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This article focuses on women’s recollections of being triangulated in their parents’ relationship within the context of domestic violence. Fifteen women were interviewed as part of a larger grounded theory study that looked into the women’s understanding of their childhood experiences of domestic violence and their impact on their individual development and their intimate relationships. The women spoke about how difficult it was for them not to take sides in their parents’ conflicts. Some actively chose to put themselves in the middle of the conflict. Some were recruited by their parents into the parental violence. Others witnessed a sibling get triangulated. Getting involved sometimes helped to limit the abusive parent’s violent behaviour. At other times, it made the fighting worse. The participants also spoke about some of the complex feelings that they had to deal with, as part and parcel of being triangulated. As the women grew up, triangulation in their family of origin’s dynamics continued to be a persistent and challenging process, especially if the parental conflict was ongoing or unresolved. The women’s experiences strongly suggest that this process needs to be paid attention to in clinical practice both when working with families where there is domestic violence and also when working with childhood survivors of domestic violence

This study is about how a therapeutic alliance is created and maintained with parents and their children working through a relational trauma. A case study design with narrative analysis as a method of research (Riessman, 2008) and a narrative approach of storying stories, inspired by McCormack (2000), is used. The participants of this study are the parents and their four children, aged between 14 and 5 years, and their systemic therapist. Rich data on the therapeutic alliance is gathered through, two live-family session observations and seven interviews, six of which were with the family members, and a two-part interview held with their therapist. Results show that the way of being of the therapist, including her ability to be intuitive and self-reflexive, and her ability to keep manoeuvrability in conversation and hold neutrality support her to connect with all the family. Creating conjoint and separate therapeutic spaces, using a creative play-based approach and navigating an alliance with the school and medical professionals, were important suggestions for practice in the field. Additionally, collaborating with parents, and balancing the benefits and drawbacks of involving children to make therapy meaningful for all, are also suggested. Specific recommendations for engagement with siblings of the identified-problem child are elicited. The strength of this study is that children’s voices, along with those of their parents’ and their systemic therapist are reported. Suggestions for practice to support children and their families who are working through a relational trauma are brought forward.

‘Whereas the couple relationship is described to be the relationship which is typically the most impacted by disability, spousal support is presented to be the most important form of support follow...

Over the past two decades, a new body of knowledge has emerged that seeks to understand the psychosocial aspects of dementia and Alzheimer’s disease (AD). Such knowledge mainly focuses on comprehending the lived experience of individuals living with dementia as well as that of their formal and informal caregivers. The evidence that transpires supports the development and implementation of a number of psychosocial interventions aimed at enhancing the quality of life in such individuals and in those who are likely to be impacted by this neurodegenerative syndrome—namely informal and formal caregivers. This chapter seeks to provide an overview of the psychosocial perspectives of living with dementia and AD with particular reference to the effect of caregiving on family dynamics and the influence of gender on the effectiveness of psychosocial interventions in the management and care of these individuals.

Through the lenses of critical realism and contextualism, this study is about how psychiatrists perceive schizophrenia and its recovery. Semi-structured interviews with six participants were conducted and analysed using thematic analysis. The findings were organized into four overarching themes: the psychiatrists’ perceptions of schizophrenia; ways of working with individuals with schizophrenia; the relational aspect of working with individuals with schizophrenia; and psychiatrists’ perceptions of recovery. All participants viewed schizophrenia as an illness with biological basis and based their diagnosis largely on clinical experience. Medication was seen as occupying a central role in treatment. Complete recovery was defined as being asymptomatic and being able to function without the use of medication; however, living in the community on medication was also seen as a form of recovery. Only one psychiatrist defined recovery according to the recovery model, viewing individuals as a whole with the potential of living a meaningful life despite having schizophrenia. The study concludes that psychiatrists’ perceptions of schizophrenia and its recovery are influenced by a mental health system which is largely hospital-based and lacks adequate community support and are reflected in the way psychiatrists interact with the patient and the treatment decisions they take on the journey of recovery.

This concluding chapter reviews the contributions in this volume and identifies five principles that run through these accounts of couple relationships across the globe. These principles include equal status, consent, capability, commitment and care. The chapters in this volume are drawn upon to illustrate how these principles manifest themselves in different settings. The work of supranational organisations is used to highlight trends and challenges in each area, and selected scholarly literature is also used for this purpose. It is contended that while legislative progress has been seen across many jurisdictions, there remains scope for faster and wider implementation to protect and support the well-being of women and men in opposite- and same-sex relationships, as well as their children. Yet legislation, though necessary, is not sufficient and its implementation must be suitably resourced. In addition to legislation, couple relationships also benefit from protection against poverty, support for work–family balance, relationship education, and access to counselling and therapeutic services as necessary. Awareness raising campaigns aimed at promoting a zero tolerance of violence and discrimination, while affirming gender equality and diversity, also remain important.

This chapter describes couple relationships in Malta, a small island in the Mediterranean experiencing a visible demographic transition. It starts by briefly outlining the larger Euro-Mediterranean scenario with respect to trends in couple formation and dissolution, and perspectives on marriage and other couple relationships. It then narrows its focus to Malta, looking at recent demographic trends and legislation, particularly data and studies related to divorce, civil union, and same-sex marriage. The remainder of the chapter is devoted to presenting and discussing findings from a multiphase study, carried out with Maltese adults by the National Centre for Family Research within the President’s Foundation for the Wellbeing of Society. This study investigated different aspects of the couple relationship, offering insights on life and relationship satisfaction among couples, factors which predict satisfaction, expectations from the relationship and challenges faced by couples. A socio-ecological model is presented to discuss the various influencing factors at the macro, meso and micro levels as emerging from the data. The chapter closes by highlighting key implications stemming from this study and other local research for professionals involved in promoting positive couple relationships in Malta.

In the context of increasing diversity and a rise in singledom across the globe, the couple relationship is still significant. An enduring preference for marriage persists, reflecting its symbolic importance. Good quality couple relationships have come to be characterized by positive affect, by the constructive management of conflict, and by healthy sexual relationships. Although good relationships enhance well-being, behaviours such as blame, emotional dysregulation and stonewalling do the opposite, and have a negative effect on health and well-being even into old age. Conflict is often triggered by inadequate income; poor couples are less likely to marry and when they do, their relationship is more likely to break down.

This chapter provides an introduction to the volume. It takes into account the cultural contexts in which the couple’s relationship is embedded. Individualism and collectivism are considered to be key cultural dimensions, which influence interpersonal behaviour in different regions of the world. The effects of globalization, of large migration flows, of technological advances and digital media, and the way these impact on how couples relate to each other are taken into account. The meaning of love and intimacy among couples in the midst of this unprecedented change are explored. Power and gender are key dynamic forces of the relationship and the emergence of couple diversity is considered as a hallmark of the twenty-first century. The running threads that are emerging across the globe are highlighted. Ways of positioning ourselves as family and couple therapists are discussed. To conclude, reference is made to ways of supporting couples and their families from a therapeutic perspective, at a community level as well as through policy.

This study seeks to understand the processes in families of resilient individuals with an acquired physical disability. Specifically, we were interested in getting to know more about the role of the family in the individuals’ resilience, and in turn, the impact on the family of the individuals’ disability and resilience. A multiple-case narrative methodology with three families was adopted. In total 19 family members participated in the construction of three stories. This described how the families were transformed and how family members continually moved and energised one another in virtuous circles of support. Empathy and altruism were motivators for these virtuous circles whilst adequate amounts of support contained the experience of each family member. Identifying, strengthening, and building on these relational processes was found to be vital in enabling both the individuals affected by disability and their families to grow following their adversity.

Multiple relationships are complex. They do not always develop smoothly and a number of tensions and dilemmas may arise. In the best of circumstances, multiple relationships move in stages but sometimes they come to a halt, move backward and then again forward. By "multiple relationships", the authors are here referring to the situation where a systemic supervisor is in a supervisory role with a person and at the same time fulfils another role which leads them to come into contact with the same person. The dominant discourse informed by the profession's ethical code of practice is that multiple relationships can be problematic. In trying to understand multiple relationships in more depth, authors were curious as to how the Anglo-American literature discusses situations where supervisor and supervisee have multiple relationships and interact according to these roles in different settings. Male and female supervisees might also behave differently in the context of multiple relationships.

This study investigated the attitudes about remarriage of married and previously married Maltese people. Respondents were selected using stratified random sampling; 810 men and 1,196 women answered a questionnaire by means of computer-assisted telephone interviewing. The majority (67.4%) of respondents did not consider remarriage. Remarriage was more likely to be considered by respondents who were younger, previously married, nonparents, had children who were not all born within marriage, and were of higher socioeconomic status. The study highlights the differences in attitude according to gender and marital status. The fact that pro-remarriage attitudes were endorsed by 32.6% of respondents and that these were more likely to come from nontraditional family forms suggests that family life in Malta is no longer dictated by normative social imperatives. The need for the legal protection of families headed by cohabiting partners is highlighted., peer-reviewed

This chapter outlines a systemic safety methodology for safe relationship therapy with couples, parents and families where physical violence is of concern. A step-by-step guide is offered here for the first time in publication. This systemic approach to safety in family relationships was developed over 20 years in the Reading, UK, ‘Safer Families’ family violence intervention service and is grounded in relevant theory and research.

Compassion fatigue and secondary traumatisation (Figley 2002) are well recognised to be risks in our work so the question of looking after ourselves in the best way to sustain ourselves over professional time has become more urgent.

When the physical violence stops, we often find that is when the couple contemplate a separation. It is as if they live under conditions of chronic crisis during the times, if not years, when violence was prevalent, and accordingly manage and cope on a day-to-day basis as best they can, and often dare not risk reflection on their options. Sometimes such reflection can be dangerous.

This chapter is about the prevention of intimate partner violence and child abuse that take place inside the home. It starts by providing a theoretical framework for understanding the processes at play when there is abuse in the family. The current legal frameworks that are in place and the strategic policies, including examples of good practice and evidence-based policies aimed to prevent violence and abuse between family members, are then reviewed.

This chapter is concerned with healing and repair in couple relationships—helping couples to reconnect and re-bond, if that is their wish, after the physical violence has stopped.

This chapter looks at some key clinical themes that may arise when working with families where intimate partner violence has stopped or when working with clients who have grown up in families where there was domestic violence. Clinicians may also find these themes relevant during the course of therapy with other clients, who might initially be present to therapy with difficulties other than experiences of domestic violence.

Physical and emotional violence is prevalent in couple and family relationships (Office for National Statistics UK in Chapter 4—Intimate personal violence and partner abuse, 2014) There are many well-established books on how to assess for the risk of future violence in families and on how to intervene therapeutically to help family members stop the violence, including the book by one of the present authors (Hamel and Nicholls in Family interventions in domestic violence: a handbook of gender-inclusive theory and treatment. Springer, New York, 2006; Hamel in Gender-inclusive treatment of intimate partner abuse: a comprehensive approach. Springer, New York, NY, 2005; Cooper and Vetere in Domestic violence and family safety: a systemic approach to working with violence in families. Whurr Publishers, London, UK, 2005). However, less is written on how to help couples and families once the violence has stopped. Many couples and families wish to stay together following the cessation of violent behaviour. Facing the legacy of violence, and often inter-generational violence and trauma, is both challenging and complex- for family members and for therapists. This book focuses on working therapeutically after the aftermath of violence in the family- at dealing with unresolved loss, trauma responses, with affect regulation concerns, and supporting coping and receiving and giving compassionate care. It also addresses professional –focused issues like supervision and consultation with practitioners who intervene with families and trauma. Finally we also take a look at policy-making, specifically prevention and early intervention with violence and abuse in relationships. In this first chapter, we start by looking at different forms of family relationships and different forms of violence in these relationships. We bring together current theory and literature not only on intimate partner violence but also on violence between siblings, and violence by children on their parents. We use clinical anecdotes and research in the area to illustrate some of the complex family dynamics that family members live with and that health and social care professionals have to contend with, and when working with families after the violence has stopped. (DeVoe and Smith in J Interpers Violence 17(10):1075–1101, 2002); Mullender et al. in Children’s perspectives on domestic violence. SAGE Publications, London, UK, 2002; Perel and Peled in Violence Against Women 14(4):457–482, 2008; Sammut Scerri in Living with contradictions of love and violence: a grounded theory study of women’s understanding of their childhood experiences of domestic violence (Doctoral dissertation). University of Surrey, Guildford, United Kingdom, 2015)

Many parents feel very distressed when experiencing serious difficulties with their children and come forward to ask for help themselves, while others are referred to clinicians for help by child protection services. Therapeutic work with families whose children are placed in out-of-home care is often about repair and healing following maltreatment. Many others, who would have been abused as children, consult with a therapist when they become adults. This chapter is about therapeutic work with families when the violence from parent to child stops. It also touches on violence from child to parent and on violence between siblings. How do we go about helping parents and their children in such difficult situations once the violence stops?

Objective: The study aimed to explore the experiences of first-time Maltese parents between pregnancy and the first six months in the postnatal period. Background: Parents’ interaction with their children appears to have an important and lasting effect on children’s cognitive and behavioural development. While both women and men anticipate equal involvement in child care, it is generally the woman who assumes primary responsibility when the new baby arrives. Methods: The qualitative paradigm was used to conduct the study by means of a semi-structured interview schedule. Data was collected at 28 weeks gestation, at 6 weeks postnatally and at 6 months postnatally. Twenty-six first-time parents (13 couples) participated in the study and were recruited by purposive sampling. Gender theory was used as the theoretical framework to guide this study. Interpretative phenomenological analysis was used during the analysing phase. Results: Two main super-ordinate themes were revealed from this study: ‘Pregnancy as a ...

Given the low incidence of marriage breakdown in Malta, this study investigates the level of marital satisfaction among Maltese couples and how they manage conflict between them. One particular interest in conducting this study has been that of exploring how cultural beliefs shape marital relationships and to what extent Maltese clinicians can rely on the Anglo-American literature in their clinical work with married couples. Three hundred and fifty-four randomly selected couples answered a self-administered questionnaire simultaneously and separately. A number of findings, namely the influence of a child-oriented family in the level of marital satisfaction and the predominance of a constructive style of conflict resolution, differed from those we normally find in the Anglo-American literature. The study addresses the importance of taking into account the cultural context when working with couples. The implications for practice of the various beliefs embedded in the culture are highlighted.

En guise d’introduction, un historique de l’apparition des pratiques systemique sera presente. En lien avec le statut de la psychotherapie a Malte aujourd’hui, l’utilite de l’approche systemique sera exploree notamment a l’aide d’interviews. Les reponses obtenues a une enquete sur la perception de la consultation familiale et systemique demontrent que les familles maltaises sont tres satisfaites de cette approche therapeutique. D’apres les differents commentaires recueillis, il semble aussi que l’orientation post-moderne de la formation a reussi a rendre la therapie familiale et la consultation systemique fort appreciees .