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Clients With Serious Mental Health Issues

Family therapy has been found to be applicable to persons with mental disorders. The present decade is bounded at start and finish by exhaustive reviews of published family therapy outcome research (Carr, 2009a, 2009b; Pinsof & Wynne, 2000). These reviews pointed to evidence that family therapy is more effective than therapy that does not involve a family member in treating the following issues: adolescent conduct disorders, adolescent suicidality, adult alcoholism and drug abuse, adult schizophrenia, aggression and noncompliance in attention-deficit/hyperactivity disorder, anorexia in young adolescent females, bulimia in young adolescent females, child and adolescent anxiety, childhood autism, childhood conduct disorders, childhood sexual abuse trauma, childhood sleep problems, dementia, depression in adults with chronic illnesses, obsessive-compulsive disorder, and poorly controlled asthma. Overall, most counselors are likely to be more effective if they include relevant, available, and appropriate family members in treatment (Carr, 2009a, 2009b; Pinsof & Wynne, 2000).

Cross-Cultural Considerations

Family is a culturally determined phenomenon. As N. J. Kaslow, Celano, and Dreelin (1995) noted,

[T]he dominant American definition, reflecting white Anglo Saxon Protestant (WASP) values, focuses on the intact nuclear family unit. African Americans' definition of family refers to a wide network of kin and community. For many Italian Americans, family implies a strong, tightly knit three-or-four generation unit including godparents and old friends. The traditional Chinese definition of family includes ancestors and decedents, (p. 622)

Thus, an effective family therapist must possess a high degree of cultural competence with diverse populations (McDowell, 2004). Otherwise, marginalizational and colonization enter and poison the family therapy process (Borstnar, Bucar, Makovec, Burck, & Daniel, 2005).

In a review of the literature on cultural competence and family interventions, Celano and Kaslow (2000) found family therapy to be the treatment of choice for culturally diverse clients. They noted that family therapists can be efficacious and culturally competent only when they (a) recognize the effects of their own culture(s) on the therapy; (b) acknowledge that family therapies, theories, and techniques reflect the culture in which they were developed; (c) attend to the dynamic interplay of the cultural influences that affect the individual's and family's functioning; and (d) devise and implement problem-resolution strategies that are culturally acceptable.

In another review, Falicov (2009) noted that there is wide conceptual and empirical support for the use of family therapy with Latinos if appropriate cultural adaptations are instituted. Beitin and Allen (2005) demonstrated the efficacy of a family systems approach with Arab American couples facing life in the post-9/11 world.

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