Doctor of Philosophy / Department of Family Studies and Human Services / Joyce Baptist / The purpose of the current study is to examine what factors contribute to how marriage and family therapy (MFT) programs address multicultural competency training and to understand the support mechanisms of the training process. A sequential explanatory mixed-method design was utilized to evaluate MFT training programs. First, a Multicultural Survey, adapted from the Multicultural Competency Checklist (Ponterotto, Alexander, & Griegor, 1995), was used to gain a preliminary understanding of the masters MFT field regarding multitcultural competency training. Out of the 70 MFT program directors contacted, 39 program directors or program representatives responded to the survey (55.71% response). Qualitative interviews from 8 participants (program directors, n = 7; program representative, n = 1) representing each geographical region (Northeast, n = 2; South, n = 2; Midwest, n = 2; West, n = 2) were used to examine programs’ multicultural competency training content, program context and training processes. Five themes emerged from the data: 1) internal program dynamic, 2) external program factors, 3) stakeholders, 4) faculty recruitment, and 5) cross-program collaboration. General systems theory, process theory and the logic model were utilized to conceptualize the results (Kellogg, 2004; Rossi, Lipsey, & Freeman, 2004; White & Klein, 2002).

Doctor of Philosophy / Department of Family Studies and Human Services / Joyce A. Baptist / The Chickasaw represent one non-reservation bound American Indian tribe whose experiences of family life, historical trauma and resilience has not been fully understood. Therefore, this study sought to identify the qualities common to Chickasaw families, Chickasaw families' experiences of historical trauma and the factors that contribute to Chickasaw families' ability to persevere under adversarial circumstances. Using in-depth phenomenological interviews with nine (N = 9) three-generation minimum Chickasaw families, four central themes emerged that answered the four research questions. The first theme, "Chokka-chaffa' Nanna Mó̲́đma Ímmayya/The Family Is Everything" indicated that Chickasaw families were a heterogeneously complex system with a natural orientation toward the family unit itself, whereby the families valued emotional closeness, warmth and affection, quality time together, praise, respect and openness. Families were involved with one another and were active participants in strengthening their own families and communities. Families were prideful of family members' accomplishments and valued extended kin and spirituality. Further, families were confronted with challenges, but showed an ability to "bend, but not break," often citing the very same qualities, such as involvement, pride and an orientation toward family, as contributing to their ability to solve problems and keep the family unit intact. The second theme, "Impalahá̲mmi Bíyyi'ka/They Have It Really Bad," indicated the families experienced historical trauma by mourning the loss of land, language, culture and identity and that losses went unacknowledged by their non-Native counterparts and were ongoing, thus expecting to affect younger and future generations. The third theme, "Chikashsha Poyacha Ilaa-áyya'shakatí̲'ma/We Are Chickasaw, and We Are Still Here" indicated that despite hardships, families saw resilience as a trait found within their Chickasaw heritage. Maintaining a positive outlook, a spirit of determination, a fierce loyalty toward family members and a close connection to the Chickasaw Nation further contributed to families' resilience. The fourth theme, "Hooittapila/They Help One Another" indicated that resilient qualities were passed in a multidirectional pattern throughout all generations of family members, whereby family members from all generations supported and uplifted one another. Also discussed are the study's strengths and limitations and the clinical and research implications for Chickasaw families.

The purpose of this study was to compare western family therapy to the "imbizo" system that is used as a kind of family therapy in the black cultural environment. The "imbizo" system is different from western therapy in its composition. Relatives play a more prominent role than in western family therapy. The imbizo system provides unique support and aftercare to its clients. Unlike western therapy, it requires no payment of fees. The "imbizo" excludes children while western family therapy includes every family member as part of the system in the therapeutic process. Semi-structured interviews were conducted with three male respondents from the Nguni ethnic group and one male and two females from the Sotho ethnic group. / Psychology of Education / M. Ed. (Guidance and Counselling)

Objective. Family Therapy (FT) and Family Management (FM) approaches to psychosis have been divided by their understanding of causality. FM holds a biological understanding which has been identified as having negative consequences for the person with psychosis. FT, by exploring family interactions has been criticised for blaming families for causing their relations psychosis. These two approaches have now been integrated, but how causality is discussed in an integrated approach has only now been explored. Design and methods. This qualitative research asked clinicians working in the most established integrated service how they discuss causality. Four focus groups were conducted and a framework approach using thematic analysis was used. Results. Five themes were explored; uncomfortable discussion; constructing a shared understanding; therapeutic style; limiting exploration; and blame. Conclusion. Discussing causality with families was identified as uncomfortable. However, through the development of a therapeutic-relationship three identified tools can be used to construct a shared understanding of causality. The therapeutic style of explorative conversation--based in FT, integrated with the stress-vulnerability model--based in FM, was identified as an important aspect of an integrated model that resolved criticisms levied at each individual approach. Factors that limited exploration were identified as major challenges to causality discussions, but techniques to remedy these problems were also identified. The risk of families feeling blamed/blaming themselves and attempts to avoid/reduce blame made up a dominant theme of the research. The research concludes by challenging the need to avoid/reduce blame, arguing that blame should be openly explored within family interventions.

This thesis sets out to explore the processes involved when family therapists decide to introduce an action method into a therapy session. Action methods are defined as therapist led physical activities which are introduced into the session for the purpose of enabling the healing of relationships. The literature is examined in relation to connections between family therapy approaches using action and psychodrama psychotherapy relation to work with families and couples. Literature which integrates the two approaches is identified. The core of the study is composed of five interviews with experienced and senior family therapists about how they use action with clients in sessions. It focuses on the beliefs, behaviours and actions which are present at the moment the therapists decide to use action. The interviews examine the therapists’ training and current practice culture, their guiding beliefs and principles about the use of action and the theories on which they have drawn in considering the implementation of action methods. Participants were asked to describe an episode of action by giving a verbal account as well as undertaking a sculpt of the episode using ‘small world’ figures. The interviews were transcribed and analysed using a unique approach blending psychodramatic role analysis (Williams 1989) with the Coordinated Management of Meaning (CMM) (Cronen and Pearce 1985) a communication theory approach used by systemic psychotherapists. The findings indicate that systemic therapists do not have one overarching theoretical approach to using action in therapy, but draw on a range of different models which may be derived from different systemic approaches. The findings further indicate that theories of action which include neurobiological information processing and embodiment are introduced into systemic trainings as important in understanding how action methods impact on individuals and families. A format for therapists to evaluate their use of action methods is proposed for use in supervision or training. It follows the format that is used in the analysis, using psychodramatic role analysis and a CMM hierarchical structure which proposes opening space, spontaneity and playfulness as markers for the culture, identity and relationship levels of the analysis.

Introdução: A presente dissertação foi desenvolvida com o intuito de investigar as possíveis mudanças na dinâmica das famílias incestuosas, após intervenção do tratamento psicoterapêutico. A hipótese é de que mudanças primárias e secundárias ocorrem nas famílias encaminhadas ao Centro de Estudos e Atendimentos Referente ao Abuso Sexual (CEARAS) a partir do tratamento proposto. Essa dissertação foi elaborada a partir de uma perspectiva psicanalítica, com enfoque psicossocial, na qual o sujeito é considerado a partir de sua imersão na cultura. Para tanto, se tomou como base de reflexão o trabalho desenvolvido por este Centro de Estudos, em relação às famílias incestuosas. Objetivo: Refletir sobre as mudanças primárias e secundárias apresentadas pelas famílias incestuosas que foram atendidas no CEARAS. Metodologia: Trata-se de uma pesquisa retrospectiva documental. Foram analisados os prontuários de 19 famílias atendidas no CEARAS no período de 1993 a 2013 que compuseram a amostra final. Levantaram-se as informações sobre os atendimentos, condições de prontuários e quanto ao tratamento. As mudanças descritas nos prontuários foram divididas em dois grupos: mudanças primárias e secundárias. Uma análise descritiva e quantitativa das variáveis foi realizada. Resultados: A maior parte das famílias que foram encaminhadas para o CEARAS não finalizaram o tratamento proposto. Em relação às mudanças observadas, 53% das famílias apresentaram mudanças primárias e secundárias, 37% primárias e 10% secundárias. Em relação às mudanças primárias, a simbolização das funções familiares foi a mais frequente e a autonomia do membros familiares a menos frequente nos prontuários analisados. Não houve predomínio de mudanças secundárias. Observou-se um maior número de mudanças nas familías que não passaram pelo processo de troca de terapeutas. Conclusão: Percebeu-se a viabilidade do trabalho, o quanto ele se faz necessário. A pesquisa apontou que as mudanças primárias e secundárias são possíveis de acontecer através da terapia familiar. A transferência das famílias não ocorre somente com a instituição, mas também com os terapeutas envolvidos no tratamento / Introduction:This research aims to investigate possible changes to the dynamics of incestuous families after the commencement of psychotherapeutic treatment. Hypothetically, primary and secondary changes happen to the families taken to the Sexual Abuse Study and Help Center (Centro de Estudos e Atendimentos Referente ao Abuso Sexual - CEARAS) from the proposed treatment. This essay has been elaborated from a psychoanalytical perspective with psychosocial emphasis, in which the individual is considered from his cultural context. To do so, the grounds for the analysis is the work developed by the Study Center with the incestuous families. Objective: To think about the primary and secondary changes that arose from the therapeutic treatment provided by CEARAS to the dysfunctional families. Methodology: This is a retrospective document research. The handbook of the 19 families supported by CEARAS from the period between 1993 and 2013 which were part of the final sample have been analysed. The information about the calls, handbook conditions and treatment have been searched. The changes described in the handbooks were split in two groups: primary and secondary changes. Results: Most families under CEARAS\' care have not finished the proposed treatment. In relation to the changes detected, 53% of the families have shown primary and secondary changes; 37% have shown primary; and 10% secondary. It has been observed in the handbooks under analysis that, in relation to primary changes, the simbolization of the family functions was the most outstanding change whereas the autonomy of the family members was the least. There was no predominance of secondary changes. There has been a higher number of changes in families that did not have to change therapists. Conclusion: It is noticeable that the work is feasible and how necessary it is.The research shows that the primary and secondary changes are possible to take place by way of family therapy. The transfer in families does not happen only with the institution but also with the therapists involved in the treatment

Atualmente há uma grande mobilização social envolvendo a questão do abuso sexual, tamanha a ocorrência deste fenômeno. A OMS (Organização Mundial da Saúde) estima que entre 7-36% de meninas e 3-29% de meninos já sofreram abuso sexual em algum momento de sua vida. No entanto, muitos dos casos de abuso sexual acabam não sendo revelados e notificados, agravando a situação por não ter a possibilidade de obter tratamento para os envolvidos. O incesto, abuso sexual que ocorre dentro da família, é um tipo de violência sexual que apresenta uma dinâmica específica, que não somente a violência envolvendo seus participantes. O presente trabalho se apoia na visão psicanalítica para a compreensão das características desta dinâmica familiar, pois a trama incestuosa indica que houve uma falha na estruturação mental de todos os participantes, demarcando uma leitura intra/intersubjetiva e relacional para além de um estigma agressor e uma vítima. Objetivos do trabalho: refletir acerca de categorias de funcionamento psíquico destas famílias, que serão vislumbrados dentro do eixo psicanalítico e analisados a partir de dados apreendidos em entrevistas de triagens obtidas em uma instituição que oferece tratamento para tal população e frente a um questionário elaborado, cujo produto foi a construção de um inventário para detecção de atuação incestuosa / Currently there is a great social mobilization involving the issue of sexual abuse, because of the phenomenon occurrence. WHO (World Health Organization) estimates that between 7-36% and 3-29% of girls and boys have already been sexually abused at some point in their lives. However, many cases of sexual abuse do not end up being revealed and reported, aggravating the situation by not having opportunity for treatment of those involved. Incest, sexual abuse that occurs within the family is a type of sexual violence and has a specific dynamic that not only has violence with the participants. This work is based on psychoanalytic view in order to understand the characteristics of incestuous family dynamics, wich the incestuous abuse indicates that there was a flaw in the mental structure of all members, marking a intra/inter subjective and relational as well beyond an aggressor/victim stigma. Goals of work: to reflect on these categories of mental functioning families, contemplated within the psychoanalytic theory and analysed data from an institutions archives that provides treatment for this population and compared to a questionnaire, wich product will be used to create an Inventory for detection of an incestuous activity

Since the government commissioned the Crossing Bridges programme in 1998 (Falcov, 1998) and through legislation and a number of government policies and initiatives since, there has been emphasis on addressing the needs of families where there are parental mental health problems. Furthermore, there is a fast-growing body of research pointing to the needs of these families. However, service structures, development and provision have lagged behind. Most often parents with mental health difficulties have access to services addressing their individual mental health needs while their needs as parents and the needs of their children remain largely invisible. One such need that has been highlighted repeatedly in the literature is the need for children to have information about and make sense of their parent’s mental health difficulties. Given the lack of services to respond to this need, it is most often left to the parent to make decisions about and respond to their child’s search for understanding. This study is a qualitative study that explores parents’ experiences of decision-making and responding to this need, and the social processes and dominant discourses that impact on these experiences. Fifteen parents with mental health difficulties were interviewed, using semi-structured individual interviews, which were transcribed, and interpretive Grounded Theory was employed to analyse and interpret the data. The grounded theory that was constructed suggest two main social processes that impact on parents’ talking with their children about parental mental health issues. Firstly, within a relational context, parents were Negotiating mutuality between themselves and their children. Secondly, within an identity context, parents had to navigate Holding on to self, holding on to life. These social processes indicate that both parents’ relationships with their children and also their own sense of themselves within the context of their mental distress powerfully shape telling, talking and keeping silent. Implications of these findings both in relation to clinical interventions and future research are considered. In particular, the importance of positioning the parent as active role-player in the healing of their child, and positioning the child as active role-payer in their own meaning-making, are highlighted. Furthermore, developing ‘double-stories’ beyond the mental health story and beyond ‘information’ is emphasised and the importance of a sense of continuity of self and identity over time for parent and child is accentuated. Finally, the importance of allowing for complex and ever-evolving understandings of mental distress is indicated, and the role of both talking and remaining silent in this process is stressed.

This study is a qualitative enquiry into family therapists’ experiences of working with young people who self-harm and their families. To date, in spite of self-harm being a serious public health concern, there is relatively little exploration of the subject in family therapy literature. The study attempts to describe, understand and illuminate family therapists’ experiences: the therapeutic issues encountered, the stances adopted in response to the issues encountered, and the emotional impact on the therapist of working with this client group. A total of nine experienced family therapists participated in semi-structured interviews. The study employed a grounded theory method for data analysis. The analysis yielded a theory of therapists’ experiences that included a Core Category and three Main Categories. The Core Category that emerged was: •Cultivating the Practice of Hope – Withstanding the Pull to Hopelessness. The three Main Categories were: •Making the Situation Safe •Conversing Therapeutically – The Practice of Hope •Team and Organisational Processes: Supporting Therapists. The Core Category is the central feature of this theory. It proposes that the central concern for the therapist is how to stay engaged with the family and the young person in the context of serious risk of self-harm and in situations where change is difficult to achieve and hopelessness can pervade. The therapist has to try to understand and make sense of family members’ distress, and be touched by and open to their feelings of despair and hopelessness without becoming overwhelmed and despairing themselves. The therapist response to this dilemma is the stance of hopefulness. It is both a therapeutic stance and orientation, and is enacted in practice through finding ways to cultivate hope in the therapeutic encounter. While the Core Category is the central ‘story’ the three Main Categories are linked to the Core Category. The Main Category, Making the Situation Safe describes the initial stage of the work, with its focus on ensuring the safety of the young person. The Main Category, Conversing Therapeutically – the Practice of Hope describes how the therapists enacted the ‘practice of hope’. The Main Category, Team and Organisational Processes: Supporting Therapists describes how the context in which the therapists work, the nature of relationships, the team and organisational structures, play a critical role in supporting therapist hope, so that they can withstand the pull to hopelessness. This study aims to make a contribution towards articulating a framework for family therapy with adolescents who self-harm and introduces a new vocabulary – the language of hope and hopelessness.

Made available in DSpace on 2016-04-28T20:38:38Z (GMT). No. of bitstreams: 1 Thais Lyrio Lima.pdf: 1879604 bytes, checksum: d96b09e22e03490c557c5d810d92bdc0 (MD5) Previous issue date: 2013-03-19 / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior / This work had as objective to understand the meanings attributed to obesity and family for an obese young adult, under the systemic theory perspective. Despite the number of studies and significant advances, the obesity problem appears to not be solved effectively by the approaches that have been proposed and evidence the need to reflect about new ways to follow the obese subject, in the present study with a proposal of a relational approach. In order to that, we adopted the qualitative method of survey that was designed by a case study and it was used a semi-structured interview, Genogram and a Timeline as data collect instruments. It was interviewed an obese young adult with 27 years old, BMI of 36.1 kg/m² , that means obesity level II. The results indicated a family behavior based on rigidity and inability to deal with crisis and conflicts, beyond the presence of secrets that work for holding off and keeping way relationships. It was noted also the relationship between food and affection in this family, that as well as the overweight, represent the identity of the familiar group and give to the participant the belonging feeling. Thus, we could reflected about her loyalty and the limitation imposed by her, complicating the identification out of the family system and the constitution of an autonomous and adult identity. Understanding the histories of the individuals and their families is a facilitator strategy in the development of interventions that are connected with family beliefs and needs and can imply as an important agent of changing. In this way, the Family Therapy proved to be a relevant resource in working with obese individuals / Este trabalho teve como objetivo compreender os significados atribuídos à obesidade e família por uma jovem adulta obesa, sob a perspectiva da teoria sistêmica. Apesar do número de estudos e avanços significativos, o problema da obesidade parece não responder de forma efetiva às abordagens que vêm sendo propostas, o que evidencia a necessidade de refletir sobre novas formas de acompanhar o indivíduo obeso, no presente estudo com uma proposta de abordagem relacional. Para tanto, adotamos o método qualitativo de pesquisa delineado por meio de estudo de caso e utilizamos a entrevista semiestruturada, o Genograma e a Linha do Tempo como instrumentos de coleta de dados com uma jovem adulta obesa, universitária, de 27 anos e IMC igual a 36.1 kg/m², ou seja, obesidade de grau II. Os resultados indicaram um funcionamento na família da participante marcado pela rigidez e inabilidade para lidar com crises e conflitos, além da presença de segredos que operam no sentido de distanciar e afastar relacionamentos. Mostraram ainda a relação existente entre comida e afeto nesta família, que, assim como o excesso de peso, constitui a identidade do grupo familiar e dão à participante o sentimento de pertencimento. Pudemos, então, refletir sobre sua lealdade e a limitação que ela impõe, dificultando uma identificação fora do sistema familiar e o estabelecimento de uma identidade autônoma e adulta. Conhecer, portanto, as histórias dos indivíduos e suas famílias é uma estratégia facilitadora no desenvolvimento de intervenções que sejam conectadas com as crenças e necessidades da família e que possam implicá-la como um importante agente de mudança. Neste sentido, a Terapia Familiar se mostrou um recurso relevante na atuação com indivíduos obesos