Published: April 24, 2018
According to three Marriage and Family Therapy (MFT) professionals from Pacific Oaks College, the expanded mindset of families and relationships have necessitated a notable evolution in the Marriage and Family Therapy program.
Dr. Bree Cook, Psy.D., has more than 13 years of experience training and managing in the fields of mental health substance abuse, co-occurring disorders, child welfare, juvenile justice, and providing social services to children and families. She currently serves as associate dean for the School of Cultural & Family Psychology at Pacific Oaks.
Cheryl Chisholm is an administrative faculty and clinical training coordinator in Pacific Oaks College’s School of Cultural & Family Psychology. Chisholm is currently studying for her doctorate in Community, Liberation, and Eco Psychologies. In 2009, she opened her private practice and continued to work in a psychosocial clubhouse in South Central Los Angeles for adults with chronic mental illnesses.
Dr. Lorene Jabola, Ph.D., has been involved in master and doctoral level marriage and family therapy programs since 1994, and is currently a core faculty member at Pacific Oaks. Dr. Jabola is the founding member (2009) of the Minnesota Psychoanalytic Society and Institute Psychotherapy Center (MPSI-PC).
Q: Marriage in the U.S. has been impacted by several societal shifts—generational, psychological, and socioeconomic—and some are even questioning the purpose of the institution. Do you believe that people care about marriage as much now as they did before or just in a different way?
Dr. Lorene Jabola: I think they still care about it. The concepts, the ideas, and the actual structures of families are what have changed more often. In a class I teach, “Theories of Marriage and Family Therapy,” one of the first big assignments is defining “What is family?” As far as the symbolism of marriage—as a long-term commitment to a particular relationship—I think that still stays pretty true and now includes more nontraditional couples. One example is the LGBTQI community. Marriage is just as important in culturally diverse contexts; hence seeing people fighting for marriage rights.
Dr. Bree Cook: Also, traditions have changed and evolved through the generations. Unless you are tied to a very strict religious group, or are very involved in a particular cultural community where marriage is common, the views on marriage probably have shifted some with younger generations. For example, the onetime belief that you had to get married when you were 19 or 20 years old doesn’t necessarily apply. In today’s society, you’re not required to marry someone just for conceiving a child with him or her. I’ve had several unmarried students who are in school and their families are wondering “What are you doing? When are you going to get married? Where are my grandkids?” We also have a lot of students who started their families young, but now their kids are older and they’re going back to school for their degrees and fulfilling other personal dreams like that.
Q: Yes, women are now more financially independent than ever before. For many, this has led to getting married later in life, or not at all. How do these shifts impact the counseling work that MFTs do with their patients?
Dr. Cook: Our job is to help individuals or couples discover and examine what they personally value, no matter what messages society is giving. We help them go deep inside and learn to listen to their own needs and desires. That hasn’t changed in the 40 years MFT has been a discipline within psychology. What I think has changed is MFTs need to continue to educate themselves about changes and trends in society so that when couples present things to us, it’s not the first time we’ve heard it.
Cheryl Chisholm: And one of those recent trends is getting past old rules that no longer pertain to them. As you mentioned, couples are marrying later in life. Women not only work, but they’re frequently finding jobs that bring them pleasure and meaning, and have no intention of giving them up. They’re also making similar salaries to their husbands and making big decisions such as whether to even have children or not. So what I see in the counseling room is people simply trying to figure out how they want to handle those conventions. Frequently they come in because there’s been friction about assumptions that each person in the relationship is making. A lot of the assumptions come from their family of origin. Couples have figured out that they are different from their families of origin, but they haven’t always figured out what that means for them and how to create their own picture of happiness, so they need help along the way.
Q: And not only are you helping couples, but also children. How does the conversation evolve when a couple is struggling, working through a divorce, or remarrying, and children are involved?
Dr. Jabola: Yes, we work with a lot of stepfamilies. The question becomes how is that couple going to team up as parents. Maybe one person doesn’t have a child and one does. So now the focus is not so much that they’re married. The focus is how are the child and stepparent going to get along. How do they nurture their relationship? That’s what MFTs focus on. Underneath the wrapping of what we know as marriage is the family. Our job is to understand the relational dynamics and what their life is like.
Chisholm: Also, children from the same family could handle the effects of divorce and other parental relationships in all kinds of different ways. One child might decide never to enter a committed relationship. Another child might constantly make efforts to have a really great permanent relationship but has failed. And still another might have continuous marriages that end in divorce. Each case is unique, depending on different temperaments of the children—and even whether you’re the first, second, or third child. When you compound that by a few generations of family dynamics on both sides of any particular couple we are working with, there is a lot to unpack in our sessions together. One of the most challenging situations we face is when physical violence is present in the home. That’s hugely negative for children and has a significant lasting impact on their ability to create healthy relationships as adults.
Q: Excellent point. How has the MFT program at Pacific Oaks taken this aspect—childhood trauma—into consideration?
Dr. Cook: We added our trauma specialization in 2014 to address all forms of trauma. We needed to create a cutting-edge program that caught up with the information that we’d been publishing. We now know PTSD doesn’t just affect veterans. PTSD can affect lots of people, including those involved in a car crash or a house fire. For children, it may be growing up in communities with lots of gun violence or domestic abuse. Childhood trauma can literally impact a child’s brain development as well. As mentioned, the effects of childhood trauma can lead to complex issues developing strong friendships and relationships later in life.
Q: Are there any other challenging situations that you face with patients on a more consistent basis nowadays?
Chisholm: One of the bigger problems we do see is that many single parents have no support. Many single parents are nowhere near their extended family or their blood family, which may also affect their children. And they may be in such an economic situation or social situation that they have not made the kinds of friends that they could really depend on for help.
Dr. Cook: And you need those nurturing relationships. Culturally there may be some common factors for the single parent who ends up with the bulk of the responsibility. Let’s say there’s a family with three kids. If one of those three kids is single, that’s usually the person—particularly for a single woman—who is going to end up being a caregiver for their parents. Along with Cheryl’s point regarding having economic and social support, humans are social beings. We need social interactions to survive. To put it simply, you need to have friends around who love you.
Q: Ultimately, what does success look like with your patients and how do you help MFT students at Pacific Oaks achieve it with their own future patients?
Chisholm: Our main goal is first to help them define the problem. And frequently simply defining the problem can be a goal in therapy. That may take a few weeks for them to open up and talk to us. They may have not even thought through their own issues. They just know something’s not working, and they’re unhappy or they’re in pain. So they have to figure out what it is they would like to achieve and what difference they would like to create in their lives.
Dr. Jabola: Ultimately, MFTs are relationship experts. That’s what makes our field stand out from other mental health fields. One of the unique characteristics at Pacific Oaks is that our students focus not only on the transformation of the client, but also on their own transformation as a therapist and a person. We require our students to participate in therapy as clients. In that way, they are embodying the idea of being agents of change and becoming a person who takes full responsibility for being a master of relationships—both their own and their clients.
Read articles from the Spring 2018 issue of Voices: