This document provides an overview of family therapy in the 21st century. It discusses feminist family therapy and how a feminist approach considers gender, power dynamics, and social contexts. It also addresses tailoring therapy to specific populations like single-parent families, African American families, and gay and lesbian families. The document outlines various relationship enrichment programs and how medical family therapy assists families dealing with illness through psychoeducation. It emphasizes the importance of being culturally sensitive and addressing issues like race, poverty, and spirituality when providing family therapy.

2. FAMILY THERAPY IN
st CENTURY
21
by Sümeyye BALCI

3. CONTENTS
Family Therapy in 21st Century
Feminist Family Therapy
A Feminist Approach to Illness and Family
Family Violence
Multiculturalism
Race
Poverty and Social Class
Gay and Lesbian Rights
Spirituality
Tailoring Treatment to Populations and Problems
Single-Parent Families
African American Families
Gay and Lesbian Families
Home-Based Services
Medical Family Therapy and Psychoeducation
Relationship Enrichment Programs

4. Family Therapy in
st
21
Century
combine models and techniques from various family therapy
theories
specific needs of every client
Postmodernism : not knowing the truth for sure. According to
Rovelli (2012), stating that some idea or phenomena is a
scientifically proved is closing the doors to improving that
idea/phenomena

5. Feminist Critique
sharing the responsibility of the problem is another
way of accusing the victim and continuing with the
remaining system
blaming women for causing their own abuse
blaming women for their children's psychopathology
and even the problem of family
the father figure who was the hero and saved the
family from dissolution?!

6. Feminist Family Therapy
differences between a feminist family therapist and a
therapist who adopted the principles and practices of
feminism
Feminist therapist is defined as the ones who
composed feminism both into their personal lives and to
their psychotherapy practice
main idea that makes a feminist family therapist is the
sensitivity to gender and a nonsexist approach towards
the clients
those who also put the gender equality in the center of
their therapy practice are should be considered as
feminist therapists

7. Feminist Family Therapy
feminist family therapist‟s one of the main goal is to
extend the assessment to the cultural and social
context in order to rescue men and women from
narrow and unequal roles that they‟ve been playing for
a long time
powerful political aspect because what this approach
aims to accomplish is to change patriarchy with a
feminist consciousness
a feminist family therapist should have a feminist
sensibility rather than feminist agenda while
challenging patriarchy

8. Feminist Family Therapy
The major conflict which is encountered by families is
the cultural coding that forces women to nurture and
support men while they are seeking success even if it
decreases women‟s development
challenge this balance by empowering women to feel
adequate
„power‟ refers to having freedom and resources to
accomplish to do things but not domination or control
over someone
Both men and women should be empowered to free
themselves from what taught them to be acceptable
and what is best for them

9. Feminist Family Therapy
Therapists are used to working with women as their
clients and in family therapy they tend to accept the
absence of father because of his work schedule. But
in order to resolve the problems that are result of the
sexist arrangement of family system, family therapist
should insist on having the father come to the therapy
with the rest of the family members(Nichols, 2013)

10. A Feminist Approach to
Illness and Family
traditional gender roles are accepted unconsciously
however in case of a chronic illness of a family member
may result the obligatory change in these roles because
of the demands of the illness
in dysfunctional couples, through health habits and
depression, there is an indirect effect on health and
health
outcomes
and
direct
effects
on
cardiovascular, immune and endocrine systems
Spouses contributions to their course of disease might
be helpful or hinder

12. A Feminist Approach to Illness
and Family
Behavior patterns of being ill is different for men and
women
an illness can challenge gender roles
For example, a woman might need to built trust first to
tell the health psychologist her illness story; and a
man might feel difficulty talking about his illness story
because this is very much related to exposing
vulnerability which is against to most men‟s
socialization.

13. Illness, couples and
family life cycle
if a couple with young children face
a chronic illness, while one of them
is mostly focused on childrearing and
the other one on working, these
differences might cause additional
difficulties because it will devastating
considering the parent roles and
responsibilities
In therapy; how each partner can
make transition into a new role and
what are the possible obstacles
towards these changes(Silverstein &
Goodrich, 2003)

14. Medical family therapy has a gender sensitivity to
fight with these oppressive experiences caused by
gender roles
aims to help families and increase agency via
psycho-education encouraging all family members to
maintain individual and family identities, develop
flexible roles for caring illness, and finding resources
independent from gender based socializations
Medical family therapy counters the traditional
medical approach by making sure the patient‟s voice
is heard by the health care professional and mutual
agreement about a treatment to avoid noncompliance

15. Family Violence
Judith Myers Avis reported that therapist who
adapt the systemic approach will keep supporting
male power in family and indirectly leading to
danger against women and children. Systemic
approach believed that family violence was result of
a cycle of mutual provocation

16. Multiculturalism
It is important to be familiar with our clients‟
backgrounds and their cultures because some
of their behavior due to their culture might be
different to us but it is not necessarily wrong

17. Race
In the US, African American therapists such
as Nancy Boyd-Franklin and Ken Hardy put
families of color into the map by emphasizing
white therapists‟ denial and ignorance
towards them and the racism they have to
live with everyday

18. Poverty and Social Class
People who are low on economic status tend to
believe that it was their own fault to become poor
because that‟s what is believed by everyone
Therapists should familiarize themselves about the
conditions that poor people live in
A therapist might help the clients see that being poor
is not the result of their own making

19. Gay and Lesbian Rights
Therapists should be aware of that a gay/lesbian
client might had to deal with pressures from society
and accepting their own identity.
When working these clients, it is a therapists
responsibility to get familiarize about the issues these
people face(Nichols, 2013).

21. Spirituality
a debate about whether therapists should
explore the spirituality of the family or not
people‟s answers about their spirituality
also tell a lot about their well-being(Nichols,
2013)

22. Integrating Spirituality in
Family Therapy
In therapy, most families wanted to gain deep meaning
about their lives and contribute to their spirituality
examples of effective faith based health care
programs which combines spirituality aspects through
clergy with communication skill for a premarital program
for couples
it is important for therapists to familiarize about their
own spirituality and religious view and related biases
It is important to acknowledge the client‟s spirituality,
religious views and beliefs rather than avoiding it

23. in Eastern cultures, to treat an illness, they use
mind, body and spirit interactions
In Chinese medicine, trying to find ways to
increase energy for internal resilience and
resistance to disease
In future, new approach to family, a more
holistic approach such as biopsychosocial and
spiritual way to approach clients

24. Spirituality and Health
our faiths, rituals and prayers provide positive effects
on our health and physical well being by triggering
emotions that influence physiological systems
elderly who have strong religious beliefs tend to be
happier with their lives and to have a lower blood
pressure(Walsh, 2009)

25. There are two ways that therapist could utilize the
spirituality of their clients in the sessions;
first, is the spirituality of the client contribute to
distress of the family;
secondly is the spirituality of the family can contribute
to solving the problems in the family
When families face a conflict, a crisis; they use their
strengths and bounds between members and
resilience which all these are enhanced by sharing
spiritual values and and practices to support one
another(Walsh, 2009)

26. Tailoring Treatment to
Populations and
Problems
Books about family therapy cover families with
specific problems such as drug abuse, single parent
families,
stepparent
families,
divorcing
families, blended families and families who are in a
transmission
A family therapist might face some difficulties when
treating single-parent families, families of minorities
and gay and lesbian families(Nichols, 2013)

27. Single-Parent Families
Single parent families have a
very similar problem with two
parent families: an
overburdened mother, who is
enmeshed with her children
and disconnect from
relationships with other adults
the goal of therapy is to
empower the mother‟s
position in the family and in
her relationships with her
children and provide her some
resources to make her life
more fulfilling

28. the therapist should support the parent with already
existed resources and empower her to acquire more
effective role in her children
providing for the children with one pay-check is very
hard and sometimes force people to put up with very
difficult conditions in workplace just to provide their
families
Financial difficulties may led to depression and low
self-esteem

29. In therapy, therapist should account for financial state of
his/her client and arrange sessions according to the parent‟s
work schedule. Further in therapy, single-parent can be
presented with options that suggest a more financially stable
life such as going back to school
Supporting the single-parent can be started with empowering
already existing bounds with his/her parents and close friends
A very important challenge that a single mother might face is
to integrate the father of her children to their lives. Usually the
father seems like an outsider and even an enemy however
the therapist should understand these negatives feelings of
the mother towards the father and help her to involve the
father (emergence of two subsystems after divorce)

30. Ambiguities after divorce
ex-spouses have different constructs about each
other and these constructs are mostly determined by
the reason led them to get a divorce
If these complicated views about ex spouses toward
each other may lead to feelings of anger and blaming
one side; the therapist should help the ex spouses to
reconstruct new images about each other so that they
can believe the other one will offer something to their
children in the future(Barnes, 2004)
In children, sadness, failure at school, violence; in
parents, increasing hostility towards one another

31. African American
Families
African American families
are characterized with their
extended families and
kinship networks which
provide support and strength
to them
Usually an African
American family came to
therapy when they lost
connections of their
extended family and
kinships

32. In therapy, therapist should focus on connecting the family
again with those extended family members and kinships to
provide them support to cope with conflicts. These
extended family members and kinship networks might be
call to the therapy sessions as well in the assessment
process.
Religion plays an important role as a source of strength in
an African American family, so it is useful to state whether
the family is practicing any religion.
particular complications in African American families
caused by absence of men (fathers: death or in
jail), presence of grandparents in the household and so on

33. Gay and Lesbian
Families
In gay community, the term
family refers to an important
reconstruction of a traditional
arrangement that was causing
difficulties and abusive for
LGBT individuals(Silverstein
&Goodrich, 2003)
specific problems same sex
couples face such as
homophobia in their families
and in
society, boundaries, gender
related behaviors and
developing social support

34. In working with same sex couples, therapist should pay
attention to use a language free from homophobic
expressions and biases as much as possible
Gender roles in heterosexual couples, are controversial in
same sex couples and led some problems for the same sex
couple
Monogamy is an issue to discuss in therapy with same sex
couples to clarify the boundaries of commitment
Because there is not a model of family in same sex
couples, the issues of couples needed to be handle more
cautiously by the therapist

35. Sex and Internet
Internet, is rather a recent
technology, is helping people
connect with others and not
connect with others while
keeping them online
socializing and having them
socialize in a non traditional
but a technological way

36. In the US, many family therapists are facing with the problems in family
caused by cybersex incidents
excessive consumption of internet pornography and infidelity issues are
very common
The dangers to internet use for children may involve cyberbullying,
cyberharassment and inappropriate sexual contact with people in real
world
For teenagers, parental control over their behavior might let to rebellion
which may not be so obvious if the subject is shame sensitive such as
sexuality
Pornography might seem rather harmless for adult audience however
there are still risks that it can turn into compulsions and their secret
nature might cause harm to trust and intimacy of the couples‟ relationship
People who are suffering from compulsive sexual behavior seek help
through recovery programs

37. Home-based Services
home-based services aims to provide the family as a
major recipient of mental health care
Home-based services has four elements: family
support services, therapeutic intervention, case
management and crisis intervention

38. Family support service involves respite care and assisting
the family to provide food, shelter, and clothing.
Therapeutic intervention involves individual, couples or
family therapy. The main goal here is to empower family to
find their own strengths to solve their problems by
themselves.
Case management include finding connections in the
resources that community provide such as medical
care, education and job trainings.
Crisis intervention refers providing 24 hours available
emergency services by contacting home-based agency or
an outside mental health emergency service

39. For a therapist, visiting the family at their home is a
great way to understand their family history, their
identities and religious beliefs. For example looking
through photo albums may be a good way to the
therapist to join the family
Studies have found that in home based therapies, the
most important thing is therapeutic relationship
between the family and the therapist. Therapist‟s
warm attitude may contribute to the relationship

40. Medical Family Therapy
& Psychoeducation
medical family therapy which emphasizing helping
families who are dealing with chronic illnesses such as
diabetics, cancer and
psychoeducational family therapy which had its
roots from working with families who have a
schizophrenic family member.

41. Psychoeducation and
Schizophrenia schizophrenia is
Some studies showed that the course of
affected by the amount of stress that the patients‟
experience after coming back to their homes
it is important for schizophrenic patients to have rather a
peaceful environment at their houses in order to prevent
relapses
Psychoeducation aims to help families of schizophrenic
patient get enough knowledge to understand the disease
and have a sense of mastery, reduce the guilt and shame
and conflict
Main goal for the family is to help them learn coping
strategies while living with a schizophrenic patient and
preventing relapse and rehospitalization

42. Medical Family Therapy
Medical family therapy aims to help families
while coping with a chronic disease. It involves
not just the family of the patient but their
physician and nurses who take care of them;
aimed to provide communication and support
between the family and their health care
provider team

43. Relationship Enrichment
Programs
developed by Bernard Guerney, Jr. in 1977 to help
couples clarify their conflicts, be open about their
feelings and acknowledge each other‟s feelings and
work through problems and finally become satisfied with
being emotional partners
three core skills: Expressive(owning) skill which
refers to an awareness towards one‟s own feelings and
taking responsibility about these feelings while not
projecting them to others; Emphatic Responding
(Receptive) skill refers to listen others feelings;
Conversive(Discussion-Negotiation/Engagement)
skill refers to learning to acknowledge what was heard.

44. PREPARE: Premarital Personal and Relationship Inventory is
developed by David Olson and his colleagues to assess the
couples history and expectations, communication, and the areas
where they might face a conflict in the future and promoting
discussions
about
these
possible
problems.
http://www.youtube.com/watch?v=QRCMOtYGTgk
Marriage Encounter Weekend: first organized by a church in
Barcelona to provide support and enrichment for Catholic
couples. In these events, couples get to work on their
communication and problem-solving skills, sexual intimacy and
spiritual issues.
PREP: Prevention and Relationship Enhancement Program
developed by Floyd, Markham, Kelly, Blumberg and Stanley in
1995 which aims to teach communication and conflict resolution
skills and explore expectations and attitudes about marriage and
avoid couples to develop unhealthy defensive patterns in their
relationships

45. References
Barnes, G. G. (2004). Family Therapy in Changing Times. New York: NY: Palgrave
Macmillan.
Dallos, R. & Draper, R. (2010) An Introduction to Family Therapy: Systemic Theory
and
Practice. Berkshire, England: Open University Press.
Nichols, M. P. (2013). Family Therapy: Concepts and Methods. Upper Saddle River:
New
Jersey: Pearson Education Inc.
Rovelli, C. (2012). This will make you smarter. J. Brockman (Ed.). New York, NY:
HarperCollins.
Silverstein, L. B. & Goodrich, T. J. (Eds.). (2003). Feminist Family Therapy:
Empowerment in
Social Context. Washington, DC: American Psychological
Association.
Walsh, F. (Eds.). (2009). Spiritual Resources in Family Therapy. New York, NY: The
Guilford
Press.

46. “Type a quote here.”
–Johnny Appleseed