Family Therapists' Response to AIDS: An Examination of Attitudes, Knowledge, and Contact

Article excerpt

As the numbers of individuals and families impacted by AIDS continue to multiply, family therapists will increasingly be asked to become engaged in the challenge of caring for those affected. To date, little has been written in family therapy journals regarding the response of family therapists to this crisis. This paper represents an initial attempt to examine the attitudes of clinical members of the American Association for Marriage and Family Therapy toward AIDS and persons with AIDS. Included in the study are data regarding the therapists' contact with persons with AIDS, gays, and lesbians, and the impact of such contact on attitudes. Implications for future research, training, and treatment of those affected by AIDS are also provided.

As the impact of the AIDS epidemic takes an increasing toll on families, it might be expected that family therapists would have actively and visibly joined the ranks of those professionals who work daily with the emotional, relational, and social crises fostered by the disease. However actively they may have worked with persons with AIDS (PWAs) in their practices, in their communities, and in authoring both popular and clinical books, family therapists have been curiously silent in their own professional journals. The Journal of Marital and Family Therapy (JMFT) received no submissions related to AIDS during 1991 (Sprenkle, 1992), and an informal survey of major family therapy journals over the past 5 years indicates that this minitrend is consistent. Family Process published no articles regarding AIDS from 1987 to 1992. Similarly, there were no articles relating to AIDS published in Family Therapy, Journal of Strategic and Systemic Therapies, American Journal of family Therapy, or Contemporary Family Therapy during the same time period. One article about AIDS was published in JMFT during this time (Maloney, 1988). The Journal of family Therapy published two AIDS-related articles in the past 5 years (Bor, Elford, Perry, & Miller, 1988; Bor, Perry, & Miller, 1989); Family Systems Medicine published five (Ackerman, 1989; Bor, Miller, & Perry, 1988; Demb, 1989, 1990; Walker, 1991). It is striking that three of these eight articles were contributed by the same group of British authors.

When compared with the multitude of AIDS-related articles which have been published in various other mental health journals, particularly those detailing clinical approaches to working with PWAs (Allers & Katrin, 1988; Barrett, 1989; Carballo-Dieguez, 1989; Cohen, 1990; Martin, 1989; Perry, 1989; Ybarra, 1991), the gap in the family therapy field becomes even more disturbing. It is important to note, however, that the lack of attention to the issue of AIDS in the field of family therapy parallels the silence in the field regarding sexual issues in general, and may be in some way connected with the apparent reluctance of family therapists to discuss sexuality in professional journals and to address sexual issues in their practices. A recent decade review of three major family therapy journals and two major sex therapy journals found only six articles published between 1980 and 1990 which discussed systemic approaches to treating sexual issues (Zimmerman & Darden, 1991). As noted in a recent issue of the American Association for Marriage and Family Therapy newspaper, Family Therapy News, family therapists have tended to refer clients who present with sexual issues to sex therapists rather than treat those issues from a systemic perspective (Goldberg, 1992). Since the issue of AIDS often brings up topics regarding specific sexual behaviors in addition to sexual orientation, it is possible that family therapists' reluctance to deal with sexual issues may encourage them to refer PWAs to other professionals in the community. As noted by Hof (quoted in Goldberg, 1992), "family therapists have dealt with human sexuality hardly at all" (p. 1).

Although a reluctance to deal directly with sexual issues in the therapy room may preclude the likelihood of working extensively with PWAs, it remains unclear whether the limited number of articles addressing AIDS accurately reflects the extent of family therapists' experience with PWAs and their families. …