One might well ask what family therapy has to do with feminist therapy. Have not the family and the institutions that support it been the primary cause of maintaining women in their stereotyped sex roles? As feminists can readily point out, “The family has been the principal arena for the exploitation of women, and however deeply rooted in social structure that exploitation may be, it is through family structure that it makes its daily presence felt.”10 Chase’s question, “What does feminism demand of therapy?”10 is the question I would like to examine in the form, “What does feminism demand of family therapy?”

A Feminist Approach to Family Therapy

The effectiveness of a family-based cardiovascular disease risk reduction intervention was evaluated in two ethnic groups. Participants were 206 healthy, volunteer low-to-middle-income Mexican-American and non-Hispanic white (Anglo-American) families (623 individuals), each with a fifth or a sixth-grade child. Families were recruited through elementary schools. Half of the families were randomized to a year-long educational intervention designed to decrease the whole family's intake of high salt, high fat foods, and to increase their regular physical activity. Eighty-nine percent of the enrolled families were measured at the 24-month follow-up. Both Mexican- and Anglo-American families in the experimental groups gained significantly more knowledge of the skills required to change dietary and exercise habits than did those in the control groups. Experimental families in both ethnic groups reported improved eating habits on a food frequency index. Anglo families reported lower total fat and sodium intake. There were no significant group differences in reported physical activity or in tested cardiovascular fitness levels. Significant differences for Anglo-American experimental vs. control adult subjects were found for LDL cholesterol. Significant intervention-control differences ranging from 2.2 to 3.4 mmHg systolic and/or diastolic blood pressure were found in all subgroups. Direct observation of diet and physical activity behaviors in a structured environment suggested generalization of behavior changes. There was evidence that behavior change persisted one year beyond the completion of the intervention program. It is concluded that involvement of families utilizing school based resources is feasible and effective. Future studies should focus on the most cost-effective methods of family involvement, and the potential for additive effects when family strategies are combined with other school health education programs.

A Family Approach to Cardiovascular Risk Reduction: Results from The San Diego Family Health Project:

This article suggests very simple three-step estimators for censored quantile regression models with a separation restriction on the censoring probability. The estimators are theoretically attractive (i.e., asymptotically as efficient as the celebrated Powell's censored least absolute deviation estimator). At the same time, they are conceptually simple and have trivial computational expenses. They are especially useful in samples of small size or models with many regressors, with desirable finite-sample properties and small bias. The separation restriction costs a small reduction of generality relative to the canonical censored regression quantile model, yet its main plausible features remain intact. The estimator can also be used to estimate a large class of traditional models, including the normal Amemiya–Tobin model and many accelerated failure and proportional hazard models. We illustrate the approach with an extramarital affairs example and contrast our findings with those of Fair.

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Three-Step Censored Quantile Regression and Extramarital Affairs

A contractual approach to forming a partnership between doctor and patient is presented in both theoretical and practical terms. Four basic contractual assumptions underly the doctor-patient relationship: both the doctor and the patient have unique responsibilities; the relationship is consensual, not obligatory; both doctor and patient must be willing to negotiate; and each must gain something in the encounters. Clinical examples are used to show practical implications of this model. Although explicit contracts are not needed for all patients, a contractual analysis of doctor-patient interactions helps both participants share the responsibility for patient care.

Partnerships in Patient Care: A Contractual Approach

Forty-seven marital therapy couples completed inventories measuring unrealistic beliefs about self and unrealistic beliefs about marital relationships. In addition, they completed questionnaire measures of their expectations and goals for therapy and their levels of marital satisfaction. As hypothesized, the clients' unrealistic beliefs, particularly those regarding relationships, were negatively associated with their estimated chance for improvement in therapy, desire to improve rather than terminate the relationship, preference for marital versus individually oriented treatment, and overall marital satisfaction. These results are consistent with the theoretical rationale for cognitive therapy with clinical couples and suggest specific targets for intervention in this process. Directions for future research are discussed.

Unrealistic beliefs of clinical couples: Their relationship to expectations, goals and satisfaction

Marriage Contracts and Couple Therapy

Professionals from the fields of psychiatry, psychology, social work, education, pediatrics, law, and religion discuss general principles of parent guidance and offer strategies for helping parents cope with their own problems as well as specific problems of children.

Lester A. Kirkendall

Papers

Marriage Contracts and Couple Therapy

Helping parents help their children

The Pursuit of Loneliness: American Culture at the Breaking Point

Family Systems in America

Summerhill: For and against