Hofstra Horizons Research

Marriage and Family Therapy Clinic

Madeline Seifer
Director

Marriage and Family Therapy Clinic

History of the Profession

The field of marriage and family therapy is relatively new. Its roots can be traced back to the early 20th century, where it first appeared in the child guidance movement and was labeled marriage counseling (Sholevar, 2003). Not until 1942, with the formation of the American Association of Marriage Counselors, did the field gain national recognition. In the mid-1950s, anthropologist Gregory Bateson and several of his colleagues adapted ideas from cybernetics and general systems theories and postulated that certain feedback loops and homeostatic mechanisms influenced here-and-now behaviors among people in relationships, and they devised the notion of circular causality. This fundamental concept, upon which family therapy is based, has the clinician focused upon the existing process that is thought to maintain or exacerbate problems between individuals.

During the mid-1960s, several distinct models of family therapy began to emerge, based upon the works of some of the original “giants” in the field. These founders include Milton Erickson, Salvador Minuchin, Jay Haley, Virginia Satir, Carl Whitaker, and Murray Bowen. The 1970s and 1980s saw an evolution of several of these seminal models, through revision and integration.

By the early 1990s, a post-modernistic approach to thinking about relationships and change process had emerged. This era produced more noted theorists, including Lynn Hoffman, Bill O’Hanlon, and Michael White. Toward the end of the 20th century and into the 21st, family therapy had grown into the second most utilized form of psychotherapy after cognitive behavioral therapy (Psychotherapy Networker, 2007).

History at Hofstra University

While all of these theories and models of treatment were evolving internationally, the Marriage and Family Therapy (MFT) Program was taking root at Hofstra University. Dr. Don David Lusterman founded the MFT Program and began training students here in 1982. One year later, the directorship of the program was passed on to Dr. Joan Atwood, who fine-tuned it and maintained the program at the cutting edge of the developing field for 23 years. Founded in 1991, the Joan and Arnold Saltzman Center was an ideal site for the Marriage and Family Therapy Program to begin its clinical work, which occurred in 1992, under the directorship of Dr. Atwood. Progress was slow for the next few years. Referrals were sparse, offering limited opportunities for clinical training. Then in 2006 New York state licensed the practice of marriage and family therapy, which contributed to an increase in referrals. In addition, Professor Madeline Seifer was appointed director of the Marriage and Family Therapy Clinic. With the advent of regulation and the input of new personnel, the Marriage and Family Therapy Clinic took its place as an integral part of the Saltzman Center.

Current Supervisors

The Marriage and Family Therapy Clinic utilizes the professional services of five supervisors, all of whom are licensed by the state of New York. They reflect various backgrounds and teach various models of family therapy.

George Simon, M.S., LMFT

The veteran member of the team, Professor George Simon began supervising at the Saltzman Center in 1994. He is one of the world’s foremost authorities in the field of structural family therapy. George Simon is an adjunct assistant professor in and director of the Master’s Program in Marriage and Family Therapy at Hofstra University. He is also a member of the faculty of the Minuchin Center for the Family. He sees couples and families in his therapeutic practice in Deer Park, New York.

Professor Simon has published numerous articles in scholarly journals and co-authored, along with Salvador Minuchin and Wai-Yung Lee, Mastering Family Therapy: Journeys of Growth and Transformation, published by John Wiley & Sons. His most recent book is titled Beyond Technique in Family Therapy: Finding Your Therapeutic Voice, published by Allyn & Bacon. Recent publications include a chapter on structural therapy with couples in the fourth edition of the Clinical Handbook of Couple Therapy, and a co-authored chapter on family assessment in the third edition of the Handbook of Multicultural Assessment: Clinical, Psychological, and Educational Applications.

Professor Simon holds a bachelor’s degree in meteorology from New York University, a master’s degree in philosophy from Fordham University, and a master’s degree in counseling, also from Fordham University. He was trained in structural family therapy by Salvador Minuchin, the chief architect of this therapeutic approach.

Madeline Seifer, M.A., LMFT

In addition to her duties as director of the Marriage and Family Therapy Clinic, Professor Madeline Seifer enjoys her role as a clinical supervisor. She is a New York state-licensed marriage and family therapist, as well as an approved supervisor for the American Association for Marriage and Family Therapy. She is an adjunct instructor in Hofstra University’s Marriage and Family Therapy Program, having graduated from the program in 1993. Prior to her graduate work at Hofstra University, Professor Seifer earned a bachelor’s degree in social psychology from CUNY’s Queens College.

Professor Seifer brings a post-modern perspective to her model of supervision and offers students an opportunity to incorporate some solution-focused techniques into their clinical work. In her private practice in Jericho, New York, Professor Seifer specializes in relationship issues of all types, particularly those that involve chronic illness, parenting and extramarital affairs. In her leisure time, Professor Seifer enjoys travel and musical theater, and is an avid tennis fan.

Julie Askew, Ph.D., LMFT

Dr. Julie Askew is an assistant professor in the Department of Health Professions and Family Studies. She earned a doctorate in child and family development with a marriage and family therapy specialization from the University of Georgia, and she holds a master’s degree in psychotherapy and psychosexual therapy from South Bank University in London, England. Dr. Askew has been working as a therapist since 1991 in a variety of settings, including private practice, mental health clinics and hospitals. She also completed two years of specialist training in couple relationships and sex therapy at the Maudsley Hospital and Institute of Psychiatry in London.

Dr. Askew teaches courses in the areas of marriage and family therapy, and sexual health. Her current research is focused on women’s sexuality after hysterectomy, and she will soon begin a new study exploring minority youth sexual behaviors in the Hempstead, New York, area. Dr. Askew has published journal articles on topics such as couples and Viagra, gynecological surgery, sex education, mothers with breast cancer, and parenting.

Nancy Cohan, M.A., LMFT

Professor Nancy Cohan recently joined the supervisory staff at the Saltzman Center, having spent the past 10 years as the director/supervisor of Family and Children’s Association of Nassau County. Professor Cohan is a graduate of Hofstra University’s Marriage and Family Therapy Program and is currently an adjunct professor in the same program. She is widely versed on several models of family therapy, but favors a solution-focused approach to her clients and to supervision.

Rhiannon C. Beauregard, M.A., LMFT

Rhiannon Beauregard is the assistant director of the Marriage and Family Therapy Clinic. She is a licensed marriage and family therapist and a clinical member of the AAMFT. She holds a B.S. in special education from Boston University and an M.A. in marriage and family therapy from Hofstra University. Ms. Beauregard is in private practice in Huntington, New York, and works with couples, families, and individuals, utilizing a client-centered, post-modern approach. She specializes in high-risk youth, families with children with disabilities, couples with sexual issues, LGBTQ couples and families, and children who are victims of sexual abuse. Ms. Beauregard is a certified equine assisted psychotherapist and specializes in using horses as a tool of emotional growth and learning. She is also certified in crisis prevention and intervention.

Different Approaches and Models of Family Therapy

Family Therapy, a different point of view

. When a child displays some acting out behavior, the explanation may be that he/she is “looking for attention,” has some learning disorder, is being mistreated, etc. These are all linear explanations. The family therapist tends to contextualize the behavior, looking for circular causality. The explanation tends to be more in context with the child’s family or larger school systems. Let’s look at how a structural family therapist might conceptualize this behavior.

A structural model of family therapy was first developed by Salvador Minuchin in the early 1970s. Professor George Simon has been teaching this model at the Saltzman Center since 1993. This model offers a blueprint for examining the process of family interactions. The structure of a family is conceptualized as the organized pattern in which family members interact. The clinician is directed to look for patterns as well as alliances and coalitions between family members. This is accomplished through a process known as enactments, during the family therapy sessions. When a misalignment of the subsystems prevents flexible functioning of the family, the clinician works to rearrange patterns of interaction by offering a wider range of behaviors to individual family members, with the hope of helping them change some of the rigid rules maintaining the problem. In our example of the acting out youngster, the structural family therapist notices “scapegoating” of the child. See Figure 1 (reprinted from Nichols, 2006).

Figure 1 represents a couple having difficulty resolving their own conflicts by diverting the focus of their concerns onto one of their children. This scapegoated child assumes the role of the reducer of conflict between his/her parents, resulting in the acting out behavior. Therapy would not merely suggest a behavior modification chart for the child, but would include a focus on the couple’s marital and parenting issues.

A post-modern assessment of the presenting problem:

Given a similar presenting problem, other supervisors at the Marriage and Family Clinic might approach the assessment and intervention differently. Both Professors Seifer and Cohan, who ascribe to a solution-focused model of family therapy, would perhaps direct their students to have family members detail times when the problem was not happening or was happening to a lesser extent. They would have the parents cite examples of times when the child was behaving better and notice what was different about those times. (Was the couple less conflicted? Were other siblings present? Did a certain activity precede the improved behavior?) The family would then be encouraged to amplify or exaggerate the times when the problem was NOT occurring. Another post-modern approach, often utilized by Dr. Askew with her students, is a narrative model. With this model, the family, with the help of the therapist, would be assisted in co-creating a slightly different story about the child’s behavior. The therapist would externalize the problem for the family members so they could unify their forces against it.

Current Activities: Groups:

In addition to the counseling services provided to family members, the Marriage and Family Therapy Clinic also facilitates psychoeducational and support groups for community members. These varied groups cover many diverse topics, and they have evolved out of particular student interests as well as community needs. As an example, one of the clinic’s most popular groups was the midlife group, begun by a “more mature” student who was interested in the topic. The group ran for a number of years, and its members maintained continuing relationships beyond their experiences at the Saltzman Center. Similarly, the women’s empowerment group began with two dedicated female interns, and continues today long after these students graduated. Currently, a student involved in his own family’s successful business is formulating a support group for community members involved in their own family businesses.

In response to the Nassau County Court System, and general community demand, the Marriage and Family Therapy Clinic has, at various times, provided the following services: parenting groups, parenting through divorce group, divorce support group, and supervised visitations.

As a multidisciplinary facility, the Saltzman Center clinics often work collaboratively to enhance each entity’s services. Several outgrowths of these sorts of collaborations have utilized the services of the Marriage and Family Therapy Clinic and have resulted in the following groups, which run when there is a demand: autism support group (for families with a child on the Autism spectrum), caring for caregivers group (for spouses of aphasia patients being seen in the Speech/Language/Hearing Clinic), families with children with disabilities group (taking referrals from within and outside of the center), and the mother/ daughter group (an extension of a program developed by the Reading/ Writing Learning Clinic).

Other areas of interest that have resulted in groups and workshops include:

  • Bereavement
  • Couples/intimacy group
  • Domestic abuse
  • Premarital group
  • Self-esteem group
  • Stress management and the family
  • LGBTQ family support
  • Teen talk group

Case Study:

Marriage and family therapists provide treatment for a host of relationship issues. Typical cases treated at the Marriage and Family Therapy Clinic involve couple difficulties, parenting, and the strife associated with the divorce process. The following case involved divorce, co-parenting, extramarital affairs, self-destructive behaviors, and, finally, a readjustment to life after divorce.

When Robert and Barbara (pseudonyms) were married 15 years ago, their future looked bright. He was an aspiring professional, and she was gainfully employed. A few years later, after he had opened his private practice, Barbara became pregnant with their first child. Another child came along a few years later. Barbara enjoyed her new role as a full-time, stay-at-home mom, while Robert maintained the somewhat traditional role as the family breadwinner. As Robert’s practice became less lucrative, he became more withdrawn. Both partners, rather than supporting one another, succumbed to the stress and turned away from each other. They retreated into Internet affairs and impulse shopping. The stress in their lives mounted, as did their debt. They eventually filed for divorce and were referred to the Marriage and Family Therapy Clinic at the Saltzman Community Services Center for help with co-parenting their children through a highly contentious situation.

The years of stress and mutual degradation had eroded their sense of themselves as a couple and as individuals. Their couple sessions devolved into shouting matches and name-calling. They were not willing, at this point in their lives, to put their issues on hold, not even for the sake of their children. Robert decided to discontinue therapy.

As Barbara continued to come in for sessions with her therapist, she used the time to vent and complain about her situation and portrayed herself as a victim. She reported that she felt better after her sessions with the therapist. However, the clinician saw the need to move her along and help her restore a sense of competency and self-worth. Solution-focused therapy was utilized.

Solution-focused therapy was developed by family therapists Steve deShazer, Bill O’Hanlon, Insoo Berg and Michelle Weiner-Davis. The model of therapy uses a competency-based approach rather than a deficit-based one. It looks for times when the problem is not present (exceptions), amplifies those times, and presents a glass half-full, rather than half-empty, assessment to the client. This reminds clients that the solutions are within themselves, since there had been times when they were already applying their own solutions but are now mired in their problem-saturated stories. In the above-cited case, Barbara was asked about times when she felt better about her relationship and about herself. She noted that she hadn’t felt competent since she stopped working. She also noticed that her self-worth was primarily based upon other peoples’ assessment of her achievements rather than upon her own.

The therapist focused the discussions onto times when the problems were not happening (exceptions). For example, it was noted that Barbara had actually been paid recently for participating in various surveys and clinical trials. She managed to save the money, and her sense of accomplishment for having done so was recognized, highlighted and amplified by the therapist. During this time, the problem (being a victim) was not happening, or was happening to a lesser extent. Noticing this, Barbara discovered the possibility for change. Almost immediately after this session, Barbara determined that she needed to find a job so that she could support herself and not remain dependent upon her ex-husband. Asked how she would do this, Barbara came up with a plan for securing a job and did so within one month. At present, she is employed, working off her debt, and feeling more competent and more confident. The issues with the children have improved, largely due to the fact that Barbara’s dependency on her husband has eased off. She is better able to handle the bickering at home and is moving forward with her life

Future of the Field and the ClinicThe field of marriage and family therapy is currently directed toward prediction and prevention of traumatic life experiences. Much like earthquakes and other natural disasters, devastation may be preventable if we have an awareness that some event is likely to occur. John Gottman (1994) has done the most extensive research in the areas of marital satisfaction and domestic violence. Others such as Carter and McGoldrick (2004) and Stith and colleaques (2003) have contributed to these areas of study as well, providing insight into predictable cycles of relational behavior.

The Marriage and Family Therapy Clinic is interested in pursuing research initiatives, particularly in the areas of pre-marital counseling and the prevention of domestic violence. External funding opportunities are continually being sought to facilitate these projects, an example of which is the Safe Homes Project, recently acknowledged by a gift to the Marriage and Family Therapy Clinic from the Target Corporation. As our burgeoning field continues to grow and develop, the Marriage and Family Therapy Clinic looks forward to an exciting future as an integral part of the Saltzman Center. Our students are eager to learn about and practice within the profession, and the clinic continues to expand its services to the community.

References

Carter, B., & McGoldrick, M. (2004). The Expanded Family Life Cycle. Boston, MA: Allyn & Bacon.

Gottman, J.M. (1994). Why Marriages Succeed or Fail: And How You Can Make Yours Last. New York: Simon & Schuster.

Nichols, M.P. (2006). Family Therapy Concepts and Methods. Boston, MA: Allyn & Bacon.

Sholevar, G.P. (2003). Family theory and therapy. In Sholevar, G.P., & Schwoeri, L.D. Textbook of Family and Couples Therapy: Clinical Applications. Washington, DC: American Psychiatric Publishing Inc.

Stith, S.M., Rosen, K.H., & McCollum, E.E. (2003). Effectiveness of couples treatment for spouse abuse. Journal of Marital & Family Therapy 29 (3).

Psychotherapy Networker. (2007, March/April). The top 10: The most influential therapists of the past quarter-century.

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