Black Lives Matter: We are in the Same Storm but we are not in the Same Boat.

Black Lives Matter is a clarion call for racial equality and racial justice. With the arrival of Africans as slaves in 1619, a racial hierarchy was formed in the United States. However, slavery is commonly dismissed as that less than noble aspect of the United States' history without really confronting the legacies of racial inequality and racial injustice left in its wake. White supremacy, based on the myths of white superiority and Black inferiority, have obscured racial inequality and racial injustice, resulting in blaming the victims. Using Black Lives Matter as a platform, we focus on some key considerations for theory, research, education, training, and practice in clinical, community, and larger systems contexts. Broadly, we focus on Black Lives Matter, literally; Black dehumanization; historical oppression; healing; and implications for the field of family therapy. More specifically, we draw attention to health disparities, mass incarceration and aggressive policing, intergenerational racial trauma, restorative justice, and antiracist work.

El movimiento Black Lives Matter (Las vidas de los negros son importantes) es un llamamiento a la igualdad y la justicia racial. Con la llegada de los africanos como esclavos en el año 1619, se formó una jerarquía racial en los Estados Unidos. Sin embargo, la esclavitud generalmente se desestima como el aspecto menos noble de la historia de los Estados Unidos sin afrontar realmente los legados de desigualdad e injusticia raciales que dejó. La supremacía blanca, basada en los mitos de la superioridad blanca y la inferioridad negra, han ocultado la desigualdad y la injusticia raciales, lo cual condujo a la culpabilización de las víctimas. Utilizando el movimiento Black Lives Matter como plataforma, nos centramos en algunas consideraciones clave para la teoría, la investigación, la educación, la capacitación y la práctica en contextos clínicos, comunitarios y en sistemas más grandes. En líneas generales, nos centramos en Black Lives Matter, literalmente; en la deshumanización de los negros, la opresión histórica, la recuperación, y las consecuencias para el área de la terapia familiar. Más específicamente, visibilizamos las desigualdades sanitarias, el encarcelamiento masivo y la vigilancia policial agresiva, el trauma racial intergeneracional, la justicia reparadora y la labor antirracista.

Treating systemic issues in families affected by cystic fibrosis: A solution-focused approach.

Cystic fibrosis (CF) presents with various symptoms that impair day-to-day functioning and require lifelong treatment. Due to the chronic and severe nature of this disease, families are often impacted by the stress associated with treatment, complications of the disease, and the understanding that their loved one will one day die from CF. This article seeks to address a perceived gap in the literature for providing a model-specific approach to address psychosocial stress in families affected by CF. We provide a rationale for using solution-focused brief therapy (SFBT) to work with this population based on its empirically supported effectiveness, versatility, and capacity to be brief in nature. We describe how SFBT interventions can be used by practitioners working with this population, present a fictitious case illustration depicting the clinical use of specific SFBT interventions, and offer suggestions for future research. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

The Musings of a Family Therapist in Asia When COVID-19 Struck.

In response to the COVID-19 crisis in Asia, a family therapist in Hong Kong shares her experiences and reflections, both personally and professionally from an Eastern lens. From a state of shock and immobilization to moments of contemplation, she highlights her struggle with being caught between her Eastern roots and Western training, which has become more salient in facing COVID-19. While the latter pulls her toward a more problem resolution stance, the former pulls her toward a more accepting position. As a result, her therapy is shaped in such a way that she tends to raise more questions instead of providing answers.

En respuesta a la crisis de la COVID-19 en Asia, una terapeuta familiar en Hong Kong comparte sus experiencias y reflexiones, tanto a nivel personal como profesional, desde una perspectiva oriental. Desde un estado de conmoción e inmovilización a momentos de contemplación, ella destaca sus dificultades al sentirse atrapada entre sus raíces orientales y su formación occidental, que ha adquirido más importancia a la hora de enfrentar la COVID-19. Si bien la última la lleva hacia una postura más orientada a la resolución de problemas, la primera la inclina hacia una postura más aceptadora. Como resultado, su terapia está moldeada de tal manera que ella tiende a plantear más preguntas que a ofrecer respuestas.

The "Flip"-Sustaining Complexity and Multiplicity Post-Quarantine.

This article describes poststructural ways of responding to the pandemic by looking for openings or gaps within more traditional ways of interacting with dilemmas. The author situates herself within a "positive deviance" epistemology, which looks for what already works rather than getting captured by the current problem. We "flip" what are the usual ways of responding and explore three different programs that illustrate inventive and assets-based approaches. Linking-Lives Storython, created specifically to utilize our COVID shelter-in-place experience; Re-Authoring Teaching: Creating a Collaboratory, begun 12 years ago to meet the needs of a widespread community; and Witness to Witness, a current response to contemporary disastrous situations-all have utilized technology to open possibilities for those who are helped as well as those who are helpers. The article shows how each program has specifically flipped more traditional ways of responding, but also how this "flip" employs a practice of "disciplined improvisation." Each program has a built-in structure that depends on technology to make it work; each has a disciplined approach that allows the helpers to improvise to meet the needs of the receivers. It is this "flip," this way of thinking, that can sustain us and our work in times of great complexity and multiplicity.

En este artículo se describen las formas posestructurales de responder a la pandemia buscando aberturas o grietas en las formas más tradicionales de interactuar con los dilemas. La autora se sitúa dentro de una epistemología de "desviación positiva", que busca lo que ya funciona en lugar de quedar atrapada por el problema actual. Nosotros "damos un giro" a las formas típicas de responder y analizamos tres programas diferentes que ilustran métodos inventivos y basados en ventajas. Linking-Lives Storython, creado específicamente para aprovechar nuestra experiencia de confinamiento por la COVID-19; Re-Authoring Teaching: Creating a Collaboratory, que se inició hace doce años para satisfacer las necesidades de una comunidad amplia; y Witness-to-Witness, una respuesta actual a situaciones contemporáneas de catástrofe, han utilizado la tecnología para abrir posibilidades tanto a quienes reciben ayuda como a aquellos que ayudan. El artículo demuestra cómo cada programa ha dado un giro específicamente a las formas más tradicionales de responder, y también cómo este "giro" emplea una práctica de "improvisación disciplinada". Cada programa tiene una estructura incorporada que depende de la tecnología para que funcione; cada uno tiene un método disciplinado que permite a los ayudantes improvisar para satisfacer las necesidades de los receptores. Es este "giro," esta forma de pensar, que puede apoyarnos y apoyar nuestro trabajo en tiempos de gran complejidad y multiplicidad.

Family Science in the Context of the COVID-19 Pandemic: Solutions and New Directions.

The coronavirus disease 2019 (COVID-19) pandemic has precipitated substantial global disruption and will continue to pose major challenges. In recognition of the challenges currently faced by family scientists, we share our perspectives about conducting family research in the context of the COVID-19 pandemic. There are two primary issues we address in this article. First, we present a range of potential solutions to challenges in research, resulting from the pandemic, and discuss strategies for preserving ongoing research efforts. We discuss approaches to scaling back existing protocols, share ideas for adapting laboratory-based measures for online administration (e.g., using video chat platforms), and suggest strategies for addressing missing data and reduced sample size due to lower participation rates and funding restrictions. We also discuss the importance of measuring COVID-19 relevant factors to use as controls or explore as moderators of primary hypotheses. Second, we discuss how the COVID-19 pandemic represents a scientifically important context for understanding how families adjust and adapt to change and adversity. Increased stress precipitated by the pandemic, varying from acute stress associated with job loss to more chronic and enduring stress, will undoubtedly take a toll. We discuss ways that family scientists can contribute to pandemic-related research to promote optimal family functioning and protect the health of family members.

La pandemia de la enfermedad por coronavirus 2019 (COVID-19) ha precipitado una alteración mundial considerable y continuará planteando grandes dificultades. En reconocimiento de las dificultades que enfrentan actualmente los científicos especializados en familias, compartimos nuestras perspectivas acerca de llevar a cabo investigaciones sobre la familia en el contexto de la pandemia de la COVID-19. Hay dos cuestiones principales que abordamos en este artículo. Primero, presentamos varias posibles soluciones a las dificultades que surgen como consecuencia de la pandemia y explicamos estrategias para mantener los esfuerzos de las investigaciones en curso. Debatimos la necesidad de reducir los protocolos existentes, compartimos ideas para adaptar medidas basadas en laboratorios y administrarlas en línea (p. ej.: el uso de plataformas de videollamadas), y sugerimos estrategias para abordar datos faltantes y un tamaño reducido de las muestras debido a los índices más bajos de participación y a las restricciones de financiación. También debatimos la importancia de medir factores relevantes de la COVID-19 para usar como controles o analizar como moderadores de hipótesis principales. Segundo, explicamos cómo la pandemia de la COVID-19 representa un contexto científicamente importante para comprender cómo las familias se ajustan y adaptan al cambio y a la adversidad. El aumento del estrés precipitado por la pandemia, que varía de un estrés agudo asociado con la pérdida del empleo a un estrés más crónico y duradero, indudablemente causará estragos. Debatimos las maneras en que los científicos de familia pueden contribuir a investigaciones relacionadas con la pandemia a fin de promover un funcionamiento familiar óptimo y proteger la salud de los miembros de la familia.

Updates on Treatments for Adolescent Anorexia Nervosa.

This article provides background information, descriptions, and evidential support for the more recent treatments for adolescents with anorexia nervosa, including family-based treatment, adolescent focused therapy, cognitive behavioral therapy, systemic family therapy, and psychopharmacologic treatments. At this time, family-based treatment has the best evidence of efficacy and cost-effectiveness. Future directions in treatment research for adolescent anorexia nervosa are discussed.

Update on Treatments for Adolescent Bulimia Nervosa.

There are few systematic studies of treatment of bulimia nervosa (BN) in adolescents. Although family-based treatment has demonstrated preliminary evidence to support involvement of caregivers in treatment, there is significant opportunity for improvement in mitigating binge-eating and purging symptoms among adolescents afflicted with BN. When caregivers are unable to participate in treatment, there is evidence that BN-specific cognitive behavioral therapy approaches are helpful for some adolescents. Further research is needed to determine for whom, and under what conditions certain types of family involvement might be most effective in adolescent treatment of BN.

Improved Perceptions of Emotion Regulation and Reflective Functioning in Parents: Two Additional Positive Outcomes of Parent-Child Interaction Therapy.

The purpose of this study was to test whether Parent-Child Interaction Therapy (PCIT), a widely used effective therapy for children's externalizing behaviors and parenting problems, was associated with improvements in parents' emotion regulation and reflective functioning. We also investigated whether these improvements had unique associations with children's improvements in externalizing and internalizing symptoms. Participants were 139 Australian children aged 29 to 83 months and their caregivers; all were referred for child externalizing behavior problems coupled with parenting skill deficits or high parent stress. All data were gathered via a questionnaire completed prior to and after completion of PCIT. Significant improvements were found in parents' self-reported emotion dysregulation and capacity to use cognitive reappraisal for emotion regulation. There was also improvement in parents' self-report of children's symptoms, parenting practices, and reflective functioning in the form of prementalizing, which measured a low capacity to understand the emotional world of the child. Multiple regression showed that improvements in cognitive reappraisal, prementalizing, and negative parenting practices were associated with improvement in children's symptoms. The findings extend the existing evidence for PCIT as an effective parenting intervention, adding parents' perceived emotion regulation and reflective functioning to the list of positive outcomes from PCIT. Improved emotion regulation and reflective functioning, unique from changes in parenting practices, could be mechanisms that help explain why PCIT has been associated with improvements in children's externalizing behaviors.

Integrative Systemic Therapy: Lessons on Collaboration and Training for the 21st Century.

The field of couple, marital, and family therapy (CMFT) is at an important juncture of identity development and synthesis. Integrative Systemic Therapy (IST) is a problem-centered metaframeworks approach that meets the growing needs of family therapists working with diverse and complex family systems and restores the field to its original focus on collaboration. This paper describes the process by which IST developed featuring anecdotes from live interviews with the founders. We briefly outline IST's theoretical pillars and the essential way IST practitioners deliver treatment including a blueprint for therapy. Finally, we propose that IST is a comprehensive, systemic guide uniquely beneficial to CMFT training and discuss our approach to integrating IST into our training of students in a COAMFTE accredited program.

Enveloping Mothers, Enveloped Sons: Positions in Chinese Family Therapy.

The increasing acceptance and use of psychotherapy in contemporary China powerfully attests to the "psychologization" of Chinese society. Yet attending therapy is only one aspect of psychologization. Analyzing the practice of therapy through case examples illuminates the broader sociocultural context of China's "psycho-boom." This includes insight into what I term an expansive-I notion of personhood. This non-singular notion of personhood is a major challenge for Chinese therapists. Therapists' attempts to resolve clients' problems by reorienting them according to psychological ideals highlight the multiple, at times contradictory relationships between psychotherapy, the state and families.

Group family-based cognitive behavioral therapy for pediatric obsessive compulsive disorder: Global outcomes and predictors of improvement.

This open, uncontrolled study examined the efficacy of a group family-based cognitive behavioral therapy (GF-CBT) protocol in treating pediatric obsessive-compulsive disorder (OCD) and explored predictors of symptom improvement. Eighty-five OCD-affected youth aged 8-18 years (M = 13.9 years, SD = 2.49; 46% male) and their parent(s) participated in a weekly, 12-session GF-CBT program. Data from multiple perspectives were gathered at the beginning and end of treatment, as well as at one-month follow-up. A broad range of assessment measures were utilized to capture clinically-relevant domains and a number of potential predictor variables were explored. Paired t-tests indicated that treatment was associated with significant reductions in clinician- and parent-rated OCD severity (d = 1.47, 1.32), youth and parent-rated functional impairment (d = 0.87, 0.67), coercive/disruptive behaviors (d = 0.75), and family accommodation (d = 1.02), as well as improvements in youth-, mother-, and father-rated family functioning (d = 1.05, 0.50, 0.88). Paired t-tests also indicated that youth remained improved at one-month follow-up. Step-wise regression identified greater homework success as a significant predictor of symptom improvement. This study provides evidence that GF-CBT significantly improves a wide range of domains for youth/families that extends beyond OCD symptom severity and supports homework as a core treatment component.

Global Mental Health: A Call for Increased Awareness and Action for Family Therapists.

Global mental health (GMH) is an emerging field that focuses on the need for culturally sensitive mental health services in low- and middle-income countries (LMICs). While many new initiatives have been established worldwide to understand GMH needs and to provide care in LMICs, family therapists have primarily worked with families in high-income countries. The few existing family-based initiatives in GMH focus on psychoeducation and are typically not based on general systems theory. However, emerging trends in family therapy may enable family therapists to impact mental health issues in LMICs. These trends, which are shared interests of both family therapy and GMH, include collaborative care, a growing emphasis on the importance of culture in understanding and treating mental health issues, recognition of the ability of families to support or impede recovery from mental illness, and the use of strength-based and evidence-based treatments. This paper describes ways for family therapists to become active in the GMH community.

Terapia familiar como um espaço de ressignificação das relações / Family therapy as a redefinition of space relations

Pretende-se, neste artigo, destacar as possibilidades de diálogos ente duas teorias, contribuindo assim para a prática clínica. Abordaremos o socioconstrucionismo e as afinidades com a teoria da aprendizagem na perspectiva da autoria do pensamento. Entendendo o socioconstrucionismo como uma abordagem teórico-clínica que enfatiza os processos relacionais e estimula as pessoas a serem capazes de construír a si mesmas e o mundo em que vivem, entendendo a aprendizagem como processo de produção de sentido onde o sujeito é protagonista e tem papel ativo, podemos pensar a terapia familiar como um espaço de aprendizagem e ressignificação das relações. O terapeuta pode operar na terapia, tal qual o ensinante opera na relação de aprendizagem: sendo um facilitador das competências. Além disso, o processo terapêutico pode se configurar numa troca onde família e terapeuta se enriquecem. Tanto o ensinante quanto o terapeuta, nestas abordagens, precisam reconhecer a legitimidade do outro e possibilitar a autoria. Dessa forma, a terapia torna-se uma construção conjunta e não um processo linear onde o terapeuta detém o conhecimento e vai transmitir à família. Nesta perspectiva, o terapeuta precisa estar sempre curioso e assumir uma postura de questionamento e reflexão a respeito do que está estabelecido, abrindo assim, espaço para o novo e para a criação.(AU)

It is intended in this article highlight the possibilities of dialogues between two theories, thus contributing to the clinical practice. We discuss the social constructionism and the affinities with learning theory in view of the authorship of thought. Understanding social constructionism as a clinical theoretical approach that emphasizes the relational processes and encourages people to be able to build themselves and the world they live in; understanding learning as meaning production process where the subject is the protagonist and has active role, we may think family therapy as a space for learning and redefinition of relations. The therapist can operate in therapy, like the teaching being active in learning relationship: being a facilitator skills. Moreover, the therapeutic process may be set on an exchange where family and enrich therapist. Both the teaching being as the therapist, these approaches must recognize the legitimacy of the other and enable the authorship. Thus, the therapy becomes a joint construction and not a linear process where the therapist has the knowledge and will convey to the family. In this perspective, the therapist must always be curious and take a questioning attitude and reflection as to what is established, thus opening space for the new and create.(AU)

Honoring the Past and Looking to the Future: Updates on Seminal Behavior Therapy Publications on Current Therapies and Future Directions.

This is the introduction to the second of two special issues in honor of the 50th anniversary of the Association for Behavioral and Cognitive Therapies. The goal of this issue is to pay tribute to prior seminal Behavior Therapy publications on current therapies and future directions, to provide an updated review of important topics covered by these papers, and to make recommendations for the future. Each invited paper in this issue highlights a particular Behavior Therapy publication's contribution to our understanding and also provides an updated review or meta-analysis on the topic of the original paper. The topics covered here include review papers on current therapies such as cognitive and behavioral therapies, youth and family psychotherapy, unified protocols, and third-wave therapies. In addition, we include a review paper on implementation science, and meta-analyses on individualized psychotherapy, and culturally adapted interventions. With the two 50th anniversary issues of Behavior Therapy, we hope to inspire additional research and discussion.

Multidimensional Family Therapy: Evidence Base for Transdiagnostic Treatment Outcomes, Change Mechanisms, and Implementation in Community Settings.

This article summarizes the 30+-year evidence base of Multidimensional Family Therapy (MDFT), a comprehensive treatment for youth substance abuse and antisocial behaviors. Findings from four types of MDFT studies are discussed: hybrid efficacy/effectiveness randomized controlled trials, therapy process studies, cost analyses, and implementation trials. This research has evaluated various versions of MDFT. These studies have systematically tested adaptations of MDFT for diverse treatment settings in different care sectors (mental health, substance abuse, juvenile justice, and child welfare), as well as adaptations according to treatment delivery features and client impairment level, including adolescents presenting with multiple psychiatric diagnoses. Many published scientific reviews, including meta-analyses, national and international government publications, and evidence-based treatment registries, offer consistent conclusions about the clinical effectiveness of MDFT compared with standard services as well as active treatments. The diverse and continuing MDFT research, the favorable, multi-source independent evaluations, combined with the documented receptivity of youth, parents, community-based clinicians and administrators, and national and international MDFT training programs (U.S.-based organization is MDFT International, www.mdft.org; and Europe-based organization is www.mdft.nl) all support the potential for continued transfer of MDFT to real-world clinical settings.