, solution-focused therapy, and brief psychotherapy. A total of 170 relevant articles were identified; 75 abstracts were retrieved and a similar number of articles read. Additional resources included seminal books on solution-focused therapy (SFT), bibliographies of salient articles, participation in workshops on SFT, and observation of SFT counseling sessions taped by leaders in the field. MAIN MESSAGE: Solution-focused therapy's concentration on collaborative identification and amplification of patient strengths is the foundation upon which solutions to an array of problems are built. Solution-focused therapy offers simplicity, practicality, and relative ease of application. From the perspective of a new learner, MECSTAT provides a framework that facilitates development of skills. CONCLUSION: Solution-focused therapy recognizes that, even in the bleakest of circumstances, an emphasis on individual strength is empowering. In recognizing patients as experts in self-care, family physicians support and accentuate patient-driven change, and in so doing, are freed from the hopelessness and burnout that can accompany misplaced feelings of responsibility. PMID:11768927
Kennedy, B J; Torkelson, J L
Familial high-tone hearing loss in males is a recessive trait often unrecognized. Cisplatin chemotherapy may be associated with hearing loss. A review was made of audiograms in 85 patients with testicular carcinoma prior to cisplatin chemotherapy to determine the extent of preexisting familial hearing loss. Clinical histories defined patients exposed to high noise levels and other common causes of hearing loss. Audiometric findings were classified according to normal hearing or mild, moderate, and severe hearing impairment. Pretreatment audiograms were normal in 51 patients and abnormal in 19 patients with histories of high-level noise exposure, and in 15 patients with high-frequency hearing loss there was no history of noise exposure, ear infection, or other potential causes of hearing loss. These last 15 patients were judged to have recessive familial hearing loss. Awareness of familial hearing loss is important in male patients in whom cisplatin chemotherapy is planned. Pretreatment hearing assessment, including audiograms, is recommended for such male patients. PMID:9589029
Davis, Susan L. R.; Davis, Donald I.
Presents a brief introduction to Neuro-Linguistic Programming (NLP), followed by case examples which illustrate some of the substantive gains which NLP techniques have provided in work with couples and families. NLP's major contributions involve understanding new models of human experience. (WAS)
Outlines the types of separation threats common in troubled families. Signs that threats are being used may include inappropriate clinging behavior, phobias, psychosomatic symptoms, and anxious attachment. Therapists may find other behaviors, often seen as problems in themselves, that are really reactions to perceived separation threats. (JAC)
Szapocznik, José; Zarate, Monica; Duff, Johnathan; Muir, Joan
Despite the efficacy of family-based interventions for improving outcomes for adolescent behavior problems such as substance use, engaging and retaining whole families in treatment is one of the greatest challenges therapists confront. This article illustrates how the Brief Strategic Family Therapy® (BSFT®) model, a family-based, empirically validated intervention designed to treat children and adolescents’ problem behaviors, can be used to increase engagement, improve retention, and bring about positive outcomes for families. Research evidence for efficacy and effectiveness is also presented. PMID:23731415
McDowell, Teresa; Fang, Shi-Ruei; Kosutic, Iva; Griggs, Julie
In this article, we report the results of a survey that accessed the perceptions of family studies and family therapy international master's and doctoral students across the United States. Our goals included giving collective voice to the experience of international students and gathering their suggestions for improving programs. Themes that…
Dickerson, Victoria C
Postmodernism began to influence family therapy very early in the 1980s with articles referencing postmodern ideas, focusing on meaning and multiplicity. With the appearance of narrative therapy on the scene in the 1990s there was a shift toward poststructural thinking, which refined the movement and politicized the clinical work. Even with a bit of a backlash, whether because this was a new idea or it somehow threatened a positivistic culture, a poststructural view has continued to have effects on family therapy. This article explores the variety of influences: the expansion of narrative ideas, the innovation of Madsen's collaborative helping, and also more nuanced effects. I argue that a poststructural view has effectively changed how many family therapists think and may also be subtly influencing how they might work. PMID:25039267
Haber, Russell; Carlson, Ryan G; Braga, Cristina
To attain information about divergent agendas in family therapy, as well as incorporate client feedback, we present the Client Feedback Note (CFN). The CFN elicits information about each family member's feelings, learning, dislikes, and wishes for each session. Anecdotal feedback after each session may help the therapist have better insight into the clients' perceptions and experience of the therapy and the therapist. Sensitivity to information generated by the CFN can help both therapist and client work to coconstruct a therapeutic process that is relevant to the diverse needs of the client system. This manuscript will (a) discuss literature supporting the use of client feedback in therapy; (b) present the CFN and rationale for its development; (c) discuss our experiences utilizing the CFN along with case examples that illustrate its use; and (d) identify practical applications, limitations, and potential research with using the CFN in systemic therapy. PMID:24702034
Christensen, Teresa M.; Thorngren, Jill M.
Presents an interview with Eliana Gil, the current director of the Starbright Training Institute for child abuse and neglect, play therapy, and family play therapy in Springfield, Virginia. Gil's publications and experiences have spoken to coconstructing family therapy sessions that effectively integrate the paradigms of play and family therapy.…
Diamond, Gary M.; Diamond, Guy S.; Hogue, Aaron
This study examined the fidelity of attachment-based family therapy (ABFT) for depressed adolescents. Trained observers used the therapist behavior rating scale (3rd version) to code therapist behaviors in 45 sessions of ABFT and 45 sessions each from two empirically based treatments for adolescent substance abusers: multidimensional family…
As a counterpoint to the oftentimes adversarial way that parents are viewed when they appear to be overinvolved in the lives of their college-aged students, this article advocates for the use of a family therapy perspective in university counseling centers. Benefits of this perspective include a broadening of the lens through which individual…
Riley, P; Hartwell, S; Sargent, G; Patterson, J E
The professions of family therapy and law share many clients and areas of overlap. Law-related coursework in family therapy programs is typically limited to legal, ethical, and professional issues. However, students can also benefit from understanding other areas of overlap, such as divorce, child custody, and mediation. This article discusses the curriculum for an interdisciplinary course that educates both family therapy and law students. The course provides: (1) a substantive education about similarities and differences between the professions, how they operate as systems, and specific areas of overlap, (2) opportunities to learn clinical skills, and (3) opportunities for personal insight about skills, personality types, and negotiation styles, and how these may differ between the professions. PMID:9338862
This paper applies the Biobehavioral Family Model (BBFM) of stress- related illness to the study and treatment of an adolescent with intractable asthma. The model is described, along with supportive research findings. Then a case study is presented, demonstrating how the model is clinically applied. We tell the story of an asthmatic adolescent presenting for therapy due to her intense asthmatic crises, and the case is presented to exemplify how the BBFM can help understand the family-psychobiological contribution to exacerbation of disease activity, and therefore guide treatment towards the amelioration of severe physical symptoms. Facets of the patient’s intra-familial interactions are consistent with the BBFM, which support clinical validation of the model. In the case described, it is likely that additional asthma medications would not have had the desired ameliorative effect, because they did not target the family relational processes contributing to the symptoms. The recognition of the influences of family relational processes on the disease was crucial for effective intervention. The therapy incorporates and weaves together BBFM understanding of family patterns of interaction and physiological/medical concerns integrated with Bowenian intervention strategies. This case study validates the importance and usefulness of BBFM for intervention with stress-sensitive illnesses such as asthma. PMID:23148727
Karofsky, P S; Keith, D V; Hoornstra, L L; Clune, C S
Fifteen families received family therapy from a pediatrician and nurse practitioner. Most families began therapy because of school problems or behavior problems with one of the children. There was serious marital discord in nine families that resulted in divorce in two of them. At least one year after the families began therapy, they were recalled for interviews by a psychologist who was unknown to them. Information was obtained during these interviews that indicates (1) pediatricians and nurse practitioners were accepted in their roles as therapists by 14 of the 15 families and (2) all families rated their family therapy experiences as useful. PMID:6839618
Weatherhead, Stephen; Daiches, Anna
We present the key issues to consider in therapy with Muslim families. Following a brief introduction, five themes are presented: self, family dynamics, causation, and coping strategies. The section on "self" includes a discussion of three terms which link the four Islamic models of "self" identified through the review. The family dynamics section pays particular attention to interconnectedness, family roles, and gender. Causation is discussed with reference to supernatural and spiritual causes. On the theme of coping strategies, religious responses are discussed as are the roles of religious leaders, and professional mental health services. Clinical implications from the key themes are also discussed in addition to limitations of the published literature in this area. This includes a discussion of the epistemological and paradigmatic issues related to the research. The review concludes by summarising these issues and presenting areas for further research. PMID:25801751
Beels, C Christian
The official history of family therapy describes its beginnings as a daring technical and philosophical departure from traditional individual treatment in the 1960s, inspired especially by the "system thinking" of Gregory Bateson. This celebrated origin story needs to be supplemented with a longer and larger history of both practice and thought about the family, and that is the subject of this article. The longer history goes back to the founding of social work by Mary Richmond, of pragmatism by William James, and of the organic view of social systems intervention by John Dewey. Seen against this background, family therapy is, among other things, a consequence of the development of persistent elements of American professional culture, experience, and philosophy. The taking of this historical-anthropological view discloses also the origins of two other histories that have made their contribution to the development of family therapy: a science of observing communication processes that starts with Edward Sapir and leads to contemporary conversation analysis, and a history of mesmerism in the United States that culminates in Milton Erickson and his followers. PMID:11924091
Focuses on systems theory as the paradigm underlying family therapy and considers the implications of this framework for conceptions of the individual, the study of parent-child interaction, and new research formulations and areas of study. Considers trends in the developmental field that move toward such formulations. (RH)
Khodayarifard, Mohammad; McClenon, James
Iranian clinical psychologists have devised family therapy methods that use cognitive behavior models that ft with their collectivist Islamic culture. The authors review Islamic-based strategies and describe family therapy with a culturally specific case of childhood obsessive-compulsive disorder. Family therapy, adapted to integrated,…
There are not a lot of conceptual tools that can help a family therapy teacher to talk and teach about the importance of the therapeutic relationship in family therapy practice. The idea that family therapy can be conceived as a dialogue might offer a fresh and promising perspective. Mainly inspired by the work of Bakhtin, Voloshinov, and Shotter,…
Wittenborn, Andrea K; Dolbin-MacNab, Megan L; Keiley, Margaret K
With training that emphasizes relationship systems, marriage and family therapists are uniquely attuned to interpersonal dynamics, interdependence, and the influence of relationships on individuals' perceptions, beliefs, and attitudes. While recent statistical advances have contributed to a proliferation of resources designed to introduce researchers to dyadic data analysis, guidelines related to the methodological aspects of dyadic research design have received less attention. Given the potential advantages of dyadic designs for examining couple and family relational and therapeutic processes, the purpose of this article is to introduce marriage and family therapy researchers to dyadic research methodology. Using examples from our own research, we discuss methodological considerations and lessons learned related to sampling, measurement, data collection, and ethics. Recommendations for future dyadic research are provided. PMID:25073839
Stoddard, F R; Wilberger, M S; Olafson, E
This case presents a technique for doing family therapy in families with young children. In family play therapy, the entire family plays together, allowing full participation of even the youngest children in the therapeutic process. Standard family therapy interventions in the latter part of each session make use of family interaction patterns and unconscious processes revealed during the earlier play. In the case presented here, the technique was successfully applied to a family with a 3-year-old son who had functional urinary retention. This case also provided an opportunity for interdisciplinary collaboration between the separate Child and Family Services at a major teaching hospital. PMID:8243618
Sheidow, Ashli J.; Woodford, Mark S.
Multisystemic Therapy (MST) is a well-validated, evidenced-based treatment for serious clinical problems presented by adolescents and their families. This article is an introduction to the MST approach and outlines key clinical features, describes the theoretical underpinnings, and discusses the empirical support for MST's effectiveness with a…
Lokeshwar, Vinata B.; Mirza, Summan; Jordan, Andre
Hyaluronic acid or hyaluronan (HA) is perhaps one of the most uncomplicated large polymers that regulates several normal physiological processes and, at the same time, contributes to the manifestation of a variety of chronic and acute diseases, including cancer. Members of the HA signaling pathway (HA synthases, HA receptors, and HYAL-1 hyaluronidase) have been experimentally shown to promote tumor growth, metastasis, and angiogenesis, and hence each of them is a potential target for cancer therapy. Furthermore, as these members are also overexpressed in a variety of carcinomas, targeting of the HA family is clinically relevant. A variety of targeted approaches have been developed to target various HA family members, including small-molecule inhibitors and antibody and vaccine therapies. These treatment approaches inhibit HA-mediated intracellular signaling that promotes tumor cell proliferation, motility, and invasion, as well as induction of endothelial cell functions. Being nontoxic, nonimmunogenic, and versatile for modifications, HA has been used in nanoparticle preparations for the targeted delivery of chemotherapy drugs and other anticancer compounds to tumor cells through interaction with cell-surface HA receptors. This review discusses basic and clinical translational aspects of targeting each HA family member and respective treatment approaches that have been described in the literature. PMID:25081525
Carlson, Thomas D.; Kirkpatrick, Dwight; Hecker, Lorna; Killmer, Mark
Although increasing attention has been given to spirituality, to date, no published studies in marriage and family therapy journals have explored marriage and family therapists' beliefs about the appropriateness of addressing spirituality in therapy. This study fills this gap by examining the beliefs of a sample of clinical members of AAMFT about…
Charlés, Laurie L
This article discusses the design and delivery of two international family therapy-focused mental health and psychosocial support training projects, one in a fragile state and one in a post-conflict state. The training projects took place in Southeast Asia and the Middle East/North Africa. Each was funded, supported, and implemented by local, regional, and international stakeholders, and delivered as part of a broader humanitarian agenda to develop human resource capacity to work with families affected by atrocities. The two examples illustrate how task-shifting/task-sharing and transitional justice approaches were used to inform the scaling-up of professionals involved in each project. They also exemplify how state-citizen phenomena in each location affected the project design and delivery. PMID:25315510
Hodgson, Jennifer L; Lamson, Angela L; Feldhousen, Elizabeth B
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. PMID:17257379
Patel, Roshni S; Scopelliti, Emily M; Savelloni, Julie
Familial hypercholesterolemia (FH) is a genetic disorder characterized by significantly elevated low-density lipoprotein cholesterol (LDL-C) concentrations that result from mutations of the LDL receptor, apolipoprotein B (apo B-100), and proprotein convertase subtilisin/kexin type 9 (PCSK9). Early and aggressive treatment can prevent premature atherosclerotic cardiovascular disease in these high-risk patients. Given that the cardiovascular consequences of FH are similar to typical hypercholesterolemia, traditional therapies are utilized to decrease LDL-C levels. Patients with FH should receive statins as first-line treatment; high-potency statins at high doses are often required. Despite the use of statins, additional treatments are often necessary to achieve appropriate LDL-C lowering in this patient population. Novel drug therapies that target the pathophysiologic defects of the condition are continuously emerging. Contemporary therapies including mipomersen (Kynamro, Genzyme), an oligonucleotide inhibitor of apo B-100 synthesis; lomitapide (Juxtapid, Aegerion), a microsomal triglyceride transfer protein inhibitor; and alirocumab (Praluent, Sanofi-Aventis/Regeneron) and evolocumab (Repatha, Amgen), PCSK9 inhibitors, are currently approved by the U.S. Food and Drug Administration for use in FH. This review highlights traditional as well as emerging contemporary therapies with supporting clinical data to evaluate current recommendations and discuss the future direction of FH management. PMID:26684558
Jurich, Anthony P.
Describes problems associated with Vietnam veterans and their families, including Posttraumatic Stress Disorder. Veterans may establish enmeshed relationships with their children, leading to problems with adolescent individualization. Presents a five-stage treatment method including Intake, Ventilation, Bridging, Education, and Taking Therapy…
Hogue, Aaron; Dauber, Sarah; Stambaugh, Leyla Faw; Cecero, John J.; Liddle, Howard A.
The impact of early therapeutic alliance was examined in 100 clients receiving either individual cognitive-behavioral therapy (CBT) or family therapy for adolescent substance abuse. Observational ratings of adolescent alliance in CBT and adolescent and parent alliance in family therapy were used to predict treatment retention (in CBT only) and…
Williams, Lee; McBain, Heidi
As the field of family therapy has evolved, there has been growing recognition as to the importance of gender in family therapy. To prepare the next generation of family therapists adequately, it is important that they recognize the many and complex ways in which gender permeates their work. In this article we present an integrative model to help…
Weinstein, Charles D.; And Others
The social learning approach to marital and family therapy is a didactic approach calling for an active and directive therapist and a collaborative client. To examine the variability of therapist and client behaviors within sessions and across the course of treatment, 24 families, in marital and family therapy, participated in the study. Families…
This article examines the unique ethical considerations for the provision of family therapy as substance abuse treatment. Use of family therapy as substance abuse treatment has grown rapidly, but the ethical codes that guide clinical practice have not kept pace. Ethical pitfalls specific to family counseling within alcohol and drug treatment…
Slesnick, Natasha; Prestopnik, Jillian L
Treatment evaluation for alcohol problem, runaway adolescents and their families is rare. This study recruited primary alcohol problem adolescents (N = 119) and their primary caretakers from two runaway shelters and assigned them to (a) home-based ecologically based family therapy (EBFT), (b) office-based functional family therapy (FFT), or (c)…
Smith, Robert L.; Stevens-Smith, Patricia
Counselors working in the areas of marriage and family counseling and therapy are expected to work effectively with couples and families experiencing a variety of issues and problems. Structural, strategic, and transgenerational family therapists may seem to be operating in similar manners, and it appears that many practicing family therapists go…
Crespi, Tony D.; Rueckert, Quentin H.
Clinicians involved in family therapy are increasingly concerned with the impact of parental alcoholism on individual development and family functioning. With more than 20 million adults raised within an alcoholic family, and with widespread problems associated with parental alcoholism, clinicians providing family treatment have a potentially…
May, Harold J.
The impact of breast cancer and mastectomy on women and their families is examined from a family systems orientation. Sexual counseling and family therapy are advocated to reduce the psychological and sexual trauma of mastectomy and enhance family adjustment. Clinical case studies provide support for therapeutic intervention. (Author)
Robbins, Michael S.; Mayorga, Carla C.; Mitrani, Victoria B.; Szapocznik, Jose; Turner, Charles W.; Alexander, James F.
This study examined the relationship between alliance and retention in family therapy. Alliance was examined at the individual (parent, adolescent) and family level (within-family differences) for families that either dropped out or completed family therapy. Participants were 31 Hispanic adolescents and their family members who received brief…
Becker, D; Liddle, H A
Almost two-thirds of African American births are to unmarried mothers, and these single parents are among the most economically vulnerable in the United States. The effects of chronic stressors such as poverty can compromise the ability of these mothers to parent effectively, particularly during the developmental period of adolescence, typically a stressful phase of parenting. This article describes a multidimensional family therapy (MDFT) approach to working with African American adolescents who have drug and/or behavior problems. It is maintained that addressing the intrapersonal functioning of African American single mothers is vital if they are to re-establish the attachment bonds necessary for the maintenance of essential parental influence in the lives of their adolescents. Through systematic attention to the parent as an individual, leading to a balance between self-care and care for others, parental supervision is more easily achieved and relational impasses between parent and adolescent more equitably resolved. PMID:11802488
Jiang, Yunyun; Ludwig, Joseph; Janku, Filip
The prognosis of adolescent and young adult patients battling metastatic Ewing Sarcoma Family of Tumours (ESFT) remains less than 30% despite the development of systemic therapies. In the era of personalized medicine, novel molecular targets have been tested in preclinical or clinical settings in ESFT. In this review, we focus on early clinical and translational research that identified multiple molecular targets, including IGF-1R; mTOR; tyrosine kinase inhibitors; EWS-FLI1-related targets, and others. Overall, novel targeted therapies demonstrated modest efficacy; however pronounced and durable antineoplastic responses have been observed in small subsets of treated patients, for example with IGF-1R antibodies. Identifying outcome-predicting biomarkers and overcoming treatment resistance remain major challenges. Due to the rarity of ESFT, multi-institutional collaboration efforts of clinicians, basic and translational scientists are needed in order to understand biology of therapeutic response or resistance, which can lead to development of novel therapeutic methods and improved patient outcomes. PMID:25869102
Dalle Grave, Riccardo; Calugi, Simona; Doll, Helen A.; Fairburn, Christopher G.
A specific form of family therapy (family-based treatment) is the leading treatment for adolescents with anorexia nervosa. As this treatment has certain limitations, alternative approaches are needed. “Enhanced” cognitive behaviour therapy (CBT-E) is a potential candidate given its utility as a treatment for adults with eating disorder psychopathology. The aim of the present study was to establish, in a representative cohort of patients with marked anorexia nervosa, the immediate and longer term outcome following CBT-E. Forty-nine adolescent patients were recruited from consecutive referrals to a community-based eating disorder clinic. Each was offered 40 sessions of CBT-E over 40 weeks from a single therapist. Two-thirds completed the full treatment with no additional input. In these patients there was a substantial increase in weight together with a marked decrease in eating disorder psychopathology. Over the 60-week post-treatment follow-up period there was little change despite minimal subsequent treatment. These findings suggest that CBT-E may prove to be a cost-effective alternative to family-based treatment. PMID:23123081
Fraser, J. Scott; Solovey, Andrew D.; Grove, David; Lee, Mo Yee; Greene, Gilbert J.
A moderate common factors approach is proposed as a synthesis or middle path to integrate common and specific factors in evidence-based approaches to high-risk youth and families. The debate in family therapy between common and specific factors camps is reviewed and followed by suggestions from the literature for synthesis and creative flexibility…
Carson, David K.; Jain, Sachin; Ramirez, Sylvia
Outpatient counseling is a relatively new concept and form of clinical practice in India. This article provides an overview of the need for and current status of counseling and family therapy in India. Examples of training programs are presented, and future prospects for the counseling and family therapy professions are highlighted. The authors…
Friedlander, Myrna L.; Bernardi, Shaina; Lee, Hsin-Hua
To be responsive to clients' evaluations of the unfolding therapy process, therapists must first accurately "read" client behavior, a particularly challenging task in conjoint family therapy. In this study, the authors compared client behavior in 28 sessions that one family member and the therapist concurred, on the Session Evaluation…
Rowe, Cynthia L.
Just 15 years ago, Liddle and Dakof ("Journal of Marital and Family Therapy," 1995; 21, 511) concluded, based on the available evidence, that family therapy represented a "promising, but not definitive" approach for the treatment of drug problems among adolescents and adults. Seven years later, Rowe and Liddle (2003) review described considerable…
May, Joanne C.
Based on attachment theory and research, Family Attachment Narrative Therapy is introduced as a new family therapy modality developed to heal the experience of early childhood maltreatment. Unresolved childhood trauma has been correlated with impaired and delayed cognitive, behavioral and emotional functioning. Gentle, soothing, nonprovocative and…
Slesnick, Natasha; Bartle-Haring, Suzanne; Gangamma, Rashmi
There is a dearth of research that examines the impact of family systems therapy on problems among sexually and/or physically abused youth. Given this void, differential outcome and predictors of substance use change were evaluated for abused, as compared with nonabused, runaway adolescents who were randomly assigned to family therapy or treatment…
Nelson, Thorana S.; Chenail, Ronald J.; Alexander, James F.; Crane, D. Russell; Johnson, Susan M.; Schwallie, Linda
In response to a series of national policy reports regarding what has been termed the "quality chasm" in health and mental health care in the United States, in January 2003, the American Association for Marriage and Family Therapy convened a task force to develop core competencies (CC) for the practice of marriage and family therapy (MFT). The…
George, Elizabeth L.; Taylor, Dawn O.; Goldstein, Benjamin I.; Miklowitz, David J.
This paper examines obstacles and challenges encountered in the manualized Family Focused Therapy-A of an adolescent with bipolar disorder. We begin by describing adolescent bipolar disorder and some of the many complications that frequently accompany it. We summarize Family Focused Therapy (FFT-A), an empirically validated treatment approach for…
Miller, John K.; Lambert-Shute, Jennifer
The authors conducted a survey of marriage and family therapy (MFT) doctoral students in programs accredited by the Commission on Accreditation for Marriage and Family Therapy Education (COAMFTE). MFT doctoral students (N = 82) from across the United States responded to a web-based survey that focused on career aspirations, training opportunities,…
Dare, Christopher; And Others
Compared family therapy with individual, supportive psychotherapy for management of severe eating disorder. Findings showed family therapy more effective for patients with early onset, short duration disorder but not in other subgroups (early onset, duration more than 3 years; late onset, after age of 18 years; and those with bulimia nervosa).…
Haddock, Shelley A.; MacPhee, David; Zimmerman, Toni Schindler
Content analysis of 23 American Association for Marriage and Family Therapy Master Series tapes was used to determine how well feminist behaviors have been incorporated into ideal family therapy practice. Feminist behaviors were infrequent, being evident in fewer than 3% of time blocks in event sampling and 10 of 39 feminist behaviors of the…
Lippert, Tonya; Favre, Tricia; Alexander, Cindy; Cross, Theodore P.
Objective: To identify child characteristics, factors related to the therapy referral, and caregivers' psychological and social variables that predict sexually abused children's beginning therapy following a therapy referral. Method: Investigators abstracted data from case records of 101 families whose children were referred to a Children's…
Dimitropoulos, Gina; Farquhar, Jamie C; Freeman, Victoria Emily; Colton, Patricia Anne; Olmsted, Marion Patricia
Multi-family therapy (MFT) has yet to be evaluated in families of adults with anorexia nervosa (AN). The study aims were: (i) assess the feasibility of MFT for AN; and, (ii) assess whether MFT is associated with improved outcomes for families compared with single-family therapy (SFT). Adult patients with AN consecutively referred to an eating disorder treatment program were assigned (non-randomly) to receive eight sessions of SFT or MFT. Assessment occurred pre-therapy, immediately post-therapy, and at 3-month follow-up. A total of 37 female patients (13 SFT, 24 MFT) and 45 family members (16 SFT, 29 MFT) completed treatment. There were significant time effects for patients' BMI, eating disorder-related psychopathology and multiple family outcome measures. There were no differences between MFT and SFT on family outcome measures at end of treatment and 3 months post treatment. MFT is a feasible intervention that can be used in adult intensive treatment for those with AN. PMID:25823423
Hantel-Quitmann, Wolfgang; Weidtmann, Katja
The emotional family climate is considered both an effective risk and protective factor for child development. Factors such as negative experiences parents made during their childhood or adolescence, which can reoccur as intergenerational transmission, a low partnership quality and a high level of conflict seem to be particularly relevant for the quality of the emotional family climate. Consequently, the relationship between partners, as the core relation within families, is particularly important for the family climate and subsequently for the development of the child. For this reason, problems in parent relationships should receive special attention in family therapeutic interventions. Mentalisation-based family therapy (MBF-T) offers promising approaches in this context. The key principles of mentalisation are introduced and the links between family and mentalisation are presented, followed by information on the history, objectives and the procedures of MBF-T. A case study of a family therapy, in which a child suffers from chronic headache, illustrates the connection and interrelation between family climate, family conflicts and the parental relationship, and it will further show the importance of mentalisation-based elements for therapeutic treatments. PMID:26758340
Pratt, Keeley J; Palmer, Elizabeth; Cravens, Jaclyn D; Ferriby, Megan; Balk, Elizabeth; Cai, Yin
Discrimination based on an individual's weight has been observed in health care, education, retail, and other public sectors (Puhl & Huer, Obesity, 17, 941, 2007). Such inequity, known as "weight bias," generates negative short-term and long-term consequences for the individuals that experience it (Puhl & Brownell, Weight bias in health care settings, 2007). Past research has shown that healthcare trainees exhibit weight bias (Phelan et al., Obesity, 22, 1201, 2014; Wigton & McGaghie, Journal of General Internal Medicine, 16, 262, 2001), yet little focus is given to weight bias in marriage and family therapy (MFT) education. The purpose of this study was to survey MFT students (N = 162) to explore weight bias and how contextual factors associate with weight bias. Participants in MFT programs reported explicit weight bias, with specific contextual factors associating with more bias. Female participants reported more fear of gaining weight, and individuals who identified as overweight had higher rates of explicit weight bias. Contextual differences and implications for training programs are discussed. PMID:25728034
Santisteban, Daniel A.; Coatsworth, J. Douglas; Perez-Vidal, Angel; Mitrani, Victoria; Jean-Gilles, Michele; Szapocnik, Jose
The intervention described in this paper used Brief Strategic/Structural Family Therapy (BSFT) to reduce the likelihood that African American and Hispanic youth would initiate drug use by decreasing existing behavior problems at the individual level and improving maladaptive family functioning at the family level. The program targeted African…
Roberts, Janine McGill
Presents methods to help family therapy trainees and clinicians articulate how to address gender in families. Describes four experiential exercises (including gender survival messages, gender framed circular questions, and process observation sheets) for training and use with clients. Can examine learnings about gender from families of origin,…
Robbins, Michael S.; Feaster, Daniel J.; Horigian, Viviana E.; Puccinelli, Marc J.; Henderson, Craig; Szapocznik, Jose
Objective: Therapist adherence has been shown to predict clinical outcomes in family therapy. In prior studies, adherence has been represented broadly by core principles and a consistent family (vs. individual) focus. To date, these studies have not captured the range of clinical skills that are represented in complex family-based approaches or…
Herschell, Amy D.; Kolko, David J.; Baumann, Barbara L.; Brown, Elissa J.
Alternatives for Families: A Cognitive-Behavioral Therapy (AF-CBT) is an evidence-based treatment for families with children aged 5 to 15 years who have been affected by verbal and physical aggression in the family. AF-CBT was designed to address risks for exposure to emotional and physical aggression as well as common clinical consequences of…
Gelcer, E; Schwartzbein, D
The Invariant Approach of Mara Selvini-Palazzoli is a new development in the Milan approach to family therapy. In order to distinguish and explain it, an overview of the Invariant Approach is given. Jean Piaget's theory of cognitive development is used to provide a framework for explaining how Selvini-Palazzoli's therapy alters the family's epistemology and facilitates change in the "family game." It is suggested that family members in therapy tend to think about their problems in a style that resembles Piaget's preoperational period. The process of therapy can be seen as geared to facilitate a shift from a preoperational to an operational style of cognitive functioning. This shift gives family members access to more adaptive ways of thinking about their problem-solving strategies. PMID:2599068
Edwards, Todd M.; Patterson, Jo Ellen
The Day Reconstruction Method (DRM) was used to assess the daily events and emotions of one program's master's-level family therapy trainees in off-campus practicum settings. This study examines the DRM reports of 35 family therapy trainees in the second year of their master's program in marriage and family therapy. Four themes emerged from the…
In family therapy, during the last years more and more importance is attached to the dynamics of the sibling subsystem. In the present paper differences between them as well as similarities are discussed from the point of view of family theory. Relevant dimensions like support, attachment, rivalry and envy between brothers and sisters contribute essentially to the family dynamics. In this clinically orientated paper, we describe by means of a case example how the couple's conflicts after their separation is unconsciously repeated in the sibling subsystem. It is shown how the intergenerational dynamics can be interrupted by the initiative of the children and the initiated family therapy. PMID:11515394
Robbins, Michael S; Mayorga, Carla C; Mitrani, Victoria B; Szapocznik, José; Turner, Charles W; Alexander, James F
This study examined the relationship between alliance and retention in family therapy. Alliance was examined at the individual (parent, adolescent) and family level (within-family differences) for families that either dropped out or completed family therapy. Participants were 31 Hispanic adolescents and their family members who received brief strategic family therapy for the treatment of adolescent drug use. Videotapes of first sessions were rated to identify parent and adolescent alliances with the therapist. Results demonstrated that Completer cases had significantly higher levels of alliance across all family members than Dropout cases, and Dropout cases had significantly higher unbalanced alliances than Completer cases. Clinical implications are discussed. PMID:18717922
Smith, Linda S
Children in highly conflicted, divorced families can become triangulated and polarized in their relationships with their parents. In time, this can lead to a child refusing to have a relationship with a parent, refusing for example, to see or talk to him or her. This access refusal can sometimes become extended, lasting months to years. When this occurs, the courts may request professional involvement to help facilitate parent-child reunification. This article outlines a family-based treatment model for parent-child reunification cases. This family-based treatment incorporates treatment goals for each family member and each family member is asked to be a part of the solution in resolving the family's problems. I provide a case illustration as well as helpful tips for treating these families. PMID:27074348
Houtrow, Amy J; Yock, Torunn I; Delahaye, Jennifer; Kuhlthau, Karen
Children with brain tumors experience significant alterations to their health and well-being due to the tumors themselves and oncologic treatment. Caring for children with brain tumors can have significant impacts on families, especially during and shortly after treatment. In this study of the impacts on families caring for children undergoing proton radiation therapy for brain tumors, the authors found that families experienced a broad array of negative impacts. Families reported feeling like they were living on a roller coaster, feeling that others treated them differently, and having to give up things as a family. In the multivariable linear regression model, older age of the child and higher reported child health-related quality of life were associated with less family impact. The presence of concurrent chemotherapy was associated with increased family impact. This is the first study to specifically evaluate the families of children being treated with proton radiation therapy. The findings in this study are consistent with the findings in other studies of children treated with standard therapy that show that families experience a variety of stressors and negative impacts while their children are receiving treatment. Health care providers should be aware of the potential impacts on families of children with brain tumors and their treatment to provide robust services to meet the health, psychological, and social needs of such children and their families. PMID:22647729
Williams, Lee; McBain, Heidi
As the field of family therapy has evolved, there has been growing recognition as to the importance of gender in family therapy. To prepare the next generation of family therapists adequately, it is important that they recognize the many and complex ways in which gender permeates their work. In this article we present an integrative model to help educators teach family therapists about gender issues. The model examines how gender influences clinical work on multiple levels, including contextual levels such as society and the marriage and family therapy field. The model also acknowledges how gender can influence individuals, including clients, therapists, and supervisors. Finally, the model attempts to capture the complexity of how gender can impact the relational dynamics between two or more individuals. PMID:16933441
Nelson, Thorana S; Smock, Sara A
Marriage and family therapy (MFT) and marriage and family therapy education (MFTE) have undergone many changes during the short history of MFT. This article describes the current trends and controversies in MFTE, including shifts toward outcome-based education (OBE). We present recommendations for MFTE, including the move toward OBE, the development of core competencies of MFT, attention to interdisciplinary issues, and recognition of the need for both foundational education and encouragement of trainees' unique styles and approaches. PMID:16206635
Segura, José Adolfo
Inspired by his ethnographic experience with the Mapuche, a native community in the South of Chile and his reflection on family therapy and the literature pertaining to ethnopsychiatry, the author proposes the elaboration of an at-home-therapeutic space (HTS), a specific device for family therapy in the homes of patients. The author describes the various steps of his approach and his first-hand experience of the device. PMID:15368013
Rocha, Semiramis Melani Melo; Correia, Carolina Camilo; Molzahn, Anita; Nascimento, Lucila Castanheira
Although Anne had many complex health issues and experienced considerable support from her extended family, she wanted freedom from the restrictions posed by peritoneal dialysis. Her quality of life changed after transplantation, with more opportunities to engage in leisure activities, ability to travel, a less restricted diet, and an improved self-image. She required fewer treatments, surgeries, and hospitalizations. She left behind the role of sick child and took up a role more like a healthy child. During the disease and decision-making process, Anne learned coping mechanisms, allowing her to gain autonomy to make decisions. The case study illustrates both the need to listen to children as well as to care for the entire family. The nursing management of this child and her family was continually changing, and multiple strategies were used to support the family. The nurse came to understand the roles of family members in constant change, the sources of their resources, and foci of tensions. Based on this knowledge, the nurse can act by mobilizing resources, strengthening the confidence of family members, and helping them develop coping mechanisms. In conclusion, care of the ill child must be family-centered. Stresses on the family have an impact on the child and vice versa. The potential to influence the quality of life of both the child and the family is considerable. PMID:20830947
Szapocznik, Jose; Feaster, Daniel J.; Mitrani, Victoria B.; Prado, Guillermo; Smith, Lila; Robinson-Batista, Carleen; Schwartz, Seth J.; Mauer, Magaly H.; Robbins, Michael S.
This study tests the efficacy of Structural Ecosystems Therapy (SET), a family-ecological intervention, in improving psychosocial functioning when compared with an attention-comparison person-centered condition and a community control condition. A sample of 209 HIV-seropositive, urban, low-income, African American women was randomized into 1 of…
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Beamish, Patricia; Navin, Sally
This document presents a review of the literature on salient ethical issues in marriage and family counseling. Issues addressed in the paper include: (1) defining the client and the welfare and rights of individuals versus those of the family system; (2) issues of informed consent and manipulative therapeutic interventions; (3) issues related to…
Burnout prevention for family therapists can be enhanced by careful consideration of the degree of responsibility taken by the therapist contrasted with responsibility placed on the family. Attention to issues of expectations, role definition, sharing of feelings, and therapeutic ambition can ease the strain on the therapist. PMID:4085618
Rynes, Kristina N.; Rohrbaugh, Michael J.; Lebensohn-Chialvo, Florencia; Shoham, Varda
Isomorphism, or parallel process, occurs in family therapy when patterns of therapist-client interaction replicate problematic interaction patterns within the family. This study investigated parallel demand-withdraw processes in Brief Strategic Family Therapy (BSFT) for adolescent drug abuse, hypothesizing that therapist-demand/adolescent-withdraw interaction (TD/AW) cycles observed early in treatment would predict poor adolescent outcomes at follow-up for families who exhibited entrenched parent-demand/adolescent-withdraw interaction (PD/AW) before treatment began. Participants were 91 families who received at least 4 sessions of BSFT in a multi-site clinical trial on adolescent drug abuse (Robbins et al., 2011). Prior to receiving therapy, families completed videotaped family interaction tasks from which trained observers coded PD/AW. Another team of raters coded TD/AW during two early BSFT sessions. The main dependent variable was the number of drug use days that adolescents reported in Timeline Follow-Back interviews 7 to 12 months after family therapy began. Zero-inflated Poisson (ZIP) regression analyses supported the main hypothesis, showing that PD/AW and TD/AW interacted to predict adolescent drug use at follow-up. For adolescents in high PD/AW families, higher levels of TD/AW predicted significant increases in drug use at follow-up, whereas for low PD/AW families, TD/AW and follow-up drug use were unrelated. Results suggest that attending to parallel demand-withdraw processes in parent/adolescent and therapist/adolescent dyads may be useful in family therapy for substance-using adolescents. PMID:23438248
Pinsof, William M.
Presents an overview of the Integrative Problem-Centered Therapy (IPCT) Model, and describes its core principles and premises, and basic methodological steps. The IPCT provides a technique for applying individual and family therapy and behavioral, communicational, and psychodynamic orientations to client problems. Its goal is to create efficient…
McFarlane, Penny; Harvey, Jenny
A collaborative therapeutic approach often proves the best way to assess and meet the needs of children experiencing barriers to learning. This book gives a concise overview of drama and family therapy and describes how both therapies can work together to provide essential pieces of the jigsaw of emotional support for troubled children within an…
Hogue, Aaron; Henderson, Craig E.; Dauber, Sarah; Barajas, Priscilla C.; Fried, Adam; Liddle, Howard A.
This study examined the impact of treatment adherence and therapist competence on treatment outcome in a controlled trial of individual cognitive-behavioral therapy (CBT) and multidimensional family therapy (MDFT) for adolescent substance use and related behavior problems. Participants included 136 adolescents (62 CBT, 74 MDFT) assessed at intake,…
Family systems theory's contribution to the world of psychotherapy was its move away from lineal causality toward a view of human relationships as not merely multi-determined, but unavoidably and inextricably inter-related and inter-dependent. Circular causation allows the therapist to assume enormous flexibility. The rise of family therapy in…
Valdez, Avelardo; Cepeda, Alice; Parrish, Danielle; Horowitz, Rosalind; Kaplan, Charles
Objective: This study assessed the effectiveness of an adapted Brief Strategic Family Therapy (BSFT) intervention for gang-affiliated Mexican American adolescents and their parents. Methods: A total of 200 adolescents and their family caregivers were randomized to either a treatment or a control condition. Outcomes included adolescent substance…
Diamond, Guy; Liddle, Howard A.
Explored the process of resolving an in-session impasse between a parent and an adolescent in family therapy. Focusing on altering the content and affective tone of a discussion, the "shift intervention" was used to direct a family's conversation away from trying to solve behavior management problems and toward a discussion of fundamental…
Weaver, Addie; Greeno, Catherine G.; Marcus, Steven C.; Fusco, Rachel A.; Zimmerman, Tina; Anderson, Carol
Objective: This pilot study examined the effect of structural family therapy (SFT) on children's impairment and depressive symptomatology and mothers' depressive symptomatology and anxiety for 31 families served by a community mental health clinic. Method: A one group predesign/postdesign, with a baseline and two follow-up time points,…
Tse, Luke M.; Wantz, Richard A.; Firmin, Michael
Unlike perceptions toward professional counseling, public opinions do not typically associate marriage and family counseling or therapy with treatments of mental disorders. The current survey of college students in this sample confirmed that most would not recommend, specifically, marriage and family therapists (MFTs) for mental health…
Miller, John K.; Linville, Deanna; Todahl, Jeff; Metcalfe, Joe
This article provides a description of a university-based project that used mock trials to train both practicum-level marriage and family therapy and law students in forensic work, and a qualitative investigation of student experiences with the training. The content of the training focused on American Association for Marriage and Family Therapy…
Lock, James; Agras, W. Stewart; Bryson, Susan; Kraemer, Helena C.
Objective: Research suggests that family treatment for adolescents with anorexia nervosa may be effective. This study was designed to determine the optimal length of such family therapy. Method: Eighty-six adolescents (12-18 years of age) diagnosed with anorexia nervosa were allocated at random to either a short-term (10 sessions over 6 months) or…
McDowell, Teresa; Brown, Andrae' L.; Cullen, Nicole; Duyn, April
In this article, we report the results of a national survey of students in COAMFTE-accredited family therapy programs who self-identify as coming from lower- or working-class backgrounds. Results of the study reveal opportunity and tension relative to family, friends, and community because of social mobility associated with graduate education.…
McDaniel, Susan H.; Harkness, Jennifer L.; Epstein, Ronald M.
Medical family therapy grew out of the experiences of family therapists working with other professionals to provide comprehensive, integrated healthcare for patients. This is the story of one such patient and provides an account of the experience through quotes from videotaped sessions and electronic mail communications that occurred throughout…
Ray, Dee; Bratton, Sue C.; Brandt, Marielle A.
States that many single parents are attending institutions of higher education to qualify for employment that will ensure the economic security of their families. Focuses on the use of filial/family play therapy with single parents attending community colleges as an effective intervention for improving the present and future welfare of these…
Brakenhoff, Brittany; Slesnick, Natasha
Substance abusing mothers and their children are more likely to experience a range of social, behavioral, and psychological difficulties. Despite the significant challenges faced by these families, little is known about their experiences in treatment. The current study analyzed 12 sessions of family therapy using thematic analysis to identify common themes that arose during substance abusing mothers and their children’s discussion during family therapy. Mothers’ ages ranged from 28 to 35 years and the children’s ages ranged from 12 to 14 years. Four therapy sessions from three families were coded for a total of 12 therapy sessions. An ecological framework was used to classify themes, in which themes related to each level of the families’ ecological systems were identified. Thematic analysis of the therapy sessions indicated that mothers and their children primarily discussed topics related to their relational and emotional needs. The findings indicated that substance use disordered mothers and their children have unique treatment needs that should be addressed when the mother seeks treatment. More research is needed to further clarify and confirm the observations in this study. In particular, future research should include a larger sample and quantitative methodology. PMID:25729116
The call for family-centered therapeutic services, especially for families of young children, has come from governmental organizations, professional associations, practitioners, and families. Play therapists and family therapists are prime candidates to provide such services, but professional research and literature suggest that practitioners…
Lindenfelser, Kathryn J; Hense, Cherry; McFerran, Katrina
Research into the value of music therapy in pediatric palliative care (PPC) has identified quality of life as one area of improvement for families caring for a child in the terminal stages of a life-threatening illness. This small-scale investigation collected data in a multisite, international study including Minnesota, USA, and Melbourne, Australia. An exploratory mixed method design used the qualitative data collected through interviews with parents to interpret results from the PedsQL Family Impact Module of overall parental quality of life. Parents described music therapy as resulting in physical improvements of their child by providing comfort and stimulation. They also valued the positive experiences shared by the family in music therapy sessions that were strength oriented and family centered. This highlighted the physical and communication scales within the PedsQL Family Impact Module, where minimal improvements were achieved in contrast to some strong results suggesting diminished quality of life in cognitive and daily activity domains. Despite the significant challenges faced by parents during this difficult time, parents described many positive experiences in music therapy, and the overall score for half of the parents in the study did not diminish. The value of music therapy as a service that addresses the family-centered agenda of PPC is endorsed by this study. PMID:22144660
Ewing, E Stephanie Krauthamer; Diamond, Guy; Levy, Suzanne
Attachment-Based Family Therapy (ABFT) is a manualized family-based intervention designed for working with depressed adolescents, including those at risk for suicide, and their families. It is an empirically informed and supported treatment. ABFT has its theoretical underpinnings in attachment theory and clinical roots in structural family therapy and emotion focused therapies. ABFT relies on a transactional model that aims to transform the quality of adolescent-parent attachment, as a means of providing the adolescent with a more secure relationship that can support them during challenging times generally, and the crises related to suicidal thinking and behavior, specifically. This article reviews: (1) the theoretical foundations of ABFT (attachment theory, models of emotional development); (2) the ABFT clinical model, including training and supervision factors; and (3) empirical support. PMID:25778674
Ramsey-Kemper, Valerie Ann
Problem. The purpose of this study was to review the literature which presents the latest advancements in the field of family therapy theory. Since such advancement has relied on the scientific developments in the study of autopoietic self-organizing complex systems, then the review began with an historical overview of the development of these natural scientific concepts. The study then examined how the latest scientific concepts have been integrated with family therapy practice. The document is built on the theory that individuals are living, complex, self-organizing, autopoietic systems. When individual systems interact with other individual systems (such as in family interaction, or in interaction between therapist and client), then a third system emerges, which is the relationship. It is through interaction in the relationship that transformation of an individual system can occur. Method. The historical antecedents of the field of family therapy were outlined. It was demonstrated, via literature review, that the field of family therapy has traditionally paralleled developments in the hard sciences. Further, it was demonstrated via literature review that the newest understandings of the development of individuals, family systems, and therapeutic systems also parallel recent natural science developments, namely those developments based on the science of self-organizing complex systems. Outcome. The results of the study are twofold. First, the study articulates an expanded theory of the therapist, individual, and family as autopoietic self-organizing complex systems. Second, the study provides an expanded hypothesis which concerns recommendations for future research which will further advance the latest theories of family therapy. More precisely, the expanded hypothesis suggests that qualitative research, rather than quantitative research, is the method of choice for studying the effectiveness of phenomenological therapy.
Cantegreil-Kallen, Inge; Rigaud, Anne-Sophie
Alzheimer's disease has a negative impact on family relationships and may trigger conflicts between the main caregiver and other family members. The systemic approach evidences the impact of dementia on structural and functional characteristics of the family system. Systemic family therapy is especially indicated in crisis situations such as emergency hospitalization or institutionalization of the patient, and when the family members do not agree on when and how to introduce care and support services at the patient's home. In this case, the aim of the intervention is to restore the communication between all the family members in order to find an agreement for the best management of the patients. Since September 2006, systemic family therapy has been offered in the memory clinic of the Broca Hospital to families having a member suffering from Alzheimer's disease. The involvement of the families was accomplished by the direct participation of the patient, main caregiver (spouse), grown-up children and grandchildren. The aim was to obtain an agreement for the access of support and care services at home from all the family members. The intervention was based on a step-by-step procedure and comprehended five sessions. The primary results of a pilot study are presented. PMID:20031507
Santisteban, Daniel A.; Perez-Vidal, Angel; Coatsworth, J. Douglas; Kurtines, William M.; Schwartz, Seth J.; LaPerriere, Arthur; Szapocznik, José
This study investigated the efficacy of brief strategic family therapy (BSFT) with Hispanic behavior problem and drug using youth, an underrepresented population in the family therapy research literature. One hundred twenty-six Hispanic families with a behavior problem adolescent were randomly assigned to 1 of 2 conditions: BSFT or group treatment control (GC). Results showed that, compared to GC cases, BSFT cases showed significantly greater pre- to post-intervention improvement in parent reports of adolescent conduct problems and delinquency, adolescent reports of marijuana use, and observer ratings and self reports of family functioning. These results extend prior findings on the efficacy of family interventions to a difficult to treat Hispanic adolescent sample. PMID:12666468
Sheehan, Alyson H; Friedlander, Myrna L
We explored how the therapeutic alliance contributed to retention in Brief Strategic Family Therapy by analyzing videotapes of eight-first sessions in which four therapists worked with one family that stayed in treatment and one family that dropped out. Although behavioral exchange patterns between clients and therapists did not differ by retention status, positive therapist alliance-related behavior followed negative client alliance behavior somewhat more frequently in the retained cases. In the qualitative aspect of the study, four family therapy experts each viewed two randomly assigned sessions and commented on their quality without knowing the families' retention status. A qualitative analysis of the audiotaped commentaries revealed 18 alliance-related themes that were more characteristic of either the retained or the nonretained cases. PMID:25640754
Czabotar, Peter E; Lessene, Guillaume; Strasser, Andreas; Adams, Jerry M
The BCL-2 protein family determines the commitment of cells to apoptosis, an ancient cell suicide programme that is essential for development, tissue homeostasis and immunity. Too little apoptosis can promote cancer and autoimmune diseases; too much apoptosis can augment ischaemic conditions and drive neurodegeneration. We discuss the biochemical, structural and genetic studies that have clarified how the interplay between members of the BCL-2 family on mitochondria sets the apoptotic threshold. These mechanistic insights into the functions of the BCL-2 family are illuminating the physiological control of apoptosis, the pathological consequences of its dysregulation and the promising search for novel cancer therapies that target the BCL-2 family. PMID:24355989
Dakof, Gayle A.; Henderson, Craig E.; Rowe, Cynthia L.; Boustani, Maya; Greenbaum, Paul E.; Wang, Wei; Hawes, Samuel; Linares, Clarisa; Liddle, Howard A.
The objective of this article is to examine the effectiveness of 2 theoretically different treatments delivered in juvenile drug court—family therapy represented by multidimensional family therapy (MDFT) and group-based treatment represented by adolescent group therapy (AGT)—on offending and substance use. Intent-to-treat sample included 112 youth enrolled in juvenile drug court (primarily male [88%], and Hispanic [59%] or African American [35%]), average age 16.1 years, randomly assigned to either family therapy (n = 55) or group therapy (n = 57). Participants were assessed at baseline and 6, 12, 18 and 24 months following baseline. During the drug court phase, youth in both treatments showed significant reduction in delinquency (average d = .51), externalizing symptoms (average d = 2.32), rearrests (average d = 1.22), and substance use (average d = 4.42). During the 24-month follow-up, family therapy evidenced greater maintenance of treatment gains than group-based treatment for externalizing symptoms (d = 0.39), commission of serious crimes (d = .38), and felony arrests (d = .96). There was no significant difference between the treatments with respect to substance use or misdemeanor arrests. The results suggest that family therapy enhances juvenile drug court outcomes beyond what can be achieved with a nonfamily based treatment, especially with respect to what is arguably the primary objective of juvenile drug courts: reducing criminal behavior and rearrests. More research is needed on the effectiveness of juvenile drug courts generally and on whether treatment type and family involvement influence outcomes. PMID:25621927
Hubbard, Irene Matis; Kautto, Judith Gilbert
Reviews the elements of constancy and the changes that have taken place in the training program of the 15-year-old Center for Family Learning (CFL) in Rye Brook, New York. Includes a discussion of historical and philosophical perspective, the structure of the training program, its theoretical approach, and the makeup of its faculty and student…
Towers, David A.
The works of Kegan and Guidano have presented cognition and emotion as complementary modes of knowing that develop together. Cognition is conceived of as being concerned with the knowledge of reality, and emotions are conceptualized as people's system for knowing of their relationship to that reality. Adult children of dysfunctional families are a…
De Haene, Lucia
Starting from examples of postmodern research and therapeutic practice, we raise the question on the role of the research-therapy dichotomy within these approaches. The article aims to show the profound convergence between postmodern ethnographic research and constructionist, collaborative therapeutic approaches on a double, epistemological and practice level. First, we point out their converging development toward narrative and constructionist epistemologies. Second, an inquiry into the core features of these disciplinary activities' goal, process, and expert role reveals their profound convergence into a dialogical practice in which the boundaries between research and therapy are radically transgressed. We conclude by questioning the implications and acceptability of this convergence for researchers' and therapists' understanding of their practices. PMID:20074120
Galvin, Rose; Cusack, Tara; Stokes, Emma
Background Stroke is a leading cause of disability among adults worldwide. Evidence suggests that increased duration of exercise therapy following stroke has a positive impact on functional outcome following stroke. The main objective of this randomised controlled trial is to evaluate the impact of additional family assisted exercise therapy in people with acute stroke. Methods/Design A prospective multi-centre single blind randomised controlled trial will be conducted. Forty patients with acute stroke will be randomised into either an experimental or control group. The experimental group will receive routine therapy and additional lower limb exercise therapy in the form of family assisted exercises. The control group will receive routine therapy with no additional formal input from their family members. Participants will be assessed at baseline, post intervention and followed up at three months using a series of standardised outcome measures. A secondary aim of the project is to evaluate the impact of the family mediated exercise programme on the person with stroke and the individual(s) assisting in the delivery of exercises using a qualitative methodology. The study has gained ethical approval from the Research Ethics Committees of each of the clinical sites involved in the study. Discussion This study will evaluate a structured programme of exercises that can be delivered to people with stroke by their 'family members/friends'. Given that the progressive increase in the population of older people is likely to lead to an increased prevalence of stroke in the future, it is important to reduce the burden of this illness on the individual, the family and society. Family mediated exercises can maximise the carry over outside formal physiotherapy sessions, giving patients the opportunity for informal practice. Trial Registration The protocol for this study is registered with the US NIH Clinical trials registry (NCT00666744) PMID:18570643
Marlowe, Stephanie L.
The present study investigated within a substance abuse treatment center the influence of family therapy on flexibility and cohesion among family members. Past studies have suggested adolescents who abuse substances exist in families who have a lack of balance of flexibility and cohesion. Unfortunately, few studies have examined the influence of…
Hernandez-Wolfe, Pilar; McDowell, Teresa
This study explores how family therapy educators from privileged social locations understand issues of privilege and the process by which they integrate their personal and professional journeys to create and model equity in family therapy training and professional development. These educators developed awareness about issues of privilege and oppression and owned their privilege. Increased awareness involved personal struggles with guilt and managing internalized voices of prejudice that are constantly reinforced in society. These educators adopted a stance of action and accountability for equity. We hypothesize that the process leading to owning one's privilege involves the ability to be compassionate for others' suffering and one's own limitations. PMID:22690858
Watson, A R
A collaborative project was initiated in two pediatric centers to examine the long-term demands and outcomes in families with children commencing renal replacement therapy. Parents returned questionnaires on stress, anxiety, depression, information needs, and intrusion factors pre, at 3 months, 6 months, and annually. A burden of care assessment (BCA) for families was devised using a scoring system based on the domains of patient, sibling, parents, environment, demands of therapy, and dialysis/transplant factors. Team members also documented medical events and family contacts. In 2 years, 38 patients (26 male) were enrolled with an age range 0.2-18.5 years. Mean stress, anxiety, and depression scores were higher in mothers than fathers, and scores were higher in parents of patients > 10 years compared to the patient group < 10 years. In families with a high initial BCA score there was a positive correlation with maternal stress and anxiety scores. Patients from families with a low BCA score had better growth performance. Older children requiring renal replacement therapy may produce more stress and intrusion for parents than younger children. Burden of care assessments may be a useful means of predicting families who require greater support from the multidisciplinary team. PMID:9360703
Gelin, Zoé; Cook-Darzens, Solange; Simon, Yves; Hendrick, Stéphan
Multiple family therapy (MFT) is a therapeutic method that brings together several families affected by the same pathology. Although from an ideological and conceptual point of view, MFT is often linked to family therapy and group therapy, it is difficult to define it with precision, a weakness which may in turn hinder research on therapeutic effectiveness. This is most notable in the field of eating disorders (ED) where, in spite of MFT's great popularity, research evidence remains limited. Within the context of a systematic review of the literature on MFT in the treatment of anorexia nervosa, the purpose of this article is to provide a theoretical and clinical framework for describing two MFT models, in an attempt to explore their common and distinct concepts, principles, techniques, and factors of change. The first program is a day treatment adaptation of the Maudsley family-based MFT approach, developed in Belgium at the Therapeutic Centre for Adolescents suffering from Eating Disorders: it focuses on the management of ED symptoms, using a strong cognitive behavioral orientation. The second is an integrated systemic MFT outpatient and inpatient program carried out on the ED unit of a pediatric hospital in Paris, France: it emphasizes intra- and inter-family relationships within a systemic framework. Our effort to describe and compare these two models constitutes a first step toward determining the relative value of different models of MFT. Indeed, each model presents specific characteristics that may make it best suited for specific ED populations and/or types of families. PMID:26223191
Rowe, Cynthia L
Just 15 years ago, Liddle and Dakof (Journal of Marital and Family Therapy, 1995; 21, 511) concluded, based on the available evidence, that family therapy represented a "promising, but not definitive" approach for the treatment of drug problems among adolescents and adults. Seven years later, Rowe and Liddle (2003) review described considerable progress in this specialty with encouraging findings on adolescent-focused models based on rigorous methodology, as well as advances with adult-focused family-based treatments. The current review brings the field up to date with highlights from research conducted in the intervening 7 years, cross-cutting issues, recommendations for new research, and practice implications of these findings. Adolescent-focused family-based models that attend to the ecology of the teen and family show the most consistent and strongest findings in recent studies. Adult-focused models based on behavioral and systems theories of change also show strong effects with drug abusers and their families. The overarching conclusion is that family-based models are not only a viable treatment alternative for the treatment of drug abuse, but are now consistently recognized among the most effective approaches for treating both adults and adolescents with drug problems. PMID:22283381
This research aimed to illuminate the experiences of adults with learning disabilities of the reflecting team, in the context of their systemic family therapy. Five adults with learning disabilities were recruited from one community learning disability team. A qualitative design using interpretative phenomenological analysis (IPA) was appropriate…
Charles, Laurie L.
This article describes the experiences of a U.S.-based family therapy practitioner during a 3-week academic consultation in the Philippines. Revisioning the concept of cultural competency as a performance that occurs in relationship, the author shares three autoethnographic stories that illustrate cultural borderlands in the global arena of family…
Gilbert, Jonathan Max; Oliff, Helen; Sutton, David; Bartlett, Catalina; Henderson, Randi
This Treatment Improvement Protocol (TIP) addresses substance abuse treatment in the context of family therapy. TIPs are best-practice guidelines for the treatment of substance use disorders that make the latest research in substance abuse treatment available to counselors and educators. The content was generated by a panel of experts in the…
Bernal, Anibal Torres
Taking a meta-theoretical perspective, this article presents a critical analytical model through which human knowledge, existence, and behaviour can be understood. The article describes the meta-theoretical model and then explains how this model applies to the evolution of seminal family therapy theories.
Lovern, John D.; Zohn, Joseph
Describes techniques of utilization and indirect suggestion in multiple-family group therapy as a component of an alcoholism treatment program. Techniques include: unconscious conditioning, therapeutic binds, indirect suggestion, and the utilization approach. Describes how a set of specific goals can be achieved using these techniques. (Author/KMF)
Merlo, Lisa J.; Lehmkuhl, Heather D.; Geffken, Gary R.; Storch, Eric A.
Pediatric obsessive-compulsive disorder (OCD) is a chronic, disabling condition that affects both patients and their families. Despite the identification of efficacious treatments (e.g., cognitive-behavioral therapy and selective serotonin reuptake inhibitor medications), not all patients respond fully. The purpose of the present study was to…
Kim, Jae Yop; Kim, Dong Goo; Nam, Seok In
Objectives: The current study evaluated the effectiveness of a form of family therapy developed in Korea. The "Thank you--Sorry--Love" (TSL) model was applied to a group of elderly retired men to improve the quality of their marriage and to reduce their stress. Methods: Thirty married retired Korean men were assigned to three groups. Group 1…
Lindstrøm, Maia; Filges, Trine; Jørgensen, Anne-Marie Klint
Purpose: This review evaluates the evidence on the effects of brief strategic family therapy (BSFT) on drug use reduction for young people in treatment for nonopioid drug use. Method: We followed Campbell Collaboration guidelines to prepare this review and ultimately located three studies for final analysis and interpretation. Results: The results…
Diamond, Guy S.; Wintersteen, Matthew B.; Brown, Gregory K.; Diamond, Gary M.; Gallop, Robert; Shelef, Karni; Levy, Suzanne
Objective: To evaluate whether Attachment-Based Family Therapy (ABFT) is more effective than Enhanced Usual Care (EUC) for reducing suicidal ideation and depressive symptoms in adolescents. Method: This was a randomized controlled trial of suicidal adolescents between the ages of 12 and 17, identified in primary care and emergency departments. Of…
Steele, Stephanie J.
The topic of core competencies has been a central focus in the marriage and family therapy field since 2003. There are currently no published studies from the supervisees' perspective about the role of supervision in the acquisition of core competencies. This qualitative study used transcendental phenomenology to explore supervisees' perspectives…
Brock, Gregory W.; Whiting, Jason B.; Matern, Brianne; Fife, Stephen T.
Reports of falsification, fabrication, plagiarism, and other violations of research integrity across the sciences are on the increase. Joining with other disciplines to actively protect the integrity of the marriage and family therapy (MFT) research literature is of utmost importance to both the discipline and the future of the profession. To…
Miller, John K.; Stone, Dana J.
The authors examined factors influencing career aspirations of doctoral students of color in family therapy doctoral programs across the country, with a special focus on careers in the professoriate. Qualitative interviews were conducted with students at varying levels of degree completion. Respondents discussed barriers to careers in academia as…
Knudson-Martin, Carmen; Laughlin, Martha J.
We examine how the issues of gender and sexual orientation have been addressed in family therapy and identify critical issues as the field defines itself in a postmodern, inclusive era. We show how unintentional bias and creation of the category of "other" persist throughout the history of clinical practice despite a rise of interest in diversity.…
Ma, Joyce L. C.; Lai, Kelly
Although family therapy has become highly acceptable in the West, its applicability and acceptability for Chinese adolescents and young women with anorexia nervosa (AN) remains unknown. In this article, we report the results of a qualitative study using post-treatment in-depth interviews to understand the subjective perceptions of sufferers of AN…
Lock, James; Couturier, Jennifer; Agras, W. Stewart
Objective: To describe the relative effectiveness of a short versus long course of family-based therapy (FBT) for adolescent anorexia nervosa at long-term follow-up. Method: This study used clinical and structured interviews to assess psychological and psychosocial outcomes of adolescents (ages 12-18 years at baseline) who were previously treated…
Ratanasiripong, Paul; Ghafoori, Bita
The first clinical training experience or practicum for graduate students in a Marriage and Family Therapy (MFT) program is one of the most important aspects of the entire training program. After a year-long journey through textbook and classroom knowledge, students have the opportunity to finally apply their skills to real life environments with…
The Milan model of systemic family therapy, developed in Italy and based on G. Bateson's cybernetic epistemology, can help meet the goals of a feminist/systemic epistemology in research by accepting data in its "traditional" form yet also connecting it to the act of researching, itself, thereby merging a feminist perspective with the domain of…
Hertlein, Katherine M.; Lambert-Shute, Jennifer
To understand which factors students consider most important in choosing a marriage and family therapy (MFT) graduate program and how programs met or did not meet these expectations of students over the course of graduate study, we conducted an online mixed-method investigation. One hundred twelve graduate students in Commission on Accreditation…
Wampler, Karen S.
In this overview, I comment on the strong theme of the need to define and improve the quality of doctoral education in marriage and family therapy that pervades the three essays. Deficits in research training are the central concern, although the essayists take different perspectives on the nature of the research training needed. The different…
West, John D.; And Others
Describes special program on live supervision in family therapy given at 1988 annual American Association for Counseling and Development (AACD) Conference that featured experts Barbara Okun and Fred Piercy discussing "cotherapy" and "one-way mirror" live supervision approaches. Provides edited transcript of their program. (Author/CM)
Cag, Pinar; Voltan Acar, Nilufer
The movie "Ya Sonra" is evaluated in respect to the basic concepts and principles of symbolic-experiential family therapy. Carl Whitaker, who called his approach "Psychotherapy of Absurdity" mainly emphasized the concepts of absurdity, experientiality, and symbolism. Based on the hypothesis that film analysis supports and…
Woodberry, Kristen A.; Popenoe, Ellen J.
Dialectical behavior therapy (DBT), an empirically supported treatment for adult women diagnosed with borderline personality disorder (BPD), has been increasingly adapted for use with adolescents across a variety of settings. This article describes a community-based application of DBT principles and strategies for adolescents and their families.…
George Washington Univ. Medical Center, Washington, DC.
A survey sought to determine the nature and extent of family therapy practiced in treatment and rehabilitation agencies serving drug abuse clients. Questionnaire responses to a three-phase study were on a voluntary basis. Phase I, with a 60% response rate, gathered information on the number of drug abuse treatment agencies providing family…
Estrada, Ana Ulloa
This article explores the relevance and challenge of Catholic Social Teaching (CST) and internationalization to the Marriage and Family Therapy (MFT) program at the University of San Diego. These issues are discussed in the context of a graduate level course on human diversity that culminated in a 1-day cultural immersion and service learning trip…
McDowell, Teresa; Goessling, Kristen; Melendez, Tatiana
This study explores the experiences of graduate students who completed one of two international courses facilitated by family therapy faculty in a U.S. master's-level counseling psychology department. Participants reported that international courses were personally and professionally transformative. Spending time in a foreign country gave them…
Leung, Cynthia; Tsang, Sandra; Sin, Tammy C. S.; Choi, Siu-yan
Objective: This study aimed to examine the efficacy of the Parent-Child Interaction Therapy (PCIT) in Hong Kong Chinese families, using randomized controlled trial design. Methods: The participants included 111 Hong Kong Chinese parents with children aged 2--7 years old, who were randomized into the intervention group (n = 54) and control group (n…
Miller, John K.; Todahl, Jeff L.; Platt, Jason J.
There is a growing movement to define competency within the field of marriage and family therapy (MFT), particularly with respect to the training of practitioners and the evaluation of clinical practice. Efforts to define competency, however, transcend the practice of MFT and much can be learned from the experiences of other disciplines.…
Rait, Douglas; Glick, Ira
Objective: Given the marginalization of couples and family therapy in psychiatric residency programs over the past two decades, the authors propose a rationale for the reintegration of these important psychosocial treatments into the mainstream of general psychiatric residency education. Methods: After reviewing recent trends in the field that…
Edwards, Todd M.; Patterson, Jo Ellen
The purpose of this article is to identify and describe four essential skills for effective supervision of family therapy trainees in primary care medical settings. The supervision skills described include: (1) Understand medical culture; (2) Locate the trainee in the treatment system; (3) Investigate the biological/health issues; and (4) Be…
Marzola, Enrica; Knatz, Stephanie; Murray, Stuart B; Rockwell, Roxanne; Boutelle, Kerri; Eisler, Ivan; Kaye, Walter H
Family therapy approaches have generated impressive empirical evidence in the treatment of adolescent eating disorders (EDs). However, the paucity of specialist treatment providers limits treatment uptake; therefore, our group developed the intensive family therapy (IFT)-a 5-day treatment based on the principles of family-based therapy for EDs. We retrospectively examined the long-term efficacy of IFT in both single-family (S-IFT) and multi-family (M-IFT) settings evaluating 74 eating disordered adolescents who underwent IFT at the University of California, San Diego, between 2006 and 2013. Full remission was defined as normal weight (≥ 95% of expected for sex, age, and height), Eating Disorder Examination Questionnaire (EDE-Q) global score within 1 SD of norms, and absence of binge-purging behaviours. Partial remission was defined as weight ≥ 85% of expected or ≥ 95% but with elevated EDE-Q global score and presence of binge-purging symptoms (<1/week). Over a mean follow-up period of 30 months, 87.8% of participants achieved either full (60.8%) or partial remission (27%), while 12.2% reported a poor outcome, with both S-IFT and M-IFT showing comparable outcomes. Short-term, intensive treatments may be cost-effective and clinically useful where access to regular specialist treatment is limited. PMID:25783849
Acar, Tulin; Voltan-Acar, Nilufer
The aim of this study was to evaluate the basic concepts of multigenerational Family Therapy and to evaluate the scenes of the film ''My Father and My Son'' according to these concepts. For these purposes firstly basic concepts of Multigenerational Family Therapy such as differentiation of self, triangles/triangulation, nuclear…
Robbins, Michael S.; Feaster, Daniel J.; Horigian, Viviana E.; Rohrbaugh, Michael; Shoham, Varda; Bachrach, Ken; Miller, Michael; Burlew, Kathleen A.; Hodgkins, Candy; Carrion, Ibis; Vandermark, Nancy; Schindler, Eric; Werstlein, Robert; Szapocznik, Jose
Objective: To determine the effectiveness of brief strategic family therapy (BSFT; an evidence-based family therapy) compared to treatment as usual (TAU) as provided in community-based adolescent outpatient drug abuse programs. Method: A randomized effectiveness trial in the National Drug Abuse Treatment Clinical Trials Network compared BSFT to…
Pavuluri, Mani N.; Graczyk, Patricia A.; Henry, David B.; Carbray, Julie A.; Heidenreich, Jodi; Miklowitz, David J.
Objective: To describe child- and family-focused cognitive-behavioral therapy (CFF-CBT), a new developmentally sensitive psychosocial intervention for pediatric bipolar disorder (PBD) that is intended for use along with medication. CFF-CBT integrates principles of family-focused therapy with those of CBT. The theoretical framework is based on (1)…
A multi-theoretical couple/family therapy clinical social work practice model synthesizes various social, family, trauma, and psychodynamic theories to inform a biopsychosocial assessment that guides clinical interventions. The client population involves adult partners who have negotiated the impact of childhood trauma, i.e., physical, sexual, and emotional abuses, including culturally sanctioned trauma. Couples may also be dealing with the aftermath of acute trauma related to interpersonal violence, political conflict, and/or the dislocations related to refugee or new immigrant status. Clinical examples demonstrate the usefulness of the model as well as contraindications when active physical violence is present. The construct of resilience remains a central focus in assessment and treatment. Specific attention to cultural and racial diversity enriches both assessment and treatment interventions with these high-risk couples and families. This practice model will be explicated in depth in an upcoming publication from Columbia University Press titled Transforming the Legacies of Trauma in Couple Therapy. PMID:15774396
Rowe, Cynthia L.
Synopsis Adolescent substance abuse rarely occurs without other psychiatric and developmental problems, yet it is often treated and researched as if it can be isolated from comorbid conditions. Few comprehensive interventions are available that effectively address the range of co-occurring problems associated with adolescent substance abuse. This article reviews the clinical interventions and research evidence supporting the use of Multidimensional Family Therapy (MDFT) for adolescents with substance abuse and co-occurring problems. MDFT is uniquely suited to address adolescent substance abuse and related disorders given its comprehensive interventions that systematically target the multiple interacting risk factors underlying many developmental disruptions of adolescence. PMID:20682221
Hartnett, Dan; Carr, Alan; Sexton, Thomas
To evaluate the effectiveness of Functional Family Therapy (FFT) 42 cases were randomized to FFT and 55 to a waiting-list control group. Minimization procedures controlled the effects of potentially confounding baseline variables. Cases were treated by a team of five therapists who implemented FFT with a moderate degree of fidelity. Rates of clinical recovery were significantly higher in the FFT group than in the control group. Compared to the comparison group, parents in the FFT group reported significantly greater improvement in adolescent problems on the Strengths and Difficulties Questionnaire (SDQ) and both parents and adolescents reported improvements in family adjustment on the Systemic Clinical Outcomes and Routine Evaluation (SCORE). In addition, 93% of youth and families in the treatment condition completed FFT. Improvements shown immediately after treatment were sustained at 3-month follow-up. Results provide a current demonstration of FFT's effectiveness for youth with behavior problems in community-based settings, expand our understanding of the range of positive outcomes of FFT to include mental health risk and family-defined problem severity and impact, and suggests that it is an effective intervention when implemented in an Irish context. PMID:26542420
Background Progressive familial intrahepatic cholestasis type 1 (PFIC1), an inherited liver disease caused by mutations in ATP8B1, progresses to severe cholestasis with a sustained intractable itch. Currently, no effective therapy has been established for PFIC1. Decreased function of the bile salt export pump (BSEP) in hepatocytes is suggested to be responsible for the severe cholestasis observed in PFIC1. We found a previously unidentified pharmacological effect of 4-phenylbutyrate (4PB) that increases the expression and function of BSEP. Here, we tested 4PB therapy in three patients with PFIC1. Methods The therapeutic potency of 4PB in these patients was tested by oral administration of this drug with gradually increasing dosage (200, 350, and 500 mg/kg/day) for 6 months. Biochemical, histological, and clinical data were collected. Results 4PB therapy had no beneficial effect on the patients’ liver functions, as assessed by biochemical and histological analyses, despite an increase in hepatic BSEP expression. However, therapy with 4PB at a dosage of 350 or 500 mg/kg/day significantly relieved the intractable itch. Serum levels of potential pruritogens in cholestasis were much higher than the reference ranges during the 4PB therapy. Conclusions 4PB therapy may be a new medication for patients with intractable cholestatic pruritus and may improve quality of life for patients and their families. PMID:25022842
Giammattei, Shawn V
Dualistic notions about gender and sexuality have permeated the field of couple and family therapy. These binary constructions have been limiting for everyone, especially those who fall outside the male/female dichotomy. This article examines the impact of these binary notions, especially on transgender and gender-creative individuals, couples, and families. Current theory and research in the field as they relate to gender identity, sexuality, and gender minority stress in couples and families are presented. Case examples are used to illustrate affirmative approaches to treatment issues such as coming out, safety, grief and loss, redefining relationships, and social/medical transitions that may arise for transgender or gender nonconforming (TGNC) individuals, couples, and families. PMID:26250935
Ten percent of all cavernomas are familial forms. 300 independent families have been identified in France since 1995. Clinical manifestations are more frequent in familial (50%) than in sporadic forms (5%). The symptoms are the same in both forms: epilepsy, hemorrhages, neurological focal deficits and headache, but hemorrhages are more frequent and the age of revelation is younger, before 30 years. It is also frequent to observe extraneural location, cutaneous and retinal. On MRI, four types of lesional aspects were described and lesions are multiple in all cases with numerous "de novo" cavernomas. The prognostic does not depend on the number of lesions, but on their topography, especially in the brain stem. Familial forms may be considered not only as a neurological but as a systemic disease for which global management with a genetic counseling should be considered. Gene therapy is not today available, but perhaps in the future. PMID:17498752
Wysocki, Tim; Harris, Michael A.; Buckloh, Lisa M.; Mertlich, Deborah; Lochrie, Amanda Sobel; Taylor, Alexandra; Sadler, Michelle; White, Neil H.
We report a randomized trial of a revised Behavioral Family Systems Therapy for Diabetes (BFST-D) intervention. Families of 104 adolescents with diabetes were randomized to standard care (SC) or to 6 months of an educational support group (ES) or BFST-D. Family communication and problem-solving skills were assessed at 0, 6, 12, and 18 months by…
Li, Jing; Meng, Huaqing; Zeng, Kebin; Quan, Fengying; Liu, Fang
Objective The aim of this study was to find if systemic family therapy (SFT) does work in anxiety and depression with epilepsy in adolescents (ADAE). Methods 104 adolescents with epilepsy, aged 13–20 years old, were included from December 2009 to December 2010, the enrolled patients were with anxiety [Hamilton Anxiety Scale (HAMA) score ≥14 points] or depression [Hamilton Depression Scale (HAMD) score ≥20 points]. The patients were randomly divided into the control group (n=52) treated with antiepileptic drugs (AED) and the intervention group (n=52) undergone Systemic Family Therapy (SFT) as well as AED. The AED improvements, anxiety and depression scores, Social Support Rating Scale (SSRS), Family Assessment Device (FAD) and scale of systemic family dynamics (SSFD) were observed after 3-month treatment. Results The frequencies of epileptic seizures in intervention group was decreased much more significantly than the control group (4.22±3.54 times/month vs. 6.20±5.86 times/month, p=0.04); and the scores of anxiety (9.52±6.28 points vs. 13.48±8.47 points, p=0.01) and depression (13.86±9.17 points vs. 18.89±8.73 points, p=0.02) were significantly decreased than the control group; meanwhile, the family dynamics and family functions were significantly improved, and the social support was also increased (p<0.05). Conclusion SFT combined with AEDs had better efficacies than AEDs alone, not only the frequency of epileptic seizures was decreased, but also the patients' anxiety and depression were improved, and the family dynamics, family functions and social support were improved. PMID:27247596
O’Farrell, Timothy J.
This review of controlled studies of marital and family therapy (MFT) in alcoholism treatment updates our earlier review (XXXXXXX). We conclude that, when the alcoholic is unwilling to seek help, MFT is effective in helping the family cope better and motivating alcoholics to enter treatment. Specifically, both Al-Anon facilitation and referral and spouse coping skills training (based on new findings) help family members cope better; and Community Reinforcement and Family Training (CRAFT) promotes treatment entry and was successfully transported to a community clinic in a new study. Once the alcoholic enters treatment, MFT, particularly behavioral couples therapy (BCT), is clearly more effective than individual treatment at increasing abstinence and improving relationship functioning. New BCT studies showed efficacy with women alcoholics and with gay and lesbian alcoholics; and BCT was successfully transported to a community clinic, a brief BCT version was tested, and BCT was adapted for family members other than spouses. Future studies should evaluate: MFT with couples where both members have a current alcohol problem and with minority patients, mechanisms of change, transportability of evidence-based MFT approaches to clinical practice settings, and replication of MFT outcomes of reduced partner violence and improved child functioning. PMID:22283384
Paley, Evelyn S.; And Others
Alzheimers Disease (AD), an incurable disability which afflicts older adults, can have devastating emotional consequences for the victim and the family. In an attempt to determine the effectiveness of multifamily psychoeducational support, group therapy (MFPSGT), 22 persons (13 families) from the Alzheimer's Disease and Related Disorders…
Alpa, Mirella; Roccatello, Dario
Familial Mediterranean fever is an autosomal recessive autoinflammatory disorder mainly affecting Mediterranean populations, which is associated with mutations of the MEFV gene that encodes pyrin. Functional studies suggest that pyrin is implicated in the maturation and secretion of interleukin-1 (IL-1). The IL-1 receptor antagonist or anti-IL-1 monoclonal antibody may therefore represent a rational approach for the treatment of the rare patients who are refractory to conventional therapy. We report the case of a young female affected by familial Mediterranean fever who proved to be resistant to colchicine and was successfully treated with canakinumab. PMID:25945034
Szapocznik, José; Muir, Joan A.; Duff, Johnathan H.; Schwartz, Seth J.; Brown, C. Hendricks
Reflecting a nearly 40-year collaborative partnership between clinical researchers and clinicians, the present article reviews the authors’ experience in developing, investigating, and implementing the Brief Strategic Family Therapy (BSFT) model. The first section of the article focuses on the theory, practice, and studies related to this evidence-based family therapy intervention targeting adolescent drug abuse and delinquency. The second section focuses on the implementation model created for the BSFT intervention– a model that parallels many of the recommendations furthered within the implementation science literature. Specific challenges encountered during the BSFT implementation process are reviewed, along with ways of conceptualizing and addressing these challenges from a systemic perspective. The implementation approach that we employ uses the same systemic principles and intervention techniques as those that underlie the BSFT model itself. Recommendations for advancing the field of implementation science, based on our on-the-ground experiences, are proposed. PMID:24274187
Saunders, James A
Fundamental Christianity and psychology are frequently viewed as incompatible pursuits. However, proponents of the integrationist movement posit that pastoral counselors can utilize principles from psychology if they adopt the premise that all truth is God's truth. Assuming this perspective, Cognitive-Existential Family Therapy (CEFT) - a theoretical integration model compatible with Christian fundamentalism - is proposed. The philosophical assumptions and models of personality, health, and abnormality are explored. Additionally, the article provides an overview of the therapeutic process. PMID:26162205
Gelin, Zoé; Fuso, Silvana; Hendrick, Stephan; Cook-Darzens, Solange; Simon, Yves
Multiple Family Therapy (MFT) has gained increasing popularity in the treatment of eating disorders and many programs have been developed over the past decade. Still, there is little evidence in the literature on the effectiveness on MFT for treating eating disorders. The present study examines the effects of a particular model of Multiple Family Therapy on eating disorder symptoms, quality of life, and percentage of Expected Body Weight (%EBW) in adolescents with eating disorders (ED). Eighty-two adolescents with ED, aged between 11 and 19 years, were assessed before and after treatment using the Eating Disorders Inventory 2 (EDI-2), the Outcome Questionnaire 45 (OQ-45) and %EBW. Results showed a significant increase in %EBW between the beginning and end of treatment, with a large effect size. 52.4% of patients achieved an EBW above 85%. Symptoms relative to all EDI dimensions (except for bulimia) significantly decreased during treatment. The three dimensions related to quality of life assessment also improved over the course of MFT. At the end of treatment, 70.7% of patients had a total OQ-45 score below clinical significance. This study suggests that Multiple Family Therapy may benefit adolescents with eating disorders, with improvement on several outcome measures (%EBW, ED symptoms, and quality of life). However, the lack of a comparison group entails caution when drawing conclusions. PMID:25243337
Rober, Peter; Van Eesbeek, Dominiek; Elliott, Robert
In this article, we look at the development in family therapy of narratives about domestic violence. We report on microanalyses of a family therapy session, using narrative research methods, including some conversation analytic tools. The main questions posed in this investigation were: How does storytelling of a highly charged and delicate topic like domestic violence develop in the session?; how do the different actors in the therapy room contribute to telling such stories?; how do actors try to put forward domestic violence as a conversational topic? and how do different actors react to these attempts? Our research illustrates how the recounting of stories of violence seems to go hand in hand with modes of interaction that discourage the telling of these stories. In the back-and-forth process between voices of hesitation and voices of reassurance, the participants weigh the level of safety in the session. In as far as the voices of hesitation can be reassured of the safety, it becomes gradually possible to talk about delicate, problematic experiences, such as violence in the family. PMID:16933436
Ivey, D C; Wieling, E; Harris, S M
The paucity of literature addressing mental health issues concerning geriatric populations represents the perpetuation of ageist practices and beliefs in the field of marriage and family therapy. The purpose of this study was to assess whether client age and clinical training relate to the evaluation of couples who present for conjoint therapy. Written vignettes describing two couples, one older and one younger, who report issues involving the absence of sexual intimacy, increased frequency of arguments, and increased use of alcohol were evaluated by practicing marriage and family therapists, therapists-in-training, and individuals with no clinical background. It was hypothesized that respondents' views would vary in connection with the age of the couple and with the three levels of participant training. Results indicate that client age and participant training are associated with perceptions of individual and couple functioning. Our findings suggest that the relational and mental health concerns experienced by elder couples are not perceived as seriously as are identical concerns experienced by younger couples. Contrary to our expectations the observed differences between views of the two age conditions did not significantly differ between levels of participant training. Training and experience in marriage and family therapy may not significantly mitigate vulnerability to age-discrepant views. PMID:10907144
Tighe, Andrea; Pistrang, Nancy; Casdagli, Lucy; Baruch, Geoffrey; Butler, Stephen
Multisystemic Therapy (MST) has been found to be effective in reducing youth antisocial behavior, but little is known about the process and impact of MST from the perspective of families themselves. This qualitative study explored parents' and young people's experiences of MST, focusing on aspects of the intervention that promoted or limited change. Thirty-seven semistructured interviews were conducted with a consecutive sample of 21 families (21 parent interviews, 16 young people) who had participated in a randomized controlled trial of MST for young offenders in the United Kingdom. Thematic analysis yielded 10 themes, organized into two domains: (a) engagement in MST and initial processes of change captures the central importance of the therapeutic relationship and the MST engagement model in families' positive experiences of MST; and (b) outcomes are complex reflects the range of positive outcomes reported (notably increased parental confidence and skills, improved family relationships, a return to education, and greater reflection and aspiration on the part of the young person) and mixed behavior outcomes. Even when the young person had reoffended, respondents indicated a range of other benefits for the family. The findings support the MST theory of change as well as point to some outcomes not usually measured in MST outcome studies. They also suggest some adaptations that may increase the impact of the intervention, including more attention to the influence of deviant peers, and ongoing support for families struggling to maintain strategies beyond the prescribed treatment period. PMID:22329390
O'Farrell, Timothy J; Clements, Kahni
This review of controlled studies of marital and family therapy (MFT) in alcoholism treatment updates the earlier review by O'Farrell and Fals-Stewart (2003). We conclude that, when the alcoholic is unwilling to seek help, MFT is effective in helping the family cope better and motivating alcoholics to enter treatment. Specifically, both Al-Anon facilitation and referral and spouse coping skills training (based on new findings) help family members cope better, and CRAFT promotes treatment entry and was successfully transported to a community clinic in a new study. Once the alcoholic enters treatment, MFT, particularly behavioral couples therapy (BCT), is clearly more effective than individual treatment at increasing abstinence and improving relationship functioning. New BCT studies showed efficacy with women alcoholics and with gay and lesbian alcoholics, and BCT was successfully transported to a community clinic, a brief BCT version was tested, and BCT was adapted for family members other than spouses. Future studies should evaluate the following: MFT with couples where both members have a current alcohol problem and with minority patients, mechanisms of change, transportability of evidence-based MFT approaches to clinical practice settings, and replication of MFT outcomes of reduced partner violence and improved child functioning. PMID:22283384
Escudero, Valentín; Boogmans, Emanuelle; Loots, Gerrit; Friedlander, Myrna L
In this article, we introduce a methodology for studying alliance rupture and repair in conjoint family therapy. Using the System for Observing Family Therapy Alliances (Friedlander, Escudero, & Heatherington, 2006), we identified rupture markers and repair interventions in a session with a single mother and her 16-year-old "rebellious" daughter. The session was selected for analysis because a severe rupture was clinically evident; however, by the end of the session, there was an emotional turnaround, which was sustained in the following session and continued until the successful, mutually agreed upon termination. The first rupture occurred when the psychotherapist suggested that the mother explore, in an individual session, how her "personal stress" may be affecting her daughter. The observational analysis showed repeated rupture markers, that is, confrontation and withdrawal behavior, hostile within-family interactions, and a seriously "split" alliance in family members' expressed feelings toward the psychotherapist. The time-stamped behavioral stream showed that the psychotherapist focused first on safety, then on enhancing his emotional connection with each client, and finally on helping mother and daughter understand each other's behavior and recognize their shared isolation. PMID:22369080
Sexton, Thomas; Turner, Charles W.
The study examined the effectiveness of Functional Family Therapy (FFT), as compared to probation services, in a community juvenile justice setting 12 months post treatment. The study also provides specific insight into the interactive effects of therapist model specific adherence and measures of youth risk and protective factors on behavioral outcomes for a diverse group of adolescents. The findings suggest that FFT was effective in reducing youth behavioral problems, although only when the therapists adhered to the treatment model. High adherent therapists delivering FFT had a statistically significant reduction of (35%) in felony, a (30%) violent crime, and a marginally significant reduction (21%) in misdemeanor recidivisms as compared to the control condition. The results represent a significant reduction in serious crimes one year after treatment, when delivered by a model adherent therapist. The low adherent therapists were significantly higher than the control group in recidivism rates. There was an interaction effect between youth risk level and therapist adherence demonstrating that the most difficult families (those with high peer and family risk) had a higher likelihood of successful outcomes when their therapist demonstrated model specific adherence. These results are discussed within the context of the need and importance of measuring and accounting for model specific adherence in the evaluation of community-based replications of evidence-based family therapy models like FFT. PMID:20545407
Szapocznik, José; Schwartz, Seth J.; Muir, Joan A.; Brown, C. Hendricks
This article reviews the brief strategic family therapy (BSFT; J. Szapocznik, M. A. Scopetta, & O. E. King, 1978, The effect and degree of treatment comprehensiveness with a Latino drug abusing population. In D. E. Smith, S. M. Anderson, M. Burton, N. Gotlieb, W. Harvey, & T. Chung, Eds, A multicultural view of drug abuse, pp. 563–573, Cambridge, MA: G. K. Hall & J. Szapocznik, M. A. Scopetta, & O. E. King, 1978, Theory and practice in matching treatment to the special characteristics and problems of Cuban immigrants, Journal of Community Psychology, 6, 112–122.) approach to treating adolescent drug abuse and related problem behaviors. The treatment intervention is reviewed, including specialized features such as engagement of difficult families. Empirical evidence supporting the BSFT approach is presented. We then illustrate ways in which clinicians can use the model with troubled families whose adolescents may be at risk for drug use and HIV. Finally, future directions for BSFT research are described. PMID:23936750
Diamond, Gary M; Shahar, Ben; Sabo, Daphna; Tsvieli, Noa
A growing body of research suggests that emotional processing is a central and common change mechanism across various types of therapies (Diener & Hilsenroth, 2009; Foa, Huppert, & Cahill, 2006; Greenberg, 2011). This study examined whether 10 weeks of attachment-based family therapy (ABFT), characterized by the use of in-session young adult-parent dialogues, were more effective than 10 weeks of individual emotion-focused therapy (EFT), characterized by the use of imaginal dialogues, in terms of facilitating productive emotional processing among a sample of 32 young adults presenting with unresolved anger toward a parent. This study also examined whether greater amounts of productive emotional processing predicted more favorable treatment outcomes. In contrast to our expectations, we found significantly more productive emotional processing in individual EFT than in conjoint ABFT. Results also showed that while both treatments led to significant and equivalent decreases in unresolved anger, state anger, attachment anxiety, and psychological symptoms, only ABFT was associated with decreases in attachment avoidance. Although amount of emotional processing did not explain the unique decrease in attachment avoidance in ABFT, greater amounts of productive emotional processing predicted greater decreases in psychological symptoms (but not other outcome measures) across both treatments. PMID:26828910
Ng, S M; Li, Albert M; Lou, Vivian W Q; Tso, Ivy F; Wan, Pauline Y P; Chan, Dorothy F Y
Asthma psychoeducational programs have been found to be effective in terms of symptom-related outcome. They are mostly illness-focused, and pay minimal attention to systemic/familial factors. This study evaluated a novel asthma psychoeducation program that adopted a parallel group design and incorporated family therapy. A randomized waitlist-controlled crossover clinical trial design was adopted. Children with stable asthma and their parents were recruited from a pediatric chest clinic. Outcome measures included, for the patients: exhaled nitric oxide (eNO), spirometry, and adjustment to asthma; and for the parents: perceived efficacy in asthma management, Hospital Anxiety and Depression Scale anxiety subscale, Body Mind Spirit Well-being Inventory emotion subscale, and Short Form 12 health-related quality of life scale. Forty-six patients participated in the study. Attrition rates were 13.0% and 26.0% for the active and control groups, respectively. Repeated-measures ANOVA revealed a significant decrease in airway inflammation, as indicated by eNO levels, and an increase in patient's adjustment to asthma and parents' perceived efficacy in asthma management. Serial trend analysis revealed that most psychosocial measures continued to progress steadily after intervention. Significant improvements in both symptom-related measures and mental health and relationship measures were observed. The findings supported the value of incorporating family therapy into asthma psychoeducation programs. PMID:18411833
Henderson, Craig E.; Dakof, Gayle A.; Greenbaum, Paul E.; Liddle, Howard A.
Objective: We used growth mixture modeling to examine heterogeneity in treatment response in a secondary analysis of 2 randomized controlled trials testing multidimensional family therapy (MDFT), an established evidence-based therapy for adolescent drug abuse and delinquency. Method: The first study compared 2 evidence-based adolescent substance…
Hoffman, Rachel; Hinkle, Michelle Gimenez; Kress, Victoria White
Family therapy can be an important component of a comprehensive treatment plan when counseling adolescents who engage in nonsuicidal self-injury. The authors provide a rationale for the use of letter writing as a therapeutic intervention when counseling families in which an adolescent engages in nonsuicidal self-injury. Descriptions of types of…
Piacentini, John; Bergman, R. Lindsey; Chang, Susanna; Langley, Audra; Peris, Tara; Wood, Jeffrey J.; McCracken, James
Objective: To examine the efficacy of exposure-based cognitive-behavioral therapy (CBT) plus a structured family intervention (FCBT) versus psychoeducation plus relaxation training (PRT) for reducing symptom severity, functional impairment, and family accommodation in youths with obsessive-compulsive disorder (OCD). Method: A total of 71…
Miklowitz, David J.; Schneck, Christopher D.; Singh, Manpreet K.; Taylor, Dawn O.; George, Elizabeth L.; Cosgrove, Victoria E.; Howe, Meghan E.; Dickinson, L. Miriam; Garber, Judy; Chang, Kiki D.
Objective: Depression and brief periods of (hypo)mania are linked to an increased risk of progression to bipolar I or II disorder (BD) in children of bipolar parents. This randomized trial examined the effects of a 4-month family-focused therapy (FFT) program on the 1-year course of mood symptoms in youth at high familial risk for BD, and explored…
Bodden, Denise H. M.; Bogels, Susan M.; Nauta, Maaike H.; De Hann, Else; Ringrose, Jaap; Appelboom, Carla; Brinkman, Andries G.; Appelboom-Geerts, Karen C. M. M. J.
Child-focused and family-focused cognitive-behavioral therapy (CBT) for 128 children with clinical anxiety disorders and their parents were compared in terms of efficacy and partial effectiveness. Results indicate that 53% of the children under the child CBT became free of anxiety disorders at posttreamtent compared to only 28% under family CBT.…
Bailey, C. Everett; Pryce, Julia; Walsh, Froma
In this article, we present an analysis and comparison of published articles in the "Journal of Marital and Family Therapy" (JMFT) between 1990-1995 and 1996-2000. This study focused on trends in author gender, highest degree, and professional affiliation, and article content on issues of cultural and family diversity (race/ethnicity, class,…
Matheson, Jennifer L; Rosen, Karen H
A sense of imbalance is common among both professors and therapists, though few studies have been published examining the work and personal life balance of those who work in both professions simultaneously. Using in-depth telephone interviews, this study examined the work and personal life balance of 16 marriage and family therapy (MFT) faculty members. Results showed that six were satisfied with their balance, six were dissatisfied, and four were "middle of the road." Men, older participants, and those who were in their career longer were more likely to report feeling satisfied with their balance. Internal indicators of their balance included family and workplace messages, health indicators, feelings of contentment, and congruence with personal values. Child and relationship status, tenure status, and gender issues also impacted their sense of balance. Specific balance enhancers and reducers were highlighted, and participants discussed coping strategies and recommendations for other MFT faculty members. Clinical, training, and career implications are discussed. PMID:22512300
Chung, Bowen; Mikesell, Lisa; Miklowitz, David
This study elicited provider and administrator preferences in implementing an evidence-based practice (EBP) for bipolar disorder or psychosis, family-focused therapy (FFT). Providers (n = 35) and administrators (n = 5) from three community mental health centers took part in FFT training and participated in pre- and post-training focus groups. Transcripts were examined using conventional content analysis. Providers and administrators discussed barriers to implementing EBPs. Successful EBPs were described as incorporating flexibility and close supervision to maximize provider adherence. Providers expressed preferences for structured EBPs like FFT that have both explicit implementation steps and built-in flexibility. PMID:24810982
Raper, S E; Grossman, M; Rader, D J; Thoene, J G; Clark, B J; Kolansky, D M; Muller, D W; Wilson, J M
OBJECTIVE: The purpose of this report was to provide detailed information on the safety and feasibility of surgical procedures associated with the first ex vivo liver-directed gene therapy trial for the treatment of vivo gene therapy for homozygous familial hypercholesterolemia (FH). SUMMARY BACKGROUND DATA: Familial hypercholesterolemia is an autosomal dominant disease in which the gene encoding the low density lipoprotein receptor is defective. Patients homozygous for this mutation have extraordinarily high levels of cholesterol and accelerated atherosclerosis and die prematurely of myocardial infarction. The concept of liver-directed gene therapy was based on the report of normalization of cholesterol levels by orthotopic cardiac/liver transplant in a child with homozygous FH. METHODS: Five patients with homozygous FH were selected for inclusion in this trial. The patients underwent hepatic resection and placement of a portal venous catheter. Primary hepatocytes cultures were prepared from the resected liver and transduced with a recombinant retrovirus encoding the gene for the human low density lipoprotein receptor. The genetically modified cells were then transplanted into the liver through the portal venous catheter. RESULTS: Numerous clinical, laboratory, and radiologic parameters were analyzed. Elevations of the hepatic transaminases and leukocyte counts and a decline in hematocrit count were noted. Transient elevations of the portal pressure were observed during cell infusion. No major perioperative morbidity--specifically, myocardial infarct, perioperative hemorrhage, or portal vein thrombosis--or death occurred as a result of this protocol. CONCLUSION: Liver-directed ex vivo gene therapy can be accomplished safely in humans and is appropriate for selected patients. Images Figure 5. PMID:8597504
Blumer, Markie L C; Hertlein, Katherine M; Smith, Justin M; Allen, Harrison
In the fifteen years since the explosion of the Internet, using cyber technology for work and social functions has exponentially increased. Yet, questions around how to manage such changes remain elusive in family therapy literature. In this investigation, we conducted a content analysis to determine to what extent marriage/couple and family therapy (M/CFT) journals have responded to the integration of the Internet in couple and family life. We found 79 of 13,274 articles across seventeen journals focused on the Internet in some capacity. Implications for clinical practice, training, and future research are discussed. PMID:24067169
Cogan, Alison M
More than 2 million U.S. military servicemembers have deployed to Afghanistan or Iraq since September 11, 2001. Unlike during prior conflicts, many servicemembers leave spouses and children behind. Long, multiple deployments cause strain on family at home, with new challenges arising when servicemembers return from combat and reintegrate into family and civilian life. In World Wars I and II, occupational therapy practitioners played a significant role in supporting servicemember reintegration. However, their presence in program delivery in this practice area is limited. Occupational therapy researchers and practitioners can make a valuable contribution by helping families tailor daily activities and routines to address challenges and optimize health and wellness. However, barriers such as reimbursement for services, workforce availability, and access to military families have limited the profession's full engagement. Advocacy is needed to help establish occupational therapy as a key component of the mental and preventive health care teams serving military servicemembers. PMID:25005512
Magill, Lucanne; Berenson, Susan
Advanced stage cancer patients experience debilitating physical symptoms as well as profound emotional and spiritual struggles. Advanced disease is accompanied by multiple changes and losses for the patient and the family. Palliative care focuses on the relief of overall suffering of patients and families, including symptom control, psychosocial support, and the meeting of spiritual needs. Music therapy and reflexology are complementary therapies that can soothe and provide comfort. When used conjointly, they provide a multifaceted experience that can aid in the reduction of anxiety, pain, and isolation; facilitate communication between patients, family members, and staff; and provide the potential for a more peaceful dying experience for all involved. This article addresses the benefits of the combined use of music therapy and reflexology. Two case studies are presented to illustrate the application and benefits of this dual approach for patients and their families regarding adjustment to the end of life in the presence of anxiety and cognitive impairment. PMID:18662423
Liddle, Howard A
For over four decades family therapy research and family centered evidence-based therapies for justice-involved youths have played influential roles in changing policies and services for these young people and their families. But research always reveals challenges as well as advances. To be sure, demonstration that an evidence-based therapy yields better outcomes than comparison treatments or services as usual is an accomplishment. But the extraordinary complexity embedded in that assertion feels tiny relative to what we are now learning about the so-called transfer of evidence-based treatments to real world practice settings. Today's family therapy studies continue to assess outcome with diverse samples and presenting problems, but research and funding priorities also include studying particular treatments in nonresearch settings. Does an evidence-based intervention work as well in a community clinic, with clinic personnel? How much of a treatment has to change to be accepted and implemented in a community clinic? Perhaps it is the setting and existing procedures that have to change? And, in those cases, do accommodations to the context compromise outcomes? Thankfully, technology transfer notions gave way to more systemic, dynamic, and frankly, more family therapy-like conceptions of the needed process. Implementation science became the more sensible, as well as the theoretically and empirically stronger overarching framework within which the evidence-based family based therapies now operate. Using the example of Multidimensional Family Therapy, this article discusses treatment development, refinement, and implementation of that adapted approach in a particular clinical context-a sector of the juvenile justice system-juvenile detention. PMID:25099536
Seponski, Desiree M; Bermudez, J Maria; Lewis, Denise C
Models of marriage and family therapy (MFT) typically reflect Western values and norms, and although cultural adaptations are made, many models/frameworks continue to be inappropriate or inadequate for use with non-Western cultures. Worldwide, therapists are examining ways of using MFT models in a culturally sensitive manner, especially when working with clients who are seen as having minority status or perceived as "other" by the dominant group. This essay suggests the use of responsive evaluation as a theoretically consistent methodology for creating and evaluating culturally responsive therapies. This approach rigorously evaluates each unique client/therapist context, culture, power, needs, and beliefs. We describe responsive evaluation and discuss how each component addresses the research needs of examining culturally responsive family therapies. A case illustration is offered delineating the process of conducting culturally responsive therapy with a Cambodian sample using solution-focused and narrative therapy. PMID:25073841
Hertlein, Katherine M; Lambert-Shute, Jennifer
To understand which factors students consider most important in choosing a marriage and family therapy (MFT) graduate program and how programs met or did not meet these expectations of students over the course of graduate study, we conducted an online mixed-method investigation. One hundred twelve graduate students in Commission on Accreditation for Marriage and Family Therapy Education-accredited programs responded to an online survey assessing what factors led them to select a specific graduate program in MFT. In the quantitative portion, students ranked each factor (personal fit, faculty, funding, research, clinical work, and teaching) as well as characteristics of each factor in relation to its importance in their selection of an MFT program. Additionally, students indicated to what level their programs meet their expectations. In the qualitative portion, students described how they believed their chosen program was or was not meeting their expectations. Both doctoral and master's students ranked personal fit as the top factor affecting their choice of graduate program in MFT, but they differed on the characteristics of each of these factors and their importance in selecting an MFT program. Implications for this research include program evaluation and program advertising, and are consistent with the scientist-practitioner model. PMID:17257378
Wampler, Karen S
In this overview, I comment on the strong theme of the need to define and improve the quality of doctoral education in marriage and family therapy that pervades the three essays. Deficits in research training are the central concern, although the essayists take different perspectives on the nature of the research training needed. The different perspectives can be understood in terms of three different models of doctoral education. The institutional model focuses on professional training with little financial support for students and lower expectations for faculty research. The community of scholars model emphasizes a balance of research and practice with students required to attend full-time and financial support provided. Research is a mix of faculty- and student-driven and is often focused on professional issues. The star researcher model often held out as the ideal, although not yet represented in marital and family therapy (MFT), emphasizes faculty externally funded programmatic research with students working on and supported by faculty grant funding. The value and role of all three models in MFT doctoral education are described and discussed. PMID:20618577
Jung, Jae Woo; Kwon, Minsuk; Choi, Jae Chol; Shin, Jong Wook; Park, In Won; Choi, Byoung Whui
The therapeutic potential of human multipotent mesenchymal stromal cells, especially human adipose tissue-derived stem cells (hASC), is promising. However, there are concerns about the safety of infusion of hASC in human. Recently, we have experienced pulmonary embolism and infarct among family members who have taken multiple infusions of intravenous autologous hASC therapy. A 41-year-old man presented with chest pain for one month. Chest CT showed multiple pulmonary artery embolism and infarct at right lung. Serum D-dimer was 0.8 µg/mL (normal; 0-0.5 µg/mL). He had received intravenous autologous adipose tissue-derived stem cell therapy for cervical herniated intervertebral disc three times (one, two, and three months prior to the visit). His parents also received the same therapy five times and their chest CT also showed multiple pulmonary embolism. These cases represent artificial pulmonary embolisms and infarct after IV injection of hASC. Follow-up chest CT showed spontaneous resolution of lesions in all three patients. PMID:23918585
Diamond, Guy; Siqueland, Lynne; Diamond, Gary M
Few effective psychosocial treatment models for depressed adolescents have been developed, let alone ones that use the developmentally potent context of the family as the focus of intervention. Attachment-based family therapy (ABFT) is a brief, manualized treatment model tailored to the specific needs of depressed adolescents and their families. Attachment theory serves as the main theoretical framework to guide the process of repairing relational ruptures and rebuilding trustworthy relationships. Empirically supported risk factors for depression are the primary problem states that therapists target with specific treatment strategies or tasks. Parent problem states include criticism/hostility, personal distress, parenting skills, and disengagement. Adolescent problem states include motivation, negative self-concept, poor affect regulation, and disengagement. Intervention tasks include relational reframing, building alliances with the adolescent and with the parent, addressing attachment failures, and building competency. A small, randomized clinical trial provides initial support for the model. Several process research studies, using both qualitative and quantitative methods, have helped refine the clinical guidelines for each treatment task. ABFT is a promising new treatment for depressed adolescents and more research on it is warranted. PMID:12836580
Krout, Robert E
Hospice care seeks to address the diverse needs of terminally ill patients in a number of physical, psychosocial, and spiritual areas. Family members of the patient often are included in the care and services provided by the hospice team, and hospice clinicians face a special challenge when working with families of patients who are imminently dying. When loved ones are anticipating the patient's impending death, they may find it difficult to express feelings, thoughts, and last wishes. Music therapy is a service modality that can help to facilitate such communication between the family and the patient who is actively dying, while also providing a comforting presence. Music therapy as a way to ease communication and sharing between dying patients and their loved ones is discussed in this article. The ways in which music therapy can facilitate a means of release for both patients and family members in an acute care unit of a large US hospice organization are specifically described. Case descriptions illustrate how music therapy functioned to allow five patients and their families to both come together and let go near the time of death. Elements to consider when providing such services to imminently dying patients and their families are discussed. PMID:12693645
An, Sun-Joung L
Documenting the effectiveness of an occupation-based family-centered therapy approach, when providing therapy for a young child with feeding problems, is needed in a culture such as Korea, which has a strong medical model of service. A case study was conducted involving a 16-month-old boy with feeding problems. An occupation-based family-centered therapy approach was carried out for 10 weeks. The results indicated that this approach addressed the physical components of the child's feeding problems and also the parent-child bonding, which together improved the overall family dynamics. Although these results may stimulate clinicians to consider an alternative approach to a medical model, further research with a larger sample is needed to provide sufficient evidence for therapists to shift to a new service delivery model. PMID:23934934
Withdrawal of life-sustaining therapy (LST) occurs commonly in critical care units, yet little is known about the family experience with this process. The purpose of this study was to understand the lived experience of families participating in the process of withdrawal of LST from a family member with an unexpected, life-threatening illness or injury. A hermeneutic phenomenological approach was used as nineteen families were interviewed and observed. Within and across family analyses were conducted. Methodological rigor was established and redundancy was achieved. The categories that evolved from the data included: this happens to other families, time to understand the severity of the illness or injury, time to see if health would be restored, riding a roller coaster, family readiness: willingness to consider withdrawal of LST as a possible option, one step at a time, family readiness: time to make a decision, the family will go on, and waiting for a miracle. The family experience participating in the process of withdrawal of LST happened for families "in their own time." The results of this study have important implications for clinical practice and future research. PMID:18980452
Kouri, Fotini M.; Jensen, Samuel A.; Stegh, Alexander H.
Glioblastoma (GBM) is a highly aggressive and lethal brain cancer with a median survival of less than two years after diagnosis. Hallmarks of GBM tumors include soaring proliferative indices, high levels of angiogenesis, diffuse invasion into normal brain parenchyma, resistance toward therapy-induced apoptosis, and pseudopallisading necrosis. Despite the recent advances in neurosurgery, radiation therapy, and the development of targeted chemotherapeutic regimes, GBM remains one of the deadliest types of cancer. Particularly, the alkylating agent temozolomide (TMZ) in combination with radiation therapy prolonged patient survival only marginally, and clinical studies assessing efficacies of targeted therapies, foremost ATP mimetics inhibiting the activity of receptor tyrosine kinases (RTKs), revealed only few initial responders; tumor recurrence is nearly universal, and salvage therapies to combat such progression remain ineffective. Consequently, myriad preclinical and clinical studies began to define the molecular mechanisms underlying therapy resistance of GBM tumors, and pointed to the Bcl-2 protein family, in particular the atypical member Bcl2-Like 12 (Bcl2L12), as important regulators of therapy-induced cell death. This review will discuss the multi-faceted modi operandi of Bcl-2 family proteins, describe their roles in therapy resistance of malignant glioma, and outline current and future drug development efforts to therapeutically target Bcl-2 proteins. PMID:22431925
This is an example of a postmodern, dialogical approach to teaching family therapy based on the work of such practitioners as Tom Andersen, Michael White, and Lynn Hoffman, among others. It demonstrates the way in which the reflecting process connects all of the participants in a web of meanings both educational and transformational. This particular consultation, which includes the author, her graduate students, the client, and guest participant Lynn Hoffman, ends with an unexpected ritual of intergenerational appreciation. Privileging the transcript, it is presented as a kind of theatre where the learning is revealed more through the dialogue than through authorial analysis. The experience is embedded in an "ethics of participation" (Hoffman, 1992) where social connectedness and attunement are key. PMID:22984977
Hazelwood, Daniela Maria; Wallner, Martin; Anderson, Kathryn Hoehn; Mayer, Hanna
Summary People are diagnosed with cancer sooner nowadays thanks to increased awareness and improvements in cancer screenings. Patients are able to live longer due to cancer treatment regimens; however, they suffer the consequences of living with cancer and therapy-related symptoms. Symptom management is challenging for both patients and family caregivers. Therefore, family members must be integrated in the patient’s care plan. For this review, a literature search was conducted to determine what types of interventions were available that involved family members of cancer patients with the management of cancer and therapy-related symptoms. The following interventions were found that were designed for the family caregivers or both the patient and caregiver to aide with symptom management: pain intervention program, massage therapy, telephone intervention, self-efficacy improvement, coping enhancement and a multidimensional intervention. A positive effect was noted in all the studies, but several had no significance in the patient intervention group but did in the caregiver intervention group. However, studies indicated decreased symptom intensity for various symptoms, decreased symptom distress for both the patient and caregiver, increased self-efficacy of the family member, and increased satisfaction with certain interventions. Further research should be conducted on both existing interventions to better determine their effect and on family symptom management of cancer patients as they need support from healthcare professionals as well. PMID:24027658
Hogue, Aaron; Henderson, Craig E.; Dauber, Sarah; Barajas, Priscilla C.; Fried, Adam; Liddle, Howard A.
This study examined the impact of treatment adherence and therapist competence on treatment outcome in a controlled trial of individual cognitive–behavioral therapy (CBT) and multidimensional family therapy (MDFT) for adolescent substance use and related behavior problems. Participants included 136 adolescents (62 CBT, 74 MDFT) assessed at intake, discharge, and 6-month follow-up. Observational ratings of adherence and competence were collected on early and later phases of treatment (192 CBT sessions, 245 MDFT sessions) by using a contextual measure of treatment fidelity. Adherence and competence effects were tested after controlling for therapeutic alliance. In CBT only, stronger adherence predicted greater declines in drug use (linear effect). In CBT and MDFT, (a) stronger adherence predicted greater reductions in externalizing behaviors (linear effect) and (b) intermediate levels of adherence predicted the largest declines in internalizing behaviors, with high and low adherence predicting smaller improvements (curvilinear effect). Therapist competence did not predict outcome and did not moderate adherence–outcome relations; however, competence findings are tentative due to relatively low interrater reliability for the competence ratings. Clinical and research implications for attending to both linear and curvilinear adherence effects in manualized treatments for behavior disorders are discussed. PMID:18665684
Liddle, Howard A
This article summarizes the 30+-year evidence base of Multidimensional Family Therapy (MDFT), a comprehensive treatment for youth substance abuse and antisocial behaviors. Findings from four types of MDFT studies are discussed: hybrid efficacy/effectiveness randomized controlled trials, therapy process studies, cost analyses, and implementation trials. This research has evaluated various versions of MDFT. These studies have systematically tested adaptations of MDFT for diverse treatment settings in different care sectors (mental health, substance abuse, juvenile justice, and child welfare), as well as adaptations according to treatment delivery features and client impairment level, including adolescents presenting with multiple psychiatric diagnoses. Many published scientific reviews, including meta-analyses, national and international government publications, and evidence-based treatment registries, offer consistent conclusions about the clinical effectiveness of MDFT compared with standard services as well as active treatments. The diverse and continuing MDFT research, the favorable, multi-source independent evaluations, combined with the documented receptivity of youth, parents, community-based clinicians and administrators, and national and international MDFT training programs (U.S.-based organization is MDFT International, www.mdft.org; and Europe-based organization is www.mdft.nl) all support the potential for continued transfer of MDFT to real-world clinical settings. PMID:27565445
Jacquemin, E; Hermans, D; Myara, A; Habes, D; Debray, D; Hadchouel, M; Sokal, E M; Bernard, O
Progressive familial intrahepatic cholestasis (PFIC) is a lethal inherited childhood cholestasis of hepatocellular origin. Different subtypes of PFIC have been described according to serum gamma-glutamyl transpeptidase (GGT) activity. There is currently no effective medical therapy available for children with PFIC. We report on 39 patients with PFIC who received ursodeoxycholic acid (UDCA) orally (20-30 mg/kg b.w./day) for a period of 2 to 4 years. Group 1 (n = 26) consisted of children with normal GGT activity, and group 2 (n = 13) of children with high GGT activity. Within group 1, liver tests normalized in 11 children, improved in 5, and stabilized or worsened in 10. Within group 2, liver tests normalized in six children, improved in four, and stabilized or worsened in three. Improvement of parameters was associated with an enrichment of the circulating pool of bile acids with UDCA. Hepatosplenomegaly and pruritus disappeared or diminished in children in whom liver tests normalized. In nine of these children, liver tests worsened and normalized again after stopping and restarting UDCA. Liver histology assessed in four children after normalization of liver tests and 2 years of treatment showed a decrease in fibrosis. We conclude that UDCA should be considered in the initial therapeutic management of children with PFIC, because it appears effective in resolving or improving the liver function and the clinical status of a fair proportion of children. Chronic UDCA therapy might thus avoid the need for liver transplantation in some children with PFIC. PMID:9049190
King, Gillian; Tam, Cynthia; Fay, Linda; Pilkington, Martha; Servais, Michelle; Petrosian, Hasmik
There is growing interest in understanding the usefulness of mentorship programs for children's rehabilitation service providers. This evaluation study examined the effects of an occupational therapy mentorship program on the skills and behaviors of 8 new and 17 experienced occupational therapists practicing at a regional children's rehabilitation center. Self- and peer-report measures of family-centered behavior, critical thinking ability, listening/interactive communication skill, and clinical behavior were collected before and after an 11-month facilitated, collaborative group mentorship intervention. Significant pre-post changes associated with intervention were found on 9 of 12 outcome measures, including information provision, respectful treatment, self-confidence, and listening and clinical skill. Changes were not found on the more trait-like variables of open-mindedness, interpersonal sensitivity, and interpersonal skill. Experienced therapists had higher scores than new therapists on most variables, including family-centered behavior, listening skill, and clinical skill. Implications regarding the utility of mentorship programs in children's rehabilitation centers are discussed. PMID:20950057
Donohue, Brad; Azrin, Nathan H.; Bradshaw, Kelsey; Van Hasselt, Vincent B.; Cross, Chad L.; Urgelles, Jessica; Romero, Valerie; Hill, Heather H.; Allen, Daniel N.
Objective Approximately 50% of Child Protective Service (CPS) referrals abuse drugs; yet, existing treatment studies in this population have been limited to case examinations. Therefore, a family-based behavioral therapy was evaluated in mothers referred from CPS for child neglect and drug abuse utilizing a controlled experimental design. Method 72 mothers evidencing drug abuse or dependence and child neglect were randomly assigned to Family Behavior Therapy (FBT) or Treatment as Usual (TAU). Participants were assessed at baseline, 6- month-, and 10-month post-randomization. Results As hypothesized, intent-to-treat repeated measures analyses revealed mothers referred for child neglect not due to their children being exposed to illicit drugs demonstrated better outcomes in child maltreatment potential from baseline to 6- and 10-month post-randomization assessments when assigned to FBT, as compared with TAU mothers and FBT mothers who were referred due to child drug exposure. Similar results occurred for hard drug use from baseline to 6- and 10-month post-randomization. However, TAU mothers referred due to child drug exposure were also found to decrease their hard drug use more than TAU mothers of non-drug exposed children and FBT mothers of drug exposed children at 6- and 10-month post-randomization. Although effect sizes for mothers assigned to FBT were slightly larger for marijuana use than TAU (medium vs. large), these differences were not statistically significant. Specific to secondary outcomes, mothers in FBT, relative to TAU, increased time employed from baseline to 6- and 10-month post-randomization. Mothers in FBT, compared to TAU, also decreased HIV risk from baseline to 6-month post-randomization. There were no differences in outcome between FBT and TAU for number of days children were in CPS custody and alcohol intoxication, although FBT mothers demonstrated marginal decreases (p = .058) in incarceration from baseline to 6-month post
Miller, John K.; Todahl, Jeff; Platt, Jason J.; Lambert-Shute, Jennifer; Eppler, Christie S.
A key component of a doctoral education in marriage and family therapy (MFT) is the completion of an internship. Virtually all MFT doctoral internships are focused on advanced clinical practice and often are located in agencies unconnected with an academic setting. This article describes an MFT doctoral internship specifically designed to foster…
Nickel, Robert E.; Gerlach, Elizabeth King
This article presents a model for communication among providers and families of children with disabilities about complementary and alternative medicine (CAM). It discusses treatments for children with attention deficit hyperactivity disorder and cerebral palsy, including the Feingold diet, herbal treatments, CranioSacral therapy, therapeutic…
Storch, Eric A.; Geffken, Gary R.; Merlo, Lisa J.; Mann, Giselle; Duke, Danny; Munson, Melissa; Adkins, Jennifer; Grabill, Kristen M.; Murphy, Tanya K.; Goodman, Wayne K.
Objective: To examine the relative efficacy of intensive versus weekly cognitive-behavioral therapy (CBT) for children and adolescents with obsessive-compulsive disorder (OCD). Method: Forty children and adolescents with OCD (range 7-17 years) were randomized to receive 14 sessions of weekly or intensive (daily psychotherapy sessions) family-based…
de la Pena, Cristina Muniz; Friedlander, Myrna L.; Escudero, Valentin; Heatherington, Laurie
Sequential analyses examined associations between the working alliance and therapist-adolescent communication patterns in 10 Spanish cases of brief conjoint family therapy. Early sessions with strong versus problematic alliances, rated by observers, were selected for coding of relational control communication patterns. No differences were found in…
Fernandez, Melanie A.; Butler, Ashley M.; Eyberg, Sheila M.
The course and efficacy of parent-child interaction therapy (PCIT) were examined in 18 socioeconomically disadvantaged African American families of preschoolers with disruptive behavior disorders. Mothers reported significant improvements in child disruptive behavior but not in maternal depressive symptoms or parenting stress. Attrition was 56%,…
Gehart, Diane R.
A continuation of Part I, which introduced mental health recovery concepts to family therapists, Part II of this article outlines a collaborative, appreciative approach for working in recovery-oriented contexts. This approach draws primarily upon postmodern therapies, which have numerous social justice and strength-based practices that are easily…
LaForme Fiss, Alyssa C.; McCoy, Sarah Westcott; Chiarello, Lisa A.
The purpose of this study was to determine whether parents and therapists have similar perceptions of therapy services provided to young children with cerebral palsy (CP), reflecting collaboration and provision of family-centered care. Forty-six parents of young children with CP and 40 therapists providing services for those children participated.…
Donohue, Brad; Azrin, Nathan; Allen, Daniel N.; Romero, Valerie; Hill, Heather H.; Tracy, Kendra; Lapota, Holly; Gorney, Suzanne; Abdel-al, Ruweida; Caldas, Diana; Herdzik, Karen; Bradshaw, Kelsey; Valdez, Robby; Van Hasselt, Vincent B.
A comprehensive evidence-based treatment for substance abuse and other associated problems (Family Behavior Therapy) is described, including its application to both adolescents and adults across a wide range of clinical contexts (i.e., criminal justice, child welfare). Relevant to practitioners and applied clinical researchers, topic areas include…
Friedlander, Myrna L.; Kivlighan, Dennis M., Jr.; Shaffer, Katharine S.
Predictions of family therapy outcome consistently vary depending on which client rates the alliance. We used the actor-partner interdependence model (Kenny, Kashy, & Cook, 2006) to test the interdependence of parents' and adolescents' ratings of alliance, session depth/value, and improvement-so-far after Sessions 3, 6, and 9. Initial analyses…
Imai, Yuzuru; Takahashi, Ryosuke
Parkinson disease (PD), is a movement disorder pathologically characterized by the progressive loss of dopaminergic neurons in the substantia nigra pars compacta. Although the inherited forms of PD account for only 5 to 10% of PD cases, the identification of gene mutations in the genes implicated in familial PD in the past 10 years, including the findings regarding the a-synuclein, Parkin, ubiquitin-C-terminal hydrolase-L1 (UCH-L1), PINK1, DJ-1 and the ATP13A2 genes, has advanced understanding of the molecular mechanisms in each case of genetic PD. Most familial forms of PD develop at an early onset. However, recent identification of the leucine-rich repeat kinase (LRRK) 2 gene for a late-onset PD, the clinicopathological feature of which closely resembles that of sporadic PD, is expected to enable the clarification of the underlying causes of general PD. Recent studies on the physiological and pathological functions of these identified gene products have revealed overlapping pathogenetic pathways. The common features of these aberrant pathways are impaired protein degradation/quality control, mitochondrial dysfunction, and altered vesicle transport. Several attempts have been made towards developing molecular-targeted therapies directed against mitochondria (e.g., antioxidants, permeability transition pore modulators, and mitochondrial biogenesis stimulators), protein quality control and vesicle transport (e.g., gene silencing, immunization of asynuclein, and protofibril-destabilizing reagents). To ensure the successful implementation of such strategies, it is important to understand the events occuring at an early stage of PD. Further, studies using mammalian PD models for pharmacological analysis combined with studies employing lower organisms for genetic analyses such as worm, fly, and yeast will be helpful to determine effective prevention and treatment strategies for PD, which will replace the conventional symptomatic treatments for PD. PMID:19697879
Fredman, Steffany J.; Baucom, Donald H.; Boeding, Sara; Miklowitz, David J.
Objective The “critical comments” dimension of the expressed emotion (EE) construct has been found to predict the illness course of patients with bipolar disorder, but less is known about the “emotional overinvolvement” (EOI) component. The goal of this study was to evaluate whether relatives’ observed appropriate and inappropriate emotional involvement (intrusiveness, self-sacrifice, and distress about patients’ well-being) moderated the effectiveness of a family-based intervention for bipolar disorder. Method 108 patients with bipolar disorder (mean age = 35.61 years [SD = 10.07]), 57% female) and their relatives (62% spouses) from two clinical trials completed 10-minute problem-solving interactions prior to being treated with pharmacotherapy plus family-based therapy (FBT) or brief psychoeducation (crisis management, CM). Patients were interviewed every 3–6 months over 2 years to assess mood symptoms. Results When relatives showed low levels of inappropriate self-sacrifice, CM and FBT were both associated with improvements in patients’ manic symptoms over 2 years. When relatives showed high levels, patients in CM became more manic over time, whereas patients in FBT became less manic. Group differences in mania trajectories were also observed at high levels of inappropriate emotional response but not at low. When relatives showed high levels of appropriate self-sacrifice, patients in both groups became less depressed. At low levels of appropriate self-sacrifice, patients in CM did not improve, whereas patients in FBT became less depressed. Conclusions Future studies of bipolar disorder should consider the prognostic value of the amount and appropriateness of relatives’ emotional involvement with patients in addition to their critical behaviors. PMID:25198285
Kajubi, P; Katahoire, Anne R; Kyaddondo, David; Whyte, Susan R
It is important to consider the complexities of family dynamics when deciding when and how to communicate with HIV-infected children about their illness and treatment. Previous research has focused on providers' and caregivers' perspectives on whether, when and how to disclose HIV/AIDS diagnosis and treatment to HIV-infected children. From the perspective of HIV-infected children, communication does not mean just giving information about illness and treatment, but also encompasses emotional and material care. This paper places communication within the broader framework of caregiving in family situations. This exploratory study was conducted in Jinja district, Uganda, between November 2011 and December 2012. Through participant observation and in-depth interviews, communication by, and with, HIV-infected children in the context of family situations was explored from the perspectives of 29 HIV-infected children aged 8-17 years on antiretroviral therapy (ART) using content thematic analysis. Children's communication with caregivers about their illness and treatment varied depending on whom they were living with and the nature of caregiving. Although a mother's care was considered best, children described others who cared 'like a mother'. For some, caregiving was distributed among several relatives and non-relatives, while others felt they had hardly anyone to care for them. Caregiving from the children's perspective involved emotional support, expressed verbally and explicitly in messages of concern, encouragement conveyed in reminders to take medicines, attention when sick and confidential conversations about the challenges of having HIV and taking ART. Caregiving was also communicated implicitly in acts of provision of food/drinks to take with medicines, counting pills to confirm they had taken the medicines and accompanying children to treatment centres. Children's communication about their health and medicines and the care they received was to a large extent
Carcone, April Idalski; Ellis, Deborah A; Chen, Xinguang; Naar, Sylvie; Cunningham, Phillippe B; Moltz, Kathleen
The purpose of this study was to determine if multisystemic therapy (MST), an intensive, home and community-based family treatment, significantly improved patient-provider relationships in families where youth had chronic poor glycemic control. One hundred forty-six adolescents with type 1 or 2 diabetes in chronic poor glycemic control (HbA1c ≥8 %) and their primary caregivers were randomly assigned to MST or a telephone support condition. Caregiver perceptions of their relationship with the diabetes multidisciplinary medical team were assessed at baseline and treatment termination with the Measure of Process of Care-20. At treatment termination, MST families reported significant improvement on the Coordinated and Comprehensive Care scale and marginally significant improvement on the Respectful and Supportive Care scale. Improvements on the Enabling and Partnership and Providing Specific Information scales were not significant. Results suggest MST improves the ability of the families and the diabetes treatment providers to work together. PMID:25940767
Carcone, April Idalski; Ellis, Deborah A.; Chen, Xinguang; Naar-King, Sylvie; Cunningham, Phillippe B.; Moltz, Kathleen
Objective The purpose of this study was to determine if Multisystemic Therapy (MST), an intensive, home and community-based family treatment, significantly improved patient-provider relationships in families where youth had chronic poor glycemic control. Methods One hundred forty-six adolescents with type 1 or 2 diabetes in chronic poor glycemic control (HbA1c ≥ 8%) and their primary caregivers were randomly assigned to MST or a telephone support condition. Caregiver perceptions of their relationship with the diabetes multidisciplinary medical team were assessed at baseline and treatment termination with the Measure of Process of Care-20. Results At treatment termination, MST families reported significant improvement on the Coordinated and Comprehensive Care scale and marginally significant improvement on the Respectful and Supportive Care scale. Improvements on the Enabling and Partnership and Providing Specific Information scales were not significant. Conclusions Results suggest MST improves the ability of the families and the diabetes treatment providers to work together. PMID:25940767
Stanton, M D; Todd, T C
Although the Wells and Dezen review made many valuable points about family therapy outcome research, their handling of the various included studies appeared uneven. To test this impression, a content analysis was performed on the "favorableness" or "positiveness" of the statements made by Wells and Dezen about the studies they reviewed. The degree of positiveness was compared across studies with the Design Quality and with the level of sophistication of these studies. All of the statistical correlations were negative--half of them significantly so--a result completely opposite to what would be expected. We conclude that Wells and Dezen tended to give undue praise to many uncontrolled studies and inordinate criticism to more sophisticated and better-designed research. In addition, other inconsistencies in the evaluation of studies were noted. Further, specific studies were presented in a distorted and inacurate manner, and without proper attention to statistical principles. In sum, it appears that Wells and Dezen (a) have not been sufficiently careful in their analysis of the reviewed research, and (b) have, through their evaluative remarks, provided a biased review which obscures many important comparisons within this field. PMID:7409096
Inomata, J; Yamazaki, K; Tsuji, R; Kobayashi, M; Sakuta, T
The number of juvenile delinquents detained by police for shoplifting, glue sniffing, and automobile and bicycle theft reached its highest level in Japan in 1980 since world war II. The incidence of delinquency has fluctuated up and down somewhat between 1981 and 1988 but has remained slightly below the 1980 peak. In 1988 the number of juvenile detainees between the ages of 14 and 18 was 187,172. Juvenile delinquents currently undergoing training and treatment at the K-Institute in Kanagawa Prefecture will be discussed. The K-Institute for the training and correction of juvenile delinquents is a public institution which was established in 1900. It has a holding capacity for 100 male offenders. We have interviewing and treating inmates by psychotherapeutic and psychopharmacological methods since 1975. The institute has recently begun to practice a form of inclusive family therapy where the parent comes and stays with the child in the institute for a short period of time. The treatment program has shown a success so that so far none of the participants have returned to the institute, while 30% of non-participants have returned to the institute. PMID:2214505
Sells, Scott P.
A model for treating difficult adolescents and their families is presented. Part 1 offers six basic assumptions about the causes of severe behavioral problems and presents the treatment model with guidelines necessary to address each of these six causes. Case examples highlight and clarify major points within each of the 15 procedural steps of the…
Neziroglu, F; Hsia, C; Yaryura-Tobias, J A
Behavioral therapy and cognitive therapy, individually and combined, are a solid base in any therapy, the goal of which is to decrease the maladaptive behaviors associated with obsessive-compulsive spectrum disorders. Future research into this area involves two branches: (1) better resolution in what components of current treatments are effective and (2) a better understanding of the cause of OCD. The therapies of choice are behavioral therapy and cognitive therapy, but often what is described as behavioral therapy and cognitive therapy varies. Further refinement of the specific components of behavioral therapy and cognitive therapy that directly apply to OCD is needed. The specific components likely include the use of ERP and rational emotive behavioral therapy but often even these therapies can be parceled into smaller discrete parts. Many facets still have not been explored thoroughly (e.g., the extent of exposure to adverse situations needed, ideal length of therapy, time needed for exposure, and the use of virtual reality versus traditional exposures). A better understanding of the biological basis for OCD also would further the field. A better understanding of the basis of this disorder also would help clinicians to treat it with medication and behavioral therapy. Research into how behavioral therapy and cognitive therapy makes neurophysiologic changes would show the effectiveness of the treatment and a biological basis. Such studies could include the use of MR imaging during different stages in behavioral therapy and the use of functional during therapy to observe changes in the brain. Although OCD still is not fully understood, researchers are now beginning to understand how to treat it, and a solid base of empiric data now exists. The authors hope that investigators will continue research toward a better understanding of this disorder so that clinicians can better help their patients. PMID:10986734
Breuk, Rene E; Sexton, Thomas L; van Dam, Astrid; Disse, Claudia; Doreleijers, Theo A H; Slot, Wim N; Rowland, Marcy K
Because of the increasing severity of adolescent problem behavior, evidence-based practices are becoming of interest as an alternative to traditional treatment with the behavior problems of adolescents in juvenile justice settings. Despite interest in evidence-based practices, questions exist regarding whether or not evidence-based intervention models can be successfully transported to cultures other than those in which they were developed. This article describes the transportation process of an American evidence-based family therapy (Functional Family Therapy [FFT]) into the service delivery system of a psychiatric day treatment center for juvenile delinquents in Amsterdam. The characteristics of FFT that make it cross-culturally sensitive are discussed. Results from the changes in service delivery suggest FFT can be successfully implemented in international settings with adjustments to make the model fit the culture(s) of The Netherlands without changing the model of FFT itself. PMID:17120523
O’Brien, Mary P.; Miklowitz, David J.; Candan, Kristin A.; Marshall, Catherine; Domingues, Isabel; Walsh, Barbara C.; Zinberg, Jamie L.; De Silva, Sandra D.; Woodberry, Kristen A.; Cannon, Tyrone D.
Objective This study investigated whether family focused therapy (FFT-CHR), an 18-session intervention that consisted of psychoeducation and training in communication and problem solving, brought about greater improvements in family communication than enhanced care (EC), a 3-session psychoeducational intervention, among individuals at clinical high risk for developing psychosis. Method This study was conducted within a randomized controlled trial across 8 sites. We examined 10-min problem-solving discussions at baseline and 6-month reassessment among 66 adolescents and young adults and their parents. Trained coders who were blind to treatment and time of assessment achieved high levels of interrater reliability when evaluating family discussions on categories of calm–constructive and critical– conflictual behavior. Results Individuals at high risk and their family members who participated in FFT-CHR demonstrated greater improvement from baseline to 6-month reassessment in constructive communication and decreases in conflictual behaviors during family interactions than those in EC. Participants in FFT-CHR showed greater increases from baseline to 6 months in active listening and calm communication and greater decreases in irritability and anger, complaints and criticism, and off-task comments compared to participants in EC. These changes occurred equally in high-risk participants and their family members. Conclusions A 6-month family skills training treatment can bring about significant improvement in family communication among individuals at high risk for psychosis and their parents. Future studies should examine the association between enhancements in family communication and reduced risk for the onset of psychosis among individuals at high risk. PMID:24188511
Greenbaum, Paul E.; Wang, Wei; Hall, Kristin; Henderson, Craig E.; Kan, Lisa; Dakof, Gayle A.; Liddle, Howard A.
This study examined gender and ethnicity as moderators of Multidimensional Family Therapy (MDFT) effectiveness for adolescent drug abuse and illustrated the utility of integrative data analysis (IDA, Bauer & Hussong, 2009) for assessing moderation. By pooling participant data from five independent MDFT randomized clinical trials (RCTs), IDA increased power to test moderation. Participants were 646 adolescents receiving treatment for drug use, aged 11 to 17 years (M = 15.31, SD = 1.30), with 19% female (n = 126), 14% (n = 92) European American, 35% (n = 225) Hispanic, and 51% (n = 329) African American. Participants were randomized to MDFT or active comparison treatments, which varied by study. Drug use involvement (i.e., frequency and consequences) was measured at study entry, 6-, and 12-months by a four-indicator latent variable. Growth curve change parameters from multiple calibration samples were regressed on treatment effects overall and by moderator subgroups. MDFT reduced drug use involvement (p < .05) for all participant groups. Pooled comparison groups reduced drug use involvement only for females and Hispanics (ps < .05). MDFT was more effective than comparisons for males, African Americans, and European Americans (ps <.05; Cohen's d = 1.17, 1.95, and 1.75, respectively). For females and Hispanics, there were no significant differences between MDFT and pooled comparison treatments, Cohen's d = 0.63 and 0.19, respectively. MDFT is an effective treatment for drug use among adolescents of both genders and varied ethnicity with males, African American, and White Non-Hispanic adolescents benefitting most from MDFT. PMID:26213796
O'Shea, Michele S; Rosenberg, Nora E; Tang, Jennifer H; Mukuzunga, Cornelius; Kaliti, Stephen; Mwale, Mwawi; Hosseinipour, Mina C
The objective of this study was to describe the pregnancy intentions of pregnant HIV-infected Malawian women on antiretroviral therapy (ART) for at least 6 months prior to the current pregnancy, and to assess whether time on ART was associated with pregnancy intention. We conducted a cross-sectional analysis of HIV-infected Malawian women receiving antenatal care at a government hospital with a survey assessing ART history, reproductive history, and family planning use at conception. We used Pearson's chi-square tests and Fisher's exact tests to compare these parameters between women on ART greater than 24 months with those on ART less than 24 months. Modified Poisson regression was performed to assess the association between time on ART and pregnancy intention. Most women (75%) reported that their current pregnancy was unintended, defined as either Mistimed (21%) or Unwanted (79%). Women on ART for longer than 2 years were more likely to report an unintended pregnancy (79% versus 65%, p = .03), though there was no significant association between time on ART and pregnancy intention in multivariate analysis. Most women (79%) were using contraception at the time of conception, with condoms being most popular (91%), followed by injectables (9%) and the implant (9%). HIV-infected women on ART continue to experience high rates of unintended pregnancy in the Option B+ era. As Option B+ continues to be implemented in Malawi and increasing numbers of HIV-infected women initiate lifelong ART, ensuring that the most effective forms of contraception are accessible is necessary to decrease unintended pregnancy. PMID:26877194
Occupational therapy interventions for autism spectrum disorder (ASD) require a sound evidence-base. In the context of emerging evidence on coaching interventions in paediatric occupational therapy practice, a review of the occupational therapy literature was conducted to investigate the use of coaching interventions for children and adolescents…
Awosan, Christiana I.; Sandberg, Jonathan G.; Hall, Cadmona A.
Past research on Black clients' utilization of therapy focused on the barriers that prevent Black clients from attending therapy and the reasons for these barriers. However, few studies have been conducted that focus on how Black clients attending therapy actually experience these barriers. This study utilized both Likert and open-ended questions…
Taub, E; Uswatte, G; Pidikiti, R
A new family of rehabilitation techniques, termed Constraint-Induced Movement Therapy or CI Therapy, has been developed that controlled experiments have shown is effective in producing large improvements in limb use in the real-world environment after cerebrovascular accident (CVA). The signature therapy involves constraining movements of the less-affected arm with a sling for 90% of waking hours for 2 weeks, while intensively training use of the more-affected arm. The common therapeutic factor in all CI Therapy techniques would appear to be inducing concentrated, repetitive practice of use of the more-affected limb. A number of neuroimaging and transcranial magnetic stimulation studies have shown that the massed practice of CI Therapy produces a massive use-dependent cortical reorganization that increases the area of cortex involved in the innervation of movement of the more-affected limb. The CI Therapy approach has been used successfully to date for the upper limb of patients with chronic and subacute CVA and patients with chronic traumatic brain injury and for the lower limb of patients with CVA, incomplete spinal cord injury, and fractured hip. The approach has recently been extended to focal hand dystonia of musicians and possibly phantom limb pain. PMID:10659807
Smith, Robert L.
Presents overview of select components most often found within family training programs: the study of systems theory, examination of family of origin, use of live supervision, and emphasis on ethical issues specific to working with couples and families. Discusses variety of challenges facing training programs, including constructivism, feminist…
Willoughby, Brian L. B.; Doty, Nathan D.
Few interventions have been proposed for the treatment of families following a child's disclosure of nonheterosexuality. To address this gap in the literature, the current paper outlines a brief cognitive behavioral family treatment (CBFT) for families negotiating the coming-out process and illustrates this approach with a case example. Parents'…
Edwards, Todd M.
Discusses the role diet and nutrition play in the stress of individuals and families who seek help from a family therapist. Discusses when to assess a client's diet. Provides methods for diet inquiry using case examples for illustration. Recommendations are provided for marriage and family counselor training. (JDM)
Glueckauf, Robert L.; Liss, Heidi J.; McQuillen, Diane E.; Webb, Pat M.; Dairaghi, Jeanne; Carter, Carol B.
Adolescents (N=19) with epilepsy and their families assigned to either issue-specific single-family counseling (IFCM) or to a multi-family psychoeducational group (PG) were studied for problem improvement through therapeutic alliance. While no overall differences were found between IFCM and PG, IFCM adolescents reported significantly stronger…
Engel, John W.; Lingren, Herbert G.
Finding a qualified marriage and family therapist that the couple or family will be comfortable with requires some effort on the part of the consumer. There are many people out there who advertise themselves as marriage counselors or family therapists but do not have the credentials. The client must shop around, interview prospective therapists,…
Scopetta, Mercedes A.
An approach to the treatment of Hispanic (particularly Cuban) American families with drug abusing members is presented in this paper. The approach, developed by the Spanish Family Guidance Center in Miami, Florida, views dysfunctionality and drug abuse as emerging from a family's internal disorganization and ecological imbalance. In order to treat…
Eroglu, Zeynep; Tagawa, Tomoko
Breast cancer characterized by overexpression of human epidermal growth factor receptor 2 (HER2) has been associated with more aggressive disease progression and a poorer prognosis. Although an improved understanding of breast cancer pathogenesis and the role of HER2 signaling has resulted in significant survival improvements in the past 20 years, resistance to HER2-targeted therapy remains a concern. A number of strategies to prevent or overcome resistance to HER2-targeted therapy in breast cancer are being evaluated. This article provides a comprehensive review of (a) the role of HER2 signaling in breast cancer pathogenesis, (b) potential receptor and downstream therapeutic targets in breast cancer to overcome resistance to HER2-targeted therapy, and (c) clinical trials evaluating agents targeting one or more members of the HER family and/or downstream pathways for the treatment of breast cancer, with a focus on metastatic disease. PMID:24436312
Lyon, Maureen E; Trexler, Connie; Akpan-Townsend, Carleen; Pao, Maryland; Selden, Keith; Fletcher, Jean; Addlestone, Irene C; D'Angelo, Lawrence J
This paper describes the development of a novel, pilot program in which a combined family group and peer approach were used to increase adherence to antiretroviral therapy in HIV-infected youths. Twenty-three HIV-positive youths, 15-22 years of age and 23 family members or "treatment buddies" participated in one of three 12-week programs. The intervention had six biweekly family and youth education sessions and six biweekly youth-only education sessions. Devices to increase adherence to antiretroviral therapy such as pill boxes, calendars, and watch alarms were introduced at youth-only sessions. Eighteen of the 23 youths completed a group. Ninety-one percent of youths self-reported increased adherence to medications after completion of a group. Four participants experienced a one-log reduction in viral loads to undetectable levels during the intervention. Two participants continued to decline antiretroviral medications at the end of the intervention and demonstrated no decrease in viral load. Participants tested five devices and rated the multiple alarm watch as the best aid for improving adherence to medication. Family/treatment buddies rated the overall program as highly helpful, citing social support as most valuable. An unanticipated benefit was an increase in other health behaviors, including medical and dental appointments, hepatitis B and influenza immunizations, and referrals to mental health and substance abuse treatment. PMID:12880493
Robbins, Michael S.; Feaster, Daniel J.; Horigian, Viviana E.; Rohrbaugh, Michael; Shoham, Varda; Bachrach, Ken; Miller, Michael; Burlew, Kathleen A.; Hodgkins, Candy; Carrion, Ibis; Vandermark, Nancy; Schindler, Eric; Werstlein, Robert; Szapocznik, José
Objective To determine the effectiveness of brief strategic family therapy (BSFT; an evidence-based family therapy) compared to treatment as usual (TAU) as provided in community-based adolescent outpatient drug abuse programs. Method A randomized effectiveness trial in the National Drug Abuse Treatment Clinical Trials Network compared BSFT to TAU with a multiethnic sample of adolescents (213 Hispanic, 148 White, and 110 Black) referred for drug abuse treatment at 8 community treatment agencies nationwide. Randomization encompassed both adolescents’ families (n = 480) and the agency therapists (n = 49) who provided either TAU or BSFT services. The primary outcome was adolescent drug use, assessed monthly via adolescent self-report and urinalysis for up to 1 year post randomization. Secondary outcomes included treatment engagement (≥2 sessions), retention (≥8 sessions), and participants’ reports of family functioning 4, 8, and 12 months following randomization. Results No overall differences between conditions were observed in the trajectories of self-reports of adolescent drug use. However, the median number of days of self-reported drug use was significantly higher, χ2(1) = 5.40, p < .02, in TAU (Mdn = 3.5, interquartile range [IQR] = 11) than BSFT (Mdn = 2, IQR = 9) at the final observation point. BSFT was significantly more effective than TAU in engaging, χ2(1) = 11.33, p < .001, and retaining, χ2(1) = 5.66, p < .02, family members in treatment and in improving parent reports of family functioning, χ2(2) = 9.10, p < .011. Conclusions We discuss challenges in treatment implementation in community settings and provide recommendations for further research. PMID:21967492
Caqueo-Urízar, Alejandra; Rus-Calafell, Mar; Urzúa, Alfonso; Escudero, Jorge; Gutiérrez-Maldonado, José
Family interventions for schizophrenia have been amply demonstrated to be effective and are recommended by most of the international clinical guidelines. However, their implementation in the clinical setting as well as in treatment protocols of patients with psychosis has not been fully achieved yet. With the increasing deinstitutionalization of patients, family has begun to assume the role of care performed by psychiatric hospitals, with a high emotional cost for caregivers as well as the recognition of burden experiences. Families have been the substitute in the face of the scarcity of therapeutic, occupational, and residential resources. For this reason, the viability of patients’ care by their families has become a challenge. This article aims to discuss the most important aspects of family interventions, their impact on families, and the most important challenges that need to be overcome in order to achieve well-being and recovery in both patients and caregivers. PMID:25609970
Caqueo-Urízar, Alejandra; Rus-Calafell, Mar; Urzúa, Alfonso; Escudero, Jorge; Gutiérrez-Maldonado, José
Family interventions for schizophrenia have been amply demonstrated to be effective and are recommended by most of the international clinical guidelines. However, their implementation in the clinical setting as well as in treatment protocols of patients with psychosis has not been fully achieved yet. With the increasing deinstitutionalization of patients, family has begun to assume the role of care performed by psychiatric hospitals, with a high emotional cost for caregivers as well as the recognition of burden experiences. Families have been the substitute in the face of the scarcity of therapeutic, occupational, and residential resources. For this reason, the viability of patients' care by their families has become a challenge. This article aims to discuss the most important aspects of family interventions, their impact on families, and the most important challenges that need to be overcome in order to achieve well-being and recovery in both patients and caregivers. PMID:25609970
Humphries, Brock; Yang, Chengfeng
MicroRNAs (miRNAs) are a large family of small non-coding RNAs that negatively regulate protein-coding gene expression post-transcriptionally via base pairing between the 5′ seed region of a miRNA and the 3′ untranslated region (3′UTR) of a messenger RNA (mRNA). Recent evidence has supported the critical role that miRNAs play in many diseases including cancer. The miR-200 family consisting of 5 members (miR-200a, -200b, -200c, -141, -429) is an emerging miRNA family that has been shown to play crucial roles in cancer initiation and metastasis, and potentially be important for the diagnosis and treatment of cancer. While miR-200s were found to be critically involved in the metastatic colonization to the lungs in mouse mammary xenograft tumor models, a large number of studies demonstrated their strong suppressive effects on cell transformation, cancer cell proliferation, migration, invasion, tumor growth and metastasis. This review aims to discuss research findings about the role of the miR-200 family in cancer initiation, each step of cancer metastatic cascade, cancer diagnosis and treatment. A comprehensive summary of currently validated miR-200 targets is also presented. It is concluded that miR-200 family may serve as novel targets for the therapy of multiple types of cancer. PMID:25762624
Miklowitz, David J.; Schneck, Christopher D.; Singh, Manpreet K.; Taylor, Dawn O.; George, Elizabeth L.; Cosgrove, Victoria E.; Howe, Meghan E.; Dickinson, L. Miriam; Garber, Judy; Chang, Kiki D.
Objective Depression and brief periods of (hypo)mania are linked to an increased risk of progression to bipolar I or II disorder (BD) in children of bipolar parents. This randomized trial examined the effects of a 4-month family-focused therapy (FFT) program on the 1-year course of mood symptoms in youth at high familial risk for BD, and explored its comparative benefits among youth in families with high vs. low expressed emotion (EE). Method Participants were 40 youth (mean 12.3 ± 2.8 years, range 9–17) with BD not otherwise specified, major depressive disorder, or cyclothymic disorder who had a first-degree relative with BD I or II and active mood symptoms (Young Mania Rating Scale [YMRS] > 11 or Child Depression Rating Scale > 29). Participants were randomly allocated to FFT–High Risk version (FFT-HR; 12 sessions of psychoeducation and training in communication and problem-solving skills) or an education control (EC; 1–2 family sessions). Results Youth in FFT-HR had more rapid recovery from their initial mood symptoms (hazard ratio = 2.69, p = .047), more weeks in remission, and a more favorable trajectory of YMRS scores over 1 year than youth in EC. The magnitude of treatment effect was greater among youth in high-EE (vs. low-EE) families. Conclusions FFT-HR may hasten and help sustain recovery from mood symptoms among youth at high risk for BD. Longer follow-up will be necessary to determine if early family intervention has downstream effects that contribute to the delay or prevention of full manic episodes in vulnerable youth. Clinical trial registration information—Early Family-Focused Treatment for Youth at Risk for Bipolar Disorder; http://www.clinicaltrials.gov/; NCT00943085. PMID:23357439
Selekman, Matthew D.
This article presents a family competency-based treatment approach that capitalizes on the strengths and resources of self-injuring adolescents and their families. Throughout the article, the author provides therapeutic tools and strategies that he has found effective in his clinical practice of working with self-injuring youth and their families…
Springer, Paul R.; Abbott, Douglas A.; Reisbig, Allison M. J.
Despite the growing numbers of Muslims in the United States, there is a scarcity of research dealing with mental health practitioners working with Muslim families. This lack of research may leave clinicians unprepared to adequately help Muslim patients and families faced with discrimination and misunderstanding, which may inadvertently lead to the…
Jordan, John R.; Sluzki, Carlos E.
Contemporary psychodynamic family clinicians emphasize intervening in the transmission of emotional patterning over generations in families. While differences exist between this model and "systems" approaches, it is argued that integration of the two is possible. Provides Sluzki's response that the two models are independent. (Author/RC)
Ronalds, Lisa; Allen-Craig, Sandy
In an effort to address the issue of youth homelessness in Australia, Regional Extended Family Services (REFS) have developed a wilderness-based therapeutic intervention. REFS aim to provide early intervention services for young people at risk of homelessness, and their families. This study examined the outcomes of the REFS wilderness program by…
Hogan, Sarah; Stokes, Jacqueline; Weller, Isobel
A common misconception about families in the UK who choose to participate in an Auditory Verbal (AV) approach for their child with hearing impairment, is that they are uniformly from affluent backgrounds. It is asserted that the good spoken language outcomes in these children are a product of the child's social background and family's values…
Eisler, Ivan; Simic, Mima; Russell, Gerald F. M.; Dare, Christopher
Background: There is growing evidence that family therapy is an effective treatment for adolescent anorexia nervosa. This study aimed to ascertain the long-term impact of two forms of outpatient family intervention previously evaluated in a randomised controlled trial (RCT). Method: A five-year follow-up was conducted on a cohort of 40 patients…
Sacco, Assuntina G; Worden, Francis P
The majority of patients with head and neck squamous cell carcinoma (HNSCC) present with locally advanced disease, which requires site-specific combinations of surgery, radiation, and chemotherapy. Despite aggressive therapy, survival outcomes remain poor, and treatment-related morbidity is not negligible. For patients with recurrent or metastatic disease, therapeutic options are further limited and prognosis is dismal. With this in mind, molecularly targeted therapy provides a promising approach to optimizing treatment efficacy while minimizing associated toxicity. The ErbB family of receptors (ie, epidermal growth factor receptor [EGFR], ErbB2/human epidermal growth factor receptor [HER]-2, ErbB3/HER3, and ErbB4/HER4) is known to contribute to oncogenic processes, such as cellular proliferation and survival. EGFR, specifically, is upregulated in more than 90% of HNSCC, has been implicated in radiation resistance, and correlates with poorer clinical outcomes. The central role of EGFR in the pathogenesis of HNSCC suggests that inhibition of this pathway represents an attractive treatment strategy. As a result, EGFR inhibition has been extensively studied, with the emergence of two classes of drug therapy: monoclonal antibodies and tyrosine kinase inhibitors. While the monoclonal antibody cetuximab is currently the only US Food and Drug Administration–approved EGFR inhibitor for the treatment of HNSCC, numerous investigational drugs are being evaluated in clinical trials. This paper will review the role of the ErbB family in the pathogenesis of HNSCC, as well as the evidence-based data for the use of ErbB family inhibition in clinical practice. PMID:27110122
Krauthamer Ewing, E Stephanie; Levy, Suzanne A; Boamah-Wiafe, Linda; Kobak, Roger; Diamond, Guy
This article describes the application of Attachment-Based Family Therapy (ABFT) to the treatment of a 13-year-old female adolescent presenting with high risk of suicide, complicated by a history of depression and sexual trauma. The article begins with an overview of ABFT, including (a) how attachment theory guides treatment; (b) the structure of the clinical model; and (c) the data that provide empirical support. A case example is then presented that exemplifies the primary clinical procedures used to reach therapeutic goals in ABFT, including attachment repair and autonomy/competence promotion. Weekly changes in suicide ideation and depression scores are presented. The article concludes with a discussion about implications for family-based treatment of suicidal youth. PMID:25329356
Barillé-Nion, Sophie; Bah, Nourdine; Véquaud, Eloïse; Juin, Philippe
Attacking cancer cell survival defense by targeting B-Cell Lymphoma 2 (BCL2) family of anti-apoptotic proteins may provide a powerful means to improve chemotherapy efficiency. This could be particularly relevant to anti-mitotic-based therapy, where tumor response relates to a competing network between mitotic cell death signaling and mitotic slippage as an adaptative response to a leaky mitotic checkpoint. In this review, we focus on recent findings that point out the major role played by BCL2 family members in response to anti-mitotic agents, which reveal dependence of cancer cell survival on BCL2 homologs during mitotic arrest and after mitotic slippage. Finally, we discuss pre-clinical data combining anti-mitotic agents with BCL2 inhibitors. PMID:23060542
Glebova, Tatiana; Foster, Sharon L.; Cunningham, Phillippe B.; Brennan, Patricia A.; Whitmore, Elizabeth
This study reports on the development and psychometric properties of a new measure assessing therapist comfort in the home treatment context, and the relationship between therapist comfort, related process variables, and therapist characteristics. Data were drawn from a longitudinal evaluation of 185 families treated by 51 therapists using Multisystemic Therapy (MST). Therapist comfort was measured at four time points. Psychometric evaluation indicated that the measure was internally and temporally consistent. Examination of the measure’s validity indicated that therapists’ feelings of safety and comfort during the provision of home-based treatment were associated with family neighborhood characteristics and family socioeconomic factors. Furthermore, the therapist’s reported level of alliance (as measured by the Emotional Bonding subscale of the Working Alliance Inventory) was related to her/his feeling of comfort. Analyses also indicated that therapists with greater belief in the clinical utility of the MST model felt more comfortable when delivering MST. Together the results suggest that economically disadvantaged families treated in home and community settings may be most at risk for erosions in the therapeutic relationship over time as a function of lower therapist comfort. Because therapist comfort was associated with therapeutic alliance - a factor found to be associated with clinical outcomes across studies and treatment models - findings imply that psychotherapists should regularly examine their own level of comfort, especially when providing services in non-traditional settings, and that therapist comfort should be routinely assessed as part of clinical supervision and training. PMID:22181024
Background US-based trials have shown that Multidimensional Family Therapy (MDFT) not only reduces substance abuse among adolescents, but also decreases mental and behavioural disorder symptoms, most notably externalising symptoms. In the INCANT trial, MDFT decreased the rate of cannabis dependence among Western European youth. We now focus on other INCANT outcomes, i.e., lessening of co-morbidity symptoms and improvement of family functioning. Methods INCANT was a randomised controlled trial comparing MDFT with individual therapy (IP) at and across sites in Berlin, Brussels, Geneva, The Hague, and Paris. We recruited 450 boys and girls aged 13 up to 18 years with a cannabis use disorder, and their parent(s), and followed them for 12 months. Mental and behavioural characteristics (classified as 'externalising’ or 'internalising’) and family conflict and cohesion were assessed. Results From intake through 12 months, MDFT and IP groups improved on all outcome measures. Models including treatment, site, and referral source showed that MDFT outperformed IP in reducing externalising symptoms. Adolescents were either self-referred to treatment (mostly on the initiative from people close to the teen) or referred under some measure of coercion by an external authority. These two groups reacted equally well to treatment. Conclusions Both MDFT and IP reduced the rate of externalising and internalising symptoms and improved family functioning among adolescents with a cannabis use disorder. MDFT outperformed IP in decreasing the rate of externalising symptoms. Contrary to common beliefs among therapists in parts of Western Europe, the 'coerced’ adolescents did at least as well in treatment as the self-referred adolescents. MDFT shows promise as a treatment for both substance use disorders and externalising symptoms. Trial registration ISRNCT: ISRCTN51014277 PMID:24485347
Leslie, Leigh A.
Reviews similarities in criticism of the treatment of women, minorities, and homosexuals by marital and family therapists. Examines the impact these critiques have had on the field and explores areas in which work is still needed. Contains 132 references. (JBJ)
McGeorge, Christi R; Carlson, Thomas Stone; Toomey, Russell B
The majority of the literature on conversion therapy has focused on clients' experiences and rationales for seeking such therapy. This study sought to explore differences in the beliefs and clinical competence of therapists who practice and believe in the ethics of conversion therapy and those who do not. The sample for this study included 762 family therapists who were members of the American Association of Marriage and Family Therapy. Data were collected using electronic surveys that assessed participants' negative beliefs about and perceived clinical competence with lesbian, gay, and bisexual (LGB) individuals. Results indicate that those who believe in the ethics of and/or practice conversion therapy report statistically higher levels of negative beliefs about LGB individuals and lower levels of clinical competence working with LGB clients. Implications for clinical practice and organizational policy are discussed. PMID:24750074
Henderson, Craig E.; Rowe, Cindy L.; Dakof, Gayle A.; Hawes, Sam W.; Liddle, Howard A.
Background Contemporary intervention models use research about the determinants of adolescent problems and their course of symptom development to design targeted interventions. Because developmental detours begin frequently during early-mid adolescence, specialized interventions that target known risk and protective factors in this period are needed. Methods This study (n = 83) examined parenting practices as mediators of treatment effects in an early-intervention trial comparing Multidimensional Family Therapy (MDFT), and a peer group intervention. Participants were clinically referred, low-income, predominantly ethnic minority adolescents (average age 14). Assessments were conducted at intake, and six weeks after intake, discharge, and at 6 and 12 months following intake. Results Previous studies demonstrated that MDFT was more effective than active treatments as well as services as usual in decreasing substance use and improving abstinence rates. The current study demonstrated that MDFT improves parental monitoring—a fundamental treatment target—to a greater extent than group therapy, and these improvements occur during the period of active intervention, satisfying state-of-the-science criteria for assessing mediation in randomized clinical trials. Conclusions and Scientific Significance Findings indicate that change in MDFT occurs through improvements in parenting practices. These results set the foundation for examining family factors as mediators in other samples. PMID:20180674
Kim, Elena Young-Kyong; Bean, Roy A; Harper, James M
To serve Korean American families effectively, marriage and family therapists need to develop a level of cultural competence. This content analysis of the relevant treatment literature was conducted to discover the most common expert recommendations for family therapy with Asian Americans and to examine their application to Korean Americans. Eleven specific guidelines were generated: Assess support systems, assess immigration history establish professional credibility, provide role induction, facilitate "saving face," accept somatic complaints, be present/problem focused, be directive, respect family structure, be nonconfrontational, and provide positive reframes. Empirical support (clinical and nonclinical research) and conceptual support for each guideline are discussed, and conclusions are reached regarding culturally competent therapy with Korean American families. PMID:15293653
Karakurt, Gunnur; Silver, Kristin E.
The aim of this paper is to understand the effects of childhood sexual abuse on a survivor’s later life. For understanding and treating the emotional distress and interpersonal problems resulting from childhood sexual abuse, attachment theory provides a valuable framework. When this framework is combined with family systems theory, it can help therapists understand the family context where sexual abuse occurs and how this affects health and functioning throughout the lifespan. Case examples of female adult sexual abuse survivors are also explored, with insight from the intersection of systems and attachment theories. PMID:24443623
Solomon, Marjorie; Ono, Michele; Timmer, Susan; Goodlin-Jones, Beth
We report the results of a pilot trial of an evidence-based treatment--Parent-Child Interaction Therapy (PCIT; Eyberg et al. "Psychopharmacology Bulletin", 31(1), 83-91, 1995) for boys aged 5-12 with high functioning autism spectrum disorders and clinically significant behavioral problems. The study also included an investigation of the role of…
King, Gillian; Tam, Cynthia; Fay, Linda; Pilkington, Martha; Servais, Michelle; Petrosian, Hasmik
There is growing interest in understanding the usefulness of mentorship programs for children's rehabilitation service providers. This evaluation study examined the effects of an occupational therapy mentorship program on the skills and behaviors of 8 new and 17 experienced occupational therapists practicing at a regional children's rehabilitation…
Kast, Karin; Rhiem, Kerstin
Summary The introduction of an increasing number of individualized molecular targeted therapies into clinical routine mirrors their importance in modern cancer prevention and treatment. Well-known examples for targeted agents are the monoclonal antibody trastuzumab and the selective estrogen receptor modulator tamoxifen. The identification of an unaltered gene in tumor tissue in colon cancer (KRAS) is a predictor for the patient's response to targeted therapy with a monoclonal antibody (cetuximab). Targeted therapy for hereditary breast and ovarian cancer has become a reality with the approval of olaparib for platin-sensitive late relapsed BRCA-associated ovarian cancer in December 2014. This manuscript reviews the status quo of poly-ADP-ribose polymerase inhibitors (PARPi) in the therapy of breast and ovarian cancer as well as the struggle for carboplatin as a potential standard of care for triple-negative and, in particular, BRCA-associated breast cancer. Details of the mechanism of action with information on tumor development are provided, and an outlook for further relevant research is given. The efficacy of agents against molecular targets together with the identification of an increasing number of cancer-associated genes will open the floodgates to a new era of treatment decision-making based on molecular tumor profiles. Current clinical trials involving patients with BRCA-associated cancer explore the efficacy of the molecular targeted therapeutics platinum and PARPi. PMID:25960722
East, C.; Grundy, S.M.; Bilheimer, D.W.
Patients with homozygous familial hypercholesterolemia produce no normal low-density lipoprotein (LDL) receptors, and as a result, LDL accumulates in plasma, causing severe premature atherosclerosis. Two years ago, liver transplantation was performed in a child with homozygous familial hypercholesterolemia, restoring LDL receptor activity to about 60% of normal and reducing the LDL cholesterol level by 81%. However, the patient's lipoprotein levels remained significantly elevated for her age and sex. Treatment with lovastatin (mevinolin) one year after transplantation produced a marked improvement in the patient's lipoprotein profile. The total and LDL cholesterol levels fell 40% and 49%, respectively, to values within the normal range. The level of very low-density lipoprotein cholesterol fell 41%, and the level of total triglycerides declined 28%. While lovastatin therapy decreased the production rate of LDL by 35%, it did not affect the LDL fractional clearance rate. Thus, the combination of liver transplantation and lovastatin restored total and LDL cholesterol levels to normal in this patient with homozygous familial hypercholesterolemia.
Eisdorfer, Carl; Czaja, Sara J.; Loewenstein, David A.; Rubert, Mark P.; Arguelles, Soledad; Mitrani, Victoria B.; Szapocznik, Jose
Purpose: The majority of persons with Alzheimer's disease (AD) are cared for at home by a family member such as a spouse or daughter. Caregiving places enormous demands on these caregivers, and the negative consequences associated with caregiving are well documented. This paper reports results from the Miami site of the REACH (Resources for…
Delbridge, A R D; Strasser, A
Escape from apoptosis is a key attribute of tumour cells and facilitates chemo-resistance. The ‘BCL-2-regulated' or ‘intrinsic' apoptotic pathway integrates stress and survival signalling to govern whether a cancer cell will live or die. Indeed, many pro-apoptotic members of the BCL-2 family have demonstrated tumour-suppression activity in mouse models of cancer and are lost or repressed in certain human cancers. Conversely, overexpression of pro-survival BCL-2 family members promotes tumorigenesis in humans and in mouse models. Many of the drugs currently used in the clinic mediate their therapeutic effects (at least in part) through the activation of the BCL-2-regulated apoptotic pathway. However, initiators of this apoptotic pathway, such as p53, are mutated, lost or silenced in many human cancers rendering them refractory to treatment. To counter such resistance mechanisms, a novel class of therapeutics, ‘BH3-mimetics', has been developed. These drugs directly activate apoptosis by binding and inhibiting select antiapoptotic BCL-2 family members and thereby bypass the requirement for upstream initiators, such as p53. In this review, we discuss the role of the BCL-2 protein family in the development and treatment of cancer, with an emphasis on mechanistic studies using well-established mouse models of cancer, before describing the development and already recognised potential of the BH3-mimetic compounds. PMID:25952548
Cain, Harry I.; Harkness, Jennifer L.; Smith, Angela L.; Markowski, Edward Mel
Family therapists are expected to engage in ethical and responsible research, while maintaining rigorous ethical standards and adhering to federal regulations that require protection for research participants. We present a short historical overview of the significant events and ethical controversies leading to the formulation of current…
Paul, Norman L.; Paul, Betty Byfield
This article describes part of the process of using different experiential and therapeutic settings for patients. The authors review how they have used the Erhard Seminar Training (EST) program to compliment a family-focussed treatment program and destigmatize a patient. (Author)
Palazzoli, Mara Selvini; And Others
Presents a therapeutic tactic called ritualized prescription which is specifically aimed at breaking up those behaviors through which each parent disqualifies and sabotages the initiatives and directions of the other parent in his relation with the children. With families following the prescription, fast and satisfying changes are observed.…
Lock, James; le Grange, Daniel; Forsberg, Sarah; Hewell, Kristen
Objective: Research suggests that family-based treatment (FBT) is an effective treatment for adolescents with anorexia nervosa (AN). This retrospective case series was designed to examine its usefulness with younger children. Method: Data were abstracted from medical records of 32 children with a mean age of 11.9 years (range 9.0-12.9) meeting…
Sayers, S. L.
There is compelling evidence that mental health problems complicate the process of family reintegration of military service members after a wartime deployment. Couples in which one spouse has recently returned from military deployment in Iraq or Afghanistan and are experiencing marital problems can present a significant treatment challenge. There…
Sowders, John Patrick
The current literature available seeking to describe the influence of mental health professions on family life is minimal. An exhaustive review of empirical research revealed that sixteen articles are present with the majority of the focus on distinct mental health professions outside of MFT such as psychiatry, social work and psychology. Two of…
Tilsen, Julie; Nylund, David
Therapists recognize that popular media culture is an influential force that shapes identities and relationships in contemporary society. Indeed, people have serious relationships with the commodities and practices that emerge from pop culture. However, they often lack the conceptual and conversational resources to engage meaningfully with clients about pop culture's influence in their lives. Cultural studies is introduced as an interdisciplinary approach that provides frameworks for both theory and practice that position therapists and clients to critically examine the role of pop culture in their lives. Cultural studies and narrative therapy are discussed as praxis allies that share a populist political intention and counter-hegemonic discursive practices. The integration of cultural studies methodologies into narrative therapy practice with a parent and her teenage daughter is illustrated through a case vignette. PMID:26879558
Weinstein, Sally M.; Henry, David; Katz, Andrea; Peters, Amy T.; West, Amy E.
Objective Prior work has demonstrated the efficacy of child-and family-focused cognitive-behavioral therapy (CFF-CBT) versus enhanced treatment as usual (TAU; unstructured psychotherapy) for pediatric bipolar disorder (PBD). The current study builds on primary findings by examining baseline child, parent, and family characteristics as moderators of symptom response trajectories. Method Sixty-nine youth ages 7–13 (M = 9.19, SD = 1.61) with DSM-IV-TR bipolar I, II, or not otherwise specified (NOS) were randomly assigned, with family members, to CFF-CBT or TAU. Both treatments consisted of 12 weekly sessions and 6 monthly booster sessions. Participants were assessed at baseline, 4, 8, and 12 weeks, and 6-month follow-up on mania and depression symptoms and overall psychiatric severity. Parents and youth also provided self-report data on baseline characteristics. Results CFF-CBT demonstrated greater efficacy for youth depressive symptoms relative to TAU for parents with higher baseline depressive symptoms and lower income, and marginally for families with higher cohesion. In addition, youth with lower baseline depression and youth with higher self-esteem showed a poorer response to TAU versus CFF-CBT on mania symptom outcomes. Age, sex, baseline mania symptoms, comorbidity, and suicidality did not moderate treatment response. Conclusion Results indicate that CFF-CBT was relatively immune to the presence of treatment moderators. Findings suggest the need for specialized treatment to address symptoms of PBD in the context of parental symptomatology and financial stress. PMID:25617252
Inman, Arpana G; Meza, Marisol M; Brown, Andraé L; Hargrove, ron K
Although the marriage and family therapy field's recent attention to multicultural issues is laudable, there appears to be little clarity on what constitutes an effective multicultural training program and the impact of the effects of such training on trainee multicultural competence. The field continues to be challenged at different levels-training, practice, research, the setting of the standards and the work of the Commission on Accreditation for Marriage and Family Therapy Education, and the goals and strategic plan of the American Association for Marriage and Family Therapy Board. This study focused on assessing the extent of multicultural integration at different levels of training and the relationship between such training and students' perception of their own multicultural competence. PMID:15293654
Gottlieb, Jennifer D; Mueser, Kim T; Glynn, Shirley M
People with schizophrenia have a high prevalence of co-occurring substance use disorders, which is related to a worse course of psychiatric illness, more frequent relapses, and increased depression and suicide, compared with those with schizophrenia alone. The Family Intervention for Dual Diagnosis (FIDD) program, which includes psychoeducation and goal setting and focuses on building communication and problem-solving skills within the family, can aid in decreasing the stress related to having a close relationship with someone with a dual disorder. Here, the case of a young man with psychosis and marijuana dependence is examined. This article describes how the FIDD intervention helped him with his problematic substance use, as well as to build skills within his relationship for increased empathy and reduced interpersonal stress. PMID:22498950
Tomasso, A; Casari, G; Maga, G
Nature has evolved DNA polymerases (Pols) with different replication fidelity with the purpose of maintaining and faithfully propagating the genetic information. Besides the four classical Pols (Pol α, δ, ε, γ), mammalian cells contain at least twelve specialized Pols whose functions have been discovered recently and are still not completely elucidated. Among them, Pols belonging to the Y family contribute to cell survival by promoting DNA damage tolerance. They are primarily involved in the translesion synthesis (TLS) pathway, incorporating dNTPs in an error-free or error-prone manner, depending on the nature of the DNA lesion. From an evolutionary point of view, their high mutagenic potential seems to guarantee the proper flexibility of vital importance for both adaptation to a changeable environment and evolution of the species. These Pols are subjected to a complex network of regulation, since their uncontrolled access to DNA might promote mutagenesis and neoplastic transformation. Altered expression of Y family is a hallmark of several tumor types. In recent years, the unique structure and properties of Y family Pols have been exploited to design molecules that selectively interfere with the Pol of interest with minimal effect on normal cells. In addition, their distinctive properties have been applied to innovative techniques, such as compartmentalized self-replication (CSR), short-patch CSR, phage display and molecular breeding. These approaches are based on mutant Pols provided with novel and ameliorated features and find applications in various fields, from biotechnology to diagnostics, paleontology and forensic analysis. PMID:24160487
Miller, John K; Todahl, Jeff; Platt, Jason J; Lambert-Shute, Jennifer; Eppler, Christie S
A key component of a doctoral education in marriage and family therapy (MFT) is the completion of an internship. Virtually all MFT doctoral internships are focused on advanced clinical practice and often are located in agencies unconnected with an academic setting. This article describes an MFT doctoral internship specifically designed to foster the skills needed as a faculty member. The primary purpose of this "future faculty" internship is to expose doctoral interns to faculty life, including participation in graduate teaching, clinical supervision, research, and faculty service-while still meeting typical clinical requirements. Results of semistructured qualitative interviews with five doctoral interns associated with the site are reported. Guidelines for the development of other doctoral internships designed for future MFT faculty members are discussed. PMID:20074125
Romero, Valerie; Allen, Daniel N.
Although child neglect and substance abuse co-occur in greater than 60% of child protective service cases, intervention outcome studies are deplorably lacking. Therefore, a home-based Family Behavior Therapy is described in the treatment of a woman evidencing child neglect, substance dependence, domestic violence and other co-occurring problems. Treatment included contingency management, self control, stimulus control, communication and child management skills training exercises, and financial management components. Results indicated improvements in child abuse potential, home hazards, domestic violence, and drug use, which were substantiated by objective urinalysis testing, and tours of her home. Validity checks indicated the participant was being truthful in her responses to standardized questionnaires, and assessors were “blind” to study intent. Limitations (i.e., lack of experimental control and follow-up data collection) of this case example are discussed in light of these results. PMID:23226920
Anderson, Leslie K; Murray, Stuart B; Ramirez, Ana L; Rockwell, Roxanne; Le Grange, Daniel; Kaye, Walter H
Dialectical behavior therapy (DBT) and family-based treatment (FBT) are two evidence-based interventions that have been applied in the treatment of bulimia nervosa (BN) in adolescents. While DBT focuses on providing skills for coping with emotion dysregulation that often co-occurs with BN, FBT targets the normalization of eating patterns. The purpose of the current article is to introduce an integration of both treatments to provide a more comprehensive approach that targets the full scope of the disorder. We provide a review of the conceptual similarities and differences between FBT-BN and DBT along with strategies to guide a blended treatment approach. Given the strengths and limitations of either independent treatment, DBT and FBT-BN complement one another and together can address the range of symptoms and behaviors typically seen in adolescent BN. PMID:26009868
Goldsmith, Kelly C; Gross, Michelle; Peirce, Susan; Luyindula, Dema; Liu, Xueyuan; Vu, Annette; Sliozberg, Michael; Guo, Rong; Zhao, Huaqing; Reynolds, C Patrick; Hogarty, Michael D
Neuroblastoma is a childhood tumor in which transient therapeutic responses are typically followed by recurrence with lethal chemoresistant disease. In this study, we characterized the apoptotic responses in diverse neuroblastomas using an unbiased mitochondrial functional assay. We defined the apoptotic set point of neuroblastomas using responses to distinct BH3 death domains providing a BH3 response profile and directly confirmed survival dependencies. We found that viable neuroblastoma cells and primary tumors are primed for death with tonic sequestration of Bim, a direct activator of apoptosis, by either Bcl-2 or Mcl-1, providing a survival dependency that predicts the activity of Bcl-2 antagonists. The Bcl-2/Bcl-xL/Bcl-w inhibitor ABT-737 showed single-agent activity against only Bim:Bcl-2 primed tumor xenografts. Durable complete regressions were achieved in combination with noncurative chemotherapy even for highest risk molecular subtypes with MYCN amplification and activating ALK mutations. Furthermore, the use of unique isogenic cell lines from patients at diagnosis and at the time of relapse showed that therapy resistance was not mediated by upregulation of Bcl-2 homologues or loss of Bim priming, but by repressed Bak/Bax activation. Together, our findings provide a classification system that identifies tumors with clinical responses to Bcl-2 antagonists, defines Mcl-1 as the principal mediator of Bcl-2 antagonist resistance at diagnosis, and isolates the therapy resistant phenotype to the mitochondria. PMID:22589275
Goldsmith, Kelly C.; Gross, Michelle; Peirce, Susan; Luyindula, Dema; Liu, Xueyuan; Vu, Annette; Sliozberg, Michael; Guo, Rong; Zhao, Huaqing; Reynolds, C. Patrick; Hogarty, Michael D.
Neuroblastoma is a childhood tumor in which transient therapeutic responses are typically followed by recurrence with lethal chemoresistant disease. In this study, we characterized the apoptotic responses in diverse neuroblastomas using an unbiased mitochondrial functional assay. We defined the apoptotic set-point of neuroblastomas using responses to distinct BH3 death domains providing a BH3 response profile, and directly confirmed survival dependencies. We found that viable neuroblastoma cells and primary tumors are primed for death with tonic sequestration of Bim, a direct activator of apoptosis, by either Bcl-2 or Mcl-1, providing a survival dependency that predicts the activity of Bcl-2 antagonists. The Bcl-2/Bcl-xL/Bcl-w inhibitor ABT-737 showed single agent activity against only Bim:Bcl-2 primed tumor xenografts. Durable complete regressions were achieved in combination with non-curative chemotherapy even for highest-risk molecular subtypes with MYCN amplification and activating ALK mutations. Furthermore, the use of unique isogenic cell lines from patients at diagnosis and at the time of relapse showed that therapy resistance was not mediated by upregulation of Bcl-2 homologues or loss of Bim priming, but by repressed Bak/Bax activation. Together, our findings provide a classification system that identifies tumors with clinical responses to Bcl-2 antagonists, defines Mcl-1 as the principal mediator of Bcl-2 antagonist resistance at diagnosis, and isolates the therapy resistant phenotype to the mitochondria. PMID:22589275
Marhefka, Stephanie L; Koenig, Linda J; Allison, Susannah; Bachanas, Pamela; Bulterys, Marc; Bettica, Linda; Tepper, Vicki J; Abrams, Elaine J
This study examines the relationship between adherence to pediatric HIV regimens and three family experience factors: (1) regimen responsibility; (2) barriers to adherence; and (3) strategies for remembering to give medications. Caregivers of 127 children ages 2-15 years in the PACTS-HOPE multisite study were interviewed. Seventy-six percent of caregivers reported that their children were adherent (taking > or = 90% of prescribed doses within the prior 6 months). Most caregivers reported taking primary responsibility for medication-related activities (72%-95% across activities); caregivers with primary responsibility for calling to obtain refills (95%) were more likely to have adherent children. More than half of caregivers reported experiencing one or more adherence barriers (59%). Caregivers who reported more barriers were also more likely to report having non-adherent children. Individual barriers associated with nonadherence included forgetting, changes in routine, being too busy, and child refusal. Most reported using one or more memory strategies (86%). Strategy use was not associated with adherence. Using more strategies was associated with a greater likelihood of reporting that forgetting was a barrier. For some families with adherence-related organizational or motivational difficulties, using numerous memory strategies may be insufficient for mastering adherence. More intensive interventions, such as home-based nurse-administered dosing, may be necessary. PMID:18627275
Jones, Andrea M.; Shealy, Kristen M.; Reid-Quiñones, Kathryn; Moreland, Angela D.; Davidson, Tatiana M.; López, Cristina M.; Barr, Simone C.; de Arellano, Michael A.
While similar rates of traumatic experiences exist in both rural and urban settings, mental health resources available to those living in rural areas are often scarce. Limited resources pose a problem for children and families living in rural areas, and several barriers to service access and utilization exist including reduced anonymity, few “after-hours” services, decreased availability of evidence-based treatments, few specialty clinics, and expenses associated with travel, taking time off work, and provision of childcare. As a solution, the authors discuss the utility, use, and set-up of a telemental health program through an existing community outreach program. Suggestions for establishing a telemental health clinic are presented along guidelines for the delivery of trauma-focused, cognitive-behavioral therapy (TF-CBT) via telemental health videoconferencing technology. Specific guidelines discussed include (1) establishing and utilizing community partnerships, (2) Memoranda of Understanding (MOU), (3) equipment setup and technological resources, (4) videoconferencing software, (5) physical setup, (6) clinic administration, (7) service reimbursement and start-up costs, (8) therapy delivery modifications, and (9) delivering culturally competent services to rural and remote areas. PMID:24320994
West, Amy E.; Weinstein, Sally M.; Peters, Amy T.; Katz, Andrea; Henry, David; Cruz, Rick; Pavuluri, Mani
Objective Previous studies have found that family-based psychosocial treatments are effective adjuncts to pharmacotherapy among adults and adolescents with bipolar disorder (BD). The objective of this study was to compare the efficacy of adjunctive Child- and Family-Focused Cognitive Behavioral Therapy (CFF-CBT) to psychotherapy as usual (control) for mood symptom severity and global functioning in children with BD. Method Sixty-nine youth, aged 7–13 (M = 9.19, SD = 1.61) with DSM-IV-TR bipolar I, II, or not otherwise specified (NOS) disorder were randomly assigned to CFF-CBT or control groups. Both treatments consisted of 12 weekly sessions followed by 6 monthly booster sessions delivered over a total of 9 months. Independent evaluators assessed participants at baseline, week 4, week 8, week 12 (posttreatment), and week 39 (6-month follow-up). Results Participants in CFF-CBT attended more sessions, were less likely to drop out, and reported greater satisfaction with treatment than controls. CFF-CBT demonstrated efficacy compared to the control in reducing parent-reported mania at posttreatment and depression symptoms at posttreatment and follow-up. Global functioning did not differ at posttreatment but was higher among CFF-CBT participants at follow-up. Conclusion CFF-CBT may be efficacious in reducing acute mood symptoms and improving long-term psychosocial functioning among children with BD. PMID:25440307
Sosa, Ivan; Culina, Kata; Bosnar, Alan
For quite some time, glaucoma has been regarded as more than just intraocular pressure [IOP] elevation. Significant contribution to this conceptual improvement has risen from a better understanding of ocular blood flow, vessel wall integrity and certain advanced ideas in neuroophthalmology, for example neuroprotection. Transforming growth factor–β (TGF-β) molecule, its inhibitors and antagonists have been increasingly researched as possible new anti-glaucoma drugs for its many, pleiotropic, effects. Among those effects, enhancing fibrosis is one of the most apparent, but certain members of this cytokine’s superfamily act as anti-fibrotics. Recent scientific efforts strongly support pushing back the frontier of conventional medical treatment. Current medical approaches already use effects on blood flow and neuronal quiescence, with significant systemic side-effects. Endeavours on the ophthalmologic exploitation of selected, favourable effects of pleiotropic TGF-βs could promote TGF-β, its inhibitors or specific antibodies as new, ideal drugs in glaucoma therapy. PMID:24600624
Han, Doug Hyun; Kim, Sun Mi; Lee, Young Sik; Renshaw, Perry F.
We evaluated whether a brief 3-week family therapy intervention would change patterns of brain activation in response to affection and gaming cues in adolescents from dysfunctional families who met criteria for on-line game addiction. Fifteen adolescents with on-line game addiction and fifteen adolescents without problematic on-line game play and an intact family structure were recruited. Over 3 weeks, families were asked to carry out homework assignments focused on increasing family cohesion for more than 1 hour/day and 4 days/week. Before therapy, adolescents with on-line game addiction demonstrated decreased activity as measured by functional magnetic resonance imaging (fMRI) within the caudate, middle temporal gyrus, and occipital lobe in response to images depicting parental affection and increased activity of the middle frontal and inferior parietal in response scenes from on-line games, relative to healthy comparison subjects. Improvement in perceived family cohesion following 3 weeks of treatment was associated with an increase in the activity of the caudate nucleus in response to affection stimuli and was inversely correlated with changes in on-line game playing time. With evidence of brain activation changes in response to on-line game playing cues and images depicting parental love, the present findings suggest that family cohesion may be an important factor in the treatment of problematic on-line game playing. PMID:22698763
Storch, Eric A.; Lehmkuhl, Heather D.; Ricketts, Emily; Geffken, Gary R.; Marien, Wendi; Murphy, Tanya K.
This study reports an open-trial of family-based cognitive-behavioral therapy (CBT) in children and adolescents with obsessive-compulsive disorder (OCD). Thirty primarily Caucasian youth with OCD (range = 7-19 years; 15 girls) who were partial responders or nonresponders to two or more medication trials that were delivered either serially or…
Carrasco, Jennifer M.; Fox, Robert A.
This study addressed the question of whether increasing the intensity of a parent and child therapy program would improve results for young children with significant behavior problems from families living in poverty. Children were randomly assigned to either a standard condition or an intensity condition that provided 50% more treatment over a…
Hartwell, Erica E.; Serovich, Julianne M.; Grafsky, Erika L.; Kerr, Zachary Y.
The present study seeks to extend previous research regarding literature related to gay, lesbian, and bisexual (GLB) issues published in couple and family therapy (CFT)-related journals by presenting the results from a content analysis of GLB studies in CFT-related journals from 1996 to 2010. Results of the analysis revealed a 238.8% increase in…
Carlson, Glenys; Armitstead, Clare; Rodger, Sylvia; Liddle, Gwen
Background: In recent years, community based therapy service providers have explored different service delivery models to optimize child and family outcomes. This qualitative study aimed to explore parents' experiences of one particular service team that adopted a strengths approach, utilizing natural learning environments. Materials and methods:…
Shpigel, Maya S.; Diamond, Gary M.; Diamond, Guy S.
This study examined whether Attachment-Based Family Therapy (ABFT) was associated with decreases in maternal psychological control and increases in maternal psychological autonomy granting, and whether such changes were associated with changes in adolescents' attachment schema and psychological symptoms. Eighteen suicidal adolescents and their…
Kolko, David J.; Iselin, Anne-Marie R.; Gully, Kevin J.
This paper examines the sustainability and outcome of Alternatives for Families: A Cognitive-Behavioral Therapy (AF-CBT) as delivered by practitioners in a community-based child protection program who had received training in the model several years earlier. Formerly described as Abuse-Focused CBT, AF-CBT is an evidence-based treatment (EBT) for…
Bond, C.; Woods, K.; Humphrey, N.; Symes, W.; Green, L.
Responsive services--in the form of individual, group, and family interventions--are a core component of the work of many school counselors. Solution focused brief therapy (SFBT), also called solution focused counseling (SFC), is increasingly used in schools due to its flexibility, brevity, and efficacy. Having a theoretically sound, effective,…
Blumer, Markie L. C.; Green, Mary S.; Knowles, Sarah J.; Williams, April
What is the extent to which marriage/couple and family therapy (M/CFT) journals address transgender issues and how many of them say they are inclusive of transgender persons when they are not? To answer these queries, a content analysis was conducted on articles published in M/CFT literature from 1997 through 2009. Of the 10,739 articles examined…
De Haene, Lucia; Rober, Peter; Adriaenssens, Peter; Verschueren, Karine
In this article, we reflect on our evolving ideas regarding a dialogical approach to refugee care. Broadening the predominant phased trauma care model and its engaging of directive expertise in symptom reduction, meaning making, and rebuilding connectedness, these developing dialogical notions involve the negotiation of silencing and disclosure, meaning and absurdity, hope and hopelessness in a therapeutic dialogue that accepts its encounter of cultural and social difference. In locating therapeutic practice within these divergent approaches, we argue an orientation on collaborative dialogue may operate together with notions from the phased trauma care model as heuristic background in engaging a polyphonic understanding of coping with individual and family sequelae of forced displacement. This locating of therapeutic practice, as informed by each perspective, invites us to remain present to fragments of therapeutic positioning that resonate power imbalance or appropriation in a therapeutic encounter imbued with a social context that silences refugees' suffering. In a clinical case analysis, we further explore these relational complexities of negotiating directive expertise and collaborative dialogue in the therapeutic encounter with refugee clients. PMID:22984976
Patient-focused research points to the necessity of continuously monitoring process and outcome in psychotherapy to supply service users and their therapists with feedback as a way of avoiding no change and detrimental development. At the Department of Child and Adolescent Mental Health, therapists implement monitoring in an intensive family therapy unit inspired by postmodern and language-oriented forms of family therapy using the Session Rating Scale and the Outcome Rating Scale. Research generated descriptions of users' experiences of these scales as conversational tools are reflected upon using concepts from the work of Vygotsky and Bakhtin. Mediation, dialogicality, voice, the zone of proximal development and the metaphor of scaffolding are offered as conceptualizations that expand the inspirational sources of the unit by creating and enhancing further possibilities for collaboration between families and their therapists. PMID:19914938
Romero, Valerie; Donohue, Brad C.; Hill, Heather H.; Powell, Suzanne; Van Hasselt, Vincent B.; Azrin, Nathan; Allen, Daniel N.
The results of a multiple-baseline case study of family behavior therapy (FBT) is described in a woman formally diagnosed with alcohol dependence, bipolar disorder, generalized anxiety disorder, specific phobia, and panic disorder. She was referred to treatment from the local Department of Family Services for child neglect and domestic violence. After baseline measures were administered, the first phase of treatment involved home safety tours aimed at reducing home hazards and cleanliness. A second phase of treatment additionally targeted family relationships through communication skills training exercises, and a third phase involved administration of the remaining FBT components to assist in comprehensively addressing other problem areas. Results indicated most problem areas were substantially improved, but only after they were comprehensively targeted in therapy. PMID:23136557
Charlés, Laurie L; Moebus, Paula; Beechinor, Lisa; Pearce, Tyler; Putney, Heather
This article describes a qualitative research methods training project undertaken in a COAMFTE-accredited family therapy master's-level program. Graduate students were trained to collect research data for a qualitative study on the resilience of families displaced to the United States because of war and politically motivated violence in their country of origin. By involving trainees in a research project with refugees, the project was intended to address a gap in clinicians' training, specific to the refugee population (Miller, Muzurovic, Worthington, Tipping, and Goldman, American Journal of Orthopsychiatry 2002; 72: 341). However, the training process was also a way to increase the students' skills at interviewing in complex situations, develop their cultural sensitivity beyond awareness, enhance their capacity for routine self-reflection, and introduce them to basic practices of qualitative research methodology. In this article, we focus on the students' experience of the training and discuss the potential implications of their feedback for family therapy training. PMID:24749482
Duarté-Vélez, Yovanska; Bernal, Guillermo; Bonilla, Karen
The article described and illustrated how a culturally adapted cognitive-behavioral therapy (CBT) can maintain fidelity to a treatment protocol while allowing for considerable flexibility to address a patient's values, preferences, and context. A manual-based CBT was used with a gay Latino adolescent regarding his sexual identity, family values, and spiritual ideas. The adolescent suffered from a major depression disorder and identified himself as gay and Christian within a conservative and machista Puerto Rican family. CBT promoted personal acceptance and active questioning of homophobic thoughts in a climate of family respect. CBT enabled identity formation and integration, central to the development of a sexual identity for lesbian, gay, bisexual, and transgender youth, with remission of the patient's depression and better family outcomes. PMID:20568254
Cui, Guozhen; Shan, Luchen; Guo, Lin; Chu, Ivan Keung; Li, Guohui; Quan, Quan; Zhao, Yun; Chong, Cheong Meng; Zhang, Zaijun; Yu, Pei; Hoi, Maggie Pui Man; Sun, Yewei; Wang, Yuqiang; Lee, Simon MingYuen
Protein disulfide isomerase (PDI) family members including PDI and ERp57 emerge as novel targets for anti-thrombotic treatments, but chemical agents with selectivity remain to be explored. We previously reported a novel derivative of danshensu (DSS), known as ADTM, displayed strong cardioprotective effects against oxidative stress-induced cellular injury in vitro and acute myocardial infarct in vivo. Herein, using chemical proteomics approach, we identified ERp57 as a major target of ADTM. ADTM displayed potent inhibitory effects on the redox activity of ERp57, inhibited the adenosine diphosphate (ADP)-induced expressions of P-selectin and αIIbβ3 integrin, and disrupted the interaction between ERp57 and αIIbβ3. In addition, ADTM inhibited both arachidonic acid (AA)-induced and ADP-induced platelet aggregation in vitro. Furthermore, ADTM significantly inhibited rat platelet aggregation and thrombus formation in vivo. Taken together, ADTM represents a promising candidate for anti-thrombotic therapy targeting ERp57. PMID:26037049
Murray, Stuart B; Anderson, Leslie K; Cusack, Anne; Nakamura, Tiffany; Rockwell, Roxanne; Griffiths, Scott; Kaye, Walter H
Adolescent bulimia nervosa (BN) remains relatively understudied, and the complex interaction between core eating psychopathology and emotional regulation difficulties provides ongoing challenges for full symptom remission. In an open pilot trial, we aimed to investigate the efficacy of a program integrating family-based treatment (FBT) and dialectical behavior therapy (DBT) in treating adolescent BN, without exclusion criteria. Participants were 35 adolescents who underwent partial hospital treatment for BN, and outcomes included measures of core BN pathology and emotional regulation difficulties, as well as parental measures of self-efficacy, completed at intake and discharge. Results indicate significant improvements in overall eating disorder pathology, t(68) = 4.52, p = .002, and in core BN symptoms, including objective binge episodes, t(68) = 2.01, p = .041, and self-induced vomiting, t(68) = 2.90, p = .005. Results also illustrated a significant increase in parental efficacy throughout the course of treatment, t(20) = .081, p = .001, although no global improvement in difficulties in emotion regulation was noted, t(68) = 1.12, p = .285. These preliminary findings support the utility of this integration of FBT and DBT, although raise interesting questions as to the mechanism of symptom remission. PMID:26009971
O'Brien, Mary P; Miklowitz, David J; Cannon, Tyrone D
Perceived criticism (PC) is a measure of how much criticism from 1 family member "gets through" to another. PC ratings have been found to predict the course of psychotic disorders, but questions remain regarding whether psychosocial treatment can effectively decrease PC, and whether reductions in PC predict symptom improvement. In a sample of individuals at high risk for psychosis, we examined a) whether Family Focused Therapy for Clinical High-Risk (FFT-CHR), an 18-session intervention that consists of psychoeducation and training in communication and problem solving, brought about greater reductions in perceived maternal criticism, compared to a 3-session family psychoeducational intervention; and b) whether reductions in PC from baseline to 6-month reassessment predicted decreases in subthreshold positive symptoms of psychosis at 12-month follow-up. This study was conducted within a randomized controlled trial across 8 sites. The perceived criticism scale was completed by 90 families prior to treatment and by 41 families at 6-month reassessment. Evaluators, blind to treatment condition, rated subthreshold symptoms of psychosis at baseline, 6- and 12-month assessments. Perceived maternal criticism decreased from pre- to posttreatment for both treatment groups, and this change in criticism predicted decreases in subthreshold positive symptoms at 12-month follow-up. This study offers evidence that participation in structured family treatment is associated with improvement in perceptions of the family environment. Further, a brief measure of perceived criticism may be useful in predicting the future course of attenuated symptoms of psychosis for CHR youth. PMID:26168262
O’Brien, Mary P.; Miklowitz, David J.; Cannon, Tyrone D.
Perceived criticism (PC) is a measure of how much criticism from 1 family member “gets through” to another. PC ratings have been found to predict the course of psychotic disorders, but questions remain regarding whether psychosocial treatment can effectively decrease PC, and whether reductions in PC predict symptom improvement. In a sample of individuals at high risk for psychosis, we examined a) whether Family Focused Therapy for Clinical High-Risk (FFT-CHR), an 18-session intervention that consists of psychoeducation and training in communication and problem solving, brought about greater reductions in perceived maternal criticism, compared to a 3-session family psychoeducational intervention; and b) whether reductions in PC from baseline to 6-month reassessment predicted decreases in subthreshold positive symptoms of psychosis at 12-month follow-up. This study was conducted within a randomized controlled trial across 8 sites. The perceived criticism scale was completed by 90 families prior to treatment and by 41 families at 6-month reassessment. Evaluators, blind to treatment condition, rated subthreshold symptoms of psychosis at baseline, 6- and 12-month assessments. Perceived maternal criticism decreased from pre- to posttreatment for both treatment groups, and this change in criticism predicted decreases in subthreshold positive symptoms at 12-month follow-up. This study offers evidence that participation in structured family treatment is associated with improvement in perceptions of the family environment. Further, a brief measure of perceived criticism may be useful in predicting the future course of attenuated symptoms of psychosis for CHR youth. PMID:26168262
Hartwell, Erica E; Serovich, Julianne M; Grafsky, Erika L; Kerr, Zachary Y
The present study seeks to extend previous research regarding literature related to gay, lesbian, and bisexual (GLB) issues published in couple and family therapy (CFT)-related journals by presenting the results from a content analysis of GLB studies in CFT-related journals from 1996 to 2010. Results of the analysis revealed a 238.8% increase in total GLB content published since the original review. Articles pertaining to therapy with GLB clients continue to represent the largest area of publication. With one exception, all surveyed journals showed an increase in the percentage of GLB content since the first study. Emerging areas of research include studies related to supervision and training, GLB mental health and substance use, and sexual minority adolescents. A movement away from deficit-based perspectives could open a new lens on family life. PMID:22765336
Archambault, Richard; Mansfield, Abigail K; Evans, Doug; Keitner, Gabor I
This article describes the videoconferencing training of a group of family therapists in the McMaster Approach to evaluating and treating families. A discussion of the key tenets of the McMaster Approach lays the groundwork for how these tenets were applied to training in a residential treatment agency for adolescents. The article serves as an example of how videoconference technology can facilitate extended training, even from a distance. PMID:24593702
Agarwal, Rishi; Liebe, Sarah; Turski, Michelle L; Vidwans, Smruti J; Janku, Filip; Garrido-Laguna, Ignacio; Munoz, Javier; Schwab, Richard; Rodon, Jordi; Kurzrock, Razelle; Subbiah, Vivek
Cancer genetics has rapidly evolved in the last two decades. Understanding and exploring the several genetic pathways in the cancer cell is the foundation of targeted therapy. Several genomic aberrations have been identified and their role in carcinogenesis is being explored. In contrast to most cancers where these mutations are acquired, patients with hereditary cancer syndromes have inherited genomic aberrations. The understanding of the molecular pathobiology in hereditary cancer syndromes has advanced dramatically. In addition, many molecularly targeted therapies have been developed that could have potential roles in the treatment of patients with hereditary cancer syndromes. In this review, we outline the presentation, molecular biology, and possible targeted therapies for two of the most widely recognized hereditary cancer syndromes -- hereditary breast and ovarian cancer syndrome and hereditary non-polyposis colorectal cancer syndrome (Lynch syndrome). We will also discuss other syndromes such as familial adenomatous polyposis and Li-Fraumeni syndrome (TP53). PMID:25549704
Li, Rongying; Chao, Hsu; Ko, Kerry W.S.; Cormier, Shelley; Dieker, Carrie; Nour, Elie A.; Wang, Shining; Chan, Lawrence; Oka, Kazuhiro
A reduction in low density lipoprotein (LDL) cholesterol or an increase in high density lipoprotein (HDL) cholesterol can reduce the risk of development of atherosclerosis through overlapping or independent mechanisms. However, the clinical outcome of combined therapy remains in debate. In this study, we first characterized effects of various constructs of helper-dependent adenoviral vector (HDAd) expressing apolipoprotein E3 or LDL receptor (LDLR) in vivo on plasma cholesterol levels. Using this information, we designed experiments and compared the effects of long-term (28 weeks) LDL cholesterol lowering or raising HDL cholesterol, or a combination of both on advanced atherosclerosis in Ldlr−/− mice, a mouse model of familial hypercholesterolemia. Our major findings are: (i) various factors influence in vivo functional activity, which appear to be context dependent; (ii) apolipoprotein AI (APOAI) gene transfer, which raises HDL cholesterol, retards progression of atherosclerosis but does not induce regression; (iii) LDLR or LDLR and APOAI combination gene therapy induces lesion regression; however, LDLR gene transfer accounts for the majority of the effects of combined gene therapy; (iv) LDLR gene therapy reduces interleukin-7, which is a master regulator of T-cell homeostasis, but APOAI gene therapy does not. These results indicate that LDL cholesterol lowering is effective and sufficient in protection against atherosclerosis and induction of regression of pre-existing atherosclerosis. PMID:23106034
Potter, Beth K; Khangura, Sara D; Tingley, Kylie; Chakraborty, Pranesh; Little, Julian
There is a need for research to understand and improve health systems for rare diseases in order to ensure that new, efficacious therapies developed through basic and early translational science lead to real benefits for patients. Such research must (i) focus on appropriate patient-oriented outcomes, (ii) include robust study designs that can accommodate real-world decision priorities, and (iii) involve effective stakeholder-engagement strategies. For transformative therapies, study outcomes will need to shift toward longer-term goals in recognition of success in preventing catastrophic outcomes. For incremental therapies, outcomes should be selected in recognition of the impact of care on quality of life for patients and families. To generate new evidence, we suggest that hybrid study designs integrating elements of practice-based observational research and pragmatic trials hold the most promise for addressing priorities such as minimizing bias, accounting for cointerventions, identifying long-term impacts, and considering clinical heterogeneity. To effectively engage with stakeholders, a knowledge exchange infrastructure is needed to foster collaboration among patients with rare diseases and their families, health-care providers, researchers, and policy decision makers. A key priority for these groups must be collaboration toward a shared understanding of the outcomes that are of most relevance to the facilitation of patient-centered care. PMID:25856667
Background Cognitive-Behavioural Family Therapy (CBFT) can be an effective psychological approach for children with β-thalassaemia major, increasing compliance to treatment, lessening the emotional burden of disease, and improving the quality of life of caregivers. Design and methods Twenty-eight β-thalassaemic major children that followed CBFT for one year were compared with twenty-eight age-matched healthy children, focusing particularly on behavioural, mood, and temperamental characteristics as well as compliance with chelation, assessed using the Child Behaviour Checklist (CBCL), Children's Depression Inventory (CDI), Multidimensional Anxiety Scale for Children (MASC), and Emotionality, Activity, Sociability and Shyness Scale (EAS). We also monitored the quality of life of caregiving mothers using the World Health Organization Quality Of Life (WHOQOL-BREF) questionnaire. Data were analysed with non-parametric standard descriptive statistics. Results 90% of β-Thalassaemic children showed good compliance with chelation therapy; however they had significantly increased somatic complains, physical symptoms and separation panic. Moreover, temperamental assessment revealed high emotionality and poor sociability in treated thalassaemic children and in their mothers. Physical and psychological domains concerning individual's overall perception of quality of life resulted impaired in mothers of β-thalassaemic children. Conclusion CBFT can be a valid tool to increase the compliance with chelation therapy in β-thalassaemic children; however, treated children continue to show an important emotional burden; moreover, CBFT therapy seems not to have any positive impact on the quality of life of caregiving mothers, who may therefore need additional psychological support. PMID:19236719
Carvalho, Mariana Albernaz Pinheiro de; Dias, Maria Djair; Miranda, Francisco Arnoldo Nunes de; Ferreira Filha, Maria de Oliveira
The aim of this study was to analyze contributions by integrative community therapy to behavior changes in users of Psychosocial Care Centers (CAPS). This was a comprehensive-interpretative study with a qualitative approach, based on thematic oral history. The study site was the Caminhar Center in João Pessoa, Paraíba State, Brazil. The study material was produced with interviews conducted with six subjects and was discussed using thematic analysis as proposed by Minayo, providing the basis for two major thematic lines: integrative community therapy as a liberating praxis and changes that make the difference. The subjects' stories revealed significant changes in the personal, professional, and community fields, based on their inclusion in the integrative community therapy circles, a strategy that promoted the recovery of processes of natural socialization that constitute human life. The use of integrative community therapy was clearly related to proposals for the participants' psychosocial integration and rehabilitation. PMID:24127097
Grusch, M.; Petz, M.; Metzner, T.; Öztürk, D.; Schneller, D.; Mikulits, W.
Both RAS and transforming growth factor (TGF)-β signaling cascades are central in tumorigenesis and show synergisms depending on tumor stage and tissue context. In this review we focus on the interaction of RAS subeffector proteins with signaling components of the TGF-β family including those of TGF-βs, activins and bone morphogenic proteins. Compelling evidence indicates that RAS signaling is essentially involved in the switch from tumor-suppressive to tumor-promoting functions of the TGF-β family leading to enhanced cancer growth and metastatic dissemination of primary tumors. Thus, the interface of these signaling cascades is considered as a promising target for the development of novel cancer therapeutics. The current pharmacological anti-cancer concepts combating the molecular cooperation between RAS and TGF-β family signaling during carcinoma progression are critically discussed. PMID:20718708
Galanter, Rachel; Self-Brown, Shannon; Valente, Jessica R.; Dorsey, Shannon; Whitaker, Daniel J.; Bertuglia-Haley, Michelle; Prieto, Metta
An evaluation was conducted for 83 parent-child dyads who participated in parent-child interaction therapy (PCIT) delivered in-home by community agency therapists. Data included self-report measures and therapist observations at baseline and posttreatment. Results indicated significant positive changes in child/parent behavior and parent attitudes…
Freedman, R; Sahhar, M; Curnow, L; Lee, J; Peters, H
Medical intervention for lysosomal storage disorders becomes part of life, shaping the reality of the condition for affected individuals and families. Enzyme replacement therapy (ERT) is available to treat some lysosomal storage disorders. ERT is costly and time consuming, requiring frequent hospital visits to receive intravenous infusions. This qualitative study sought to explore the impact of receiving ERT for a lysosomal storage disorder on the health related quality of life (HRQoL) of young patients and their families. Fifteen semi-structured interviews were conducted with young people and parents and siblings of young people accessing ERT for Pompe disease, Gaucher disease or mucopolysaccharidosis types I or II living in Victoria, Australia. Interviews were transcribed then analyzed thematically. The biopsychosocial model assisted in interpreting themes. Findings revealed positive attitudes towards ERT, with noticed improvements in physical and psychosocial well-being. Participants prioritised intervention over other activities and provided suggestions for improving current service delivery. Communication with family members and professionals was deemed important, especially in respect to information provision. Participants described challenges associated with living with a lysosomal storage disorder and receiving ERT and coping strategies, such as positive thinking and ways to manage uncertainty. These findings provide valuable insights into the impact of living with a chronic genetic condition and receiving intensive treatment on HRQoL. PMID:23536258
Glenwick, David S., Ed.; Jason, Leonard A., Ed.
In the last decade, there has been increased attention paid to the scope of mental and physical health problems that affect individuals at different points over the entire life span. This volume presents many problem areas and the range of their impact on individuals, families, and society at large. The impact of intervention programs is described…
Nelson, Briana S.
The 1992-1995 war in Bosnia-Herzegovina caused mush devastation in that region of the world. This article describes the themes and issues that emerged from information gained from interviews with Bosnian professionals through a project entitled "Trauma and Reconciliation in Bosnia-Herzegovina." Recommendations and implications for family and…
Bigfoot, Dolores Subia; Funderburk, Beverly W
The Indian Country Child Trauma Center, as part of the National Child Traumatic Stress Network, designed a series of American Indian and Alaska Native transformations of evidence-based treatment models. Parent-Child Interaction Therapy (PCIT) was culturally adapted/translated to provide an effective treatment model for parents who have difficulty with appropriate parenting skills or for their children who have problematic behavior. The model, Honoring Children-Making Relatives, embeds the basic tenets and procedures of PCIT in a framework that supports American Indian and Alaska Native traditional beliefs and parenting practices that regard children as being the center of the Circle. This article provides an overview of the Honoring Children-Making Relatives model, reviews cultural considerations incorporated into ICCTC's model transformation process, and discusses specific applications for Parent-Child Interaction Therapy within the model. PMID:22400462
Lloyd, Samantha; Chalder, Trudie; Rimes, Katharine A
The aim of this study was to investigate the long term efficacy of family-focused cognitive behaviour therapy (CBT) compared with psycho-education in improving school attendance and other secondary outcomes in adolescents with chronic fatigue syndrome (CFS). A 24 month follow-up of a randomised controlled trial was carried out. Participants received either 13 one-hour sessions of family-focused CBT or four one-hour sessions of psycho-education. Forty-four participants took part in the follow-up study. The proportion of participants reporting at least 70% school attendance (the primary outcome) at 24 months was 90% in CBT group and 84% in psycho-education group; the difference between the groups was not statistically significant (OR = 1.29, p = 0.80). The proportion of adolescents who had recovered in the family-focused CBT group was 79% compared with 64% in the psycho-education, according to a definition including fatigue and school attendance. This difference was not statistically significant (Fisher's exact test, p = 0.34). Family-focused CBT was associated with significantly better emotional and behavioural adjustment at 24 month follow-up compared to psycho-education, as reported by both adolescents (F = 6.49, p = 0.02) and parents (F = 4.52, P = 0.04). Impairment significantly decreased in both groups between six and 24 month follow-ups, with no significant group difference in improvement over this period. Gains previously observed for other secondary outcomes at six month follow-up were maintained at 24 month follow-up with no further significant improvement or group differences in improvement. In conclusion, gains achieved by adolescents with CFS who had undertaken family-focused CBT and psycho-education generally continued or were maintained at two-year follow-up. The exception was that family-focused CBT was associated with maintained improvements in emotional and behavioural difficulties whereas psycho-education was associated with
Bellmunt, J; Hussain, M; Dinney, C P
The improved understanding of the molecular biology of urothelial malignancies is helping to define the role of new targets and prognostic indices that can direct the most appropriate choice of treatment for advanced disease. Many human tumors express high levels of growth factors and their receptors that can be used as potential therapeutical targets. Tyrosine-kinase receptors, including many growth factor receptors such the receptors for epidermal growth factor (EGF), vascular endothelial growth factor (VEGF), and Her2/neu, have been found overexpressed in urothelial tumors. For many of these growth factor receptors, the degree of expression has been associated with the progression of cancer and a poor prognosis. Among the best studied growth factor receptors are the two members of EGF receptor familiy EGFr (ErbB-1), and Her2/neu (ErbB-2). Several preclinical studies in bladder cancer models, have confirmed that systemic administration of growth factor inhibitors inhibits the growth and metastasis of human transitional cell carcinoma established in the bladder wall of athymic nude mice. Additional studies indicate that therapy with EGFR inhibitors enhances the activity of conventional cytoreductive chemotherapeutic agents, in part by inhibiting tumor cell proliferation, angiogenesis, and inducing apoptosis. Novel targeted therapy hold promise to improve the current results of bladder cancer treatment. Based on the success seen with anti-HER2 monoclonal antibodies (Herceptin) and the promising results with EGFR targeted agents (IMC-C225 Cetuximab, ZD1389 Iressa, OSI-774 Tarceva, GW 57016) in other tumor types, and based on the results obtained in preclinical models, there is a great interest in assessing these agents in patients with bladder cancer. Several trials are now ongoing testing these new agents alone or in combination with chemotherapy in bladder cancer patients. The integration of these newer biologic agents, probably to supplement rather than to
Burg, James E.
Therapeutic adventure with families is a promising integration of adventure therapy and family therapy. Issues that must be addressed to legitimize the field include licensure and legal scope of practice, developing minimum standards for practitioners, incorporating family development and family therapy theories into practice, and conducting more…
Donohue, Brad C.; Romero, Valerie; Herdzik, Karen; Lapota, Holly; Al, Ruwida Abdel; Allen, Daniel N.; Azrin, Nathan H.; Van Hasselt, Vincent B.
High rates of co-occurrence between substance abuse and child neglect have been well documented and especially difficult to treat. As a first step in developing a comprehensive evidence-based treatment for use in this population, the present case examination underscores Family Behavior Therapy (FBT) in the treatment of a mother who evidenced Substance Dependence, child neglect, Post-Traumatic Stress Disorder, Bipolar I Disorder, and domestic violence. Utilizing psychometrically validated self-report inventories and objective urinalysis, treatment was found to result in the cessation of substance use, lower risk of child maltreatment, improved parenting attitudes and practices, and reduced instances of violence in the home. The importance of utilizing validity scales in the assessment of referrals from child welfare settings is discussed, and future directions are reported in light of the results. PMID:23457426
Darnell, Adam J.; Schuler, Megan S.
Functional Family Therapy (FFT) is an intensive community-based treatment program designed to reduce youth behavior problems such as violence, drug use, and other delinquency. Although there is evidence of FFT efficacy and effectiveness with predominantly White samples, there is very little evidence with racial/ethnic minority samples. In light of the over-representation of African American and Latino youth in the juvenile justice system, this study examined the effectiveness of FFT and an adaptation of FFT to probation supervision, called Functional Family Probation (FFP), among a predominantly Latino and African American sample of youth returning home from court-ordered out-of-home placements (OHP). Propensity score weighting was used to compare the likelihood of subsequent OHPs among youth receiving standard probation (Comparison group), and youth receiving FFT (with standard probation), youth receiving FFP (instead of standard probation), and youth receiving FFT in combination with FFP. Results indicated that youth receiving FFT (both with standard probation and FFP), relative to Comparison youth receiving standard probation only, had significantly lower likelihood of OHP during the first two months following release, but this advantage disappeared in later months. Youth receiving only FFP also had lower likelihood of OHP than Comparison youth in the first two months, though not significantly. These findings provide encouraging evidence of positive effects of FFT, in combination with FFP or standard probation, among a diverse sample of juvenile justice system-involved youth. PMID:25767310
Horigian, Viviana E; Anderson, Austen R; Szapocznik, José
Adolescent substance use is a major risk factor for negative outcomes, including substance dependence later in life, criminal behavior, school problems, mental health disorders, injury, and death. This article provides a user-friendly, clinically focused, and pragmatic review of current and evidence-based family treatments, including multisystemic therapy, multidimensional family therapy, functional family therapy, brief strategic family therapy, ecologically based family therapy, family behavior therapy, culturally informed flexible family treatment for adolescents, and strengths-oriented family therapy. Outcomes, treatment parameters, adolescent characteristics, and implementation factors are reviewed. PMID:27613341
Zuk, Gerald H.
Family therapy has been deficient in accounting for the impact of ethnic, religious, and racial values on success or failure in treating families. Jewish families respond well in family therapy due to a set of values. An individual's neurotic disposition may evolve from conflicts between family values and independent identity. (Author/JEL)
Yan, Max; Rayoo, Mukta; Takano, Elena A; Fox, Stephen B
Estrogen receptor (ER) α has been studied extensively in familial breast cancers but there are limited data on ERβ and its isoforms. This is an important issue since many BRCA1-associated tumours are "triple negative" and are resistant to conventional and targeted therapies. We performed an immunohistochemical study of pan-ERβ, ERβ1 and ERβ2 in a cohort of 123 familial breast carcinomas (35 BRCA1, 33 BRCA2 and 55 BRCAX) using a cut-off for positivity at 20% (Shaaban et al. in Clin Cancer Res 14:5228-5235, 2008). BRCA1 cancers were more likely to be nuclear ERα negative and nuclear pan-ERβ positive (21/32, 66%) when compared with BRCA2 (2/29, 7%) and BRCAX cancers (11/49, 22%) (both P < 0.001). For survival analysis, expression was also stratified using cut-offs defined by Bates et al. (Breast Cancer Res Treat 111:453-459, 2008) (score out of 7). Cytoplasmic ERβ2 expression correlated with shorter overall survival at 15 years regardless of cut-off used (both P < 0.046) At a cut-off score of 6 out of 7, cytoplasmic ERβ2 expression correlated with a poorer response to chemotherapy in both univariate (P = 0.011) and multivariate analyses including grade, lymph node status and chemotherapy as an interaction variable (P = 0.045, Hazard ratio 1.22, 95% CI 1.004-9.87). A similar trend was seen in a univariate analysis with a cut-off of 20% although this did not reach statistical significance (P = 0.057). Expression of nuclear ERβ1 was associated with a favourable response to endocrine therapy at 15 years regardless of cut-offs employed (both P < 0.025). However, this did not reach statistical significance in a multivariate analysis (P > 0.05). Since a significant proportion of ERα negative familial breast carcinomas are positive for nuclear ERβ1 and cytoplasmic ERβ2, the different ERβ isoforms and their intracellular location may need to be assessed, to identify patients that may benefit from hormonal and chemotherapy. PMID:20490651
Pejic, Rade N.
Background Familial hypercholesterolemia (FH) is an autosomal dominant-inherited genetic disorder that leads to elevated blood cholesterol levels. FH may present as severely elevated total cholesterol and low density lipoprotein (LDL) cholesterol levels or as premature coronary heart disease (CHD). Methods This review presents information on the disease and on the effects of drug treatment and lifestyle changes. Results Routine lipid testing should identify most patients with FH. Once an index case is identified, testing should be offered to family members. Early diagnosis and aggressive treatment with therapeutic lifestyle changes and statins can prevent premature CHD and other atherosclerotic sequelae in patients with FH. Conclusion Emerging therapies such as LDL apheresis and novel therapeutic agents may be useful in patients with homozygous FH or treatment-resistant FH. Liver transplantation is the only effective therapy for severe cases of homozygous FH. PMID:25598733
Background Complementary medicines (CMs) are widely used by women. Although, women in Australia are frequent users of CM, few studies have examined their utilisation by women attending a family planning service. The aim of this study was to examine (i) the extent of and type of CM, (ii) women’s views about safety and efficacy, and (iii) the factors influencing women’s decision-making. Methods A cross-sectional survey using a convenience sample of 221women aged greater than 18 years attending a family planning (FP) service was undertaken over a two week period in Sydney, Australia. An anonymous self-administered questionnaire was designed to examine women’s current and previous use of CMs, their attitudes towards safety and effectiveness, the factors influencing their decision-making, and their disclosure of CM use to a FP health professional. Demographic questions were designed to describe the diversity of the participants. Logistic regression was used to examine the association between CM use and demographics. Results Sixty-seven percent of women surveyed were currently using CMs, and 83% reported use during the previous 12 months. Most respondents utilised CMs to maintain their general health or for prevention of ill health. Over 30% of women lacked information to make an informed response to questions examining their views about the safety of CMs. Forty-four percent of participants stated they discussed their use of CMs with their FP providers. The main reason why women did not mention CMs was they did not see the relevance to their consultation (43%). Lower rates of CM use were found for younger women (OR 0.24, 95% CI 0.09-0.61), and those not completing high school (OR 0.44, 95% 0.20-1.00). Conclusion The use of CM is very common among women attending an Australian FP clinic, however our findings may not be generalisable to all women. We identified a notable gap in women’s awareness of the potential for interactions between CM and prescribed
Cohen, M M; Levy, M; Eliakim, M
Thirty-eight patients suffering from Famlial Mediterranean Fever (FMF) and undergoing colchicine therapy for periods varying from one week to three years were examined cytogenetically. Preparations were derived from short-term lymphocyte cultures; mitotic rate, percent tetraploidy, and chromosome breakage rates were determined. Twenty-one patients were examined prior to treatment, 22 during treatment and 5 both before and during treatment and 5 both before and during treatment. No statistically significant differences were observed in the parameters studied between ten controls and the patient groups. An in vitro experiment indicated a direct correlation between increased colchicine concentration and mitotic rate. However, tetrapoloidy or chromosome damage showed no such association with colchicine concentration. Among the patient group, pregnancy occurred in four patients while under treatment; three pregnancies resulted in the birth of normal children while the fourth has not yet been completed. In one preganancy, cultured fetal amniotic fluid cells demonstrated no effect of colchicine on the cytogenetic parameters invetigated. These results indicate no untoward effects on long-term colchicine treatment in FMF with respect to fertility, teratogenicity and chromosomal damage. PMID:602955
Mazur, Pawel K; Herner, Alexander; Mello, Stephano S; Wirth, Matthias; Hausmann, Simone; Sánchez-Rivera, Francisco J; Lofgren, Shane M; Kuschma, Timo; Hahn, Stephan A; Vangala, Deepak; Trajkovic-Arsic, Marija; Gupta, Aayush; Heid, Irina; Noël, Peter B; Braren, Rickmer; Erkan, Mert; Kleeff, Jörg; Sipos, Bence; Sayles, Leanne C; Heikenwalder, Mathias; Heßmann, Elisabeth; Ellenrieder, Volker; Esposito, Irene; Jacks, Tyler; Bradner, James E; Khatri, Purvesh; Sweet-Cordero, E Alejandro; Attardi, Laura D; Schmid, Roland M; Schneider, Guenter; Sage, Julien; Siveke, Jens T
Pancreatic ductal adenocarcinoma (PDAC) is one of the most lethal human cancers and shows resistance to any therapeutic strategy used. Here we tested small-molecule inhibitors targeting chromatin regulators as possible therapeutic agents in PDAC. We show that JQ1, an inhibitor of the bromodomain and extraterminal (BET) family of proteins, suppresses PDAC development in mice by inhibiting both MYC activity and inflammatory signals. The histone deacetylase (HDAC) inhibitor SAHA synergizes with JQ1 to augment cell death and more potently suppress advanced PDAC. Finally, using a CRISPR-Cas9–based method for gene editing directly in the mouse adult pancreas, we show that de-repression of p57 (also known as KIP2 or CDKN1C) upon combined BET and HDAC inhibition is required for the induction of combination therapy–induced cell death in PDAC. SAHA is approved for human use, and molecules similar to JQ1 are being tested in clinical trials. Thus, these studies identify a promising epigenetic-based therapeutic strategy that may be rapidly implemented in fatal human tumors. PMID:26390243
Turunen, Tytteli A K; Kurkipuro, Jere; Heikura, Tommi; Vuorio, Taina; Hytönen, Elisa; Izsvák, Zsuzsanna; Ylä-Herttuala, Seppo
Plasmid-based Sleeping Beauty (SB) transposon vectors were developed and used to deliver genes for low-density lipoprotein and very-low-density lipoprotein receptors (LDLR and VLDLR, respectively) or lacZ reporter into liver of an LDLR-deficient mouse model of familial hypercholesterolemia (FH). SB transposase, SB100x, was used to integrate the therapeutic transposons into mice livers for evaluating the feasibility of the vectors in reducing high blood cholesterol and the progression of atherosclerosis. Hydrodynamic gene delivery of transposon-VLDLR into the livers of the mice resulted in initial 17-19% reductions in plasma cholesterol, and at the later time points, in a significant stabilization of the cholesterol level for the 6.5-month duration of the study compared to the control mice. Transposon-LDLR-treated animals also demonstrated a trend of stabilization in the cholesterol levels in the long term. Vector-treated mice had slightly less lipid accumulation in the liver and reduced aortic atherosclerosis. Clinical chemistry and histological analyses revealed normal liver function and morphology comparable to that of the controls during the follow-up with no safety issues regarding the vector type, transgenes, or the gene transfer method. The study demonstrates the safety and potential benefits of the SB transposon vectors in the treatment of FH. PMID:26670130
... from the following areas among others: psychiatry, clinical psychology, mental health counseling, clinical social work, marriage and family ... Cognitive Therapy for Depression by SJ Rupke, M.D., ...
Nomura, S; Merched, A; Nour, E; Dieker, C; Oka, K; Chan, L
We tested the efficacy of low-density lipoprotein receptor (LDLR) therapy using helper-dependent adenovirus (HD-Ad), comparing it with that of very low-density lipoprotein receptor (VLDLR), an LDLR homolog. We treated high cholesterol diet fed LDLR-/- mice with a single intravenous injection of HD-Ad expressing monkey LDLR (1.5 x 10(13) or 5 x 10(12) VP/kg) or VLDLR. Throughout the 24-week experiment, plasma cholesterol of LDLR-treated mice was lower than that of VLDLR-treated mice, which was in turn lower than that of PBS-treated mice. Anti-LDLR antibodies developed in 2/10 mice treated with high-dose HD-Ad-LDLR but in none (0/14) of the other treatment groups. HD-Ad-treated mice displayed significant retardation of atherosclerotic lesion progression. We next tested the long-term efficacy of low-dose HD-Ad-LDLR injected into 12-week-old LDLR-/- mice. After 60 weeks, atherosclerosis lesions covered approximately 50% of the surface of aortas of control mice, whereas aortas of treated mice were essentially lesion-free. The lipid lowering effect of HD-Ad-LDLR lasted at least 108 weeks (>2 years) when all control mice had died. In addition to retarding lesion progression, treatment caused lesion remodeling from a vulnerable-looking to a more stable-appearing phenotype. In conclusion, HD-Ad-mediated LDLR gene therapy is effective in conferring long-term protection against atherosclerosis in a mouse model of familial hypercholesterolemia. PMID:15269711
FALLOON, IAN R. H.; MCGILL, CHARISTINE W.; MATTHEWS, SUSAN M.; KEITH, SAMUEL J.; SCHOOLER, NINA R.
The NIMH Treatment Strategies in Schizophrenia (TSS) collaborative study group investigated the efficacy of antisychotic drug maintenance strategies involving reduced medication exposure in interaction with applied and supportive family management for the long-term treatment of schizophrenia. Therapy was provided at five centers by 25 clinicians who did not participate in the development of the therapies. They were trained by two of the authors, I.R.H.F and C.W.M, in applied family management, a homebased treatment derived from the behavioral family therapy developed by them. Clinicians’ characteristics, selection, and training methods, as well as patient rehospitalization rates, are reported for the two family management conditions. The TSS study represents a bridge between the development of a novel therapy and its dissemination in general clinical practice. PMID:22700264
Hudock, Anthony M., Jr.; Warden, Sherry A. Gallagher
This article reflects a review of research relevant to family systems training and the use of films in the teaching of family systems theory. Advantages and disadvantages of using movies in an introductory-level graduate family therapy course are discussed. An outline of family therapy training objectives, as well as examples of a movie-based…
McCroskey, Jacquelyn; Meezan, William
This book reports a study of the outcomes of home-based family preservation services for abusive and neglectful families in Los Angeles County. Using the Family Assessment Form, the research project evaluated services provided by two voluntary agencies, and focused on changes in family functioning between the opening and closing of services during…
Wang, Liang-Jen; Lu, Shing-Fang; Chong, Mian-Yoon; Chou, Wen-Jiun; Hsieh, Yu-Lian; Tsai, Tung-ning; Chen, Ching; Lee, Yi-Hsuan
Objective The abuse of illegal substances by youths in Taiwan has become a major public health issue. This study explores the outcomes (relapse rate and academic or social status) of a family-oriented therapy program conducted for substance-using youths who were referred by a judge to participate in it. Methods The present study includes 121 participants categorized into three groups: 36 youths underwent a weekly ten-session outpatient motivational enhancement psychotherapy (MEP) group program; 41 youths participated in a program that combined the aforementioned MEP program with an additional weekly ten-session parenting skill training (PST) program for their guardians (MEP + PST group); and 44 adolescents who received standard supervision by the court served as the control group. All participants were followed-up for a maximum of 2 years. Results Of the 121 participants (mean age: 16.1±1.1 years), 33.1% relapsed into substance use during the follow-up period. The probability of relapse did not differ significantly between the MEP group (36.1%) and the control group (40.9%), but the youths in the MEP + PST group (22.0%) were at a lower risk of relapse than the control group participants (adjusted hazard ratio =0.48, 95% confidence interval [CI] =0.21–1.09). By the end of the study follow-up period, participants in both the MEP group and the MEP + PST group were more likely to be attending school (MEP group: adjusted odds ratio [aOR] =6.61, 95% CI =1.60–27.35; MEP + PST group: aOR =8.57, 95% CI =1.94–37.82) or employed (MEP group: aOR =7.75, 95% CI =1.95–30.75; MEP + PST group: aOR =7.27, 95% CI =1.76–29.97), when compared to the control group. Conclusion This study revealed that a family-oriented treatment approach may be a more effective option for preventing youths’ relapsing into substance abuse. In comparison to individuals who received standard supervision by the court, those who received MEP experienced a better school attendance or social
van der Linden, Lonneke; Vives-Adrián, Laia; Selisko, Barbara; Ferrer-Orta, Cristina; Liu, Xinran; Lanke, Kjerstin; Ulferts, Rachel; De Palma, Armando M; Tanchis, Federica; Goris, Nesya; Lefebvre, David; De Clercq, Kris; Leyssen, Pieter; Lacroix, Céline; Pürstinger, Gerhard; Coutard, Bruno; Canard, Bruno; Boehr, David D; Arnold, Jamie J; Cameron, Craig E; Verdaguer, Nuria; Neyts, Johan; van Kuppeveld, Frank J M
The genus Enterovirus of the family Picornaviridae contains many important human pathogens (e.g., poliovirus, coxsackievirus, rhinovirus, and enterovirus 71) for which no antiviral drugs are available. The viral RNA-dependent RNA polymerase is an attractive target for antiviral therapy. Nucleoside-based inhibitors have broad-spectrum activity but often exhibit off-target effects. Most non-nucleoside inhibitors (NNIs) target surface cavities, which are structurally more flexible than the nucleotide-binding pocket, and hence have a more narrow spectrum of activity and are more prone to resistance development. Here, we report a novel NNI, GPC-N114 (2,2'-[(4-chloro-1,2-phenylene)bis(oxy)]bis(5-nitro-benzonitrile)) with broad-spectrum activity against enteroviruses and cardioviruses (another genus in the picornavirus family). Surprisingly, coxsackievirus B3 (CVB3) and poliovirus displayed a high genetic barrier to resistance against GPC-N114. By contrast, EMCV, a cardiovirus, rapidly acquired resistance due to mutations in 3Dpol. In vitro polymerase activity assays showed that GPC-N114 i) inhibited the elongation activity of recombinant CVB3 and EMCV 3Dpol, (ii) had reduced activity against EMCV 3Dpol with the resistance mutations, and (iii) was most efficient in inhibiting 3Dpol when added before the RNA template-primer duplex. Elucidation of a crystal structure of the inhibitor bound to CVB3 3Dpol confirmed the RNA-binding channel as the target for GPC-N114. Docking studies of the compound into the crystal structures of the compound-resistant EMCV 3Dpol mutants suggested that the resistant phenotype is due to subtle changes that interfere with the binding of GPC-N114 but not of the RNA template-primer. In conclusion, this study presents the first NNI that targets the RNA template channel of the picornavirus polymerase and identifies a new pocket that can be used for the design of broad-spectrum inhibitors. Moreover, this study provides important new insight into the
van der Linden, Lonneke; Vives-Adrián, Laia; Selisko, Barbara; Ferrer-Orta, Cristina; Liu, Xinran; Lanke, Kjerstin; Ulferts, Rachel; De Palma, Armando M.; Tanchis, Federica; Goris, Nesya; Lefebvre, David; De Clercq, Kris; Leyssen, Pieter; Lacroix, Céline; Pürstinger, Gerhard; Coutard, Bruno; Canard, Bruno; Boehr, David D.; Arnold, Jamie J.; Cameron, Craig E.; Verdaguer, Nuria
The genus Enterovirus of the family Picornaviridae contains many important human pathogens (e.g., poliovirus, coxsackievirus, rhinovirus, and enterovirus 71) for which no antiviral drugs are available. The viral RNA-dependent RNA polymerase is an attractive target for antiviral therapy. Nucleoside-based inhibitors have broad-spectrum activity but often exhibit off-target effects. Most non-nucleoside inhibitors (NNIs) target surface cavities, which are structurally more flexible than the nucleotide-binding pocket, and hence have a more narrow spectrum of activity and are more prone to resistance development. Here, we report a novel NNI, GPC-N114 (2,2'-[(4-chloro-1,2-phenylene)bis(oxy)]bis(5-nitro-benzonitrile)) with broad-spectrum activity against enteroviruses and cardioviruses (another genus in the picornavirus family). Surprisingly, coxsackievirus B3 (CVB3) and poliovirus displayed a high genetic barrier to resistance against GPC-N114. By contrast, EMCV, a cardiovirus, rapidly acquired resistance due to mutations in 3Dpol. In vitro polymerase activity assays showed that GPC-N114 i) inhibited the elongation activity of recombinant CVB3 and EMCV 3Dpol, (ii) had reduced activity against EMCV 3Dpol with the resistance mutations, and (iii) was most efficient in inhibiting 3Dpol when added before the RNA template-primer duplex. Elucidation of a crystal structure of the inhibitor bound to CVB3 3Dpol confirmed the RNA-binding channel as the target for GPC-N114. Docking studies of the compound into the crystal structures of the compound-resistant EMCV 3Dpol mutants suggested that the resistant phenotype is due to subtle changes that interfere with the binding of GPC-N114 but not of the RNA template-primer. In conclusion, this study presents the first NNI that targets the RNA template channel of the picornavirus polymerase and identifies a new pocket that can be used for the design of broad-spectrum inhibitors. Moreover, this study provides important new insight into the
Whitman, Brenda; Perrin, Kathy Riske; Knudson-Buresh, Alana
Pre/posttest data from 84 nursing, occupational therapy, physical therapy, and social work students who were mentored by families of children with special needs indicated an increase in family-centered attitudes, understanding, and respect among these future service providers. (SK)
Sporakowski, Michael J.
Addresses three concerns from family therapy perspective: current strengths and weaknesses of U.S. family life; challenges to family life in next decade; and family therapist's role in strengthening family life. Examines challenges and opportunities for family therapists in the future, viewing enhancement of functioning as vital mode of future…
Paylo, Matthew J.
In this column, the author focuses on the ways that family counselors can use solution-based therapies (solution-oriented and solution-focused) to work with families with adolescents in individual and/or family therapy. The theoretical foundation for solution-based therapies suggests techniques that help families focus on solutions and not remain…
McWhirter, Ellen Hawley; And Others
This article describes concepts underlying the idea of the "family as a system"; compares and contrasts four approaches to family therapy (those of Virginia Satir, Jay Haley, Murray Bowen, and Salvador Minuchin); and offers suggestions to teachers referring parents for family counseling. (DB)
Marshall, Keith; Ferris, Jan
There is a higher incidence of mental health problems amongst people with intellectual disabilities. Family members and support staff who provide support to people with intellectual disabilities with mental health difficulties are more likely to experience increased stress. In the mainstream mental health literature it has been demonstrated that psycho-educational family interventions have a positive impact on the person with mental health difficulties and on the family members who support them. This article uses a case study to illustrate the implementation of a family intervention with the support system around someone with intellectual disabilities, autism and chronic mental health difficulties. Following intervention the family member reported a marked decrease in levels of strain. Both the family and team members reported improvement in functioning within the support system. PMID:22496309
Myers-Walls, Judith A.; Ballard, Sharon M.; Darling, Carol Anderson; Myers-Bowman, Karen S.
Many scholars have defined family life education (FLE), and some have differentiated it from other family-related fields. For example, Doherty (1995) provided a definition of the boundaries between FLE and family therapy; however, we believe those criteria can be improved. We explore the professions of family life education, family therapy, and…
Coco, E. Lane; Courtney, Linda J.
Utilizes a family therapy approach to restructure family relationships in order to prevent further runaway behavior of a 15-year-old Mexican-American female. The approach involves a family interview, genogram, and family therapy. The Family Satisfaction Scale was administered to evaluate the effectiveness of the approach. (Author/MKA)
Fiese, Barbara H
To realize the broad and complex nature of the field of family psychology, I have slightly revised the mission statement of the Journal of Family Psychology (JFP) to capture contemporary scholarship in family psychology and to advance systems perspectives in this top-tier scientific journal. Over the next 6 years, I hope that authors will consider JFP as an outlet for their best work in the following areas: (1) JFP addresses societal challenges faced by families today; (2) JFP publishes important studies on what makes couple and family relationships work; (3) JFP is a leader in publishing reports that use cutting-edge sophisticated approaches to research design and data analysis; and (4) JFP imparts knowledge about effective therapy and prevention programs relevant to couples and families. The journal is also expanding its publication rate to eight issues per year. PMID:26845635
Vacha, Edward F.; McLaughlin, T. F.
Article outlines potential strategies for reducing the disproportionate rate of firearm accidents among low-income children. Suggests this problem stems from risky gun storage practices that are in response to high rates of victimization and fear of crime. Discusses the role that child behavior therapy can have in reducing the risk of firearm…
de Groot, Marieke; Neeleman, Jan; van der Meer, Klaas; Burger, Huibert
Grief interventions are more effective for high risk individuals. The presence of suicide ideation following suicide bereavement was examined to determine whether it indicates a high risk status. Using data from a randomized controlled trial (n = 122) on the effectiveness of cognitive-behavior therapy, the effect of suicide ideation on the…
Runyon, Melissa K.; Deblinger, Esther; Schroeder, Christine M.
Child physical abuse (CPA) is not only a highly prevalent public health problem, but it has been associated with a wide range of debilitating psychosocial sequelae that may develop during childhood and persist into adulthood. This paper outlines a treatment model, Combined Parent-Child Cognitive-Behavioral Therapy (CPC-CBT), that addresses the…
Marien, Wendi E.; Storch, Eric A.; Geffken, Gary R.; Murphy, Tanya K.
Serotonin reuptake inhibitor medications and cognitive-behavioral therapy (CBT) are both effective treatments for pediatric obsessive-compulsive disorder (OCD). Despite recommendations that youth with OCD be treated with CBT alone or together with serotonin reuptake inhibitor medication, many youth are treated with medication alone or with non-CBT…
Bond, Caroline; Woods, Kevin; Humphrey, Neil; Symes, Wendy; Green, Lorraine
Background and scope: Solution focused brief therapy (SFBT) is a strengths-based therapeutic approach, emphasizing the resources that people possess and how these can be applied to a positive change process. The current study provides a systematic review of the SFBT evidence base and a critical evaluation of the use and application of SFBT in…
Chan, Zenobia C. Y.; Ma, Joyce L. C.
This paper challenges the monolithic assumption of the anorectic families in Hong Kong by blindly adopting the western theoretical framework of family therapy. It is problematic that family therapy lacks indigenous culture-specific knowledge and ignores the voices of these multi-categories of families. It is inappropriate to conceptualize these…
Avci, Rasit; Çolakkadioglu, Oguzhan; Öz, Aysegül Sükran; Akbas, Turan
The purpose of this study was to adapt "The Boundary Violations Scale" (Madden et al., 2002), which was created to measure the intergenerational boundary violations in families from the perspective of children, to Turkish and to test the validity and reliability of the Turkish version of this instrument. This instrument was developed…
Hall, C M
Sociological concepts are used to demonstrate applications of views of the cosmos to everyday living. Optimal recovery in therapy is defined as increased participation and increased life-satisfaction in family and society, with meaningful motivation and orientation to the universe.Cosmology and therapy concepts are applied to five different kinds of marital relationships in order to clarify possibilities and define contrasts. Family processes which evolve as shifts in views of the cosmos, beliefs, and behavior occur are described. Strengths and weaknesses of this therapy are discussed, and attention is paid to ways in which beliefs provide motivation, meaning, and direction for behavior. PMID:24301690
McDaniel, Susan H., Ed.
Regardless of whether a patient's health-care provider works from a traditional biomedical or a new biopsychosocial model, therapists and counselors need to work with patients and their families challenged by the onset of a serious illness. This book addresses this need and outlines the five goals of medical family therapy: (1) help the family…
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Kotkin, Amy J.; Baker, Holly C.
Discusses the Family Folklore Program of the Smithsonian Institution's annual Festival of American Folklife, in which the whole family can be involved in tracing family history through story telling, photographs, etc. (MS)
Zimmerman, Toni Schindler; Fetsch, Robert J.
Notes that internal and external threats could squeeze ranch and farm families out of business. Offers six-step Consensus Management Model that combines strategic planning with psychoeducation/family therapy. Describes pilot test with intergenerational ranch family that indicated improvements in family functioning, including reduced stress and…
Colangelo, Nicholas; Doherty, William J.
Presents the Family Fundamental Interpersonal Relations Orientation (Family FIRO) Model, an integration of small-group theory and family therapy. The model is offered as a framework for organizing family issues. Discusses three fundamental issues of human relatedness and their applicability to group dynamics. (Author/NB)
Levitt, Dana Heller
One form of treatment for anorexia nervosa that continues to be developed is family therapy. In the following article, anorexia nervosa and its prevalence are defined, theories of its development are discussed, and family therapy interventions that have been applied to the treatment of the disorder are outlined. (Contains 15 references.) (GCP)
Seita, John R.
Family privilege is defined as "strengths and supports gained through primary caring relationships." A generation ago, the typical family included two parents and a bevy of kids living under one roof. Now, every variation of blended caregiving qualifies as family. But over the long arc of human history, a real family was a…
Wadhwa, Elizabeth; Nicolaides, Theodore
The bromodomain and extraterminal (BET) family proteins associate with transcriptional activation through interaction with acetylated chromatin, therefore playing a key role as epigenetic regulators. BET proteins serve to regulate the expression of importance oncogenes, including those involved in apoptosis as well as cell cycle progression. Due to this potential as an epigenetic target, small molecule inhibition of BET proteins have been investigated and demonstrate promising activity in both solid and hematologic malignancies, including brain tumors. Glioblastoma multiforme (GBM), subsets of medulloblastoma, and diffuse intrinsic pontine glioma (DIPG) are types of brain tumors with dismal prognoses, and as such have been the subjects of preclinical studies using BET inhibitors both in vivo and in vitro. While results from these preclinical investigations have shown promise, clinical trials are in early phases at this time. In this review, we will summarize the current literature on BET family proteins, their potential as therapeutic targets in brain tumors as well as other malignancies, and the preclinical and clinical investigations that have been undertaken to date. PMID:27382528
The bromodomain and extraterminal (BET) family proteins associate with transcriptional activation through interaction with acetylated chromatin, therefore playing a key role as epigenetic regulators. BET proteins serve to regulate the expression of importance oncogenes, including those involved in apoptosis as well as cell cycle progression. Due to this potential as an epigenetic target, small molecule inhibition of BET proteins have been investigated and demonstrate promising activity in both solid and hematologic malignancies, including brain tumors. Glioblastoma multiforme (GBM), subsets of medulloblastoma, and diffuse intrinsic pontine glioma (DIPG) are types of brain tumors with dismal prognoses, and as such have been the subjects of preclinical studies using BET inhibitors both in vivo and in vitro. While results from these preclinical investigations have shown promise, clinical trials are in early phases at this time. In this review, we will summarize the current literature on BET family proteins, their potential as therapeutic targets in brain tumors as well as other malignancies, and the preclinical and clinical investigations that have been undertaken to date. PMID:27382528
Duffy, Maureen; Gillig, Scott
Examines the role of the family counselor in working with cancer patients and their families. Suggests ways in which the family counselor can work proactively with families in the area of cancer prevention and helping them cope more effectively with its impact on their lives. Uses a clinical case example to illustrate intervention with cancer…
Toiyama, Yuji; Inoue, Yasuhiro; Kitajima, Takahito; Okigami, Masato; Kawamura, Mikio; Kawamoto, Aya; Okugawa, Yoshinaga; Hiro, Jyunichiro; Tanaka, Koji; Mohri, Yasuhiko; Kusunoki, Masato
A 39-year-old man received a diagnosis of unresectable multiple liver metastases from multiple colorectal cancers with familial adenomatous polyposis. After construction of an ileostomy, modified FOLFOX6 (mFOLFOX6) with panitumumab was administrated because rectal cancer and sigmoid colon cancer are KRAS wild type. The 13 courses of chemotherapy resulted in a marked reduction in the size of liver metastases and sigmoid colon cancer. Consequently, curative resection with total colectomy, ileal pouch anal anastomosis, and liver metastasis resection with radiofrequency ablation was performed. Progression of KRAS wild-type rectal cancer after chemotherapy suggested that each clone from rectal and sigmoid colon cancer might have a different sensitivity to epidermal growth factor receptor antibody. Immunohistochemical analysis revealed loss of PTEN expression in rectal cancer compared with liver metastases from sigmoid colon cancer, showing that the difference of mFOLFOX6 with panitumumab might be related to activation of the PI3K-AKT pathway. PMID:25437589
The focus of this chapter is on how clinicians can understand and communicate with the families of patients suffering from cancer. Most doctors and nurses do not have training in this area and are uncomfortable when conducting interviews with whole families. The need to extend our skills in the family context reflects the changes in the way care is provided to patients with a serious illness. We recognise the part families play in providing care and the subsequent effects on family life. The influence of systemic thinking and social construction theories has led to the acknowledgement that we are all part of systems which interact with each other and it is no longer appropriate to see the patient in isolation. The chapter will look at ideas from family therapy which can help us assess and intervene when necessary. The patient suffering from a life-threatening illness such as cancer looks to his family and friends for care and support. The management and course of the illness is affected by the involvement of the family and how they manage the stress and the effects of illness on a family member (Wright and Leahey 2000). Duhamel and Dupuis (2003) point out that there are three important factors in the management of the illness: the effects of family stress, the needs of the family as caregivers, and the effects of the role and how the family cope with the way the patient experiences his illness. This presents professionals working in the field with challenges they are often ill-equipped to deal with. Most healthcare workers have inadequate training in understanding family dynamics and even less knowledge about how to communicate effectively with whole families. Consequently, many healthcare professionals avoid couple and family interviews, feeling inadequate and helpless like the families themselves. I will address some of these issues in the chapter, firstly by examining what we now regard as the family and then by using ideas from systemic theory I will look at
Ripoll-Nunez, Karen; Villar-Guhl, Carlos Felipe; Villar-Concha, Eduardo
There is a gap in the Marriage and Family Therapy literature regarding clients', therapists', and family judges' theories of change in relational therapy for family violence. We conducted in-depth interviews with eleven court-referred families, their therapists, and two family judges in Bogota, Colombia. Interviews focused on their expectations of…
Unni, K.E. Sadanaandan
Seven completed suicides in a family of lower socioeconomic status and suburban domicile in Pondicherry are reported. The presence of bipolar affective disorder in the family members and the absence of exogenous factors are illustrated by utilising both family history method and family study method. The details collected formed the basis for the terminology ‘familial suicide’. The management of the index case, one of the only three surviving male members of the family, who presented with suicidal ruminations and depressive features, is described. PMID:21584122
Goldman, E; Miller, R; Lee, C A
An Indian Sikh family affected with both HIV and haemophilia is described. The use of interpreters; the regular follow-up in the Concorde trial; family therapy and help with practical problems have been approaches used to help the family despite language and cultural differences. PMID:8461364
Haber, Russell A.
Describes the dynamics and characteristics of families with a chemically abusive member. Suggests that since the family is intricately involved in the addictive system, family therapy is needed to promote clear communication, consistent parenting, and aid in developing independent living skills and attitudes. (Author/JAC)
Palmer, Molly Lependorf; Healey, Kathryn
Proposes a new model for psychological practice called Family Consulting, which is based on a developmental and non-pathological perspective. Provides background information on the building blocks of this perspective, namely the life span theory of development, family life-cycle literature, and object relations family therapy. Discusses the role…
Wieck, Colleen, Ed.; McBride, Marijo, Ed.
This "Feature Issue" of the quarterly journal "Impact" presents 19 brief articles on family support systems in the United States for persons with developmental disabilities and their families. Emphasis is on provisions of Public Law 99-457. Articles include: "Family Support in the United States: Setting a Course for the 1990s" (James Knoll);…
Describes a Kellogg Family Collaborative project that involves the University of Montana and four tribal colleges in a family-strengths approach to improving student retention and achievement. States that the project is grounded in social work theory and research that recognize and reinforce family and student resilience through promotion of…
Goetz, Kathy, Ed.
This "special focus" journal issue consists of 13 individual articles on the theme of rural family programs relating to school, health services, church, and other institutions. It includes: (1) "Towards a Rural Family Policy" (Judith K. Chynoweth and Michael D. Campbell); (2) "Montana: Council for Families Collaborates for Prevention (Jean…
Schwabe, Arthur D.; Terasaki, Paul I.; Barnett, Eugene V.; Territo, Mary C.; Klinenberg, James R.; Peters, Robert S.
The success of colchicine therapy in the management of familial Mediterranean fever has provided new direction to investigations into the pathogenesis of this disease. Examination of HLA antigen frequencies in 53 patients with familial Mediterranean fever and appropriate controls, as well as various immunologic studies have yielded no significant differences. However, B lymphocyte typing and assays for immune complexes, lymphokines and prostaglandins may be of potential interest. Preliminary studies indicate that leukocytes of patients with familial Mediterranean fever release increased amounts of lysozyme (P<0.01), when subjected to high temperatures, and of both lysozyme and myeloperoxidase at low osmotic concentrations. The known and potential effects of colchicine on leukocyte and cellular metabolism, and the current status of colchicine prophylaxis are reviewed. In patients receiving an optimum colchicine dose of 1.5 to 1.8 mg per day, side effects have been minimal and the frequency of attacks has been decreased significantly. PMID:878470
Miller, Lynn D., Ed.
This book offers practical suggestions for school counselors to begin integrating family counseling methods into their practice, while providing a rationale and the research support for working with families from a school base. It also provides specific techniques for using solution-focused tools, conducting family therapy with children, working…
Star Snyder, Marjorie
A comprehensive search of multiple databases for references to the connection between families and schools yields a rich representation from family therapy, school counseling, school psychology, and education literature supporting the idea that schools must serve not only students, but students' families as well. One of the common themes emerging…
Ariel, Shlomo; And Others
Presents three articles discussing the concept of family homeostasis and the related concepts of family rules and family feedback. Includes a reply by Paul Dell citing the need for family therapy to go beyond homeostasis and further comments by Ariel, Carel, and Tyano. (JAC)
This paper describes a qualitative study involving in-depth interviews with women who identify themselves as feminist family therapists. It includes a summary of the themes identified in these three questions: How did you become a feminist family therapist? How do you DO feminist family therapy? What does it mean to be a feminist family therapist?…
Nerin, William; Robertson, Anne
Family reconstruction is an imaginative process of family therapy whereby in a day's time a person gets connected to his or her family roots in a new and viable way leading to inner strength and wholeness. In family reconstruction, the person who does the reconstruction is called the Explorer. Within a group of people, the Explorer (who previously…
Doherty, William J.; Burge, Sandra K.
Argues that family therapy is failing to attend to the contexts in which family mental health services are provided. Presents a model for describing the institutional contexts of family mental health treatment in North America, and explores how these contexts influence family treatment, using 3 levels: primary, secondary, and tertiary care.…
Feldman, Gail C.
Only children and their parents may have special problems settling the issues of parent-child identification and attachment. Children without siblings and their parents face a continuing oedipal triangle unless the parents maintain united partnership at best, or at least are able to encourage independence in the child. (Author)
Oliveira, Sarah Siqueira; Amorim, Dalton De Souza
The Lygistorrhinidae are a family belonging to the suborder Bibionomorpha, with no previous record from Colombia. This paper refers for the first time to the occurrence of the family in the country, an undetermined species of the genus Lygistorrhina (Probolaeus) Williston. PMID:27395260
The International Committee on the Taxonomy of Viruses potyvirus study group has revised the description of the family Potyviridae for inclusion in the ICTV 9th report. Characteristic features of each genus within the family is presented. Revised criteria for demarcation and nomenclature of viral sp...
Focuses on various aspects of mammal family life ranging from ways different species are born to how different mammals are raised. Learning activities include making butter from cream, creating birth announcements for mammals, and playing a password game on family life. (ML)
Sinclair, Mary F., Ed.; And Others
This feature issue of IMPACT focuses on the empowerment of families with a member who has a developmental disability. It presents strategies and models for a collaborative, respectful approach to service provision, and presents the experiences of families in seeking support and assistance. Feature articles include "Two Generations of Disability: A…
Bennett, Dave; Rees-Jones, Tanny
A Family Workshop is an informal, multidisciplined educational program for adults and children, organized by a team of teachers. This article discusses the Lavender Hill Family Workshop, one of many, which attempts to provide education in various subject areas for adults and for children while also integrating both objectives in order to educate…
MacDonald, Peter J.; Brown, Alan
A large number of patients with psychosocial or psychiatric disorders present to family physicians, and the family physician needs a model of psychotherapy with which to cope with their problems. A model of brief psychotherapy is presented which is time limited, goal directed and easy to learn. It consists of four facets drawn from established areas of psychotherapy: characteristics of the therapist; characteristics of the patient; Eriksonian developmental stages; and the process of therapy as described by Carkhuff. These facets fit together in a way which is useful to the family physician in managing those patient problems for which brief psychotherapy is indicated. PMID:21267176
Taylor, Matthew RG; Carniel, Elisa; Mestroni, Luisa
Dilated cardiomyopathy (DCM) is a heart muscle disease characterized by ventricular dilatation and impaired systolic function. Patients with DCM suffer from heart failure, arrhythmia, and are at risk of premature death. DCM has a prevalence of one case out of 2500 individuals with an incidence of 7/100,000/year (but may be under diagnosed). In many cases the disease is inherited and is termed familial DCM (FDC). FDC may account for 20–48% of DCM. FDC is principally caused by genetic mutations in FDC genes that encode for cytoskeletal and sarcomeric proteins in the cardiac myocyte. Family history analysis is an important tool for identifying families affected by FDC. Standard criteria for evaluating FDC families have been published and the use of such criteria is increasing. Clinical genetic testing has been developed for some FDC genes and will be increasingly utilized for evaluating FDC families. Through the use of family screening by pedigree analysis and/or genetic testing, it is possible to identify patients at earlier, or even presymptomatic stages of their disease. This presents an opportunity to invoke lifestyle changes and to provide pharmacological therapy earlier in the course of disease. Genetic counseling is used to identify additional asymptomatic family members who are at risk of developing symptoms, allowing for regular screening of these individuals. The management of FDC focuses on limiting the progression of heart failure and controlling arrhythmia, and is based on currently accepted treatment guidelines for DCM. It includes general measures (salt and fluid restriction, treatment of hypertension, limitation of alcohol intake, control of body weight, moderate exercise) and pharmacotherapy. Cardiac resynchronization, implantable cardioverter defibrillators and left ventricular assist devices have progressively expanding usage. Patients with severe heart failure, severe reduction of the functional capacity and depressed left ventricular ejection
World Health Organization, Copenhagen (Denmark). Regional Office for Europe.
This document is made up of a selection of some of the papers distributed to participants in courses on "Family Health and Family Planning" which have been organized each year since 1973 by the International Children's Center and the World Health Organization Regional Office for Europe. Six courses, held between 1973 and 1978, brought together a…
Breit, Miranda; And Others
Describes the operation of a 10-session brief therapy unit for families who have failed in more traditional treatment modalities. Case material is presented to exemplify five different treatment strategies: symptom prescription, reframing, illusion of alternatives, role play, and strategic alliances. Advantages and limitations are discussed.…
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The introduction of assisted reproduction has led to unusual forms of procreation. This article describes the social consequences of lesbian motherhood and of families headed by single heterosexual mothers. PMID:15819999
Santos, Charles Morphy D; Carmo, Daniel D D
The family Rhagionidae is one of the oldest Brachyeran lineages. Its monophyly is still uncertain. There are four rhagionid genera distributed in Neotropical Region but only three species of Chrysopilus are found in Colombia. PMID:27395270
Falaschi, Rafaela Lopes; Oliveira, Sarah Siqueira; Amorim, Dalton De Souza
The Bibionidae are a family belonging to the suborder Bibionomorpha with four genera and 17 species known from Colombia. This work expands the distribution of these species to other localities in the country. PMID:27395253
Pickett, Robert S.
Author states that "...the traditional form of family which has been the norm in recent times in the West will persist, but will be forced to "move over" to accommodate other forms of domestic life." (Author)
... not mean that everyone gets along all the time. Conflicts are a part of family life. Many things can lead to conflict, such as illness, disability, addiction, job loss, school problems, and marital issues. Listening to ...
Dr Robert Smith surveys the history of birth control and sounds a warning for the future of mankind, if the population explosion is allowed to continue unchecked. He stresses the importance of the role of the general practitioner in the limitation of births. Sir Theodore Fox describes the work of the Family Planning Association and stresses that, increasingly, this is a specialist service covering all aspects of fertility. He also feels that the general practitioner has a role in family planning. PMID:5954261
Provides strategic and structural therapy concepts to use when addressing a child's school phobia. Describes how a family systems approach, which is solution-focused, employs family resources and fosters parental competencies. Offers a case study with a careful analysis of each session. Discusses implications for school counselors. (RJM)
Schachter, Robert S.
Kinetic Psychotherapy consists of young children's games which facilitate interaction and mobilize feelings. When used as a mode of family therapy, this process enables the therapist to catalize and observe change in the family's patterns of communication, interaction, and level of functioning while involving members in a relatively nonthreatening…
Nichols, William C.
Directed at practitioners and students of family therapy, this book presents a treatment framework that is compatible with a wide variety of therapeutic techniques. Focusing on the development over time of the family life cycles--from marriages in formation to the "postparental couple"--this book explores the unique challenges and opportunities…
Sinha, N K
Between 1901-1921, India gained 12.9 million people because mortality remained high. The death rate fell between 1921-1951, but birth rates remained the same. Therefore 110 million people were added--2 times the population increase between 1891-1921. Between 1951-1981, the population increased to 324 million. Socioeconomic development was responsible for most of the downward trend in the birth rate during the 20th century. Even though large families were the norm in early India, religious leaders encouraged small family size. The 1st government family planning clinics in the world opened in Mysore and Bangalore in 1930. Right before Independence, the Bhore Committee made recommendations to reduce population growth such as increasing the age of marriage for girls. Since 1951 there has been a change in measures and policies geared towards population growth with each of the 7 5-Year Plans because policy makers applied what they learned from each previous plan. The 1st 5-Year Plan emphasized the need to understand what factors contribute to population growth. It also integrated family planning services into health services of hospitals and health centers. The government was over zealous in its implementation of the sterilization program (2nd 5-Year Plan, 1956-1961), however, which hurt family planning programs for many years. As of early 1992, sterilization, especially tubectomy, remained the most popular family planning method, however. The 7th 5-Year Plan changed its target of reaching a Net Reproductive Rate of 1 by 2001 to 2006-2011. It set a goal of 100% immunization coverage by 1990 but it did not occur. In 1986, the Ministry of Health and Family Welfare planned to make free contraceptives available in urban and rural areas and to involve voluntary organizations. The government needs to instill measures to increase women's status, women's literacy, and age of marriage as well as to eliminate poverty, ensure old age security, and ensure child survival and
Constraint-induced (CI) therapy is a term given to a family of efficacious neurorehabilitation treatments including to date: upper extremity CI movement therapy, lower extremity CI movement therapy, pediatric CI therapy, and CI aphasia therapy. The purpose of this article is to outline the behavior analysis origins of CI therapy and the ways in…
Bouhairie, Victoria Enchia; Goldberg, Anne Carol
Familial hypercholesterolemia is a common, inherited disorder of cholesterol metabolism that leads to early cardiovascular morbidity and mortality. It is underdiagnosed and undertreated. Statins, ezetimibe, bile acid sequestrants, niacin, lomitapide, mipomersen, and low-density lipoprotein (LDL) apheresis are treatments that can lower LDL cholesterol levels. Early treatment can lead to substantial reduction of cardiovascular events and death in patients with familial hypercholesterolemia. It is important to increase awareness of this disorder in physicians and patients to reduce the burden of this disorder. PMID:26892994
Fachin, Diego Aguilar; De Assis-Pujol, Cristiane Vieira
The family Stratiomyidae has more than 2,800 described species, of which 1001 species belongs to the Neotropics. This catalog for Colombia presents 87 species distributed in 32 genera, and ten subfamilies. Merosargus gracilis and the genus Microchrysa, with a single species M. bicolor are recorded for the first time to Colombia. The fauna is very expressive but still poorly known, representing nearly one tenth of the Neotropical diversity of the family in numbers of species, and one fifth of generic diversity. PMID:27395274
Cleek, Elizabeth N; Wofsy, Matt; Boyd-Franklin, Nancy; Mundy, Brian; Howell Lcsw, Tamika J
The family empowerment program (FEP) is a multi-systemic family therapy program that partners multi-stressed families with an interdisciplinary resource team while remaining attached to a "traditional" mental health clinic. The rationale for this model is that far too often, families presenting at community mental health centers struggle with multiple psychosocial forces, for example problems with housing, domestic violence, child care, entitlements, racism, substance abuse, and foster care, as well as chronic medical and psychiatric illnesses, that exacerbate symptoms and impact traditional service delivery and access to effective treatment. Thus, families often experience fragmented care and are involved with multiple systems with contradictory and competing agendas. As a result, services frequently fail to harness the family's inherent strengths. The FEP partners the family with a unified team that includes representatives from Entitlements Services, Family Support and Parent Advocacy, and Clinical Staff from the agency's Outpatient Mental Health Clinic practicing from a strength-based family therapy perspective. The goal of the FEP is to support the family in achieving their goals. This is accomplished through co-construction of a service plan that addresses the family's needs in an efficient and coherent manner-emphasizing family strengths and competencies and supporting family self-sufficiency. PMID:22690861
Lopez, M. Elena; Dorros, Sybilla
The Families Matter series of papers from the Harvard Family Research Project advances the concept of family-centered child care, advocating an approach to early childhood education that addresses the development of the child and family together. Grounded in family support principles, which build on family strengths and work from a community's…
Thune-Larsen, Kari-Brith; Vrabel, Karianne
Working with families with a child or an adult with an eating disorder is to work with the resources and limitations in the families, how they could cope with this challenge. Family interventions in eating disorders are counselling, working with the family and family-oriented therapy. Studies show documented effects, especially for patients below 18 with anorexia nervosa who have had this disorder for less than three years. Indications for going from working with the family to family therapy are conflicts between parents or between the child and parents, delayed or disturbed psychological development of the child, or when siblings or other family members are believed to have an effect on the healing. Family therapy is to work with the family as a system. The professional responsibilities, the practical tasks and the goals are about interaction in the family, about relations and communication patterns. Interventions in the family are mainly rooted in systemic family therapy. Motivational methods are important, as are cognitive methods and psychoeducational methods, information and learning how to cope with eating disorders. PMID:15356693
This paper considers the structure of family income, examines some factors affecting family size, reviews alternative definitions of an adequate income for families with varying numbers, and presents data on actual consumption, according to family income and family size. A model depicting the causal relations among factors affecting consumption is…
Stowasser, M; Gordon, R D
Primary aldosteronism (PAL) may be as much as ten times more common than has been traditionally thought, with most patients normokalemic. The study of familial varieties has facilitated a fuller appreciation of the nature and diversity of its clinical, biochemical, morphological and molecular aspects. In familial hyperaldosteronism type I (FH-I), glucocorticoid-remediable PAL is caused by inheritance of an ACTH-regulated, hybrid CYP11B1/CYP11B2 gene. Genetic testing has greatly facilitated diagnosis. Hypertension severity varies widely, demonstrating relationships with gender, affected parent's gender, urinary kallikrein level, degree of biochemical disturbance and hybrid gene crossover point position. Analyses of aldosterone/PRA/cortisol 'day-curves' have revealed that (1) the hybrid gene dominates over wild type CYP11B2 in terms of aldosterone regulation and (2) correction of hypertension in FH-I requires only partial suppression of ACTH, and much smaller glucocorticoid doses than those previously recommended. Familial hyperaldosteronism type II is not glucocorticoid-remediable, and is clinically, biochemically and morphologically indistinguishable from apparently sporadic PAL. In one informative family available for linkage analysis, FH-II does not segregate with either the CYP11B2, AT1 or MEN1 genes, but a genome-wide search has revealed linkage with a locus in chromosome 7. As has already occurred in FH-I, elucidation of causative mutations is likely to facilitate earlier detection of PAL and other curable or specifically treatable forms of hypertension. PMID:11595502
Carvalho-Fernandes, Sheila Patrícia
Sciaridae are a widely distributed family with high number of species. They are known as black fungus gnats due to their dark color and feeding activity. This catalogue presents 17 species from Colombia distributed in eight genera, and for each species the geographical distribution is provided. PMID:27395255
Maia, Valéria Cid
This large family is poorly known in Colombia, where only 44 species have been recorded in 20 genera. All of them are included in Cecidomyiinae, which is the most diverse subfamily of gall midges in number of species and feeding habits, including phytophagous, predaceous and fungivorous species. Most of them are galler. The other subfamilies have never been recorded in this country. PMID:27395254
Koda, Yu Kar Ling; Vidolin, Eliana
A 7-year-old white boy was referred to us with a history of 3 attacks of hypogastric pain over the previous 2 years and persistently elevated serum amylase concentrations. At physical examination, he was well with no evidence of clinical abnormalities. His weight and height were normal. Laboratory diagnostic investigations were all normal except for the presence of Ascaris lumbricoides in the feces and persistently elevated serum amylase levels. Serum amylase determinations in the family members were normal in his father and maternal grandmother but elevated in his mother, sister, maternal aunt, and uncle, all of whom asymptomatic. Macroamylasemia was excluded in the child and in the mother. The finding of persistently elevated amylasemia in the child and in the other family members spanning 3 generations, and the exclusion of diseases that lead to hyperamilasemia are consistent with the diagnosis of familial hyperamylasemia. Until now, only 1 similar case has been reported. Familial hyperamylasemia must be considered in the differential diagnosis of hyperamylasemias in childhood. PMID:11981589
Sorgen, Carol, Ed.
This quarterly publication, issued by the National Institute on Alcohol Abuse and Alcoholism (NIAAA), contains articles dealing with family violence and alcohol abuse, children of alcoholic parents, training programs for counselors, and confidentiality of client records. The three articles on alcohol abuse suggest that: (1) there is a clear…
Araoz, Daniel L.; Negley-Parker, Esther
A therapeutic model to help families activate experiential and right hemispheric functioning through hypnosis is presented in detail, together with a clinical illustration. Different situations in which this model is effective are mentioned and one such set of circumstances is described. (Author)
This article provides a brief review of the taxonomic structure, virion properties, genome organization and replication strategy, antigenic properties, and biological properties of viruses in the family Tymoviridae. Criteria for demarcation of genus and species are provided. A brief review of each...
Wolff, Marta; Lamas, Carlos José Einicker
Asilidae is one of the largest Diptera families with more than 7,000 recognized species worldwide. All their species are predators on arthropods, mainly insects. This catalogue presents 71 species distributed in 26 genera, ten tribes or generic groups and four subfamilies. For each species we present the available geographical information and relevant references. PMID:27395278