Melissa Allen - Family Therapy Magazine

Supporting Daughters of Latin American Immigrants Navigating Higher Education

A topic seldom discussed is the challenges that daughters of Latin American immigrants face and overcome when seeking higher education. Studies have shown there has been an increase in Latin women pursuing higher education than in previous years (Mora, 2022). Despite the growing numbers, attainment of degrees often stays the same due to the incompletion [...]

Beyond Our Struggles: Addressing Stereotypes in Latinx Families

In 2020, the U.S. Latinx population reached 62.1 million, constituting 19% of the entire American population. This positions it as the second-largest racial or ethnic group in the nation, following White Americans, as reported by the U.S. Census Bureau (2021). Since 1970, when Latinx people made up 5% of the U.S. population and numbered 9.6 [...]

From Adversity to Empowerment: Using Ancestral Stories to Guide Latinx Therapy

The Latinx community finds richness in the art of storytelling folk traditions that have shaped many Latin-American countries since the times of their independence from Spain in the 19th century (Miller, 2004). As bilingual marriage and family therapists (MFTs), supervisors, and instructors at a Hispanic-serving institution, we have witnessed the relevance and power of using [...]

Journal of Marital and Family Therapy Award Winners

Each year, the editor of Journal of Marital and Family Therapy, in consultation with the advisory council, selects an article to honor as the “Article of the Year.” This year, two articles have been selected. Article reviewers consider impact, originality, and quality of the scholarship in each manuscript. 2022 Award Winners Article of the Year [...]

All Hands on Deck: Let Us Serve With Those Who Serve

“Thank you for your service” is a statement that those currently serving, or who have served, in the U.S. military receive from family, friends, and strangers. Additionally, Thank You For Your Service is the title of a movie that was released in 2017, which depicts U.S. soldiers returning home from Iraq and their struggles to [...]

Maybe I Was Overreacting: A MedFT’s Role with Autism Spectrum Disorder

One in 44 children was diagnosed with autism in 2020 (Maenner et al., 2021), or approximately 1.7% of children in the United States (Bridgemohan et al., 2019). Despite increasing autism awareness, parents still express dissatisfaction with care from their primary care physician (PCP; Carbone et al., 2010). One-third of parents expressed concerns with the diagnostic [...]

What Is “Science-based” Therapy and How Do I Practice It?

After a decade of working with clients, there are important questions I’m asking myself. Why do I use the theories I use? What makes therapy effective? Why do some clients fail to meet treatment goals? And how do I practice science-based therapy? These questions are related, but the very last question is the one I’ll [...]

Dangerous Patients and You—Terminating a Contentious Relationship

Treating dangerous patients who represent a risk to themselves or others can often trigger worrisome ethical issues—What constitutes a reportable danger? Does a specific person have to be threatened? How specific does the threat have to be? Who must be informed of the threat? These are common but complex issues that are frequently discussed in [...]

Making Social Justice “Stick”

Social justice is a term that is frequently heard in marriage and family therapy (MFT) training programs. However, there is evidence that suggests that even when social justice is taught and discussed in the learning environment, it doesn’t end up in practice later (Bell, 2007; Almeida et al., 2008; Nixon et al., 2010) How can [...]

Increasing Belongingness for the Future of MFT Programs, the Field, and Our Association

Social, environmental, and contextual stressors can lower students’ academic pursuit for post-secondary education and professionals’ engagement with the field and AAMFT, and often create barriers to success. I [NI] believe within the field of marriage and family therapy, the question of “why it matters who the services come from?” needs to be addressed in depth [...]

TREATNET Family and the United Nations: Family Therapy with Adolescents at Risk of Substance Abuse and Contact with the Criminal Justice System

In 2018, we (LLC and MP) met in person for the first time in the lobby outside a large conference room at the United Nations Office in Vienna. Although we had collaborated previously (Palit & Levin, 2016; Charlés & Samarasinghe, 2016), we had never met face-to-face. In Vienna, we were invited participants in a United Nations Office on Drugs and Crime (UNODC) technical consultation: “Elements of Family-based Treatments for Adolescents with Drug Use Disorders: Creating Societies Resilient to Drugs and Crime.” This consultation meeting included 25 experts across the fields of family therapy, staff from the UNODC PTRS unit, and the World Health Organization, and subject matter experts in substance use disorders and countering violent extremism. The meeting was convened for a memorable week in Vienna, with participants from over 13 countries. The goal of the meeting was “to identify key elements of effective approaches to the treatment of adolescents with drug use disorders and to provide guidance for the development of a UN training package on family therapy.” A key aspect of the “effective approaches” and “guidance” asked of us as a group of technical experts was that we had to consider FT adaptation and implementation in low and middle income countries. The challenge is clear; while research studies in many contexts illustrate how systemic family therapy practices are part of the evidence base, Busse et al. (2021) noted that:

…almost all these studies were conducted in high-income countries and almost all of them were conducted within a research context in university setting. As such, the findings might not be generalisable to studies conducted in LMICs …. Furthermore, adolescents with SUDs and their families in LMICs do not have or very little access to effective treatment such as family-based therapy. To address this accessibility gap as well as to increase quality and diversity of treatment options for adolescents with drug and other SUDs, the Treatnet Family (TF) was developed by the United Nations Office on Drugs and Crime (UNODC; 2020). (p. 2)

That package that was begun in 2018 in Vienna is now called Treatnet Family (see below for an example of some of the concepts addressed in the package). Treatnet Family has been a part of feasibility studies, has been implemented in many countries and regions, and involved hundreds of practitioners across the globe. The package is openly accessible at no cost, and as of this writing, has been translated into four languages, with more on the way. We need more multilateral efforts and collaborations like this one, and family therapy as an established field needs to hear much more and much more often about the ways practice must be adapted to meet country contexts across the globe.

A recent publication by Busse et al. (2021) described Treatnet Family (TF) as:

containing elements of evidence-based family therapy which has been developed specifically for adolescents with SUDs and their families in low resource settings. TF focuses on family interactions and uses elements of family therapy to interrupt ineffective communication within the family. It contains the key components of family therapy, such as:

positive reframing (i.e., positive labeling of a negative behavior without necessarily accepting it as fine. It involves emphasizing the possible positive intent behind a seemingly negative behavior),
positive relational reframing (i.e., positive labeling of a negative behavior in relationship to the family without necessarily accepting it as okay. Even when the behavior is self-destructive, the intent behind it can be understood and appreciated, yet not necessarily condoned).
perspective taking (i.e., developing empathy and the ability to take another person’s viewpoint into account).
relational questions (i.e., to support perspective taking, relational questions are asked [e.g., “When Narendra gets into trouble, who feels most sorry for him?”] in order to encourage perspective taking and relational thinking).
going with resistance (i.e., helping family members feel heard and understood, which reduces defensiveness and makes more productive conversations possible).

TF has six sessions, with each session lasting between 90 and 120 minutes. Each session is to be attended by the adolescent with SUDs and his/her family members because the primary focus of the sessions is on the relationships among family members. The practitioner’s role is to interrupt problematic cycles, ineffective communication, and harmful behaviors family members currently use to meet their emotional and interpersonal needs. As change in family interaction can influence each family member’s behavior, family members are encouraged to be part of the solution.” (p. 2)

For more on Treatnet Family: https://www.unodc.org/documents/southeasterneurope/UNODC_Treatnet_Family_brochure_190320.pdf

Author: Melissa Allen