McDowell, Teresa; Knudson‐Martin, Carmen; Bermudez, J. Maria
doi: 10.1111/famp.12383pmid: 30178616
We contend that the field of family therapy is undergoing a notable shift from second‐ to third‐order thinking. We offer theoretical support and examples to demonstrate how third‐order thinking provides a framework for integrating heightened sociocultural attunement into family therapy practice. We discuss the importance of third‐order thinking relative to being prepared to invite families into third‐order change. Finally, we offer a case example to show specific guidelines for third‐order practice.
doi: 10.1111/famp.12427pmid: 30729514
Social justice tends to be narrowly defined as equality without due recognition of human dignity and respect for those whose daily lives continue to be adversely impacted by race. This article seeks to explore key issues and challenges at the intersection of social justice and race for couple and family therapy. These include: (a) defining social justice; (b) diversity and inclusion; (c) power and privilege; (d) witness; and (e) personal responsibility.
doi: 10.1111/famp.12429pmid: 30786004
Low‐income Latinas/os are exposed to widespread mental health disparities in the United States. Most recently, a resurgence of anti‐immigration narratives has led vulnerable Latina/o immigrants to experience considerable contextual stressors with multiple deleterious consequences for their overall well‐being, including significant disruptions to their parenting practices. Within this context of adversity and despite the multiple benefits associated with parent training (PT) prevention interventions, the availability of contextually and culturally relevant PT interventions remains limited in underserved Latina/o communities. This paper constitutes a contribution to this gap in knowledge by presenting a model of intervention delivery utilized in the dissemination of culturally adapted versions of the evidence‐based intervention known as GenerationPMTO.© The proposed model also describes a process of change that we have documented in empirical research with low‐income Latina/o immigrant parents who have been exposed to the adapted interventions. The manuscript is organized in four sections. First, an overview of the model is discussed, along with a brief summary of major theories. Next, the core components of the model are described, complemented by the presentation of a case study. Finally, implications for prevention and clinical intervention are discussed.
Anderson, Riana E.; McKenny, Monique C.; Stevenson, Howard C.
doi: 10.1111/famp.12412pmid: 30552778
Researchers have illustrated the deleterious psychological effects that racial discrimination has exerted on Black Americans. The resulting racial stress and trauma (RST) from experiences with discrimination has been linked to negative wellness outcomes and trajectories for Black youth and families. Racial socialization (RS)—defined as the verbal and nonverbal messages that families use to communicate race to their children—can be a cultural strength and has been associated with positive outcomes in Black youth. Furthermore, the Racial Encounter Coping Appraisal and Socialization Theory (RECAST) encourages the frequent and competent use of RS between family members to cope with the negative impact of RST. Guided by RECAST, the purpose of this article is to describe the development of the Engaging, Managing, and Bonding through Race (EMBRace) intervention targeting the RS practices between Black adolescents and families. The authors explore current research on RST, discuss why traditional coping models for stress are inadequate for racially specific stressors, highlight RECAST as a burgeoning racial coping and socialization model, and describe how RS can be used as a tool to intervene within Black families. This is followed by a detailed description of the development and use of the EMBRace intervention which seeks to reduce RST through RS psychoeducation and practice, stress management, and the promotion of bonding in Black families. This article aims to serve as an example of a culturally relevant RS intervention for Black families who may benefit from clinical treatment for psychological distress from racially discriminatory encounters.
Roesler, Thomas A.; Nassau, Jack H.; Rickerby, Michelle L.; Laptook, Rebecca S.; DerMarderosian, Diane; High, Pamela C.
doi: 10.1111/famp.12350pmid: 29600509
This paper describes a unique treatment program for complex pediatric illness. The Hasbro Children's Partial Hospital Program uses a family systems orientation, integrated care, and a partial hospital setting to treat children with a wide range of pediatric illnesses that have failed outpatient and inpatient treatments. We have treated more than 2000 children with at least 80 different ICD‐9 diagnoses. The multidisciplinary treatment team functions as a meta‐family for children and their families who present with illness and family beliefs that impede successful outcomes with standard care. The three features: family systems orientation, integrated care, and partial hospital setting, hopefully interact to create an environment that helps families expand and modify their explanatory models regarding participating in effective medical care. The goal of treatment is for both children and their parents to feel empowered to take control of the illness. Parents completing standardized measures at intake describe their children and families as experiencing significant emotional distress, low levels of general family functioning, and poor quality of life. Although the children are described as having distinct behavioral differences, the families are described as responding to the experience of a seriously ill child in similar ways. A treatment program that addresses the noncategorical aspects of how families respond to illness while addressing the specific diseases of the children can allow children and their families to respond favorably to treatment.
Priest, Jacob B.; Roberson, Patricia N. E.; Woods, Sarah B.
doi: 10.1111/famp.12357pmid: 29577264
The objective of this study was to use the Biobehavioral Family Model (BBFM) to delineate which psychophysiological variables link romantic and family relationship satisfaction variables to health outcomes. Data from individuals who reported being partnered from the second wave of the National Survey of Midlife Development in the United States (MIDUS II), Project 4 (n = 812) were used to test a structural equation model which explored which psychophysiological variables potentially mediated associations between positive and negative family emotional climate variables and disease activity. This model found that current and past family variables had larger associations with the psychophysiological variables than romantic partner variables; depressive symptoms, anxiety, and inflammation partially mediated associations between family relationships and health; and, contrary to the hypotheses, romantic partner and family support were linked to worse health outcomes. However, the findings should be viewed with regard to the cross‐sectional design of the study. Overall, the findings support the use of the BBFM as a model that can guide clinical interventions.
Emerson, Natacha D.; Morrell, Holly E. R.; Neece, Cameron; Tapanes, Daniel; Distelberg, Brian
doi: 10.1111/famp.12361pmid: 29663349
Although self‐concept has been identified as salient to the psychosocial adjustment of adolescents dealing with a chronic illness (CI), little research has focused on its predictors it. Given that depression and parent–child attachment have been linked to self‐concept in the population at large, the goal of this study was to evaluate these relationships longitudinally in a sample of adolescents with CI. Using participant data from the Mastering Each New Direction (MEND) program, a 3‐month psychosocial, family based intensive outpatient program for adolescents with CI, we employed multilevel modeling to test longitudinal changes in self‐concept, as predicted by depressive symptoms and parent–child attachment, in a sample of 50 youths (Mage = 14.56, SDage = 1.82) participating in MEND. Both “time spent in the program” and decreases in depressive symptoms were associated with increases in self‐concept over time. Higher baseline levels of avoidant attachment to both mother and father were also associated with greater initial levels of self‐concept. Targeting depressive symptoms and supporting adaptive changes in attachment may be key to promoting a healthy self‐concept in pediatric CI populations. The association between avoidant attachment and higher baseline self‐concept scores may reflect differences in participants’ autonomy, self‐confidence, or depression. Limitations of the study include variability in the amount of time spent in the program, attrition in final time point measures, and the inability to fully examine and model all potential covariates due to a small sample size (e.g. power).
Zhang, Xian; Pinderhughes, Ellen E.
doi: 10.1111/famp.12355pmid: 29533467
Parents raising children adopted from a different racial/ethnic group usually engage in cultural socialization—providing activities in adoptees’ birth culture—hoping to instill pride and help adoptees develop a positive identity. Adoptive parents engage in a wide variety of socialization activities, yet adult adoptees have reported not having deep enough exposure from their parents. The present study explored the depth of cultural socialization in transracial adoptive families. Informed by Pinderhughes' Ethnic‐Racial Socialization model, this study developed a continuum examining the depth in cultural socialization with three indicators: (1) the depth of cultural activities, (2) parents’ motivation for cultural socialization, and (3) parental cultural attitudes. Qualitative analyses of 41 White parents raising children adopted from China found that parents’ motivation and acknowledgement of cultural differences reflected deep appreciation of adoptees’ birth culture, however, activities they provided were not as deep. Activities that facilitated close relationships with people who shared adoptees’ background in a natural context appeared to provide the deepest cultural connection. Despite limitations, the study demonstrated that the depth continuum was able to capture variations and nuances in cultural socialization. Suggestions for future research and recommendation for practice were also included.
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