This paper reports results of a qualitative study on family therapy conducted in Hong Kong, which aims to identify Chinese families’ treatment expectations, delineate their subjective experience and the outcome in treatment. By comparing the expectations, the experience and the outcome, this study examines and challenges the belief that the practice of family therapy should necessarily be fundamentally adapted to be ‘culture‐specific’, an assumption that has hitherto been untested and possibly based on overgeneralized cultural stereotyping. This study provides empirical evidence for family therapists who have interests in working with local and overseas Chinese families to improve their practice.

This article reports the results of a telephone survey (n = 1002) conducted in November 2008, which aimed to identify parenting stress and perceived family functioning of Chinese parents in Hong Kong; to explore the effects of the parents' socio-demographic characteristics (gender, family income, education and family structure) on the aforementioned stress and functioning variables; and to examine the interrelationship among these characteristics and the two variables in question. Results showed that the reported parenting stress was at average level, while the perceived family functioning was slightly below average. The results also indicated that the parenting stress of mothers, single parents, the low-income and the less-educated was higher than that of fathers, parents of nuclear and extended families, the high-income and the better-educated. Socio-demographic characteristics except the parent's gender had similar effects on perceived family functioning. Higher parenting stress was associated with lower family functioning, and explained a larger variance in the perceived family functioning than the socio-demographic characteristics taken alone. The results of the study have provided empirical support regarding the interrelationships among the vulnerable groups in society, parenting stress and perceived family functioning. Implications of the study for social work practice are discussed.

There are two untested cultural beliefs commonly held among family therapists in Hong Kong: (1) Chinese families are reserved in disclosing their conflicts to an ‘outsider’; and (2) it would be culturally inappropriate to elicit family conflicts in treatment. In this article, an attempt is made to examine these cultural beliefs based on the results of a qualitative study of thirty‐five Chinese patients suffering from anorexia nervosa. These patients and their families have participated in a pre‐treatment family interview prior to the commencement of family treatment. The results of the study have shown that the afflicted Chinese families are very willing to disclose their difficulties to the researcher. The onset of the disorder has led to different types of family conflicts including: (1) overt family conflicts related to food refusal; (2) covert family conflicts; (3) increased sibling rivalry; (4) increased parent–child conflict; and (5) marital tension and distress. The clinical implications of this study are discussed at the end of the article.

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Although enhancing family functioning has become a rising concern of social workers in Chinese contexts such as Hong Kong, little has been known on perceived family functioning and family resources. To fill in this knowledge gap, this article reports part of the results of a telephone survey conducted in Hong Kong, aiming to identify the sex differences in these two areas. The results of the study have shown that Chinese women perceived better affective involvement, one of the crucial indicators of family functioning, than Chinese men. However, among the different family resources, men rated better physical and mental well-being whereas women's social connection was stronger than men's. Further analysis have shown that the linkage of three family resources (namely stress coping efficacy, time spent with family and income) to perceived family functioning was statistically significant irrespective of genders. Implications of this study for social work practice are discussed at the end of the article.

BackgroundEating disorders are serious mental illnesses that have a significant effect on afflicted individuals’ quality of life. Evidence has shown that they can be improved with treatment. Internet-based interventions are useful in engaging individuals with eating disorders in self-management and treatment. This study aimed primarily to identify the change in quality of life of individuals with disordered eating after participating in an open trial of an Internet-based self-help programme, and compared their quality of life at assessment with that of healthy controls. Factors affecting their quality of life were examined. Secondary outcomes related to symptom improvement were also reported.MethodsThis study included 194 individuals with disordered eating and 50 healthy controls. The former group was recruited from eating disorder outpatient clinics and treatment units, as well as via information disseminated through various Internet websites, while the healthy controls were recruited from university student newspapers and university campuses. The Medical Outcomes Study Short Form Survey (SF-36v2) was used to assess participants’ quality of life. Other measures were used to assess their symptoms and motivational stages of change to recover from an eating disorder. The Wilcoxon signed ranks test and one-way repeated measures ANOVA were used to identify the change in quality of life of individuals with disordered eating from baseline to 1-, 3- and 6-month follow-ups. The Mann–Whitney U test was employed to compare the difference in quality of life between participants with disordered eating and the healthy controls. Spearman rank order correlations were performed to examine the factors associated with quality of life.ResultsThe participants with disordered eating had significantly poorer quality of life than the healthy controls in both physical and psychological domains. The factors associated with their poor quality of life included dieting behaviour, use of laxatives, severe eating disorder psychopathology, depression and anxiety. Over a six-month follow-up period, a significant number of participants engaged in self-help behaviours using the Internet-based programme. They experienced improvements in their quality of life, eating disorder psychopathology, depression severity, anxiety level and motivational stages of change.ConclusionsInternet-based self-help programmes have the potential to enhance quality of life in individuals with disordered eating and could be useful adjuncts to professional treatment.

This study aims to identify themes from the treatment of Chinese families with an adolescent or an adult member suffering from anorexia nervosa (AN), through a multiple case study. This study reveals that self-starvation may be regarded as a cultural metaphor. Four major themes emerged at the family level: self-starvation as an expression of love and control, coalition of the AN daughter with the mother, family loyalty, and the powerlessness and helplessness of the mother. The themes identified are narrative accounts of the Hong Kong Chinese families, rather than causal explanations proposed by Western literature. The emerging themes are believed to be constructed and legitimized by traditional Chinese cultural values, with females being subordinated to and dependent on males and the self being subjugated to or sacrificed for the collective. Treatment implications are discussed.

This paper identifies social difficulties commonly faced by a group of fortytwo Hong Kong transsexuals who had applied for sex reassignment surgery. It describes the use of a systems perspective to conceptualize their problems and a structural family therapy approach to social work intervention.