Jody Russon

Attachment-Based Family Therapy: A Review of the Empirical Support

Attachment-based family therapy (ABFT) is an empirically supported treatment designed to capitalize on the innate, biological desire for meaningful and secure relationships. The therapy is grounded in attachment theory and provides an interpersonal, process-oriented, trauma-focused approach to treating adolescent depression, suicidality, and trauma. Although a process-oriented therapy, ABFT offers a clear structure and road map to help therapists quickly address attachment ruptures that lie at the core of family conflict. Several clinical trials and process studies have demonstrated empirical support for the model and its proposed mechanism of change. This article provides an overview of the clinical model and the existing empirical support for ABFT.

Differences in Mental Health Symptoms Across Lesbian, Gay, Bisexual, and Questioning Youth in Primary Care Settings.

PURPOSE Lesbian, gay, bisexual, and questioning (LGBQ) youth exhibit significantly higher rates of mental health problems, including anxiety, depression, suicidal ideation, and nonsuicidal self-injury than their heterosexual peers. Past studies tend to group LGBQ youth together; however, more recent studies suggest subtle differences in risk between sexual minority groups. This study examined differences in mental health symptoms across male and female youth who are attracted to the same sex (gay and lesbian), opposite sex (heterosexual), both sexes (bisexual), or are unsure of whom they were attracted to (questioning) in a sample of 2,513 youth (ages 14-24 years). METHODS Data were collected using the Behavioral Health Screen-a Web-based screening tool that assesses psychiatric symptoms and risk behaviors-during routine well visits. RESULTS Bisexual and questioning females endorsed significantly higher scores on the depression, anxiety, and traumatic distress subscales than did heterosexual females. Lesbians, bisexual females, and questioning females all exhibited significantly higher lifetime suicide scores than heterosexual females. Interestingly, bisexual females exhibited the highest current suicide scores. Gay and bisexual males endorsed significantly higher scores on the depression and traumatic distress subscales than did heterosexual males. Gay males also exhibited higher scores on the anxiety subscale than heterosexual males, with bisexual males exhibiting a nonsignificant trend toward higher scores as well. CONCLUSIONS Findings highlight varying level of risk across subgroups of LGBQ youth and suggest the importance of considering LGBQ groups separately in the context of a behavioral health assessment, especially for females.

Authenticity and Career Decision-Making Self-Efficacy in Lesbian, Gay, and Bisexual College Students

Theories in career development have discussed the importance of career decision-making self-efficacy (CDMSE); however, there has been little development in this area for the lesbian, gay, and bisexual (LGB) community. Research has shown that LGB individuals may experience disruptions in career development if psychological energy is diverted to developing sexual identity. The present study sought to determine if authenticity, a strength-based characteristic, predicted CDMSE among LGB individuals. Survey results from 95 LGB-identified individuals indicated that components of authenticity, specifically unbiased processing and awareness, accounted for a significant amount of variance in CDMSE. Implications for social service professionals are discussed.

Promoting parental acceptance of bisexuality: A case study of attachment-based family therapy

ABSTRACT Attachment-based family therapy is an empirically supported, manualized treatment spanning over 15 years of research and clinical practice. Increasingly, research and clinical evidence emphasize the modification of family therapy models to meet the needs of diverse clients. Best practices require culturally-sensitive therapists to attend to issues of race, gender identity, sexual orientation, ethnicity, class, and ability. The ABFT model has been evolving to address the health disparities associated with marginalization and attend to the specialized needs of diverse families. This clinical case study demonstrates how ABFT clinicians must adopt an intersectional approach to be successful in building and sustaining relational repair. Transcripts from a case with a religious, African-American family and their bisexual daughter outline the structure and sequence of ABFT. An analysis of this case illustrates the impact of intersectionality on clinical processes and mechanisms of change.

Predicting Alliance for Depressed and Suicidal Adolescents: The Role of Perceived Attachment to Mothers

ABSTRACT Although therapeutic alliance is a robust predictor of treatment outcomes in child and adolescent psychotherapy, less is known about relational factors, such as youth’s attachment, to mothers and fathers. The current study investigated anxious or avoidant attachment to mothers or fathers as predictors of early formation of the therapeutic alliance in a high-risk sample of depressed and suicidal adolescents. Changes in adolescents’ alliance ratings between the 1st and 4th treatment sessions were examined in a comparative efficacy trial (N = 115) of attachment-based family therapy and family-enhanced nondirective supportive therapy for suicidal and depressed adolescents. Multilevel regression analysis accounted for nested data by therapist and treatment condition. After accounting for significant random effects in our multilevel model associated with therapist to treatment condition, results revealed a significant effect of perceived insecurity to mothers leading to lower levels of therapeutic alliance at Session 4 (β = −0.49, p < .05). The quality of adolescents’ attachments to parents may play an important role in adolescents’ ability to form strong working relationships with a therapist. Findings suggested that adolescents with avoidant attachment styles may be more difficult to engage in treatment and could benefit from specific interventions focused on alliance-building.

Attachment-Based Family Therapy for Depressed and Suicidal Adolescents: Development, Research and Clinical Practice

Attachment-Based Family Therapy (ABFT) is an evidence-based model designed to treat depressed and suicidal adolescents. ABFT works with adolescent psychopathology in the context of family relationships by addressing ruptures in the parent–child relationship and restoring parents’ caregiving capacities and adolescents trust in attachment security. This paper provides a rational for family-based treatments for this disorder, an overview of clinical model and a review of some of the empirically work supporting the treatment efficacy and effectiveness.