FEATURES - Family Therapy Magazine

May / June 2024 Volume 23, No. 3

From Exhaustion to Empowerment: A Therapist’s Guide to Supporting Clients Through Burnout

Maria, 34, comes into your office and slumps into the couch opposite you. She looks drained, and you notice that her outfit seems a little less put-together than usual. Something is clearly going on. She immediately dives into how “over work” she is, citing a micromanaging boss, unrealistic expectations, and no time off to speak [...]

March / April 2024 Volume 23, No. 2

How EMDR Therapy Helps Families and Individuals with Disabilities

Individuals with intellectual, developmental, and physical disabilities are more likely to experience traumatic experiences than individuals without a disability (i.e., Rumball, 2020; Hulbert-Williams et al., 2014; Soylu et al., 2013). For instance, approximately 45% of individuals with autism report symptoms of post-traumatic stress disorder (PTSD; Rumball, 2020). Adults with intellectual disability are more likely to [...]

March / April 2024 Volume 23, No. 2

Systemic Family Therapy and Disabilities

Family Systems Illness Model and neurodevelopmental disabilities John Rolland’s Family Systems Illness (FSI) model provides a systemic framework for us to conceptualize both disabilities and family functioning as well as their intersection and reciprocal influences (Rolland, 2018). Foundational to the field of marriage and family therapy is systems theory, conceptualizing health issues within their relational [...]

March / April 2024 Volume 23, No. 2

When “Miracles” Aren’t Possible: Careful Considerations When Working with a Client or Family with a Disability

I stopped seeing my therapist because she kept stating that my Autism was a ‘problem’ or asking me what life would be like without it. It started to make me feel bad about myself. Much like working with any diverse population, when working with clients with a physical, developmental, or intellectual disability, our language needs [...]

January/February 2024 Volume 23, No. 1

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 [...]

January/February 2024 Volume 23, No. 1

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 [...]

January/February 2024 Volume 23, No. 1

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 [...]

November / December 2023 Volume 22, No.6

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 [...]

November / December 2023 Volume 22, No.6

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 [...]

November / December 2023 Volume 22, No.6

Indigenizing the Workforce and Workplace

When I was a newly licensed therapist, nearly 20 years ago, it was even rarer to have access to an Indigenous mental health provider. As a marriage and family therapist, I often heard comments like: “It is so easy to talk to you,” “You understand me,” and “You are not judging me.” These comments were [...]

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