Mental health professionals place value on education in the hopeful expectation that ethics instruction will provide the knowledge and awareness required to empower therapists to make ethical clinical decisions. This study examined the current status of ethics education in accredited and non accredited marriage and family therapy graduate programs in the United States and Canada. Surveys were sent to ethics instructors in 123 graduate programs, 72 of which have full or provisional accreditation by the AAMFT Commission on Accreditation for Marriage and Family Therapy Education. A total of 65 surveys were returned, resulting in an overall response rate of 53%. Information was gathered using a modified version of a survey designed by Vanek (1990) that examined eight areas of ethics training: 1) professional and educational characteristics of the instructor, 2) structure of ethics education, 3) instructional methods, 4) goals for ethics education, 5) specific content areas, 6) evaluation indices, 7) instructional materials, and 8) rationale for ethics education. Particular attention was placed on ethical content areas that are unique to a systemic approach to therapy. The future direction of ethics instruction was examined to determine whether instructors would significantly alter ethics education in the future. A series of paired t tests for within-group comparisons was used to determine if significant differences existed between the current and desired emphasis placed on 16 educational goals and 34 content areas. With the exception of four goals, there were statistically significant differences (p<.05) between the current and future emphasis placed on all other goals by ethics instructors. There were also statistically significant differences (p<.05) between the current and future emphasis placed on 22 of the 34 content areas by ethics instructors. These results indicated that the majority of ethics instructors place emphasis on these goals and content areas, but acknowledge a desire to place greater emphasis on them in the future. A series of t tests for independent groups determined that there were no significant differences (p<.05) between accredited and non accredited programs in the degree of emphasis currently placed on any of the specified goals or content areas. / Ph. D.

The purpose of this study was to contribute an increased understanding of therapists' experiences working with therapy dogs in couple and family therapy. This qualitative study sought to describe the overall experience of therapists who work with therapy dogs in couple and family therapy, including managing the therapy dog's presence with more than one client and the benefits and challenges of doing so. Eight individuals participated in semi-structured interviews and areas of inquiry included how therapists made the decision to work with a therapy dog, how the therapy dog was managed in session, the impact of the therapy dog's presence (e.g. benefits and challenges), and recommendations for therapists who aspire to work with Canine-Assisted Psychotherapy (CAP) in their practices. The data was analyzed using transcendental phenomenology. Findings from the data analysis suggest that the majority of therapists who use CAP with couples and families find it to be beneficial for the therapists, the couples and families, and the therapy dog, with only a few challenges. Participants focused more on being flexible and observing the system's dynamics surrounding the therapy dog, whereas in individual therapy it appears that therapy dogs are included to fulfill a treatment goal or enhance a therapy model. Additionally, the majority of participants reported on the therapy dog's ability to help the therapist better understand their couple and family clients and overcome particular challenges when working with more than one client. The findings contribute to the CAP literature, have clinical implications, and provide areas for further exploration. / Master of Science

Doctor of Philosophy / Department of Family Studies and Human Services / Sandra Stith / Recent years have seen a rise in the medicalization of treatments for erectile dysfunction (ED). While there has been a divide between the medical and psychological communities, some have called for a more collaborative relationship. Little research has been done on the collaboration between medical professionals and psychotherapists in treating ED. This study seeks to increase current knowledge about medical professionals’ referral practices and communication post-referral. An online survey was developed and distributed to the members of the Sexual Medicine Society of North America (SMSNA) (N = 541). Survey questions inquired as to the factors that increased participants’ willingness to refer ED patients, the form of communication participants currently desire to have with psychotherapists and the participants’ desired level of communication with psychotherapists to whom they might refer. Less than ten percent of the medical professionals invited to participate in the study completed the survey (n=50). Those who did complete the survey were primarily male, specialized in urology and practiced in the U.S. Almost half the respondents were employed in an academic setting while just over half of respondents worked in hospital-based, group, or solo practices. Just over half of the survey participants practiced in urban areas. Although the number of medical professionals who completed the survey was small, findings indicated that those who completed a sexual medicine fellowship and who had a larger percentage of their patient population being seen for ED were more likely to refer patients to psychotherapists. Participants who have referred ED patients to psychotherapists reported little-to-no communication between them and the psychotherapists to whom they refer. The study participants expressed a desire to refer patients to psychotherapists who are experienced in working with both sexual and couples issues. Questions about the desires and experiences of medical professionals who have not referred to psychotherapists were not able to be answered because of the limited number of these individuals in the data set. Although the number of participants who completed the survey limits the generalizability of the data, this study demonstrates that most medical professionals who responded to the survey are willing to refer ED patients to psychotherapists.

Excerpt: Dr. Augustus Napier, a respected pioneerin the field of family therapy, received his doctral degree in clinical psychology from the University of North Carolina.

Adlerian family counseling was developed and systematized by Rudolf Dreikurs and carried into the world by his many student/colleagues, including Oscar Christensen and Manford Sonstegard. This is an experiential workshop using Dreikurs’ model in multiple family consultation demonstrations. Interventions include assessments of family constellation, mistaken goals, typical days, goal disclosure, and the use of encouragement and natural and logical consequences.

Family therapy does not consist of just a single way of working with people but is composed of many different approaches. This article divides family therapy into four historical groupings and explores the degree to which Adler's ideas have influenced, whether directly or indirectly, the various models of family therapy. Family systems therapy, often without recognition, has incorporated much of what Adler and his associates brought to the understanding of human nature and the contexts in which humans live and work.

Book Summary: The ninth edition of Corey's best-selling THEORY AND PRACTICE OF COUNSELING AND PSYCHOTHERAPY helps you develop your own counseling style. With this text, you will gain a firm foundation in the major counseling theories (psychoanalytic, Adlerian, existential, person-centered, Gestalt, reality, behavior, cognitive-behavior, family systems, feminist, and postmodern approaches) as they are used in practice. By means of the case of "Stan," you will see how the theory presented in each text chapter informs therapeutic decision making. The "DVD for Theory and Practice of Counseling and Psychotherapy: The Case of Stan and Lecturettes" is an extension of the text. "At a Glance" charts pinpoint the major differences between theories in areas such as multicultural focus, basic philosophies, and limitations.

Book Summary: CASE APPROACH TO COUNSELING AND PSYCHOTHERAPY, Eighth Edition, vividly illustrates how major counseling approaches work with a single client, Ruth. Dr. Corey provides solid examples of psychoanalytic, Adlerian, existential, person-centered, Gestalt, reality, behavior, cognitive-behavior, family systems, feminist, and postmodern theories in action. Dr. Corey applies each therapeutic approach to a single client, illustrating how the various theories work and helping you see exactly how the techniques differ. Well-respected and widely recognized practitioners serve as guest commentators, offering their unique perspectives on Ruth's case. Commentators include founders of some of the therapies, such as William Glasser for choice theory and reality therapy, Arnold Lazarus for multimodal therapy, and Albert Ellis for rational emotive behavior therapy.

This paper presents results from cost-analysis research for treating Post-Traumatic Stress Disorder in adults. Data for this research was provided by Cigna, a nation-wide healthcare manager in the United States of America. The sample size was 12,845 adults who were diagnosed with PTSD and received outpatient individual and family psychotherapy from one of the following mental health care providers: Marriage and Family Therapists (MFTs), Master’s Nurses (RNs), Medical Doctors (MDs), Professional Counselors (LPCs), Psychologists (PSYs), and Social Workers (MSWs). Results were compared across treatment modality, across practitioner license type and between practitioner educational levels. The results demonstrated that family therapy was most cost effective and used the fewest sessions, while mixed therapy was least cost effective. Among practitioner licensure types MDs were found to be the most cost effective, while the group of RNs, MSWs and MFTs were least cost effective compared to one another. Also, no significant differences in cost effective treatment outcomes were found between Masters Level and Doctoral Level practitioners.

Adverse childhood experiences (ACEs) include childhood sexual abuse, physical abuse, emotional abuse, physical neglect, emotional neglect, and household dysfunction. Much has been reported about the detrimental outcomes associated with these experiences. The associated negative outcomes of ACEs can include addiction, suicide, disability, teenage pregnancy, and early death. However, it is well known that many people experience ACEs and do very well. Rather than viewing negative outcomes only as symptoms of trauma and positive outcomes only as signs of resilience, it is possible to consider adaptations. This study focused on how adults adapted to their adverse childhood experiences. Data were collected based on semistructured interviews with nine members of the ACEs Connection Social Network, an online support group. The data were analyzed using a constructivist grounded theory methodology. A grounded theory then emerged from data, supporting the adaptation construct.