Treatment efficacy of multiple family therapy in helping Chinese children of depressed parents in Hong Kong, China.

This article reports results of a study that assessed the efficacy of multiple family therapy (MFT) for helping children of depressed parent(s), using a quasi-randomized controlled trial design. In total, 76 children participated in the study, with 51 children were assigned to the experimental group (EG) and 25 to the comparison group (CG). The EG children and their parents completed the three-month MFT program, while the CG children and their parents attended two psychoeducational talks scheduled at the same time as the MFT. A group × Time repeated measure ANCOVA did not discern the intervention types having any effect on children's lives in the post-treatment phase or at the three-month follow-up. However, the MFT brought some promising positive changes in the EG children's perceived social support, both overall and that from the father and other family members at three-month follow-up; compared to the CG children, the EG children also attached more importance to the support from their mothers in the post-treatment phase and that from other family members at the three-month follow-up. The results implied the potential efficacy of the MFT in facilitating an increase in the overall social support of children of depressed parents and their positive interactions with both the healthy and the depressed parent and other family members. Owing to multiple statistical limitations, caution is required while interpreting the results. A larger sample and a more sophisticated research design were suggested for future studies examining the efficacy and therapeutic mechanism of the MFT.

En este artículo se informan los resultados de un estudio que evaluó la eficacia de la terapia familiar múltiple (TFM) para ayudar a hijos de padres deprimidos usando un diseño de ensayo controlado cuasialeatorizado. En total, participaron 76 niños en el estudio, con 51 niños asignados al grupo experimental y 25 al grupo comparativo. Los niños del grupo experimental y sus padres completaron el programa de TFM de tres meses, mientras que los niños del grupo comparativo y sus padres asistieron a dos charlas psicoeducativas programadas al mismo tiempo que la TFM. Un ANCOVA de medidas estandarizadas de grupo × tiempo no percibió que los tipos de intervención tuvieran ningún efecto en las vidas de los niños en la fase posterior al tratamiento ni tres meses después. Sin embargo, la TFM trajo algunos cambios positivos prometedores en el apoyo social percibido por los niños del grupo experimental, tanto en general como en el padre y otros familiares en el seguimiento de los tres meses. En comparación con los niños del grupo comparativo, los niños del grupo experimental también dieron más importancia al apoyo de sus madres en la fase posterior al tratamiento y al de otros familiares en el seguimiento de los tres meses. Los resultados indicaron la posible eficacia de la TFM a la hora de facilitar un aumento en el apoyo social general de los niños de padres deprimidos y sus interacciones positivas con el padre sano y el padre deprimido y otros familiares. Debido a las múltiples limitaciones estadísticas, es necesario interpretar los resultados con cuidado. Se sugirió una muestra más grande y un diseño de investigación más sofisticado para futuros estudios que analicen la eficacia y el mecanismo terapéutico de la TFM.

Sitting In: The Experience of Learning and Practicing Family Therapy through Being a Co-Therapist in Hong Kong.

This article explores family therapy trainees' subjective experiences of working as cotherapists with a supervisory-level therapist in a Chinese context, regarding their perceptions of and positioning in it and also their opinions on the benefits and/or pitfalls of cotherapy. Individual interviews with a total of six cotherapists revealed three themes: (1) Cotherapy was perceived as an experiential learning journey that evolved from anxiety and excitement to empowerment and nurturing; (2) a collaborative master-apprentice relationship of openness, trust, and mutual respect was developed with both sides' interactive effort, which included common commitment and concern for the client, the supervisor's awareness and explicit address of the role hierarchy, principle setting prior to the cooperation, and honest pre- and-postsession sharing and discussion; (3) the dual-purpose supervisor-trainee cotherapy brought direct benefits for all involved parties and for others. The findings have useful implications for integrating treatment and training for optimal training/learning outcomes and for advancing knowledge transfer from senior to junior and from academia to the field, with reference to local cultural characteristics.

Este artículo analiza las experiencias subjetivas de los practicantes de terapia familiar en su trabajo como coterapeutas con un terapeuta supervisor en un contexto chino, con respecto a sus percepciones de la coterapia y a su posicionamiento en ella, y también sus opiniones sobre los beneficios o los inconvenientes de la coterapia. Las entrevistas individuales con un total de seis coterapeutas revelaron tres temas: (1) la coterapia se percibió como un viaje de aprendizaje empírico que pasó de la ansiedad y el entusiasmo al empoderamiento y el estímulo; (2) se desarrolló una relación colaborativa de sinceridad, confianza y respeto mutuo entre el maestro y el aprendiz con el esfuerzo interactivo de ambas partes, que incluyó el compromiso común y la preocupación por el paciente, la comprensión del supervisor y el abordaje explícito de la jerarquía de roles, la fijación de principios antes de la cooperación, y el intercambio y el debate sinceros antes y después de la sesión; (3) la coterapia con doble finalidad entre el supervisor y el practicante tuvo beneficios directos para todas las partes implicadas y para los demás. Los hallazgos tienen consecuencias útiles para la integración del tratamiento y la capacitación a fin de obtener resultados óptimos a nivel de capacitación y aprendizaje, y de fomentar el traspaso de conocimiento desde los profesionales experimentados a los profesionales noveles, y desde el mundo académico al ejercicio de la profesión, con referencia a características culturales locales.

Radiotherapy-related complications presenting to a urology department: a more common problem than previously thought?

OBJECTIVE: To quantify the burden of the side effects of radiotherapy on a tertiary referral urology department. PATIENTS AND METHODS: A prospective study of all urology admissions to a public urology department at a tertiary hospital in a 6-month period was performed. Patients admitted with complications attributable to radiotherapy were included in the study. Data obtained included patient demographics, radiotherapy details, complication type and management required. RESULTS: A total of 1198 patients were admitted; 921 (77%) were elective and 277 (23%) were emergency admissions. Thirteen out of the 921 (1.4%) elective admissions and 20 out of the 277 (7.2%) emergency admissions were attributable to radiotherapy complications. Radiotherapy complications was the fourth most common reason for emergency admission, ahead of acute urinary retention. These 33 admissions were accounted for by 21 patients. A total of 39 separate complications attributable to radiotherapy were diagnosed, with some patients having multiple complications. The median (interquartile range) time to onset of complications was 4 (1-9) years. The surgical intervention rate was 67%. The commonest procedures were washout with/without clot evacuation or diathermy in theatre (15.8%) and urethral dilatation/bladder neck incision (15.8%). Two urinary diversions and two cystoprostatectomies plus urinary diversion were performed. CONCLUSION: Radiotherapy complications are consequential and account for a substantial proportion of a tertiary urology department's emergency workload. These complications generally occur years after radiotherapy and frequently require surgical intervention.

Treatment Efficacy of Multiple Family Therapy for Chinese Families of Children with Attention Deficit Hyperactivity Disorder.

The treatment efficacy of multiple family therapy (MFT) for Chinese families of children with attention deficit hyperactivity disorder (ADHD) has not been studied in the past. In this paper, the effect of MFT on different aspects of the lives of the parents in the experimental group (n = 61) was compared with the effect of only the psychoeducational talks on parents in the control group (n = 53). The results of a MANOVA have shown that by the time they reached the posttreatment phase, the parents who had completed the full 42 hours of the MFT program perceived their children's ADHD symptoms as being less serious and less pathological than they had originally thought compared to the parents in the control group. The effect of MFT on parent-child relationships, parenting stress, parental efficacy, hope, and perceived social support was statistically insignificant. Contributions and limitations of our study are discussed.

Multifamily Therapy for Children With ADHD in Hong Kong: The Different Impacts on Fathers and Mothers.

Objective: Medication combined with psychosocial intervention is the recommended treatment for ADHD. What is not clear is which of the parents participate in psychosocial interventions, and whether the impacts are different for fathers and mothers. This is important because of the different roles fathers and mothers have in shaping their child's development. This article examines the impact of multifamily therapy on a sample of fathers and mothers from Hong Kong whose children suffer from ADHD. Method: Fathers and mothers ratings on ADHD severity, parent-child relationship, parenthood stress, and parental self-esteem were compared between those who attended multifamily therapy and those who attended psychoeducation talks. Results: Fathers and mothers of the multifamily group, but not the psychoeducational group, reported reduction of child ADHD symptom severity. When the reduction was clinically significant, mothers reported an increased sense of competence while fathers reported improved father-child relationship. Conclusion: Fathers and mothers experienced different gains from attending MFT. Fathers' involvement in their child's treatment should be encouraged and facilitated.

Eating disorders, parent-child conflicts, and family therapy in Shenzhen, China.

In this article, I report the results of a qualitative study conducted in Shenzhen, China, in which I aimed to (a) identify the characteristics of parent-child conflicts between Shenzhen youths suffering from eating disorders and their parents and (b) contextualize these intergenerational conflicts to understand their meanings within the immediate sociocultural context. I have employed multiple-case studies as the research design. Data have been collected through reviews of the family treatment sessions for ten families, each with an adolescent daughter suffering from eating disorders, and with the session being videotaped with written consent from the youths and the families. Emerging from the data were three types of parent-child conflicts: (a) intergenerational control and power struggle, (b) growing up versus remaining childlike, and (c) pursuit of personal goals or living up to parental expectations. Implications for clinical practice are also discussed.

Unwrapping the box: dancing with the clients.

The authors describe the case of a girl suffering from anorexia nervosa who was regarded as a great challenge by her family therapist in Hong Kong. The metaphor of unwrapping a box was adopted to describe the therapeutic strategy of helping the girl express her inner feelings, and of helping the parents listen to their daughter describe her pain and suffering in the presence of the therapist. Health care professionals have to lead the dance, creating a space where their clients can share their secrets with their family and their therapist.

The Subjective Experiences of Attention-Deficit/Hyperactivity Disorder of Chinese Families in Hong Kong: Co-Construction of Meanings in Multiple Family Groups.

The subjective experiences of Chinese children in Hong Kong with attention-deficit/hyperactivity disorder (ADHD) are underexplored. This article reports the results of a qualitative study that aims to understand the subjective experiences of children with ADHD in Hong Kong, taken from among a clinical sample of Chinese families with children struggling with ADHD who have participated in cross-disciplinary research of multiple family groups (MFG). The participating children revealed the subjective experiences of their struggle with the disorder in response to their parents' concern at a "press conference," one of the MFG activities, which underscored the importance of developing a new social work model to meet the multiple psychosocial service needs of these families. The article concludes with the discussion of the implications for the new model.

Family themes of food refusal: disciplining the body and punishing the family.

A problematic issue in studying anorexia nervosa (AN) has been the absence of a qualitative study that probes the deep meanings of food refusal. We attempt to close this gap by studying the family meanings of food refusal by a single case study of a family in Hong Kong with an AN daughter. Eight videotapes of family therapy sessions, each lasting 90 minutes, were intensively reviewed, transcribed verbatim, and content analyzed. Two family themes of food refusal were discerned: the AN daughter disciplined her body and punished her family. The conclusions imply a need to revisit the Chinese gender role expectation in understanding AN patients and their families.

Daughter praising, mother bashing: a case study from Hong Kong.

In this paper, we present the case of a mother and daughter in family therapy. We call for a critical examination of Western literature that describes how a mother praises her child. I illustrate how one observer (the first author) perceives the issue of maternal praise differently from other observers. To illustrate the interaction between this family and the family therapist (the second author), some representative vignettes of the sixth session have been extracted for discussion. Ten observers from the Chinese University of Hong Kong, 7 of whom were master's students and 3 were doctoral students, observed the therapy sessions from the adjoining room. The article is composed of four parts: (a) parental styles and relationships in families with an anorectic daughter literature review; (b) vignettes of the sixth family therapy session; (c) the observers' comments about the therapist; and (d) discussion. The paper concludes with a question of whether the impact of praise on a child's development in Western society functions in the same way and produces the same effects on a child's development as it does in Chinese society.