NOTEWORTHY - Family Therapy Magazine

January / February 2022 Volume 21, No. 1

global perspectives Family-based Intervention for Chinese Families with Children with ADHD AAMFT Professional Member Joyce L. C. Ma, PhD, reviewed the clinical utility of family-based treatment (FBT), comprised of multiple family therapy (MFT) and structural family therapy (SFT), in helping Hong Kong Chinese families with children with attention deficit hyperactivity disorder (ADHD). Ma identifies the [...]

November / December 2021 Volume 20, No. 6

Ethical Practice & Global Perspectives

data note global perspectives A Multifamily Therapy Model in Havana, Cuba Interfamily therapy (IFT) is a specific model for multifamily therapy of recent expansion in Latin American and European countries. The term multifamily therapy refers to a range of therapeutic interventions carried out in multifamily groups, which are therapeutic environments in which both patients and [...]

September / October 2021 Volume 20, No. 5

Obesity, Nutrition, & Global Perspectives

data note therapy talk In “What MFTs Should Know About Nutrition, Psychosocial Health, and Collaborative Care with Nutrition Professionals,” by Josh R. Novak, Lindsey P. Robinson, and Leslie E. Korn, published July 15, 2021 in the Journal of Marital and Family Therapy, the authors note that “MFTs should consider the client's sociocultural context when it [...]

July / August 2021 Volume 20, No. 4

Nurturing Nature & Global Perspectives

therapy talk In the JMFT article “Nurturing Nature: Exploring Ecological Self-of-the-Therapist Issues,” authors Tracey A. Laszloffy and Sean D. Davis (2019) note that the ﬁeld of family therapy has its roots in the systemic premise that context shapes our realities. We cannot understand individuals devoid of seeing them in their family context, and we cannot [...]

May / June 2021 Volume 20, No. 3

Living with Disabilities

data note therapy talk From the Journal of Marital and Family Therapy—Expanding our international reach: Trends in the development of systemic family therapy training and implementation in Africa Authors Ronald Asiimwe, Elmien Lesch, Michelle Karume, and Adrian J. Blow discuss how family therapy is growing around the world, including in many parts of Africa. Although [...]

March / April 2021 Volume 20, No.2

Data and Research on Transgender Populations

data note therapy talk “We’re just two people in a relationship”: A qualitative exploration of emotional bond and fairness experiences between transgender women and their cisgender partners: Appearing in JMFT Early View — Trans‐including couples experience systemic marginalization impacting their relationships, yet studies on these relationships or narratives of strength are few. AAFMT Clinical Fellow [...]

January / February 2021 Volume 20, No. 1

Multilateralism

therapy talk Recently on the AAMFT Blog, AAMFT Clinical Fellow Laurie L Charlés, PhD, LMFT, wrote: Multilateral, a term more utilized in international politics rather than family therapy, is about collaboration, and about working together across borders and sovereign states on global issues. Systemic thinkers are natural multilateralists—skilled at lateral engagement—able to work across multiple [...]

November / December 2020 Volume 19, No. 6

Social Relationships

therapy talk Relationships Matter. Associations Matter. People who are more socially connected to community are happier, physically healthier and live longer, with fewer mental health problems than those less well connected. As a society and as individuals, we must invest in building and maintaining good relationships and tackling the barriers to forming them. Relationships not [...]

September / October 2020 Volume 19, No. 5

Baby Boomers and the Demographic Shift

therapy talk Within 10 years, all of the nation’s 74 million baby boomers will be 65 or older. The most senior among them will be on the cusp of 85. Experts say the U.S. isn’t prepared for this vast demographic shift and its far-reaching consequences. Never have so many people lived so long, entering the [...]

July / August 2020 Volume 19, No. 4

Racial Justice

therapy talk We owe it to ourselves, and to the families and communities we serve, to work for racial justice not just at the ballot box on election day, but in our everyday interactions. Our privilege gives us voice in the larger culture. Speaking up is one of the most important ways we can use [...]

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