Family Therapy Research Articles

Retention in Individual Trauma-Focused Treatment Following Family-Based Treatment Among US Veterans

Despite the availability of several empirically supported trauma-focused interventions, retention in posttraumatic stress disorder (PTSD) psychotherapy is poor. Preliminary efficacy data shows that brief, family-based interventions may improve treatment retention in a veteran's individual PTSD treatment, although whether this occurs in routine clinical practice is not established. To characterize receipt of family therapy among veterans diagnosed with PTSD and evaluate whether participation in family therapy is associated with an increased likelihood of completing individual trauma-focused treatment. This retrospective cohort study used the Veterans Health Administration (VHA) Informatics and Computing Infrastructure to extract electronic health record data of participants. All participants were US veterans diagnosed with PTSD between October 1, 2015, and December 31, 2019, who attended at least 1 individual trauma-focused treatment session. Statistical analysis was performed from May to August 2023. Receipt of any family psychotherapy and subtype of family-based psychotherapy. Minimally adequate individual trauma-focused treatment completion (ie, 8 or more sessions of trauma-focused treatment in a 6-month period). Among a total of 1 516 887 US veterans with VHA patient data included in the study, 58 653 (3.9%) received any family therapy; 334 645 (23.5%) were Black, 1 006 168 (70.5%) were White, and 86 176 (6.0%) were other race; 1 322 592 (87.2%) were male; 1 201 902 (79.9%) lived in urban areas; and the mean (SD) age at first individual psychotherapy appointment was 52.7 (15.9) years. Among the 58 653 veterans (3.9%) who received any family therapy, 36 913 (62.9%) received undefined family therapy only, 15 528 (26.5%) received trauma-informed cognitive-behavioral conjoint therapy (CBCT) only, 5210 (8.9%) received integrative behavioral couples therapy (IBCT) only, and 282 (0.5%) received behavioral family therapy (BFT) only. Compared with receiving no family therapy, the odds of completing individual PTSD treatment were 7% higher for veterans who also received CBCT (OR, 1.07 [95% CI, 1.01-1.13]) and 68% higher for veterans received undefined family therapy (OR, 1.68 [95% CI, 1.63-1.74]). However, compared with receiving no family therapy care, veterans had 26% lower odds of completing individual PTSD treatment if they were also receiving IBCT (OR, 0.74 [95% CI, 0.66-0.82]). In this cohort study of US veterans, family-based psychotherapies were found to differ substantially in their associations with individual PTSD psychotherapy retention. These findings highlight potential benefits of concurrently providing family-based therapy with individual PTSD treatment but also the need for careful clinical attention to the balance between family-based therapies and individual PTSD treatment.

PECULIARITIES IN CORRECTING ANXIETY AND DEPRESSIVE DISORDERS IN CARE-GIVERS FOR SERIOUSLY ILL PATIENTS WITH CANCER

The challenges faced by families of patients with cancer can be categorized into three main groups: emotional disorders in caregivers, behavioral changes, and problems related to the care and treatment system. Emotional disorders encompass anxiety, uncertainty about the patient's health, and a pervasive sense of helplessness. Behavioral changes involve shifts in family roles and lifestyle, intensified care-giving responsibilities, particularly in the later stages of treatment, and financial hardships stemming from the costs of anticancer treatment. Systemic challenges in care and treatment further compound the difficulties experienced by the family unit. Anxiety and depressive disorders were detected in 69.3±3.8% of relatives of patients with malignant neoplasms. To correct emotional disorders in caregivers for patients with cancer, a correctional complex was proposed, which included a combination of rational, short-term positive, cognitive-behavioral and family psychotherapy with psychopharmacotherapy. Under the influence of the proposed complex for the correction of anxiety-depressive disorders in caregivers, a significant decrease in the severity of symptoms of depression (MADRS, p<0.05) and anxiety (HAM-A) was noted after 4 weeks. This was clinically manifested by a subjective improvement in mood, a decrease in the amplitude of fluctuations in affective disorders, diminished signs of emotional labiality, improved sleep, increased productivity in everyday activities, and a reduction in signs of anxiety. The proposed intervention demonstrated its efficacy in positively impacting the well-being of caregivers, highlighting the importance of a multifaceted approach to address the complex challenges faced by families in the context of cancer care.

Evaluation of Culturally Informed and Flexible Family-Based Treatment for Adolescents (CIFFTA) implemented in community-based settings.

Effective family-based interventions are needed for youth who are experiencing emotional and behavioral difficulties and who are impacted by powerful environmental stressors. Culturally Informed and Flexible Family-Based Treatment for Adolescents (CIFFTA) is a manualized and evidence-based, multicomponent family-based treatment that has been shown to be efficacious in research settings. The purpose of this paper is to report on the effectiveness of implementing CIFFTA for the treatment of Latino and Black youth and families in community settings. Utilization of services offered and changes in youth presenting problems and family functioning were used to evaluate the program. Two hundred thirty-two youth (11-18 years of age) and their caregivers were recruited over 2 years and CIFFTA was delivered by experienced masters-level family therapists over a 12-16-week period. Seventy-six percent met the 8-session criteria for retention in treatment and 71% completed treatment. Results showed significant improvements in youth behavioral and emotional presenting problems, reduction in family conflict and improvement in family cohesion and communication. Caregiver well-being such as reductions in parental stress, relational frustration, and improvement in parental confidence also showed significant improvement. Analyses of reliable change indices showed a substantial improvement in youth who entered the program in the clinical range of presenting problems. The findings point to CIFFTA's ability to retain youth and families who tend to underutilize needed services, to significant reductions in presenting problems, and to improvements in family functioning when implemented in a community setting.

Reflections on a “Black and White” Model of Teaching Family Therapy to First Nations Students

In this transcribed interview, facilitated by the paper’s third author, Stephen Andrew, Robyne (Robbie) Latham and Banu Moloney discuss La Trobe University’s Graduate Certificate in Family Therapy: First Nations, the development of its pedagogy, its importance to Indigenous and non-Indigenous therapists, the complex relationships between teaching, learning, and listening, and the deep, cross-cultural significance and power of words such as “family” and “therapy”.

What is day hospital treatment for anorexia nervosa really like? A reflexive thematic analysis of feedback from young people

BackgroundA significant proportion of young people do not respond to the NICE recommended treatment for anorexia nervosa: Family Therapy. Whilst historically these young people would be admitted to inpatient services, which are associated with greater treatment cost, greater risk of relapse, and worse outcome, more recently evidence is building for the effectiveness of day programmes. One day programme that has been found to be effective is the Intensive Treatment Programme (ITP) of the Maudsley Centre for Child & Adolescent Eating Disorders in London, UK. However, to-date no studies have investigated how young people experience such a day programme.MethodAnonymous feedback was completed via online survey by 51 young people over a 5-year period (2018–2023) on discharge from ITP.ResultsFour main themes were identified: (1) Support—young people expressed the importance of boundaries but also of feeling validated, and encouraged; (2) Uniqueness: an experience like no other—ITP was described as different to any other treatment received before (both outpatient and inpatient); (3) Relationships – young people valued connecting with others in a similar situation and reflected that relationships at home changed throughout treatment; (4) Self-development – learning skills, developing independence, and exploring an identity outside of the eating disorder was valued.ConclusionsIt is hoped that the reflections from these young people can help to inform clinicians working in DPs and those hoping to set up novel DPs about key aspects of treatment.

Mental health professionals’ perspectives on the relevance of religion and spirituality to mental health care

BackgroundA large body of evidence indicates that spiritual and religious backgrounds, beliefs, and practices (SRBBPs) are related to better psychological health. Spirituality and religion (R/S) are also important aspects of multicultural diversity. There is evidence that clients would like to talk about their spirituality, and that including it in assessment and treatment planning can be beneficial. However, the extent to which practicing mental health professionals view SRBBPs as relevant to mental health and clinical practice is unclear.MethodsA survey examining several aspects of addressing SRBBPs in clinical practice was distributed to 894 professionals across mental health disciplines, including psychiatry, psychology, social work, marriage family therapy, licensed professional counselors, certified chemical dependency counselors, and psychiatric mental health nurses.Results89% of mental health professionals agreed that clinicians should receive training in R/S competencies. There were no differences between mental health disciplines in ratings of importance of such training. Younger individuals and those who identify as more spiritual were more likely to consider R/S training as important. Although 47.1% of professionals had not received much R/S training, many perceived themselves to be highly competent in R/S clinical integration practices (57.8% considered themselves able to display them very much or completely). In addition, respondents with more R/S training evaluated themselves as more proficient in R/S clinical integration. Nearly two-thirds (65.2%) of respondents reported encountering few to no barriers to engaging in R/S competent mental health care.ConclusionsThere is a growing consensus among mental health care professionals that mental health professionals should be trained in R/S competencies. Strong agreement exists that basic R/S competencies include respect, empathy, examination of bias, and routine assessment of R/S in mental health care. Four in five of those surveyed agree that more active competencies, such as identifying and addressing religious and spiritual struggles and problems and helping clients explore and access R/S strengths and resources should be included, whereas one in five report less comfort with these competencies.

The ‘role’ of improvisational theater in learning family therapy

Mastering family therapy is a core competence in the Brown child and adolescent psychiatry fellowship program. To acuminate our skills, in addition to working doing a half day per week of family therapy for the duration of our training, we have weekly family therapy seminars led by Dr. Michelle Rickerby. Most of the time, we spend the hour discussing one or two challenging cases among our class, and if there is time, allot the last 5 to 10 minutes of class to play out a particularly arduous interaction. However, once or twice a year, Dr. Rickerby invites improvisational “improv” actors from a local theater for an extended workshop on family therapy. I was fortunate that my case was chosen as a prompt for this year's workshop.

Spousal religious difference, marital satisfaction, and psychological well‐being of Chinese older adults

AbstractObjectivesThis study aims to explore the associations between spousal religious difference (one religious and one nonreligious), marital satisfaction, and the psychological well‐being of middle‐aged and older Chinese adults.BackgroundBoth religion and marital relationships are critical in coping with aging‐related challenges.MethodWe adopted the China Health and Retirement Longitudinal Study (CHARLS) data, which collected a nationally representative sample of Chinese people over 45 years old. The sample included 1,285 adults (714 men and 571 women). Descriptive statistics, multiple regression models, and a path analysis based on generalized structural equation modeling (GSEM) were adopted.ResultsWives' marital satisfaction mediated spousal religious difference and psychological well‐being, including depression and life satisfaction. Marital satisfaction was associated with depression and life satisfaction for both genders, and wives' marital satisfaction had a stronger association with life satisfaction than husbands'.ConclusionsSpousal religious difference has significant negative associations with marital satisfaction and psychological well‐being among middle‐aged and older people in China, especially among women.ImplicationBased on the results of this study, further research is needed to focus on the individual and interpersonal outcomes of religiosity in middle‐aged and older adults. In family therapy involving couples with different religious affiliations, counselors should pay attention to gender differences and prioritize addressing wives' marital satisfaction. Additionally, policies and services should also recognize the significant role of wives' marital satisfaction in the well‐being of such couples.

To what extent are early alliance perceptions a function of romantic partners' initial expectations for couple therapy?

AbstractIn this study, we investigated the association between clients' initial outcome expectations and their subsequent perceptions of the expanded therapeutic alliance. Romantic partners (N = 252) who received at least four sessions of systemic couple therapy from thirty‐one therapists from the Marriage and Family Therapy Practice Research Network (Johnson et al., 2017; www.mft‐prn.net) completed an outcome expectation measure before session 1 and a therapeutic alliance measure before session 4. Results showed a strong association between expectations and alliance (r = 0.51). While fourteen per cent of the variability in session 4 alliance scores was uniquely attributable to therapists, 31.6 per cent of the variability in the expectations/alliance association was uniquely attributable to couples, with only 6.1 per cent uniquely attributable to individual clients. Taken together, these results suggest that, while some therapists are better at developing strong alliances, couple and client factors associated with expectations for therapy set the stage for how the expanded alliance develops.

A Systematic Review of Evidence-Based Interventions for Afghan Refugee Mental Health: A Cultural Adaptation Analysis

Under the United Nations High Commissioner for Refugees’ (UNHCR) seven-decade mandate, Afghan refugees have faced some of the largest and most protracted experiences with forced displacement. This intergenerational exposure to forced migration has had innumerable consequences for the mental health of this population across different stages of their displacement. Afghan refugees who have resettled into Western nations face a unique set of challenges as they must navigate resettlement into societies that are linguistically, culturally, and spiritually distinct from their own backgrounds. This systematic review explores the (a) effectiveness and (b) cultural adaptation of interventions that have addressed the mental health of Afghan refugees resettled into Western countries since the year 2000. This systematic review will employ the Cultural Treatment Adaptation Framework (CTAF) to organize the extent of cultural adaptations. Through the systematic search of four databases, 1709 studies emerged from our search terms, seven of which met the criteria for this review, for example, study includes more than 2/3 Afghan participants; study includes outcome variables. Studies included programs in Germany, Serbia, Sweden, and Austria. The most common outcomes that interventions addressed included posttraumatic stress disorder (PTSD) ( n = 5), depression ( n = 3), and quality of life ( n = 3). Program modalities ranged between Cognitive Behavioral Therapy ( n = 4), emotion regulation ( n = 1), family therapy ( n = 1), and multimodal interventions ( n = 2). Most studies only incorporated peripheral changes to interventions in the service of cultural adaptation, and only one intervention included core changes. This program reported the highest effect sizes in reducing PTSD and depressive symptoms when compared with the rest of the studies. These findings provide a direction for future studies as they consider whether the extent of cultural adaptations can influence the effectiveness of programs for Afghan refugee populations. We provide recommendations for mental health practice with this population, including a special attention to the role of daily stressors, the significance of faith and culture-based meaning making in the service of coping, and the salience of isolation.

CONCEPTUAL REVIEW OF FAMILY RESILIENCE

Family resilience is a dynamic process that helps families to navigate and overcome adversities and crises. The introduction of general systems theory and its application to family therapy further contributed to developing the concept of family resilience. This paper aims to provide a comprehensive understanding of family resilience while highlighting some of the challenges in its conceptualization, whose reconsideration might be of broader importance in future research. Starting from the understanding of the development path of the concept of family resilience, this paper provides insight into how to view the key constructs incorporated in the concept of family resilience. Following this, emphasis in this paper is given to the challenges in conceptualizing family resilience. These challenges include definitions of family resilience, central terms used in models, and variations in the operationalization and measurement of key constructs. The models of family resilience presented in the paper are the ones considered influential in contemporary family studies. They provide frameworks for understanding the processes and cycles involved in family adjustment, adaptation, and response to stress and crisis. The conceptual review offered by this paper could contribute to conducting further research on family resilience.

In conversation: transgenerational attachment trauma, the infant, and the family therapist

AbstractThis paper shares a far‐ranging set of conversations between professors Jennifer McIntosh, Louise Newman, and Carol George, all child and family practitioners, and infant mental health (IMH) and attachment specialists. They explore the domain of infant–family work with high‐risk populations experiencing complex relational and intergenerational trauma. George and McIntosh discuss the intersection between family therapy and IMH from an attachment perspective. They explore what family therapy can offer to supporting coherence in caregiving states of mind, beyond the offerings of traditional dyadic mother–baby models of intervention. They highlight the infant's contribution to family work, and the application of attachment theory in a family therapy context. Newman and McIntosh discuss a sensitive and graded approach to high‐risk family work with an infant. Newman reflects on when and whom to invite to a family session and the power of enabling the family to speak the unspeakable in the presence of the baby, supporting a future focused path for trauma integration and recovery. For family therapists who may be new to IMH work, there are some important offerings about integrating these fields, bringing into play the family therapist's deep grasp of curiosity, circularity, and capacity to reconceptualise with an IMH perspective on early relational trauma.

Family therapy and infant mental health: exploring the potential space

AbstractFor this special issue, we sought perspectives on the contributions of the infant to their family's development, including recovery from intergenerational trauma and the contribution of the family to the infant's relational security. This special issue features a series of 12 invited papers from a diverse group of professionals, including infant mental health specialists, Indigenous and non‐Indigenous family therapists, academic family therapy teaching staff, and developmental psychology and systemic researchers. The contributions span several methodologies – ranging from curated conversations and qualitative research to conceptual insights, theoretical discussions, intervention reports, and new intergenerational empirical data. Through this editorial, we provide a brief overview of the collective works, spotlighting the invaluable synergistic contributions that infant mental health and family therapy approaches provide, while highlighting the untapped potential at their intersection.

Broadening the life course framework: the implications of the Charter for the Rights of Children yet to be Conceived proposed by First 1000 Days Australia

AbstractThis article examines the unique propositions within the ‘Charter for the Rights of Children yet to be Conceived’ posited by First 1000 Days Australia. It argues that the Charter's pioneering focus on preconception conditions significantly broadens the life‐course framework for early childhood, challenging traditional rights frameworks that typically commence at birth. The Charter's tenets, their implications, and their relation to international rights frameworks are also discussed. The Charter for the Rights of Children yet to be Conceived expands the landscape within which family therapists can explore not just cultural inclusivity, but an inclusion of imagining what sort of world, future, and family we want for children yet to be conceived; and what we imagine these children would want from us for this to be achieved.

Open to interpretation: An integrated primary care behavioral health training approach for treating linguistically diverse patients.

Integrated primary care settings serve an increasingly high volume of linguistically diverse patients. In English language-dominant countries, limited English proficiency (LEP) is associated with disparities in access and quality of behavioral health (BH) care. Interpretive services (IS) aim to address these disparities by assisting in the delivery of clinical care between patients and providers who speak different languages. Yet, there is a need for greater emphasis on the utilization of IS in clinical training for BH professionals (e.g., psychology, social work, counseling, and family therapy). In this conceptual article, we describe a BH practicum rotation for predoctoral psychology trainees in a free, student-run integrated primary care clinic that largely serves uninsured adults with LEP. First, we discuss our training model which includes a 90-min didactic lecture on IS for BH and supervised applied clinical experiences (e.g., psychotherapy, warm handoffs, and consultation). Then, we present vignettes prepared by trainees about the challenges and benefits associated with delivering BH care with IS at the predoctoral level of training. From the practicum experience, clinical psychology trainees reported improved knowledge and competencies in utilizing IS as well as generalizable skills for delivering BH care with a focus on multicultural practice. We recommend that other integrated primary care BH training sites consider emphasizing training in IS. This article concludes with recommendations for implementation and dissemination of our training model on other sites. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Caste and Black intergenerational racial trauma in the United States of America.

The United States (U.S.) racial caste system and White dominance began in slavery, culminating in Black intergenerational racial trauma. Until recently, Black intergenerational racial trauma largely was ignored by family scholars and therapists. Given that Black intergenerational racial trauma is inseparable from racial caste in the United States, it should be regarded as a wider, systemic problem, requiring intervention at the micro (e.g., family) and macro (e.g., society) levels. The U.S. dominant White society's investment in conserving racial caste furthers the ideological (e.g., political) and sentimental (e.g., democratic ideals) nullification of Black intergenerational racial trauma. Therefore, Black intergenerational racial trauma is often disenfranchised and can hamper Black people's experience of racial trauma as a collective. As passive bystanders, family scholars and therapists are co-conspirators in the long, enduring suffering of Black people. As advocates, family scholars and therapists are called upon to name the racial hierarchy in the United States as a caste system and to advance Black humanization. Specifically, Wilkerson's (Caste: The origins of our discontents. Random House, 2020) notion of the U.S. racial hierarchy as a functioning caste system frames the discussion of Black intergenerational racial trauma and includes the following topics: Black racial trauma, disenfranchised Black intergenerational racial trauma, collective Black intergenerational racial trauma, Black intergenerational racial trauma and the U.S. academy (traditionally White institutions of higher learning), history and its impact on Black intergenerational racial trauma, the Black body and racial trauma, intersectionality and the U.S. caste system, and collective hope and resilience.

Understanding families impacted by opioid use: Outcomes of a therapist training program.

Increasing the substance use workforce is vital in addressing the many complexities of opioid use among families. The purpose of the present research was to examine 6-month outcomes of a training program focusing on opioid use among families, for master-level family therapy (MFT) and community mental health counseling (CMHC) students. In total, 58 students participated in self-reported survey assessments at baseline and 6-month follow-up across the following domains: attitudes about substance use, interpersonal professional collaboration, trainee confidence, professional quality of life, and cross-cultural counseling competence. The study results indicated a significant improvement between scores on attitudes of working with families impacted by substance use disorders from baseline to follow-up. There was a significant positive change in cross-cultural competency, interprofessional competency, and trainee confidence from baseline to follow-up. The findings contribute to extant literature by examining the potential role of participating in substance use training for graduate-level MFT and CMHC trainees and considerations for implementing specific substance use training components among graduate-level trainees. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Personal Features and Their Impact on an Individual’s Hardiness

Hardiness characterizes the degree of formation the ability to withstand a stressful situation, maintain internal balance, without reducing the success of activities and is the foundation of personal characteristics. The purpose of the study is to identify personal resources and determine their impact on hardiness. Methods of the research. The following methods were used to identify personal resources and determine their impact on hardiness: Maddi’s Hardiness Scale; Shostrom’s Personal Orientation Inventory; Sheldon’s Self Determination Scale; Crumbaugh Purpose in Life Test; Ryff’s Scales of Psychological Well-being; Wiesbaden Inventory for Positive Psychotherapy and Family Therapy. The sample of our study consisted of 807 people, aged from 14 to 70 years, different in terms of education, professional employment, specialty, family and social status and from different cities and villages of Ukraine. The results of the research. It was investigated that the values of the hardiness indicators components are expressed at an average level and are within the normal range. The average level of hardiness (68.2%) prevails among the respondents. It has been found that the hardiness predictors are meaningfulness of life, autonomy, self-acceptance and self-confidence. We established the relationship between hardiness and personal resources, which include primary and secondary abilities, using the correlation analysis. All components of hardiness have been shown to correlate with primary capacities such as time, contact, trust, hope, sexuality, and love. Diligence, reliability and thrift are influential among the secondary abilities. Conclusions. The analysis of personal resources proves that meaningful life goals are the resource for the hardiness development. The components of hardiness are related to self-determination, self-organization, psychological wellbeing, and the reality and awareness of life goals. The leading role in the hardiness development belongs to personal resources. The resources that influence hardiness are determined using variance analysis: love, contacts, hope and trust.

Canadian Federal Policies and the Inuit Youth Suicide Crisis

Since the late 1980s, an unusually high number of suicides and cases of self-harm has been recorded among the Indigenous inhabitants of the Canadian Arctic, the Inuit. The statistics on child and adolescent suicides are particularly drastic. This situation appears to be primarily a symptom of historical trauma which was acquired due to the colonization and assimilation processes and passed down from generation to generation. Federal policies, such as forced relocations and residential schools, have directly contributed to the severing of family ties and the abandonment of traditional lifestyles. Over the years, the federal government tried to address the issue of the Inuit youth suicide crisis through various proposals. The best strategies to end the suicide crisis seem to be the respect and incorporation of Indigenous leadership, upholding local traditions and ceremonies, as well as investing in psychological support and family therapy for the first inhabitants of the Arctic. To effectively address the problem, the solution must be comprehensive and Inuit-specific rather than symptom-focused. This article discusses how particular federal policies and programs in northern Canada have impacted the communal well-being of the Inuit, and it outlines the most important strategies aiming at decreasing suicide rates among Inuit youth.

Initiating the dialogue between infant mental health and family therapy: a qualitative inquiry and recommendations

AbstractThis qualitative study explores infant‐family mental health experts' perspectives and experiences regarding the inclusion of infants in the family therapy setting. Infant socioemotional development is relational in nature and evolves in the context of both dyadic attachment relationships and broader multi‐person co‐parenting systems. Given this, we sought to understand why family therapy interventions involving families with infants rarely include the infant in a triangular or family systemic approach. Interviews were completed by clinical and/or research experts whose work integrates tenets of both infant mental health (IMH) and family theory and therapy. All interviewees brought at least 5 years of expertise and were actively engaged in the field. Interviewees expressed consistent beliefs that infants have a rightful and helpful place in family therapy approaches. They maintained that infants' innate social drive and communicative capacities position them to make meaningful and clinically significant contributions within family and systemic psychotherapy contexts. Noting that infants have remained on the periphery of these practices, experts advocated expansion and greater integration between IMH and family therapy, while preserving each field's distinctive identity. Experts reported that the interplay between IMH and family therapy fields has been uni‐directional as family systems concepts are embedded within IMH approaches, but few IMH premises are incorporated in mainstream family therapy practices. The disconnect was attributed to multiple factors, including graduate and professional training and theoretical, clinical, research, and sociocultural barriers, which were mutually reinforcing. Experts also identified clinical gains for both infants and family members when infants were meaningfully included in family interventions. Common ground was identified between the disciplines, with a belief that relationally distressed young children and parents are best served by clinical engagement with their network of relationships. Results call for greater collaboration between disciplines to challenge existing traditions and to more fully include infants in mainstream family therapy. Recommendations for integration of family therapy and IMH in clinical, theoretical, research, training, and sociocultural domains are offered.