Artificial Intelligence (AI) has rapidly altered the practice of couple/marital and family therapy (CMFT). While much has been written in other disciplines about competencies to be developed in integrating AI into one's work, to date no competencies have been presented for use in CMFT. In this article, we present the first competencies for AI in CMFT. These new competencies cross six domains and were informed by three other competency frameworks: the condensed core competencies for CMFT, interdisciplinary competencies for telebehavioral health, and AI competencies for medicine. Emphasis is placed on the development of AI-specific competencies that align with relational ethics and person-centered care.

Autistic people report poorer treatment outcomes for their eating disorder (ED) in comparison to non-autistic peers. Eating disorder focused family therapy (FT-ED) is the leading outpatient intervention for adolescents with Anorexia Nervosa (AN). The aim of this study was to explore the experiences of parents of autistic young people who have received FT-ED, and any recommended adaptations to treatment. Parents of an autistic young person who had received FT-ED within the last 3years were invited to take part in interviews. Transcripts were analysed using reflexive thematic analysis. Twelve parents of autistic young people with AN completed interviews and analysis generated four core themes: (1) Questioning the principles of FT-ED, (2) Navigating the FT-ED process, (3) Parental (dis)empowerment, (4) Adapting FT-ED. This paper is the first exploration of parents of autistic young peoples' experience of FT-ED for AN, and it highlights possible treatment adaptations for this population. It is part of a larger body of work to consider adaptations to FT-ED, with the aim of making ED treatments more effective, accessible and acceptable for autistic young people and their families.

ABSTRACT In this article, we examine the possibilities and limitations of collaborative-dialogical therapeutic models in addressing the issue of power in family therapy. We argue that such approaches would be insufficient if therapists merely facilitate dialogue with a not-knowing attitude, as this risks turning therapy into a mirrored room of dominant discourses – ultimately reproducing the power asymmetries that exist in society. To avoid this situation, therapists working within a collaborative-dialogical framework must remain aware of the broader socio-political context and the dynamics of power, steering the therapeutic process in a way that challenges dominant discourses through meaningful dialogue with the clients.

ABSTRACT Caregiver–child interactions starting in infancy play a crucial role in socio-emotional development, including the formation of object representations and defense mechanisms. Projective tests, such as the Thematic Apperception Test (TAT), have been used to explore these unconscious processes. In the TAT, participants create narratives based on images depicting characters in various emotional states and interpersonal situations. In doing so, participants project aspects of their internal world into the stories they construct. While the TAT has been effective in differentiating diagnostic groups and providing insights into socio-emotional functioning in both children and adults, few studies have directly compared TAT narratives between caregivers and children. This paper presents a case-based examination of caregiver–child TAT narratives drawn from data from a larger mixed-methods research study of 20 dyads. In this paper, six dyads were selected to illustrate how the process of in-depth analysis of key relational and emotional themes, language use, and narrative structure can offer important insights for treatment planning with children, caregivers, and families. The findings underscore how narrative material can illuminate relational patterns and guide individualized interventions in child and family therapy.

Though Family System Theory supported that function of members in the family are shaped by their interactions with all members in the family unit, many previous studies have often focused on the perspective of only one parent without considering the dynamics between both parents. This study investigates the effects of positive coparenting perceptions on child social skills via parenting stress within the framework of the dyadic family system. Utilizing the Future of Families and Child Wellbeing Study, this study included 3,003 fathers and mothers who were interviewed when the focal child was 3 years old. An actor-partner interdependence model was employed to include both actor and partner effects. Results indicate a negative association between positive coparenting perceptions and parental stress for both mothers and fathers, with no significant partner effects observed. Further analysis using actor-partner interdependence model mediation models revealed that maternal parenting stress mediated the relationship between mother's perception of positive coparenting and child social skills, while no direct or indirect effects were found for father's perception of positive coparenting. These findings identify the role of positive coparenting on parenting stress within a dyadic family system and highlight roles of maternal factors in child social skills. Implications for family therapy and intervention programs are discussed. Future research is needed to deepen our understanding of coparenting dynamics and their impact on child development. (PsycInfo Database Record (c) 2026 APA, all rights reserved).

Family-based interventions have broadened from early systemic work in psychosis to encompass a range of approaches for mood disorders, developmental and behavioral conditions, and substance related problems. This review integrates core theoretical models (e.g. systems theory, communication patterns) and clinical schools of family therapy (structural, strategic, Bowenian, experiential, cognitive-behavioral, and family-focused therapies) with an emphasis on evidence and relevance in contemporary practice. We highlight key therapeutic mechanisms such as lowering expressed emotion, enhancing communication and problem-solving skills, and bolstering family support of treatment adherence.Sociocultural and resource factors that shape family involvement in settings like India are examined, and the critical role of psychiatric social workers in assessment, education, intervention delivery, and advocacy is discussed. Challenges related to limited specialized training, engagement and ethical complexities are reviewed. Emerging directions, including culturally adapted practice and telehealth-enabled family work, are described. Overall, this narrative review argues that family therapy is an essential component of person-centered,recovery-oriented mental health care,especially in contexts where families remain primary caregivers and supports.

The opening article of this special issue presents a dialog between Dr Wai Yung Lee, an internationally acclaimed veteran family therapist currently working in Asia, and Professor Sim, this Special Edition's Associate Editor. The dialog focuses on unraveling the intricate processes of interparental conflict and child psychopathology in therapy, based on Dr Lee's work for close to three decades with nearly 100 Chinese families in Shanghai. The main themes are: interparental conflicts affects children like a "dance of three"; children's psychopathology is frequently linked to anxiety stemming from prolonged interparental conflict; children become expressive and lively when discussing their parents in therapy; when one parent blames the other, the blamed parent turns to the child; when parents begin to address their conflicts, children's psychopathology improves; and behind the psychopathology of children, there often lies an unhappy couple. Through nuanced analyses of three Chinesecases where there is suicide ideation, eating disorder, and tic, this article critically examines the possible ways of uncovering the intricate dynamics, therapeutic movements used to address them, and salient issues, such as culture, gender, and power.

Emotionally Focused Therapy is commonly treated as treatment-as-usual for entrenched relational resentment and emotional disconnection, relying on attachment repair through empathic, emotion-oriented engagement. This case report offers a clinically and ethically grounded alternative by using Strategic Family Therapy, which emphasizes therapist-directed systemic pattern disruption rather than intrapsychic exploration or affective processing. The case involves a heterosexual couple in their early 40s, married 18 years, presenting with chronic resentment during an empty-nest transition. Across three 90-minute sessions, the therapist integrated radical honesty as a directive, systemic intervention with radical presence as a stabilizing stance. Interventions included direct systemic confrontation, therapist vulnerability, and strategic reframing, all deployed within Haley’s strategic model. Data from transcripts, therapist notes, and patient reflections were examined through thematic, narrative, and content-analytic methods. Radical honesty, operationalized through explicit therapist-driven challenge, disrupted ingrained avoidance sequences and generated relational accountability. Radical presence enabled the therapist to maintain ethical attunement while sustaining pressure without escalating hostility. The couple shifted from reciprocal blame to shared responsibility through structured disruption rather than insight or empathic attunement alone. This case demonstrates that, within SFT, radical honesty and presence function as deliberate tools of ethical disruption, supporting relational change where treatment-as-usual modalities may be insufficient.

ABSTRACT Background Limited research explores clinician perspectives on treatments for children and young people (CYP) experiencing first-episode psychosis (FEP), and clinician views on involving CYP in clinical trials. Understanding these perspectives can inform service development and research design. Method A survey was completed by 116 clinicians working in Early Intervention in Psychosis (EIP) and Child and Adolescent Mental Health Services. It captured treatment preferences between antipsychotic medication (AP), cognitive behavioural therapy, and family therapy (FT); preferred trial designs; and outcome priorities. Responses were analysed using Kruskal−Wallis tests for group differences and content analysis for open responses. Results AP was most frequently offered (M = 72.14; SD = 37.54) but rated least helpful (M = 65.95; SD = 23.20). FT was considered the most helpful standalone intervention (M = 74.51; SD = 21.43), though least often provided (M = 51.48; SD = 39.25; p < 0.01). Clinicians identified the combination of CBT, FT and AP as most helpful overall (M = 83.29; SD = 19.40). They preferred flexible trial designs allowing movement between treatment arms. Coping and recovery were key outcome priorities. Discussion The study highlights a disconnect between treatments commonly offered and those viewed as most effective, with attitudes and beliefs likely to influence practice and willingness to support trials. Differing views demonstrate the need for further research to guide improvements in services for CYP with FEP.

ABSTRACT This article revisits longstanding differences between modern and postmodern theory within systemic and family therapy and discusses its implications for practice. Drawing on Derrida's understanding of deconstruction as an ethical relation, it proposes a hospitable stance that holds theory lightly and irreverently, opening practice to multiple forms of theory and knowing. This ethical posture precedes epistemology, where the priority for practice is less what and more how therapists know. The paper highlights the benefits of postmodern therapy, with its emphasis on collaborative‐dialogic practice, language, not‐knowing and relationality, while arguing it risks becoming yet another orthodoxy, foreclosing the pluralism and dialogue it intended to promote. The demands of contemporary practice require therapists to apply modern and postmodern sensibilities, drawing on evidence‐based models, neuroscience, trauma‐informed frameworks as well as postmodern approaches such as narrative therapy, collaborative‐dialogic practice and systemic thinking in a flexible way. The paper proposes a paramodern stance towards theory as a deconstructive bridge—one that acknowledges the enduring value of modern therapy approaches while welcoming the relational, contextual and dialogic perspectives of postmodernism. Here, knowledge can be seen as a spectrum of knowing and not‐knowing, where one informs and sits inside the other rather than being opposed as binaries. The author argues for a critical realist and deconstruction perspective that preserves the insights of social constructionism while being theory flexible and irreverent in challenging its anti‐realist assumptions. Finally, deconstruction invites a systemic practice grounded in an ethic of hospitality—one that regards theory as a resource for therapy practice. This legitimises diverse models and methodologies where to deconstruct theory is to engage practice in a way that is flexible, grounded in the modern science of therapy while being relationally attuned, collaborative and ethically accountable.

Scholars in family therapy are increasingly calling for family-centered interventions for trauma-affected refugees, as many trauma-informed therapies favor individual models of treatment. Research contributes to the study and implementation of family-centered care models. However, for methodological reasons, research on family therapy with displaced populations is limited. In response to scholars' call, this paper argues for the use of documentary film as qualitative research data in refugee family therapy research. Documentary films have historically been used in the social sciences to examine people's lived experiences and to address data gaps in hard-to-reach populations. This paper outlines key methodological considerations inherent in research with refugee populations, including challenges related to recruitment and retention, language and cultural barriers, insecure and unstable living conditions affecting participants, research design constraints, and ethical complexities. It then discusses how the use of documentary film can help mitigate these challenges through careful epistemological positioning, research design, data selection and analysis strategies, and attention to ethical and research trustworthiness considerations. By doing so, the paper contributes to the development of qualitative research skills necessary for studying refugee family well-being and supporting the growth of family-centered therapeutic approaches.

ABSTRACT Artificial intelligence (AI) has pronounced utility in systemic therapy when used with clear purpose, ethical alignment, transparency, specialized models, and guardrails for safety. This paper offers a practical roadmap for couple and family therapists (CFTs) to integrate AI in treatment as a support to, rather than a replacement for, human clinical judgment and processes. Strategies for using AI in systemic therapy include: 1) identify and articulate the function and purpose clearly, 2) distinguish AI’s role in treatment as the agent or tool, 3) align with professional standards and ethical codes, 4) promote transparency in AI use and processes, 5) prioritize the use of smaller, domain-specific language models when feasible, 6) establish robust safeguards and risk-mitigation protocols, and 7) formalize critical thinking processes. The strategies are presented in detail and accompanied by applied examples and ethical guidelines intended to support clinicians, supervisors, training programs, and clinical systems. A description of how to implement the strategies is presented, including a template of an AI-informed consent for clinical care. Implications for training and supervision are discussed.

Attention to climate- and nature-related issues is largely absent from systemic practice and the field of Couple and Family Therapy (CFT). The effects of climate change and the consequences of living as if humans are separate from and dominate over the natural world are compromising health and driving planetary degradation. Ecological distress (including ecological anxiety, grief, and depression) is rising alongside increasing disconnection from nature. As a result, the demand for clinicians competent in addressing these issues is growing. This review examined climate- and nature-related content in 17 peer-reviewed systemic and relational therapy journals published from January 1, 2009 through September 7, 2025. Less than 1% (n = 102) of the total published original articles (N = 14,116) included climate- or nature-related content. These articles addressed seven broad themes: eco-informed thinking and practice; disaster effects and therapeutic responses; environmental and social justice challenges; reproductive and family planning decision-making; migration, immigration, and refugee experiences; cultural and historical contexts; assessment tools and validation. Over half (n = 55) of the included articles at least partially included social justice issues and over a third (n = 35) included diverse samples. Although publications have increased, climate- and nature-related concerns remain under-explored in the CFT literature. Anthropocentrism and the dominant practice of systems theory are discussed as contributing factors to the ongoing inattention to ecological topics. Researchers, educators, and clinicians are encouraged to integrate an eco-centric approach by utilizing eco-informed assessments to screen for ecological distress and facilitating discussions about climate- and nature-related topics.

The present study aimed to investigate the mediating role of infidelity tendencies in the relationship between relationship-focused obsessive-compulsive symptoms and marital instability. A total of 227 (Female = 155, Male = 72) married individuals participated and completed measures assessing relationship-focused obsessive-compulsive symptoms (including relationship-related and partner-related obsessions), infidelity tendencies, and marital instability. Using structural equation modeling with SmartPLS, results indicated that relationship-related and partner-related obsessions were positively associated with infidelity tendencies. In turn, infidelity tendencies significantly predicted marital instability. Mediation analyses also revealed that infidelity tendencies were the main pathway through which obsessions about relationships and partners caused a higher level of marital instability. These findings show the psychological processes linking obsessive relational concerns to the risk of infidelity and marital disruption. The clinical implications of this study suggest the need for working with obsessive relational dynamics and infidelity risk factors in couples and family therapy.

ABSTRACT Family therapy, like any other theory within the helping professions, is as moulded by the systems of colonisation. This paper, which explores how this occurred, utilises client material to explore just how we might recognise, challenge and decolonise the ideas that have shaped our profession. Although presented through the lens of individual psychotherapy work, the author recognises that family therapy is well‐positioned in this regard and encourages readers to use their undoubted talents to challenge the structures that inhibit us as we work with clients from other varying cultures.

Autism treatment in the United States often centers on child behavior change, with caregivers viewed as adjunct rather than central. In contrast, this qualitative study examines caregiver perspectives at treatment entry, exploring how they conceptualize success and perceive barriers. We analyzed intake responses from 81 caregivers of autistic children across three developmental stages (&lt;6, 6–11, 12–17 years) using a structured thematic analysis. Four core themes emerged, organized into two overarching themes: Understanding and Supporting the Autistic Child (Layers of Self; Help Them Thrive) and Empowering the Family System (We’re in This Too; Healing the System). Caregivers articulated layered goals spanning emotional regulation, social identity, autonomy, caregiving capacity, family wellbeing, and systemic navigation. Their perspectives challenge traditional child-only models by highlighting the reciprocity between child outcomes and family functioning. Findings underscore the suitability of Marriage and Family Therapists (MFTs) to lead holistic, family-centered autism care, bridging child and family priorities, tailoring support to caregiver readiness, and navigating systemic barriers. By centering caregiver voices within a systemic framework, this study offers a pathway toward more relationally responsive and sustainable autism interventions.

ABSTRACT The history of the mental health sciences includes numerous instances where parents were unjustly blamed for their children's psychological distress. From its inception, family therapy moved away from linear causal, intrapsychic explanations to emphasise complex family dynamics. However, systemic perspectives may still have unintentionally sustained a culture of blame. In contemporary Western society, high expectations around ‘good parenting’ place considerable pressure on parents to create ideal conditions for their children's development, often leaving them feeling insecure and inadequate. While guilt can motivate reparative actions, it becomes counterproductive when internalised as a fixed parental identity. This article explores how transgenerational family scripts provide a contextual lens for reflecting on difficult family interactions, while aiming to minimise the reinforcement of negative self‐perceptions. It highlights the importance of acknowledging societal pressures in therapy to help parents navigate personal and social expectations. A case study illustrates the ongoing relevance of family scripts in systemic practice.

ABSTRACT Purpose The psychosocial needs of couples impacted by aphasia are often unmet. This study aimed to determine what marriage and family therapists (MFTs) practicing in the United States (US) know and understand about aphasia and how aphasia education impacts their perceptions. Methods MFTs practicing in the US completed a Qualtrics survey. Respondents were randomly assigned to one of two groups in which they underwent brief written education with or without exposure to video footage from couples undergoing Relationship-Centered Communication Partner Training. Descriptive statistics were used to analyze MFTs knowledge, experience, confidence, and comfort; Inferential statistics were used to analyze the effects of aphasia education. Results MFTs (n = 61) overwhelmingly demonstrated limited knowledge about aphasia (80.3% of respondents) and limited experience and confidence working with aphasia (≥82% of respondents). Lack of training was a major barrier (identified by 83.6% of respondents). Despite this, MFTs reported comfort addressing communication strategies and marriage roles and responsibilities (≥62.3% of respondents) and felt that doing so was within their scope of practice (≥70.5% of respondents). Written aphasia education – especially when paired with video examples – improved MFT’s knowledge and confidence and mitigated concerns about their lack of training. Conclusion MFTs would benefit from direct education and training about aphasia especially when it includes video exposure. Interprofessional education could facilitate these educational experiences.

Asian American sexual and gender minoritized youth (SGMY) experience unique patterns of emotional distress in part linked to bullying based on their multiple marginalized identities, leading to elevated rates of depressive and anxiety symptoms. This article examined the modifying associations of LGBTQ family support, teacher support, and therapy attendance in relation to depressive and anxiety symptoms among Asian American SGMY. Using a national sample of Asian American SGMY ( N = 1,335) between the ages of 13 and 18 ( M age = 15.80, standard deviation = 1.54), this study investigated the protective factors against negative mental health outcomes of Asian American youth who experienced bullying based on race and sexual orientation, gender identity, and gender expression (SOGIE). The results showed that SOGIE- and race-based bullying and past-year therapy attendance were related to elevated depressive and anxiety symptoms. Whereas higher LGBTQ family support and teacher support were associated with lower depressive symptoms among Asian American SGMY, only teacher support was associated with anxiety symptoms. These results emphasize the need for further research on both culturally informed, school-based interventions against SOGIE- and race-based bullying faced by Asian American SGMY, and culturally informed, family-based interventions to increase LGBTQ family support and teacher support for Asian American SGMY.

This study examined indirect pathways from attachment to post-divorce growth (PDG) through self-efficacy and the moderating role of social support among divorced Korean women. Data from 191 women aged 20–49 were analyzed using PROCESS Models 4 and 14. Attachment anxiety showed a positive direct association with PDG but a negative indirect effect via reduced self-efficacy, indicating suppression. Attachment avoidance was consistently negatively associated with PDG. Informational support strengthened PDG among women high in attachment anxiety. Findings highlight the clinical relevance of growth-oriented, systemic, attachment-informed family therapy interventions conceptualizing divorce as a relational transition within broader familial and sociocultural systems.