Centering the Voice of the Client: On Becoming a Collaborative Practitioner with Low‐Income Individuals and Families

Abstract

Despite current interest in collaborative practices, few investigations document the ways practitioners can facilitate collaboration during in-session interactions. This investigation explores verbatim psychotherapy transcripts to describe and illustrate therapist's communications that facilitate or hinder centering client's voice in work with socioeconomically disadvantaged populations. Four exemplar cases were selected from a large intervention trial aimed at improving shared decision making (SDM) skills of psychotherapists working with low-income clients. The exemplar cases were selected because they showed therapist's different degrees of success in facilitating SDM. Therapist's verbalizations were grouped into five distinct communicative practices that centered or de-centered the voice of clients. Communication practices were examined through the lens of collaborative approaches in family therapy. The analysis suggests that cross-fertilization between SDM and family-oriented collaborative and critical approaches shows promise to illuminate and enhance the challenging road from clinician-led to client-led interactions. This paper also stresses the importance of incorporating relational intersectionality with individuals and families who may not feel entitled to express their expectations or raise questions when interacting with authority figures.

Risk, resilience and family relationships among at‐risk Ethiopian immigrant youth in Israel: A focus group investigation

“…Clinicians must consider how the context of social exclusion and marginalization affects parent–youth dynamics in Ethiopian immigrant families (McDowell et al, 2019). Clinical strategies are recommended which seek to counter the influence of oppressive social structures and may include consciousness raising, social education, and the use of a collaborative therapeutic approach (D'Arrigo‐Patrick et al, 2017; Falicov et al, 2021). Importantly, these strategies require therapists to engage in self‐reflection around status and power differentials (Falicov et al, 2021).…”

“…However, scarce research has examined how immigrant family members experience vulnerability and resilience from the perspectives of both parents and their adolescent children . In addition, research has shown the advantages of family‐centered intervention, particularly in resource‐poor environments (Weine et al, 2005) for harnessing family resilience resources (Walsh, 2003), as well as the need for understanding and addressing the socio‐political context in which the family operates within the therapy context (Falicov et al, 2021; McDowell et al, 2019). Consistent with our sensitizing concepts, we sought to develop a conceptual understanding of Ethiopian origin parents' and adolescents' lived experiences in the context of immigration related stressors.…”

Expanding Possibilities: Flexibility and Solidarity with Under‐resourced Immigrant Families During the COVID‐19 Pandemic

“…Students and practitioners adhere to the premise that the patient or the client is the teacher/expert on their own lives. Recent studies support the effectiveness of ground‐up and shared decision‐making approaches in the treatment of ethnic minorities (Falicov, Nakash, & Alegría, in press; Fraenkel, 2006; Parra‐Cardona et al, 2009). Modifying existing mainstream psychological practices or finding innovations that consider culture and context can result in increased access, appeal, and retention in mental health services (Falicov, 2009b; Kanel, 2002).…”

Welcoming Melanie M. Domenech Rodríguez

“…The world of family research and couple/family therapy are much different now even than 11 years ago when I began as editor of the journal. We have seen a pandemic and with it monumental changes in how families interact and how relational therapies are practiced (previously video therapy was a relatively rare format for practice; Burgoyne & Cohn, 2020; de Boer et al, 2021; Stanley & Markman, 2020); the wide acceptance in parts of the world of new family forms (Addison & Coolhart, 2015; Green & Mitchell, 2015); a vast expansion in couple and family research and with that the emergence of shared understandings about essential factors in successful family life (Brock & Laifer, 2020; Lebow, 2021b); a broad acceptance of the need for a multicultural and intersectional perspective and the central place for advancing social justice (Bernal & Domenech Rodríguez, 2012b; Falicov et al, 2021; PettyJohn et al, 2020); the rise of repressive governments in some parts of the world and in parallel the politicization of the findings of family science and methods of couple and family therapy in relation to issues such as immigration, sexual orientation, and sexual preference (Lebow, 2021a; Sluzki, 2017); the movement of family scholarship to truly becoming international and with it a move away from the assumption that findings and clinical narratives in North America and Western Europe apply throughout the world (Kapadia et al, 2023; Watson et al, 2020); the emergence of better research, both quantitative and qualitative (Doss et al, 2022; Fiese et al, 2019; Tseliou et al, 2021); and a migration from scholarship anchored in specific, narrow theories to one that is more open and allows for a pluralism, anchored in pragmatics where many approaches and forms of intervention and integrative practice thrive (Fiese et al, 2019; Lebow & Snyder, 2022). What we publish in this journal is a vital barometer of that world.…”