Unveiling the shadows: Exploring the reality of commercial sexual exploitation among LGBTQ+ youth in out-of-home care.

BACKGROUND: LGBTQ+ youth frequently encounter familial rejection based on their sexuality and gender identity and are at greater risk of being maltreated by their family, often prompting them to leave or run away from their parents' home. Such youth may find themselves living independently and, once they leave home, tend to be vulnerable to all kinds of abuse and sexual victimization, sometimes leading to different types of commercial sexual exploitation. OBJECTIVE: This study aimed to comprehensively explore the subjective perspectives and understandings of commercial sexual exploitation among LGBTQ+ youth in out-of-home care in Israel. METHODS: The study employed a critical constructivist grounded theory approach. Thirty-one in-depth semi-structured interviews were conducted with LGBTQ+ youth aged 16 to 32 (average 21.6), who aged out of one or more of the out-of-home care services for LGBTQ+ youth in Israel. RESULTS: Our analysis indicates four main constructions of commercial sexual exploitation that depict the experiences of the participants: (1) survival sex; (2) gray prostitution; (3) sugar daddy; and (4) sex work. CONCLUSIONS: Our findings highlight the diverse manifestations of commercial sexual exploitation among LGBTQ+ youth, shedding light on its pervasive nature and significant scale. Several of these manifestations are characterized by ambivalence and are placed in the gray areas of commercial sexual exploitation, making it challenging to identify.

"I miss not being able to offer my couples a box of tissues ": Couples' and therapists' perspectives on the therapeutic alliance with the transition to online couple therapy.

The purpose of this study is to advance theory concerning the experiences of couples and therapists involved in online couple therapy and the meanings they assign to them, with a particular focus on the therapeutic alliance. Using constructivist grounded theory methodology, in-depth semi-structured online interviews were conducted with 36 individuals, including 18 couples who had participated in online couple therapy via videoconference. Additionally, 15 couple and family therapists were interviewed in four online focus groups. Our analysis indicates three dimensions that impact the formation of the therapeutic alliance in online couple therapy: (1) emotional closeness, as a conduit for establishing physical or emotional space; (2) limited care, due to the therapist's difficulty providing comfort and security; and (3) body language, as reflected in the lack of physical presence and the close inspection of the face, at two opposite ends of a continuum. We discuss our findings through the lens of the closeness-distance dynamic, which posits that therapists' ability to regulate themselves depends on their clients' emotional needs. We conclude with implications for clinical practice.

Not a happy story. A love story: Professional perceptions of love in families with child sexual abuse in two US mid-Atlantic Child Advocacy Centers.

BACKGROUND: Although research on child sexual abuse (CSA) has greatly evolved, studies revealing survivors' conflicting feelings towards their perpetrators and family members are scarce. Professionals' perceptions of love in intrafamilial CSA are often overlooked. OBJECTIVE: The current study examined the perceptions of professionals working on CSA multidisciplinary teams (MDT). The research questions were: (1) How do professionals define love in families with CSA? (2) What are professionals' perceptions of parental love in families with CSA? (3) What are professionals' perceptions of love from the abused child towards their parents and siblings? (4) What are the differences between professionals' perceptions of love and those of the families they serve, and how do professionals deal with these different perceptions during interventions? METHOD: Five focus groups with a total of 34 child advocacy center (CAC) and MDT professionals from two CACs in the US mid-Atlantic region were conducted virtually and analyzed using a thematic approach. RESULTS: The findings indicated that professionals recognized parental love at the center of familial child sexual abuse (FCSA) cases and its range from benevolent and healthy to maladaptive, offensive love. Professionals also recognized the mechanisms enabling children's love for both offending and non-offending parents and complex expressions of love between siblings, even when one sibling sexually abused another. CONCLUSIONS: This study highlights the importance of promoting discourse on love in cases of intrafamilial CSA. Recognizing and embracing the complexity of love bonds may empower the abused child and support their need to believe in their parents' love.

Online clinical supervision in couple and family therapy: A scoping review.

Online clinical supervision, or telesupervision, is a growing practice in couple and family therapy. This scoping review aims to identify and synthesize the existing body of knowledge regarding the utilization, experiences, and perceptions of telesupervision among the couple and family therapists and to highlight gaps in the literature. The review followed the five-step approach proposed by Arksey et al. (2005). Fifteen articles were included and their analysis yielded four themes: 1. telesupervision competence; 2. setting and boundary management; 3. advantages of telesupervision; and 4. challenges of telesupervision. Our review clearly demonstrates the dearth of available conceptual and empirical work. The rapidly growing use of online therapy and telesupervision in couple and family therapy has created a critical need to expand this body of knowledge by collecting evidence that can later be translated into practice. Moreover, we identified several gaps in the existing body of knowledge, including a lack of reports on the efficacy of telesupervision and on the experiences, processes, and ascribed meanings of the supervisors and supervisees. We also noted a lack of practice and ethical guidelines for telesupervision. We conclude our analysis by suggesting areas and directions for further investigation.

Parenting as a full time job: The experience of secular middle-class Jewish parents of transgender emerging adults in Israel.

Background: Emerging adulthood is a developmental period that encompasses individuals from their late teens through at least their mid-twenties, causing parents to be engaged in "parenting" activities longer than in the past. The present study aims to explore the parenting experience and its ascribed meaning among parents of trans emerging adults in Israel. Method: Perceptions and perspectives of 18 Israeli parents of trans emerging adults regarding their parenting experiences were explored using in-depth, semi-structured interviews. All interviews were audiotaped, fully transcribed verbatim, and thematically analyzed. Results: Analysis of the interviews yielded three main themes. The first pertains to parental worries; the second pertains to parental support practices, including accompanying and supporting their child in different arenas and serving as their companions and advocates; and the third pertains to parental coping skills. Conclusion: Participants portrayed the parenting of trans emerging adults as a demanding, challenging, and complex experience which they described as a "full time job." Their parenting experiences revolved around the tension between responding to the special needs of their trans children by helping them navigate this period of experimentation and exploration, and the need to give them autonomy and help them develop the independence they want and need. This tension should be understood in light of the specific situation and the stage of the child's transition, the parent-child relationship, and the family situation, in addition to the wider societal context, which is often hostile and transphobic.

"He Who Spareth the Rod Hateth His Son": Perceptions Regarding Corporal Punishment Among Ultra-Orthodox Jewish Fathers in Israel.

Based on the findings of substantial research, Western professionals today perceive corporal punishment as a threat to child well-being. They also view it as a violation of children's rights. Nonetheless, many minority groups in Western societies still consider it to be a legitimate child-rearing practice. In response to this gap, this article presents qualitative findings from an exploratory context-informed study of Ultra-Orthodox Jewish fathers in Israel, regarding their perceptions and ascribed meanings of corporal punishment. Our exploration was guided by the following research question: What are the constructions, perceptions, beliefs, and meanings associated with corporal punishment among Ultra-Orthodox Litvak fathers in Israel? The thematic analysis of 15 in-depth semi-structured interviews yielded two central themes. The first is the view of corporal punishment as an educational tool with legitimacy based on religious sources and emotion-focused rationales. The second theme deals with different limitations on and guidelines regarding this legitimacy. Children were struck as a result of behavior that parents experienced as extreme, and striking the child in response to religious wrongdoing was viewed as problematic. The fathers interviewed stressed the need to suit the punishment to the child, in terms of the intensity of the blow, frequency, and the age of the child. The fathers also emphasized the importance of the child's subjective experience being one of education as opposed to humiliation. Implications from these findings illustrate the gaps between the Ultra-Orthodox community and professionals who espouse the Western view that prohibits corporal punishment; at the same time, they portray the fathers as expressing an intricate approach toward corporal punishment, with conditions and limitations, as opposed to absolute approval. This article advocates a context-informed approach toward dealing with corporal punishment in minority groups that legitimize the practice. Adopting such an approach may contribute to better cooperation between professionals and their clients from minority groups, and advance child well-being.

Between Vulnerability and Resilience: Parents of Transgender Young Adults.

This study explores the lived experiences of Israeli parents of transgender young adults, depicting gender diversity as a family-relational phenomenon. The analysis of 18 in-depth, semi-structured interviews with Israeli parents of trans young adults suggests that the parents' experiences were characterized by a dialectic between feelings of vulnerability and resilience. The parents' vulnerability was shaped by their social positioning as a minority group as well as their socio-political environment, and their ability to cope with these hardships enhanced their resilience. As the parents developed their resilience through meaning-making, social support, and activism, they gained a new sense of agency alongside a deep sense of vulnerability, suggesting that vulnerability and resilience are not objective, opposite binaries but rather fluid categories that are continually constructed through the intersection of micro- and macro-level factors.

En este estudio se analizan las experiencias vividas por padres israelitas de adultos jóvenes transgénero y se describe la diversidad de género como fenómeno relacional familiar. El análisis de 18 entrevistas profundas semiestructuradas con padres israelitas de jóvenes transgénero indica que las experiencias de los padres estuvieron caracterizadas por una dialéctica entre los sentimientos de vulnerabilidad y de resiliencia. La vulnerabilidad de los padres estuvo determinada por su situación social como grupo minoritario, así como por su entorno sociopolítico, y su capacidad para afrontar estas dificultades mejoró su resiliencia. A medida que los padres desarrollaron su resiliencia mediante la creación de significado, el apoyo social y el activismo, adquirieron una nueva sensación de acción junto con una sensación profunda de vulnerabilidad, lo cual sugiere que la vulnerabilidad y la resiliencia no son binarios objetivos y opuestos, sino categorías variables que se construyen continuamente mediante la intersección de factores a nivel micro y macro.

"Always Thinking About Safety": African American Lesbian Mothers' Perceptions of Risk and Well-being.

Although there is a growing body of knowledge focusing on lesbian families and their parenting experiences, African American lesbian mothers are often underrepresented in research. This qualitative exploratory study aims to understand the constructions and perspectives of African American lesbian mothers, from an urban East Coast area, on risk and well-being. Fifteen in-depth semi-structured interviews were conducted and analyzed at the end of 2016, coinciding with the presidential election yielding main themes that were significant for the participants pertaining to the mothers' experiences and construction of the challenges and risks to well-being. Main themes first focused on discrimination and insensitivity in everyday spaces; then moved into the effects of political climate on perceived safety and security, conditions and unintended consequences of the coming out process; and ended with strategies for reducing risk. Adoption of an intersectional framework to discuss our findings allowed us to explore the ways in which multiple identities engage to shape experiences and constructions of risk and well-being among African American lesbian parents. The results suggest the importance of context (e.g., political, historical, gender-related, racial) when working with LGBTQ+ families of color.

Aunque hay un corpus cada vez más extenso que se centra en las familias lesbianas y sus experiencias de crianza, las madres lesbianas afroamericanas generalmente están infrarrepresentadas en las investigaciones. Este estudio cualitativo exploratorio tiene como finalidad comprender las construcciones y las perspectivas sobre el riesgo y el bienestar de las madres lesbianas afroamericanas de un área urbana de la Costa Este. A finales de 2016, se llevaron a cabo y se analizaron quince entrevistas semiestructuradas detalladas que coincidieron con los temas principales generados por la elección presidencial y que eran significativos para las participantes en relación con las experiencias de las madres y la construcción de las dificultades y los riesgos para el bienestar. Los temas principales se centraron primero en la discriminación y la insensibilidad en los espacios cotidianos; luego pasaron a los efectos del clima político en la seguridad y la protección percibidas, las condiciones y las consecuencias involuntarias del proceso de salir del clóset; y terminó con estrategias para reducir el riesgo. La adopción de un marco interseccional para debatir nuestros resultados nos permitió analizar las maneras en las que interactúan las diferentes identidades para determinar las experiencias y las construcciones de riesgo y bienestar entre madres lesbianas afroamericanas. Los resultados indican la importancia del contexto (p. ej.: político, histórico, relacionado con el género, racial) a la hora de trabajar con familias de color LGBTQ+.

Behind the (Virtual) Mirror: Online Live Supervision in Couple and Family Therapy.

Online therapy and supervision, a rapidly rising practice in couple and family therapy, has been the subject of a growing body of literature. From its early days, family therapy training has included live supervision, which has typically been conducted by a supervisor and a team of trainees situated on the other side of a one-way mirror. With the outbreak of the COVID-19 global pandemic, we-the staff of supervisors at the Barcai Institute in Tel Aviv, Israel-were compelled to find solutions to continue meeting with clients and to provide supervision for family therapy trainees. To this end, we have shifted our live supervision courses ("practicums") to the virtual arena, adapting the popular application "Zoom" into what we call "PractiZoom." Based on over 100 PractiZoom sessions conducted between March and May 2020, involving 14 supervisors and 28 therapists-in-training and their clients, the article reflects on this pioneering online practicum for the online live supervision of therapists with geographically distributed participants. In this article, we outline our operational methods and adaptations for conducting live behind-the-mirror supervision online. Following a short theoretical background, we outline the process of online live supervision, discuss our reflections and those of our trainees on the challenges and possibilities it poses, and offer a number of preliminary conclusions and recommendations.

La terapia y la supervisión en línea, una práctica que está aumentando rápidamente en la terapia de pareja y familiar, ha sido tema de publicaciones crecientes. Desde sus primeros días, la capacitación en terapia familiar ha incluido la supervisión en vivo, que normalmente ha sido dirigida por un supervisor y un equipo de practicantes ubicados del otro lado de un vidrio de visión unilateral. En la medida de nuestro conocimiento, la bibliografía aún tiene que abordar la supervisión en línea en vivo que incluya una familia, un terapeuta, un supervisor y un equipo, todos en línea. Con el brote de la pandemia mundial de la COVID-19, nosotros─el personal de supervisores de Barcai Institute de Tel Aviv, Israel─nos vimos obligados a encontrar soluciones para continuar las reuniones con los pacientes y supervisar a los practicantes de terapia familiar. Con ese fin, hemos trasladado nuestros cursos de supervisión en vivo ("prácticas") al área virtual, adaptando la famosa aplicación "Zoom" a lo que nosotros llamamos "PractiZoom." Sobre la base de 100 sesiones en PractiZoom realizadas entre marzo y mayo de 2020, en las que participaron 14 supervisores y 28 terapeutas en prácticas y sus pacientes, el artículo reflexiona sobre esta práctica innovadora en línea para la supervisión en línea de terapeutas con participantes geográficamente dispersos. En este artículo, describimos nuestros métodos operativos y adaptaciones para llevar a cabo una supervisión en línea en vivo detrás del espejo. Después de un breve marco teórico, describimos el proceso de la supervisión en línea en vivo, debatimos nuestras reflexiones y las de nuestros practicantes sobre las dificultades y las posibilidades que plantea, y ofrecemos numerosas conclusiones y recomendaciones preliminares.

Outsider Witness Groups as a Means of Professional Growth in Family Therapy Training: An Exploratory Qualitative Study.

This exploratory qualitative study examines the experiences and meanings associated with family therapy trainees' participation in the narrative practice of Outsider Witness Groups (OWG). At the Barcai Institute in Tel Aviv, we incorporate OWGs into our live clinical supervision courses. In some sessions, we offer the families undergoing therapy the opportunity to listen to the reflections of the group of trainees regarding what they witnessed during the session. Twenty-nine family therapy trainees participated in the study in five focus group interviews. Analysis of the interviews yielded four core themes regarding the trainees' experiences: (i) Exploring the stance of the therapist; (ii) The art of listening; (iii) Reflection on hierarchy and boundary setting; and (iv) Negotiating self-disclosure. The findings indicate that family therapy trainees stand to benefit significantly in their professional journey, development, and growth from integrating OWG practices into their training. OWG fosters the development of critical reflectivity in trainees, including the deconstruction of common and taken-for-granted assumptions. It also fosters practices related to family therapy, and perhaps also to therapy in general. The findings also suggest that taking part in OWGs during training may contribute to family therapy trainees' development of critical reflectivity as a means of introducing a more critical and political approach to therapy and developing their own preferred stories as therapists.

Este estudio exploratorio cualitativo analiza las experiencias y los significados asociados con la participación de practicantes de terapia familiar en la práctica narrativa con grupos de testigos externos (OWG; White, 2007). En el Barcai Institute de Tel Aviv, incorporamos grupos de testigos externos en nuestros cursos de supervisión clínica en vivo. En algunas sesiones, ofrecemos a las familias que están en terapia la oportunidad de escuchar las reflexiones del grupo de practicantes con respecto a lo que observaron durante la sesión. Veintinueve practicantes de terapia familiar participaron en el estudio en cinco entrevistas de grupos focales. Los análisis de las entrevistas arrojaron cuatro temas principales relativos a las experiencias de los practicantes: (a) el análisis de la postura del terapeuta; (b) el arte de escuchar; (c) la reflexión sobre la jerarquía y la fijación de límites; y (d) la negociación de la autorrevelación. Los resultados indican que los practicantes de terapia familiar salen ganando considerablemente en su recorrido, desarrollo y crecimiento profesional como consecuencia de la integración de las prácticas de grupos de testigos externos en su formación. Los grupos de testigos externos fomentan el desarrollo de la reflexividad crítica en los practicantes, incluida la deconstrucción de los supuestos comunes y dados por sentado. También promueven las prácticas relacionadas con la terapia familiar, y quizá también con la terapia en general. Los resultados también sugieren que formar parte de los grupos de testigos externos durante la formación puede contribuir al desarrollo de la reflexividad crítica de los practicantes de terapia familiar como forma de incorporar un enfoque más crítico y político de la terapia y desarrollar sus propias historias preferidas como terapeutas.

In the eyes of the beholder: Parental and professional value mismatch in child risk and protection in two communities in Israel.

This paper aims to identify several of the mismatches at play when social workers encounter families belonging to diverse groups and assess risk, well-being and protection for children. Two minority groups in Israel were studied: the Ultra-Orthodox Jewish community and Jewish immigrants from Ethiopia. A context-informed approach was adopted to explore the subjective perceptions and constructions of "risk," "well-being," and "protection" among parents of the two communities (N = 60) and the social workers who work with them (N = 50). The social workers included some who belong to the minority groups they serve and others who are from the majority group. The analysis of the interviews yielded two main themes: (a) an understanding of the discrepancies in parents' and professionals' perceptions and constructions of "risk" and "protection" for children as the product of differences in the values, norms and contexts of these two groups; and (b) the implications of these discrepancies for the relationship between professionals/social service agencies and parents who are potential service users. Our findings call upon professionals to re-visit "universals" in the "risk" discourse while taking into account the realms of culture, ethnicity, religiosity, spirituality and community life when assessing risk and treating children and families of minority communities.

Caregivers' Perceptions and Attitudes Toward Child Maltreatment: A Pilot Case Study in Tel Aviv, Israel, and Cleveland, USA.

The purpose of this pilot cross-national study was to uncover similarities and differences in three areas that might affect the development of community-based programs targeting child maltreatment: behaviors considered to be maltreatment, perceived contributors to maltreatment, and whether the government or neighbors can do anything about maltreatment. Data were obtained from two neighborhood-based, cross-sectional surveys of adult caregivers of minors: one in Cleveland, USA, the other in Tel Aviv, Israel. The sample consisted of a total of 120 caregivers, in each city 20 residing in a low-SES neighborhood, 20 in a medium-SES neighborhood, and 20 in an elevated-SES neighborhood. Participants were asked (a) to provide three examples of behaviors they considered to be child abuse, (b) to rate the degree to which each of 13 factors contribute to child maltreatment, and (c) to rate the degree to which they agreed with a range of attitudes about maltreatment. The same coding scheme was used in both sites. Logistic regression analyses assessed city differences in dichotomous outcomes, while linear regression analyses assessed city differences in ratings of continuous outcomes. Analyses adjusted for individual and neighborhood characteristics, and accounted for residential clustering in neighborhoods. Primary results indicated that residence in Tel Aviv was associated with greater odds of citing emotional/psychological abuse compared to Cleveland residents. Also compared to Cleveland residents, Tel Aviv residents (a) viewed family structure, family values, religion, child-raising knowledge, and personal history of maltreatment as contributing less to maltreatment, (b) were less likely to agree that anyone could abuse a child or that spanking is necessary, and (c) had substantially greater odds of endorsing the government's ability to address child maltreatment. Concerning study implications, this investigation demonstrated the importance of context in shaping constructions of child maltreatment and the need for caution in replicating interventions without due consideration of potential differences in context, policy, and public opinion.

Culture and context in understanding child maltreatment: Contributions of intersectionality and neighborhood-based research.

In the early 1990s, the U.S. Advisory Board on Child Abuse and Neglect commissioned a series of reviews that appeared as the edited volume, Protecting Children from Abuse and Neglect (Melton & Barry, 1994). Using the 1994 review "Sociocultural Factors in Child Maltreatment" (Korbin, 1994) as a background, this article reconsiders culture and context in child maltreatment work. Since 1994, conditions promoting research and practice attention in this area include immigration-driven global increases in diverse, multicultural societies where different beliefs and practices meet (and clash); expanding purview of the human rights discourse to children; and the disproportionate and disparate representation of cultural, ethnic, and racial groups in child-welfare systems. Although research on child maltreatment has advanced in many ways over 20 years, the complexity of child maltreatment leaves many critical questions demanding further attention, culture and context among them. To help address these questions, we propose two approaches for future maltreatment research: intersectionality - the simultaneous examination of multiple identities (such as gender, race, and socioeconomic status) - as a framework for understanding the complexity of cultural factors; and neighborhood-based research as a means for understanding the context of child maltreatment from the perspective of an ecological framework.

Couples therapy with childhood sexual abuse survivors (CSA) and their partners: establishing a context for witnessing.

This article proposes a clinical practice for therapy with couples in which one partner suffered sexual abuse in childhood. Such couples often encounter unique difficulties with physical contact, intimacy, sexuality, communication, and trust, and their relationship dynamic may be marked by reenactments of past traumatic relational patterns. This clinical practice is founded on the assumption that establishing the witnessing lacking during the traumatic event in childhood can break the traumatic reenactments in adulthood, and spur recovery. The suggested practice may facilitate twofold witnessing: the couple's therapist witnesses the reenactments of the trauma in the couple's relationship; and the survivor's partner witnesses the trauma's effect on the survivor's personal life and relationship. Twofold witnessing can help break the cycle of traumatic reenactment and help the survivor integrate the events of her life into a more coherent, continuous narrative. The partner's presence also facilitates acknowledgement of what happened to the survivor, and helps the survivor elaborate on her stories of resistance, survival, and strength. Finally, each of the partners is able to appear more wholly and fully, and together to tell the preferred stories of their life as a couple, replete with the multiple relational patterns they wish to live, which may contradict the characteristics of the original trauma.