1. Counselling goals

With a greater portion of the world adapting westernized family cultures and practices, there are growing feuds and issues in relationships. These lead to growing challenges and families struggling to cope with such issues, impacting children in a great manner (Rempel et al, 2007). Family counselling can offer assistance to families struggling with varied issues of relationships, feuds, sibling relationships, and many more. The domain of couple therapy has emerged in recent times as an integral intervention in treating varied types of mental health issues (Segal, 2010). In the western world, there has been diagnosed with growing demand in the society for varied couple therapy due to arising complexities in relationships and couple-based therapy is only available as an evidence-based treatment. In the current scope of analysis, there has been seen a number of complex and growing issues amongst the couple as well as in children that need to be attended to (Thomas, & Pender, 2008).

In the current case scenario, there is present a series of complex relationships between couples. Penny approaches for counselling as she is interested to know ways in which family, couples and group counselling can assist her family. Her husband does not communicate or help out his son from a past relationship (Evans et al, 2012). His son seems to be moody, not concentrating on studies, keeps on playing video games, and does not communicate with the family. Penny’s daughter, who is quite young appears to be sexting to her boyfriend. Penny’s husband Sam does not like Penny’s sister Dawn, visiting them as he feels that Dawn uses Penny for babysitting her small children (Papernow, 2018). Further Dawn feels that Sam does not talk or provide adequate time to his son, Peter. For counselling sessions, there needs to be specific goals designed for the family, couple, and group as a whole. Some goals ascertained for this case include;

• Goal for couple:
  • Goal for the couple is to improve communication skills, such that they can resolve problems quickly.

• Building respect and empathy towards one another, to support one another during difficult times. 

• Strengthening the connection, including intimacy.      

• Goal for the family:
  • Goals for the family is to improve communication.

• Goal for the entire family will be to improve family bonding.

• Goal for the family will be to create a better functioning home environment by including engagement of all. 

• Goal for the group:
  • Goal for the entire group will include. 

• Goal for the entire group will be to initiate a sense of belongingness and relatability by understanding or sharing common experiences.    

• Goal for the entire group includes behavioral changes. 

2. Evidence-based approach

The above goals are developed inconsistency with the presenting issues. The several issues presented in the case have been diagnosed to analyze specific approaches as well as consider the possible benefits, limitations as well as risks associated with each of the designated goals (Kottler, & Shepard, 2014). An analysis of the possible benefits, limitations as well as risks associated with each of the presenting issues have been undertaken below, as referring to peer-reviewed research papers.  

1. Sam does not give adequate time to his family: 

The goal is important as a couple of relationships require a considerable amount of efforts for establishing a healthy relationship. In a couple of relationships, both the partners need to share equal responsibilities for dealing with various challenges faced in the family, in the sharing of responsibilities (Lukas, 1993). Penny used to bear most of the burden of the relationship, while Sam totally ignored his responsibilities and stayed away most of the time. This evidence is of much importance because as Sam is seen to be totally ignorant of the various pressures in the family that Penny has to deal with. Sam is seen to have almost no empathy towards Penny, also Penny due to her troubles is not able to understand the work pressure that Sam faces (Burford, 2017). There can be seen lacking empathy towards one another which has led to the couple facing troubles. Engaging the couple in the therapy session will assist in drawing attention towards issues that are faced by one another. The possible risks arising from such a situation is becoming resistant to one another. As indicated by Muntigl, (2013) couples often develop resistance towards therapy and start getting distant from one another in case of the presence of a complex relationship. The therapy might lead to becoming away from one another and being resistant to one another. Such counselling sessions might also lead to couple conflicts leading to disturbed atmosphere back at home. Wolska, (2011) discusses several contradictions in marital relationships like this one requiring intervention approaches from the therapist.

Whenever he was within the family, he used to ignore sharing his responsibilities of discussing the challenges faced. Schofield et al (2012) discuss various approaches in resolving couple related conflicts through therapeutic intervention techniques. This will make the couple healthy and happy. While some individuals are able to continue in a relationship in a smooth manner, in other relationships like this one, couples might find it extremely difficult in undertaking positive change. Sam remains away for his work for many days together, while Penny also works as a nurse (Freeman, & Couchonnal, 2006). It is stated in the case that when Sam becomes available also, he likes to not talk regarding family problems and Penny gets highly stressed dealing with multiple situations faced in the family along with her work-related stress. With a trained professional counseling-based approach, the relation between Sam and Penny can be enhanced and specific issues in their marital relationship can also be solved (Davis et al, 2012). This will not only help attend to specific issues but also improve trust and communication and prevent divorce. Communication between the couple can assist in resolving issues present between Sam and Penny, it can also assist Penny to deal with her anxiety related to her family in a better manner. This will gain greater engagement from Sam and share the issues the family is facing right now (Bakhshandeh et al, 2015). Possible risks facing this type of counseling goal is more distance being present between Sam and Penny, with Sam moving away from the relationship, having to bear so many responsibilities and spending time in communicating with one another. Schrc’ider, (2014) details the various types of counselling approaches that might assist in overcoming couple issues and deal with possible risks arising from the same.     

For any couple relationship, it is important that there is intimacy and the couples share each other’s troubles. This connection forms the basis of a long and healthy relationship, and bonds couples with one another. Sam and Penny are seen to be distantly attached to one another (Mustaffa et al, 2013). Their relationship is not deep and owing to the several challenges faced by the couple and pressures from their work. It is important at this stage as the couple’s children from previous relationships are residing with them that they sort out any issues that might be hampering their relationship. Kashefi, and Honarparvaran, (2015) discuss the effectiveness of couple therapy dependent on several indications especially communication. Hence effective couple therapy is possible when there are participation and communication between the couples openly with the therapist. The couple needs to seek therapy such that their relationship can be re-established with new couple goals, and they can be directed towards a positive experience. This will help establish a strong and intimate relationship between the couple.      

• A lot of complex relationships residing in the same place:

This will increase engagement in the family. Family therapy for such kind of nuclear family members with stepfamily can be greatly beneficial. One of the goals of family therapy is improvising communication such that matters complex as this one can easily be dealt with (Shaw, & Crawley, 2007). Evidence of such therapy includes a lack of communication between Sam and Peter, also between Penny and Monique. This includes family bonding between different members of the family. The primary goal of the therapy is to re-establish the broken family bonds and improvise it, amongst various members of the family, especially amongst young children and teenagers. Evidence of such kind of therapy session will benefit all members of the family, also impacting the gradual mental development of Sarah, and she found a protective environment in growing up. Sexton et al, (2011) suggest making use of evidence-based approaches in providing therapy for families. This will make the father-son relationship and mother-daughter relationship happy. Therapy will assist in counselling between the different types of relationships such that healthy boundaries can be fostered and positive relationships can be reinstated amongst varied members of the family. Stratton et al, (2011) there is required significant competencies amongst therapists to offer family members with effective counselling approaches.  

Possible risks arising from such therapy sessions include rigid personality defenses arising in individuals and relationships. Especially, there are considerable risks faced by Peter as he is seen to be moody and rarely communicates with anyone from his family, he can become defensive as an individual. Also, like Monique, is in adolescent age, opting for counselling for her can highly be stressful for her. It is very much possible that she does not grasp concepts and interactions that take place during family therapy sessions. In order to deal with such kind of risks, it is advisable that the children as well as adolescents can opt for the same therapists. Such therapy will assist in the development of relationships, which have almost been absent between the parents and the children. McDowell et al, (2012) state that significant counsellor competencies are needed in understanding possible risks of therapeutic sessions. Possible risks arising from such type of therapy session are Peter and Monique becoming more distant from the family as they will be confronted with these possible issues. They are at a growing age and both are transforming into adults, this can lead them to possibly become difficult when they are faced with the pressures of confrontation while adopting therapeutic sessions. Hunter and Commerford, (2015) discussed the varied types of relationship complexities and issues that hamper the day-to-day relationships of couples as well as of families.

Various stressors being faced by the family had led to disruption in the functioning of the home environment. Currently, there are various disruptions facing the family especially with the growing and adolescent children that need to be tackled in an effective manner. Evidence of such therapy is needed as there can be seen no communication between Peter and Sam, further Penny is not seen assisting Peter for his condition, rather reporting it only. Penny is not able to assists her own daughter Monique in her adolescent period. Moreover, though Sarah has reported regarding her sister to her mother, yet no action has been assumed by Penny, to communicate with Monique to resolve her current issue. Moore, & Seu, (2011) states that children’s voices are integral and need to be considered in therapeutic counselling. Therapy can tremendously assist in increasing engagement between varied members of the family. Possible risks facing such therapy includes unsettling disputes and disputes being created in the family regarding increasing engagement needed in the family.     

• Dependence of Dawn on Penny post her divorce:

Sam is seen to dislike Dawn and not like children visiting them often also Dawn has a number of issues that she feels like Sam not giving adequate time to Peter. These issues can be resolved through therapy sessions by working with the entire group. Through group counselling sessions it is possible to bring together, such that they are able to gain support from the sessions. Interaction between different members of the group can assist in starting a new behavior, which in turn can boost self-esteem within the group. When the clients within the group will start making use of new behavior as a part of the treatment procedure, then fitting and supportive behavior can be achieved. Risks in adopting such types of group counselling session include negative therapeutic changes amongst the participants leading to averting the relationship altogether. As the participants start recognizing the efforts to go to the engagement procedure for the communication, they might totally become avert to it.

Group counselling therapies can especially be effective in reinstating a sense of belongingness and establish effective relationships within a group by sharing common experiences. Such therapy is especially needed for Penny and Peter such that they can be brought about in a platform where they can share a certain relationship that is needed to stay in a home together (Rait, 2000). This will also enable the establishment of a care-based relationship approach between them. Similarly, between Sam and Dawn though there is a distant relationship, the engagement between Penny and Peter as well as Sam and Dawn, can lead to changing the behavioral attitude between them. Evidence-based on such therapy can lead to effective intervention for counselling for each of the members of the group (Dattilio et al, 2014). Group counselling can offer the effected members a common sense of experience. There might however be risks arising from such counselling session includes risks of conflict. Personalities can easily hold back from coping mechanisms as they work and can also increase additional concerns. The participants can hold back from the counselling sessions and not attend further counselling sessions.    

Sam and Dawn need to indulge counselling session such that they are able to interact with one another with proper behavior. Further such changes in behavior will be seen to impact behavior existing between Sam and Penny and also between Penny and Dawn. In short, such counselling session will bring about a tremendous amount of improvement in the relationship existing between the group as a whole (Sperry, & Peluso, 2018). Evidence of counselling can be seen in the negative attitude of Sam towards Dawn and also that of Dawn towards Sam. The counselling session is expected to bring about tremendous effectiveness and a behavioral change between their existing relationship. As their presenting issues include not able to get along well with one another. The limitation of such behavioral changes might however be temporary in nature and might be short-lived till the time the counselling session lasts. Possible risks arising from counselling goals might include making feel uncomfortable with both Sam as well as Dawn. As group sessions include personal discussions that might get intense, including role-play scenarios often, it can lead to a point of discomfort till a point where there is no therapeutic value being present in the group. This might lead to risks of leaving the group counselling in totality and not returning anymore.     

3. Developing therapeutic relationships

Establishing therapeutic relationships between therapists and clients is essential for undertaking effective therapy and working alliance. Therapeutic relationships vary when they are provided for couples, family, and group counselling sessions, especially when engaging more than one person. All three therapies couple, group and family therapies include working with more than one individual at the same time. The similarity between these therapies not only includes working with more than one individual at the same time but also includes asking intense questions for resolving conflicts (Glebova et al, 2011). The focus of establishing all the three different types of the therapeutic relationship lies in assisting couples/ group/ family members to improve communication skills and resolving conflicts.

While establishing a therapeutic relationship within couples, it includes engagement of both the individuals in the couple by enhancing communication patterns within them. Unlike individual therapy, couple therapy includes the therapists entering the life of the couple and discussing more directly with them (Benson et al, 2012). It focusses on bringing out regular habits and routines directly into the session. It is more intensive than individual therapy as it is more intense also the therapists will analyze and offer feedback regarding the couple’s interaction such that they can improvise it. Group therapy includes dynamic interaction between the members of the group. Also, the emphasis of such a session is on assisting the participants in the group to understand any projection they are having towards other members. Through therapy, they are made to learn from feedback received from others including the therapists. Couple therapy is contrasted to group therapy or family therapy in its intensity as the therapist might ask personal questions to the couple as well as the group resorting to the therapy (Bartle-Haring et al, 2012). The difference between building alliance between family therapy and couple therapy is, in family therapy the counsellor can ask certain members to join or rejoin if they have left but in case of couple therapy equal as well as neutral support for each of the partner is essential. The counsellor can in group therapy also ask members to join or rejoin which is again not suitable in couple therapy, where equal support needs to be extended to both the partners (Luterman, 2017). Though in all the types of therapy feedback is provided to the members, couple therapy mostly includes understanding and negotiating on points project by each partner, with the therapists adopting a suitable recommendation.   

In couple therapy, family therapy as well as in group therapy, there is needed to engage more than one person in the counselling practice (Sperry, 2013). Counsellors need to adapt various steps and strategies so as to engage more than one person to take active roles and participate in a positive manner in counselling sessions. Most clients are averting to the concept of therapeutic counselling hence it is important that counsellors keep the first few sessions in an orientation session. While the first session will need to welcome the client to the consultation session, orientation is different, and it needs to focus on the difference that therapy sessions can offer. Such orientation sessions will provide the outline of all factors that will be attended through the counselling sessions. This will assist in extending a professional approach to counselling and avoid losing out on the client’s interests in the sessions. Moreover, the diagnostic evaluation by the therapists needs to be super-short by identification of the presenting issues quickly. Most importantly the feedback to the client needs to be open and should not be rushed. The clients should be able to grasp through the entire sessions of feedback and adopt it in their regular lives as well, this will, in turn, determine the effectiveness of such therapeutic sessions. The therapists can share the initial plan with the clients, this will assist the client ascertain and charting out concrete ways to resolve the presenting issues (Potash et al, 2013). All questions of the client need to be answered, if possible, and wrapped up quickly by providing them the choice for the follow-up session. Lastly, the therapists need to keep connected over email such that clients can get back and take assistance at any time.

It is seen to be most difficult in engaging children and teenagers in family counselling and therapeutic sessions. Most importantly, while engaging young people in therapeutic sessions, these sessions need not start by asking confronting topics. Engagement with young people is possible by discussing that confidentiality and privacy come prior to any sort of personal information. Such type of information might be shared with their parents in this case or alternatively caregivers. The therapeutic alliance is of utmost importance and needs to be established in the first session (Bernal et al, 2015). In the absence of a therapeutic relationship being established, it will not be possible to ensure that the young person returns for later sessions. Sufficient time needs to be provided to the young person for responding. Therapists need to make use of a strength-based approach and identify resilience such that ongoing engagement can be promoted. The therapists need to appear to be genuine and authentic and be warm and friendly by reducing possible perceived power imbalance.       

4. Skills evaluation for Counselling

An effective therapist needs to make use of several skills for effective diagnosis as well as for planning suitable intervention (feedback) for the clients. In this case, there are three presenting issues for the couple, family, and for the group (Weiner-Davis, 2006). Therefore, from the varied skills, that a counsellor should ideally possess, the top five skills identified include advanced empathy, exception questions, coping questions, scaling questions, and circular questions. These skills are applied to this case study with proper examples for the same;

• Advanced empathy: Advanced empathy enables the client visual new perspectives ion their experiences, behaviors, and feelings. The counsellor communicates to the client is the felt sense. By listening intensely to the client, probing clues, and reading the client’s body language and expression, the counsellor is able to see or sense feelings or feelings that the client is seldom aware of (McVey et al, 2015). By making use of the underlying meaning of the unknown, the counsellor provides effective feedback to the client. This skill is selected for the client as only Penny was interested in getting counselling sessions from the therapists while other members of the family as well as the group remained unaware and not acknowledging any challenges faced by them.

Examples:

1. Understand the pain faced by Penny in her relationship
   1. Try and explore the behavior of Peter to understand his underlying feeling
   1. Understand distance (misunderstanding) in relationship present between various members of the group
2. Exception questions: Exception questions are those that arise in a client’s lives in case their problems took place were less severe in nature. Such questions generally focus upon who, what, where, and when conditions which led the exception case to take place.

Examples:

• When are the times the problem did not happen?
  • When did Peter did not face any problem?
  • Are there times when the problem does not happen in the group or is less serious?
• Coping questions: These are questions that enable the client in shifting his/her to focus on the problem factors and towards whatever the client does for surviving through the stressful or painful circumstances.

Examples:

• What did you (Penny) find that was helpful in managing this situation?
  • Considering Peter’s current situation was it possible to continue working on the goals?
  • What are the factors that have helped to work on the goals for the group?
• Scaling questions: It includes inviting clients to put down their observations, predictions, and impressions from a scale from 0 to 10, 0 reflects no chance, and 10 being every chance. It includes specific questions, by citing specific circumstances and times.   

Examples:

1. On a scale of 0 to 10, with 0 being not serious and 10 being not serious, how seriously do you (Penny) think the problem is now?
   1. On a scale of 0 to 10, what number wound it take for considering the problem to be solved sufficiently?
   1. On a scale of 0 to 10, how likely that the problem can be solved?
2. Circular questions: It is a technique that is increasingly used in family therapy for getting valuable information regarding dynamics and relationships within the family. When one family member is asked regarding a question, then subsequent members of the family responds to the same question.  

Examples:

1. Who in the couple remains the most depressed?
   1. Who in the family does not provide sufficient time in the family?
   1. Who in the group does not accept positive feedback?

5. Tailoring therapeutic outcomes

Tailoring therapy is essential for an effective therapeutic outcome. Counsellor needs to design and channelize their therapeutic practices such that it can meet family, couples, and group counselling participants (Chen, & Rybak, 2017). Issues that need to be provided adequate attention to while rendering appropriate counselling interventions include diversity issues between the counsellor and participants and cultural issues or differences between the counsellor and the clients. In the current scenario, Sam is Chinese, and his son is also Chinese, whereas Penny, her children, Dawn, and her children are Australians (Shechtman, 2017). Therefore, there is a significant cultural difference between the therapeutic counsellor and Sam and his son, hence therapeutic counselling sessions need to be modeled such that it can effectively overcome such cultural issues and attend to designated outcomes.   

Attaining effective therapeutic interventions and to make clients accept intervention approaches suggested by the therapists, it is essential that all cultural and diversity related issues are addressed appropriately (Dodson, & Kurpius, 2013). As effective interventions across diversified patient are the foremost concerns for therapeutic counsellors. Theoretical orientation across all treatment modalities along with therapy alliances forms a critical factor for the determination of favorable outcomes from the therapy undertaken. As a therapeutic counsellor it is essential to examine and understand the client’s cultural settings which include values, beliefs, a perspective from the ethnic group or geographic region (Carlson, & Lambie, 2012). It is essential to share such diversity related issues with the client such that there are no differences in perception and the clients do not feel culturally ignored.          

6. Counselling skills for attending to an ethical issue

There might arise several ethical issues that need to be addressed by therapeutic counselling methods. Having started working with the family, Penny discovered her daughter sexting to her boyfriend. While Penny is aware of this information, she does not make Monique aware of such information and wants to know how to deal with such issues. This issue needs to be attended in family counselling sessions and as a therapeutic counsellor, I will need to talk with Monique and explore her feelings (Jalali et al, 2018). The ethical issue seen that needs to be addressed in counselling is directly exploring issues faced with young children, instead of confiding such feelings.

The ethical issue involved in this issue of exploring feelings of Monique, it is essential to monitor Signs of Safety (Sori, & Hecker, 2015). This will prevent arising of any ethical challenges with respect to this client while working with young children. Thus, I will work gradually, taking permission from Monique in order to deal with her issue or offer acceptable counselling suggestions. I would involve Penny for solving this issue and the goals will be to maintain appropriate communication amongst them in an open manner for a healthy mother-daughter relationship.      

References

Bakhshandeh, M., Sedrposhan, N., & Zarei, H. (2015). The Effectiveness of Cognitive-Behavioral Group Counseling to Reduce Anxiety, Marriage; Single People have to be Married in Esfahan City (2013-2014). Journal of Social Sciences and Humanities Research, 3(01), 11-15.

Bartle-Haring, S., Knerr, M., Adkins, K., Delaney, R.O., Gangamma, R., Glebova, T., Grafsky, E., McDowell, T. & Meyer, K. (2012). Trajectories of therapeutic alliance in couple versus individual therapy: Three-level models. Journal of Sex & Marital Therapy, 38(1), 79-107. Doi: 10.1080/0092623X.2011.569635.

Benson, L. A., McGinn, M. M., & Christensen, A. (2012). Common principles of couple therapy. Behavior therapy, 43(1), 25-35.

Bernal, G., MoralesCruz, J., & GómezArroyo, K. (2015). Family counseling and therapy with diverse ethnocultural groups. Counseling across cultures, 457.

Burford, G. (2017). Family group conferencing: New directions in community-centered child and family practice. Routledge.

Carlson, J. D., & Robey, P. A. (2011). An Integrative Adlerian Approach to Family Counseling. Journal of Individual Psychology, 67(3).

Carlson, R. G., & Lambie, G. W. (2012). Systemic–developmental supervision: Clinical supervisory approach for family counseling student interns. The Family Journal, 20(1), 29-36.

Chen, M. W., & Rybak, C. (2017). Group leadership skills: Interpersonal process in group counseling and therapy. SAGE Publications.

Dattilio, F. M., Piercy, F. P., & Davis, S. D. (2014). The divide between “evidenced‐based” approaches and practitioners of traditional theories of family therapy. Journal of marital and family therapy, 40(1), 5-16. Doi: 10.1111/jmft.12032.

Davis, S. D., Lebow, J. L., & Sprenkle, D. H. (2012). Common factors of change in couple therapy. Behavior therapy, 43(1), 36-48.

Dodson, L. S., & Kurpius, D. J. (2013). Family counseling: A systems approach. Routledge.

Evans, P., Turner, S., & Trotter, C. (2012). The effectiveness of family and relationship therapy: A review of the literature. Psychotherapy and Counselling Journal of Australia.

Freeman, E. M., & Couchonnal, G. (2006). Narrative and culturally based approaches in practice with families. Families in Society, 87(2), 198-208.

Glebova, T., Bartle‐Haring, S., Gangamma, R., Knerr, M., Delaney, R. O., Meyer, K., … & Grafsky, E. (2011). Therapeutic alliance and progress in couple therapy: Multiple perspectives. Journal of Family Therapy, 33(1), 42-65. Doi: 10.1111/j.1467-6427.2010.00503.x.

Hunter, C., & Commerford, J. (2015). Relationship education and counselling. CFCA Paper. Retrieved from <https://core.ac.uk/download/pdf/30671645.pdf>

Jalali, A., Yekzaman, M., Bazrafshan, M. R., Salari, N., & Rahmati, M. (2018). Investigating the effect of family counseling on the acceptance and support of patients under methadone maintenance treatment. Shiraz E Medical Journal, 19(5).

Kashefi, Z. A. H. R. A., & Honarparvaran, N. A. Z. A. N. I. N. (2015). Evaluate The Effectiveness Of Couples Therapy Based On Commitment And Acceptance (ACT) On Reducing Marital Conflict Working Couples In Isfahan Education. J Biol Alied Sci, 4(10), 213-20.

Kottler, J. A., & Shepard, D. S. (2014). Introduction to counseling: Voices from the field. Cengage Learning.

Lukas, S. (1993). Where to start and what to ask: An assessment handbook. WW Norton & Company.

Luterman, D. M. (2017). Counseling persons with communication disorders and their families. PRO-ED, Inc. 8700 Shoal Creek Boulevard, Austin, TX 78757-6897.

McDowell, T., Goessling, K., & Melendez, T. (2012). Transformative learning through international immersion: Building multicultural competence in family therapy and counseling. Journal of Marital and Family Therapy, 38(2), 365-379. Doi: 10.1111/j.1752-0606.2010.00209.x.

McVey, L., Lees, J., & Nolan, G. (2015). Practitioner‐based research and qualitative interviewing: Using therapeutic skills to enrich research in counselling and psychotherapy. Counselling and Psychotherapy Research, 15(2), 147-154. Doi: 10.1002/capr.12014.

Moore, L., & Seu, I. B. (2011). Giving children a voice: children’s positioning in family therapy. Journal of Family Therapy, 33(3), 279-301. Doi: 10.1111/j.1467-6427.2011.00556.x.

Muntigl, P. (2013). Resistance in couples counselling: Sequences of talk that disrupt progressivity and promote disaffiliation. Journal of Pragmatics, 49(1), 18-37. Doi: 10.1016/j.pragma.2013.01.003.

Mustaffa, S., Ghanbaripanah, A., & Ahmad, R. (2013). Assessment in family counseling. Procedia-Social and Behavioral Sciences, 93, 2205-2208.

Papernow, P. L. (2018). Clinical guidelines for working with stepfamilies: What family, couple, individual, and child therapists need to know. Family Process, 57(1), 25-51.

Potash, J. S., Ho, R. T. H., Chick, J. K. Y., & Yeung, F. A. (2013). Viewing and engaging in an art therapy exhibit by people living with mental illness: implications for empathy and social change. public health, 127(8), 735-744. Doi: 10.1016/j.puhe.2013.05.004.

Rait, D. S. (2000). The therapeutic alliance in couples and family therapy. Journal of clinical psychology, 56(2), 211-224.

Rempel, G. R., Neufeld, A., & Kushner, K. E. (2007). Interactive use of genograms and ecomaps in family caregiving research. Journal of family nursing, 13(4), 403-419.

Schofield, M. J., Mumford, N., Jurkovic, D., Jurkovic, I., & Bickerdike, A. (2012). Short and long-term effectiveness of couple counselling: a study protocol. BMC public health, 12(1), 735. Doi: 10.1186/1471-2458-12-735.

Schrc’ider, T. (2014). Couples counselling. New York: Handbook of Counselling, 58. 2^nd Edition.

Segal, J. (2010). Therapeutic process as a means to navigate impasse? Reflections on a complex case of crosscultural adolescent family therapy. Australian and New Zealand Journal of Family Therapy, 31(3), 266-274.

Sexton, T., Gordon, K. C., Gurman, A., Lebow, J., Holtzworth‐Munroe, A. M. Y., & Johnson, S. (2011). Guidelines for classifying evidence‐based treatments in couple and family therapy. Family process, 50(3), 377-392. Doi: 10.1111/j.1545-5300.2011.01363.x.

Shaw, E. F., & Crawley, J. (Eds.). (2007). Couple Therapy in Australia: Issues emerging from practice. PsychOz Publications.

Shechtman, Z. (2017). Group counseling and psychotherapy with children and adolescents: Theory, research, and practice. Routledge.

Sori, C. F., & Hecker, L. L. (2015). Ethical and legal considerations when counselling children and families. Australian and New Zealand Journal of Family Therapy, 36(4), 450-464. Doi: 10.1002/anzf.1126.

Sperry, L. (2013). Integrated behavioral health: Implications for individual and family counseling practice. The Family Journal, 21(3), 347-350.

Sperry, L., & Peluso, P. (2018). Couple Therapy: Theory and Effective Practice. Routledge.

Stratton, P., Reibstein, J., Lask, J., Singh, R., & Asen, E. (2011). Competences and occupational standards for systemic family and couples therapy. Journal of Family Therapy, 33(2), 123-143. Doi: 10.1111/j.1467-6427.2011.00544.x.

Thomas, R. V., & Pender, D. A. (2008). Association for specialists in group work: Best practice guidelines 2007 revisions. The Journal for Specialists in Group Work, 33(2), 111-117.

Weiner-Davis, M. I. C. H. E. L. E. (2006). It takes one to tango: couples therapy with individuals. Psychotherapy in Australia, 13(1), 12.

Wolska, M. (2011). Marital therapy/couples therapy: Indications and contraindications. Archives of Psychiatry and Psychotherapy, 3, 57-64. Retrieved from <http://ww.archivespp.pl/uploads/images/2011_13_3/57Wolska__APP3_2011.pdf>