Family Therapy and COVID-19: International Reflections during the Pandemic from Systemic Therapists across the Globe.

The COVID-19 pandemic has convulsed human communities across the globe like no previous event in history. Family therapists, paradoxically, given the core of their work is with systems, are also experiencing upheaval in professional and personal lives, trying to work amidst a society in chaos. This paper offers a collection of reflections by systemic and family therapists from diverse cultures and contexts penned in the midst of the pandemic. The main intention in distilling these narratives is to preserve the 'cultural diversity' and 'ecological position' of the contributors, guided by phenomenology, cultural ecology, and systemic worldviews of 'experiencing.' The second intention is to 'unite' promoting solidarity in this isolating situation by bringing each story together, creating its own metaphor of a family: united, connected, stronger. As a cross-cultural family practitioner, with a strong mission for collaboration, the lead author acknowledges the importance of Context - the nation and location of the experience; Culture - the manner in which culture impacts on experience; Collaboration - enhancing partnership, enriching knowledge, and mapping the journey's direction; and Connectedness - combating isolation while enhancing unity. Since the key transmission of culture is through language, raw reflections were sought initially in the practitioners' own language, which were translated for an English-speaking readership. These narratives are honest and rich descriptions of the authors' lived experiences, diverse and distinctive. The contributors trust colleagues will find these reflections helpful, validating and acknowledging the challenges of this unique period in history.

Reaching Up, Down, In, and Around: Couple and Family Coping During the Coronavirus Pandemic.

The worldwide coronavirus (COVID-19) has had profound effects on all aspects of life: physical health, the ability to travel locally or to more distant destinations, material and financial resources, and psychosocial wellbeing. Couples, families, and communities and individual persons in those relationships have struggled to cope with emerging depression, anxiety, and trauma, and the rise of relational conflict. In this article, we suggest that the existential nature of the pandemic's challenges requires more than just the usual psychosocial interventions. We propose a taxonomy of responses to foster coping and resilience-"Reaching Up, Down, In, and Around." "Reaching Up" includes accessing spiritual, religious, and ethical values. "Reaching Down" includes ideas and practices that foster a revised relationship with the Earth and its resources, and that engage families to participate in activities that aid the Earth's recovery from decades of human-caused damage. "Reaching In" represents a turn towards experiences available in the mind and in shared minds in relationships that provide pleasure, excitement, joy, and peace, given that external sources of these emotions are of limited availability due to quarantine. "Reaching Around" involves reframing the mandate for "social distancing" as fostering social connection and support while maintaining physical distancing. The challenges for family therapists, whose practices are confined largely to online therapy, and who are struggling with the same fears and constraints as those persons they are attempting to help, are also discussed.

El coronavirus (la COVID-19) mundial ha tenido efectos profundos en todos los aspectos de la vida: en la salud física, en la posibilidad de viajar a nivel local o a destinos más distantes, en los recursos materiales y económicos y en el bienestar psicosocial. Las parejas, las familias, las comunidades y las personas individuales de esas relaciones se han esforzado para hacer frente a la depresión, la ansiedad y el trauma emergentes, y al aumento del conflicto relacional. En este artículo, sugerimos que la índole existencial de las dificultades de la pandemia necesita más que solo las intervenciones psicosociales habituales. Proponemos una taxonomía de respuestas para fomentar el afrontamiento y la resiliencia: "Llegar arriba, abajo, adentro y alrededor". "Llegar arriba" implica acceder a valores espirituales, religiosos y éticos. "Llegar abajo" implica ideas y prácticas que fomenten una relación revisada con la Tierra y sus recursos, y que capten la atención de las familias para participar en actividades que ayuden a la recuperación de la Tierra de décadas de daño causado por los humanos. "Llegar adentro" representa un giro hacia experiencias que hay en la mente y entre mentes por relaciones que brindan placer, entusiasmo, alegría y paz, dado que la disponibilidad de las fuentes externas de estas emociones es limitada debido a la cuarentena. "Llegar alrededor" implica replantear la orden de "distanciamiento social" como fomento de la conexión social y el apoyo mientras se mantiene la distancia física. También se explican las dificultades para los terapeutas familiares, cuyas prácticas están limitadas en gran medida a la terapia en línea, y quienes están luchando contra los mismos miedos y limitaciones que esas personas a quienes intentan ayudar.

Love in Action: An Integrative Approach to Last Chance Couple Therapy.

This article presents an integrative approach to the special challenges of therapy with couples on the brink of dissolution or divorce-who often describe this therapy as their "last chance." In some, one partner is considering ending the relationship, and in others, both partners are considering ending it. Often, these couples have had prior dissatisfying experiences in couple therapy. Four types of last chance couples are described: high-conflict couples; couples in which partners have differing goals for their lives or different timelines for reaching shared goals; couples in which one or both partners have acted in a manner that violates the values, expectations, emotional comfort, or safety of the other; and couples in which there has been a gradual loss of intimacy. The Therapeutic Palette, a multiperspectival, theoretically eclectic integrative approach, is enlisted as a general framework for selecting and sequencing use of particular theories and their associated practices, based on the three "primary colors" of couple therapy: time frame/focus, level of directiveness, and change entry point. An additional complementary framework, the creative relational movement approach, is proposed to provide an integrative frame encompassing both language-based and action-based practices, suggesting that meaning is held and expressed as much through interaction or "relational motion" as it is through language. Principles of change are described. Due to the couple's level of crisis and desire for immediate evidence of possible improvement, priority is given to action-based interventions in early stages of therapy, by engaging couples in "experiments in possibility." Typical action approaches are described. An extended vignette follows.

Is committed desire intentional? A qualitative exploration of sexual desire and differentiation of self in couples.

The question of what heightens or diminishes sexual desire has long been a passionate theme across cultures in literature, arts, media, and medicine. Yet, little research has been conducted to determine what affects level of desire within couples. The degree of differentiation of self has been suggested as an important variable in shaping partners' level of desire. Through a qualitative analysis of dyadic couple interviews, this study provides an account of characteristics, processes, and trajectories of sexual desire and differentiation in 33 heterosexual couples of varying ages and relationship duration. Factors associated with high desire were change and autonomy, whereas conflict and children were reported to be desire-diminishing factors. Innovation, sharing, autonomy, and effort emerged as desire-promoting strategies, while fostering personal interests, investing in a positive connection, and enhancing personal integrity were identified as couples' strategies to promote and preserve differentiation of self. The results also shed light on couples' perceptions of whether and how sexual desire changes over the course of the relationship and challenge common cultural assumptions about desire in committed relationships-namely the myth that the only authentic expression of desire is that which occurs spontaneously and without intention and planning. Implications for couple therapy are discussed.

Narrative and collaborative practices in work with families that are homeless.

This article reports on the use of narrative therapy ideas and practices in working with families that are homeless in a shelter-based, multiple-family discussion group program called Fresh Start for Families. It begins with a review of the challenges facing homeless families. It then briefly describes the collaborative methods used to develop the program. It then describes a range of practices and activities that provide opportunities for families to be witnessed in telling their stories of challenge and coping, to help and be helped by other families experiencing similar challenges, to reconnect and strengthen a positive sense of family identity while externalizing the constraining, stigmatizing descriptions associated with homelessness, and to envision and take steps towards their preferred futures.

Engaging families as experts: collaborative family program development.

This article presents the collaborative family program development (CFPD) model, a collaborative research-based approach to creating community-based programs for families. In this approach, families are viewed as experts on the nature of their challenges and on what they desire in a program. This approach is particularly useful in developing programs for families who have experienced social oppression and who may have been reluctant to participate in programs created for them by professionals without their consultation. In contrast, when professionals adopt the stance of respectful learners, families respond by actively engaging in the program development research and in the program created from it. This article describes the nature and complexities of a collaborative program development stance, the unique contribution to community-based program development offered by a family systems focus, and the 10 steps in the CFPD approach. These 10 steps guide movement from initiating the project and forming collaborative professional partnerships to engaging cultural consultants; conducting in-depth research to understand the problems, resources, contexts, and recommendations from the perspective of families who will receive the program and from the perspective of front-line professionals working with these families; transforming research findings into program contents and formats; and implementing, evaluating, revising, and replicating the program. The approach is illustrated by a program called Fresh Start for Families, developed and replicated for families in New York City who are homeless and attempting to move from welfare to work.

The history of couple therapy: a millennial review.

In this article, we review the major conceptual and clinical influences and trends in the history of couple therapy to date, and also chronicle the history of research on couple therapy. The evolving patterns in theory and practice are reviewed as having progressed through four distinctive phases: Phase I--Atheoretical Marriage Counseling Formation (1930-1963); Phase II--Psychoanalytic Experimentation (1931-1966); Phase III--Family Therapy Incorporation (1963-1985); and Phase IV--Refinement, Extension, Diversification, and Integration (1986-present). The history of research in the field is described as having passed through three phases: Phase I--A Technique in Search of Some Data (1930-1974), Phase II--Irrational(?) Exuberance (1975-1992), and Phase III--Caution and Extension (1993-present). The article concludes with the identification of Four Great Historical Ironies in the History of Couple Therapy.