Cultural context model

1. Introduction

Version followed: the Cultural Context Model (CCM) as practised at the Institute for Family Services (IFS), Somerset, New Jersey, as written up in Hernández, Almeida & Dolan-Del Vecchio (2005, Family Process) and Hernández (2008, Training and Education in Professional Psychology). Where the two disagree, both are given. The fullest book account, Almeida, Dolan-Del Vecchio & Parker (2008), Transformative Family Therapy: Just Families in a Just Society, and Almeida's edited Liberation Based Healing Practices (2019) are not drawn on here [uncertain]. Points that rest on them only are marked [uncertain].

What it is. The CCM is a social-justice approach to family therapy. Rhea V. Almeida and colleagues developed it at IFS, which Almeida founded in 1986. The model came out of work with domestic violence and grew into a community-based treatment model for whole families [source: H2005; H2008; CCF interview; NCJRS abstract of the 1999 Violence Against Women article]. It is not a licensed, manualised protocol. It is a practice model plus a training tradition. Its wider name and movement is Liberation-Based Healing (LBH). LBH has an annual conference co-hosted by universities and community agencies, the fifth of which was held in 2010 with the UT Austin School of Social Work and SafePlace [source: UT news 2010; CCF interview]. No certification or licensing requirement for using the CCM name was found [uncertain]. Training has been given through IFS, through live supervision and through the LBH conferences [source: H2008; CCF interview].

How change happens. Personal and family problems are understood as embedded in social, economic and political contexts: gender, race, class, sexual orientation, immigration and colonisation. Healing is understood as liberation, and it happens in community rather than in the isolated family. Change moves through three linked processes:

• Critical consciousness: learning to see how one's own life is shaped by power, privilege and oppression. This is "the first and necessary step" [source: H2005 p.110].
• Accountability: taking responsibility for one's impact on others and making repair.
• Empowerment: gaining voice and "power with" others [source: H2005; H2008 p.10–13].

Most of the work is done in multi-family, gender-based "culture circles". Trained community members called "sponsors" take part in the circles alongside a therapist team [source: H2005 pp.107–110].

2. Framework

The CCM runs in a fixed sequence: intake, then socio-education, then culture circles. Couple and family sessions are added inside the culture-circle phase. Throughout, a team works with one therapist in the room and one or more behind a one-way mirror, using live supervision [source: H2005 pp.107–110; H2008 pp.11–12].

Criteria for moving between phases: suggested markers [synthesis]. The sources do not define these. In an adaptation, consider:

• Ready for culture circles: the client can name at least one way gender, race or class has shaped their family. They have presented a cultural genogram. They can listen to group feedback without leaving or attacking.
• Moving toward ending: a written accountability or empowerment letter has been delivered or completed. Repair is being made in behaviour, not only in words. Where violence was the issue, the partner independently reports safety. The client is using community supports outside sessions. Some former clients go on to sponsor.

Adapting to settings without the IFS infrastructure [synthesis]. In solo or small-team practice, approximate the model this way:

• Run a time-limited socio-education group alongside couple or family sessions.
• Recruit trained volunteer mentors only with proper screening and supervision.
• Use a reflecting colleague or video review where no one-way mirror is available.

State to clients that this is an adaptation of the CCM, not the full model.

3. Guiding principles

[source for 3.1–3.12: H2005; H2008; CCF interview; NCJRS abstract; principles 3.13–3.15 as marked]

1. Context before pathology. Read symptoms and conflict against social forces such as racism, sexism, heterosexism, class, immigration and colonisation. In practice: ask about social context in the first session; do not wait for the client to raise it.
2. Bring gender, race and sexuality into the foreground. Almeida argues these should be raised by the therapist rather than only when clients bring them up [source: CCF]. In practice: social-location questions are routine, not optional.
3. Critical consciousness comes first. Accountability and empowerment follow it, they do not precede it [source: H2005 p.110]. In practice: do not demand apologies or repair before the client can see the power pattern.
4. Accountability and empowerment are balanced. For men who batter, the model requires accountability for the abuse while supporting the empowerment of victims and children [source: NCJRS abstract]. In practice: the team behind the mirror watches whether a session is drifting toward blaming or toward excusing [source: H2005 p.109].
5. Healing happens in community. Problems are "only really solved in community" in the LBH framing [source: UT news 2010]. In practice: put multiple families in the same treatment setting; private sessions are the exception.
6. Do not group people by diagnosis. Grouping by presenting problem reinforces an identity built on pathology [source: H2005 p.107]. In practice: circles are mixed across problems. Participants share diverse life experiences rather than working toward a common symptom goal [source: CCF].
7. Gender-separated work first. Women and men develop critical consciousness at different paces [source: H2008 p.12]. In practice: begin in same-gender groups; bring mixed-gender work in after that.
8. Rights versus privileges. Rights secure necessities such as shelter and safety. Privileges are unearned advantages tied to identity [source: H2008 p.13]. In practice: help clients sort what they are entitled to from what they receive because of their position.
9. Accountability is relational and reparative. It means attending to one's impact on others, interpersonally and systemically, and taking reparative action that shows empathic concern [source: H2008 p.13]. In practice: repair is something done, not only something said.
10. Empowerment means power with others. Clients develop a voice and take part in challenging oppression [source: H2008 p.13]. In practice: support collective as well as individual action.
11. Three levels of analysis. Look at family experience, institutional processes, and global economic, immigration and military policy [source: H2005 pp.112–113]. In practice: trace a family problem outward to the institutions and policies that touch it.
12. Therapists are inside the analysis. Trainees and supervisors do their own cultural genograms, are held accountable for their own privilege, and attend to parallel process between client, trainee, supervisor, organisation and community [source: H2008 pp.12–15]. In practice: examine your own social location for every case.
13. Involve community leaders. Educators, faith and civic leaders and graduates are invited in as helpers and sponsors [source: H2005 p.108; CCF]. In practice: map the community resources the family can draw on.
14. Language reflects context. Therapists attend closely to their own language and to how it links to institutional contexts [source: H2005 p.110]. In practice: avoid framings that privatise or excuse abuse, such as "anger problem" or "cultural misunderstanding" [synthesis on the examples].
15. Safety of those with less power first [synthesis, consistent with principle 4]. In practice: any conjoint work with violence must be subordinate to the safety of victims and children. The sources do not give a written safety protocol [uncertain].

4. Intervention inventory

Scope: the sources describe the following procedures. Steps marked [synthesis] are my operationalisation of what the sources describe in outline. The IFS sources give no session scripts. All example language is illustrative unless it is quoted and cited.

4.1 Team intake with the whole family

• Purpose / when: the first contact for every family. It gathers the presenting problem from everyone, sets up the team frame and leads straight into group placement [source: H2005 p.107; H2008 p.11].
• Steps:
  1. Invite all household members to the first interview, including partners and older children [source: H2005; H2008].
  2. One therapist works in the room; a second observes behind a one-way mirror. Explain the mirror and the team at the start and get consent to observation [source: H2005 p.107; consent step is synthesis].
  3. Take each person's account of the presenting problem.
  4. Draw a basic genogram with everyone present (step 4.2).
  5. Introduce the power-and-control wheel and the genogram as the two information tools (step 4.3) [source: H2005 p.107].
  6. Screen privately for violence and coercion before any conjoint discussion of conflict [synthesis; the sources do not describe screening].
  7. Place each member in a same-gender socio-education group, ideally starting that day [source: H2005 p.107].
• Example language (illustrative): "We work as a team. A colleague behind the glass helps me notice things I might miss. We'll also ask about things families often aren't asked about: how being a man or a woman, your race, your money situation and your immigration story shape what happens at home."
• Watch for: one member speaking for everyone, often the person with more power; a partner who looks frightened or contradicts herself when the other is present. Do private safety checks. It is working when every member gives a version of the problem and accepts a group placement.

4.2 Basic genogram at intake

• Purpose / when: at intake, to map the family structure and start the information-gathering that the cultural genogram will deepen [source: H2005 p.107].
• Steps: draw at least three generations with the family present. Note migration, language, religion, class position, and who earns and who does care work. Mark known violence, addiction or cut-offs factually [synthesis on specific content; H2008 notes three generations for the later cultural genogram].
• Example language (illustrative): "Let's put your families on paper. Who came from where, and why? Who worked, and at what?"
• Watch for: gaps where a family will not name abuse or migration hardship. Do not push this in front of a possibly abusive partner; note it for the same-gender group.

4.3 Power-and-control wheels as orientation and assessment tools

• Purpose / when: at intake and in socio-education, to name patterns of domination concretely across physical, emotional, economic and other domains. Used together with genograms [source: H2005 p.107].
• Steps: show the wheel. Ask each person, separately where violence is possible, which spokes they recognise in their own relationships, families of origin and institutions [synthesis on procedure]. The sources do not specify which wheel versions IFS uses. Variants adapted for immigrant, same-sex or other relationships exist in the domestic-violence field, but their use at IFS was not confirmed [uncertain]. Use published wheels with attribution and do not alter them as if they were your own.
• Example language (illustrative): "This wheel lists ways people keep control in relationships: money, isolation, threats, using the children. Which of these have you seen, or done, or had done to you?"
• Watch for: minimising ("only once"), turning it into mutual blame, or a victim endorsing items and then retracting them in front of the partner. It is working when men start naming their own behaviours without being prompted.

4.4 Placement in multi-family, same-gender socio-education groups

• Purpose / when: after intake, for 8 weeks [source: H2005 p.107; H2008 p.11].
• Steps:
  1. Form groups of the same gender, and per Hernández (2008) of similar age, drawn from several families.
  2. Mix presenting problems deliberately; do not form diagnosis-based groups [source: H2005 p.107].
  3. Meet every other week [H2005] or weekly [H2008] [uncertain].
  4. Include sponsors where available.
  5. Where couples are in the programme, put partners in separate gender groups [synthesis consistent with the model].
• Example language (illustrative): "You'll start in a men's group with men from other families. It's not a group about one problem. It's about how we were raised to be men and what that costs the people around us, and us."
• Watch for: clients objecting that "my problem is different". Answer by framing the shared social context. It is working when members begin referring to each other's stories.

4.5 Socio-education: media-based critical consciousness teaching

• Purpose / when: the core content of the 8-week phase. Didactic material and discussion about how gender, class, ethnicity, race and sexual orientation shape relationships [source: H2005 pp.107–108; H2008 p.12].
• Materials named in the sources:
  • Film clips: Killing Us Softly, Men's Work, Dialogues With Mad Women, Aladdin, Pocahontas, Girl Fight, The Joy Luck Club, Monsoon Wedding, Bowling for Columbine, Desert Hearts [H2005]; Crash [H2008].
  • Song lyrics, books, articles, and sponsors' own narratives [H2005; H2008].
  • Videotapes of Muslim sponsors and Arab feminists [H2005 p.111].
• Steps [synthesis on sequencing]:
  1. Pick a short clip that fits the group's composition and an issue that is live in the group.
  2. Show it.
  3. Ask what messages about men, women, race, money or sexuality the clip carries.
  4. Ask where members learned similar messages: family, religion, school, media.
  5. Ask how those messages show up in their own home now.
  6. Ask a sponsor to give a short account of their own change.
  7. End with each member naming one observation to bring to their cultural genogram.
• Example questions: the sources give questions such as "In your culture, who is expected to educate children regarding the rules of relationships?" and "Who gets blamed when children do not follow these expected rules" [source: H2005 p.111, short quotes]. Illustrative follow-up: "What did that ad teach you about what a woman is for?"
• Watch for: intellectual debate that stays abstract; moving from stereotypes of other cultures to stereotypes of one's own. Receive challenges respectfully; the authors describe challenges being met with respectful reception [source: H2005 p.111]. It is working when members link the clip to a specific scene in their own lives. This follows Martín-Baró's stages, which the authors cite: decoding one's world, grasping how oppression works, then forming a new social identity [source: H2005 pp.110–111].

4.6 Cultural genogram

• Purpose / when: built in the socio-education groups and continued in the circles. It maps multigenerational legacies, gender and racial norms, and migration over time, emphasising legacies of oppression and privilege along with their shame and pride [source: H2005 p.107; H2008 pp.12–13; it adapts Hardy & Laszloffy 1995 and McGoldrick et al. 1999].
• Steps:
  1. Extend the intake genogram to three generations.
  2. For each generation, note: migration (why, under what conditions, what was lost); what men and women were expected to do; experiences of racism, colonisation, class mobility or loss; where the family held privilege; sources of pride and of shame.
  3. The client presents the genogram to the same-gender group, which asks questions.
  4. Link legacies explicitly to present patterns, and later to accountability and empowerment tasks [source for linking: H2008 p.15; details are synthesis].
• Example language (illustrative): "When your grandfather lost the farm, what happened to how he treated your grandmother? What did your father take from that about being a man?"
• Watch for: genograms used to excuse current behaviour ("my father hit, so..."). Name the difference between explaining a legacy and being accountable for continuing it. It is working when the client can hold both pride and responsibility.

4.7 Community circle presentation of legacies

• Purpose / when: at the end of socio-education. Intergenerational legacies and resilience are discussed before the whole community, so the community holds each person's story [source: H2005 p.107].
• Steps [synthesis on format]:
  1. Prepare each presenter in their same-gender group.
  2. The presenter gives a short account of key legacies and one resilience.
  3. Community members respond with what they heard and what they connect to.
  4. Never use this forum for disclosures that would put a victim at risk in front of a perpetrator.
• Example language (illustrative): "Tell the community one thing your family survived and one thing you don't want to pass on."
• Watch for: shame flooding; pressure on victims to disclose publicly. It is working when presenters report feeling witnessed rather than exposed.

4.8 Culture circles (same-gender and mixed-gender)

• Purpose / when: the main treatment format after socio-education; most of the therapy takes place here [source: H2005 pp.109–110]. A culture circle is a "heterogeneous helping community" of families, a therapist team and sponsors [source: H2008 p.11 fn.2].
• Steps:
  1. Alternate between same-gender and mixed-gender circles; Hernández (2008) says weekly [source: H2005; H2008].
  2. Seat one or two sponsors with newly entering families and longer-term members [source: H2005 p.109].
  3. Open with a check-in on the week, keeping attention on power and impact rather than events alone [synthesis].
  4. Work on one or two members' issues in depth, drawing in the circle's experience.
  5. Assign or review accountability and empowerment tasks: letters, reparations, rituals (4.13–4.19).
  6. Encourage members to build relationships within the circle and to contact sponsors often between meetings [source: H2005 p.109].
  7. The team behind the mirror consults during and after the session (4.10).
• Example language (illustrative): "Before you answer him, can the men in the room say what they hear in how he described his wife's 'nagging'?" or "Who in this circle has been where she is, and what helped?"
• Watch for: circles turning into venting without movement; senior members dominating; mixed-gender circles in which women go quiet. Move back to same-gender work if that happens [synthesis]. It is working when members challenge and support one another without the therapist prompting, and when solutions involve people outside the nuclear family.

4.9 Sponsorship

• Purpose / when: throughout treatment. Sponsors mentor family members in critical consciousness, model equitable relationships, break isolation and widen conversations about family life [source: H2005 pp.108–109]. Each family member is assigned a sponsor of the same gender [source: H2005 p.108].
• Who sponsors: adult community members, including programme graduates, clients in later stages, graduate students working as cultural consultants, and church or civic leaders [source: H2005 p.108].
• Training: 12 weeks of training in critical consciousness about oppression: institutional racism, male dominance, homophobia and class discrimination [source: H2005 p.108]. Selection criteria, payment and supervision arrangements are not given in the sources [uncertain]. A phenomenological study of female sponsors (Ryu 2010) found "critically-informed, progressive transformation" to be the core of the experience, with community and critical consciousness as central themes [source: Ryu 2010 abstract].
• Steps for setting up sponsorship [synthesis beyond the points above]:
  1. Screen candidates, including for their own history of perpetration and for current safety.
  2. Complete the critical-consciousness training.
  3. Agree role boundaries in writing: what sponsors may and may not do, confidentiality, no dual financial or romantic relationships, and when to escalate to the team.
  4. Introduce the sponsor to the client in a circle.
  5. Hold regular sponsor debriefs with the team.
• Example language (illustrative, sponsor to new member): "I sat where you're sitting. I thought I'd done nothing wrong. Call me this week if things heat up at home."
• Watch for: sponsors colluding with a man's minimising, rescuing a woman in ways that take over her decisions, or carrying risk information they don't pass to the team. It is working when clients contact their sponsor between sessions and quote their sponsor's perspective.

4.10 Live team consultation behind the mirror

• Purpose / when: at every stage. Observers help the therapist in the room balance accountability and empowerment, and give live supervision [source: H2005 p.109; H2008 p.11, p.15].
• Steps:
  1. Observers watch through the mirror and listen on the speaker system [source: H2008 p.15].
  2. They call in, or meet briefly mid-session, when the session tips toward blaming the less powerful person or excusing the more powerful one.
  3. They debrief after the session [source: H2005; H2008; call-in method is synthesis].
• Example language (illustrative, team message): "The team is struck that we've spent twenty minutes on her tone and none on his threats. We'd like to hear more about the threats."
• Watch for: the team voice being used to shame. Deliver it as curiosity about pattern.

4.11 Systemic cultural analysis (three levels)

• Purpose / when: in the circles, especially when building accountability. It traces a problem across three levels: (1) family experiences of oppression; (2) institutional processes; (3) global economic, immigration and military policy [source: H2005 pp.112–113].
• Steps [synthesis on sequencing]:
  1. Name the family-level event.
  2. Ask which institutions touched it: police, employer, school, immigration, courts, religious body.
  3. Ask which larger policies shaped those institutions.
  4. Return to the family: what is now each person's responsibility, and where can the community act?
• Example language (illustrative): "You lost your job the same month you started controlling the money at home. What was happening at work, and who decided that? And what does your wife lose when you take the bank card?"
• Watch for: the analysis being used to shift blame wholly onto systems. Always return to personal accountability (principle 4).

4.12 Rights versus privileges exercise

• Purpose / when: for clients with relative privilege, often men and white or middle-class clients, to distinguish entitlements everyone should have from unearned advantages [source: H2005 pp.112–113; H2008 p.13].
• Steps:
  1. Define rights (necessities such as safety and shelter) and privileges (unearned advantages based on identity).
  2. Use a daily-living comparison. The sources' example is comparing one's experience of walking outside with that of a man of color [source: H2005].
  3. Ask the client to list privileges he uses at home, such as free time, not doing the second shift, or financial control.
  4. Link the list to reparations (4.14).
• Example language (illustrative): "Walking to your car at night, what do you think about? Now imagine your wife doing the same, or a young Black man in this town. What's a right here, and what's a privilege?"
• Watch for: defensiveness ("I worked for everything"). Validate effort and keep the distinction. It is working when clients name a privilege unprompted.

4.13 Letter of accountability

• Purpose / when: once the client can name the harm and its context. A written acknowledgment of responsibilities and impact, addressed to the person harmed and read in a circle or session [source: H2005 pp.113–114; H2008 p.13, where a man read his letter acknowledging responsibilities to his ex-wife and adult children].
• Steps [synthesis on drafting]:
  1. The client drafts the letter with his same-gender circle and sponsor. It should name specific behaviours, their effects, the social messages that supported them (without excusing), and the repair he will make.
  2. The circle critiques drafts for minimising, self-pity or demands for forgiveness.
  3. The letter is read aloud in circle.
  4. It is shared with the recipient only with her informed consent, at a time she chooses and with safety assessed. She owes no response.
• Example language (illustrative, therapist): "Read it again and take out every sentence that asks her to understand you. What's left?"
• Watch for: letters used to pressure reconciliation. It is working when the letter is followed by a behavioural repair plan that is carried out. The same tool is used among trainees and staff [source: H2008 p.14].

4.14 Reparations (reparative action)

• Purpose / when: after accountability is acknowledged. Concrete action that shows empathic concern [source: H2008 p.13]. The source examples, all from H2005 pp.112–114:
  • A middle-class husband nurtures his wife and reconnects her with her family.
  • A working-class husband invites men from his circle into his home for help and arranges tutoring for his children from them.
  • A client involved with pornography and the sex industry wrote a letter of accountability, agreed to pay his partner a sum of money, and was encouraged to join a date-rape prevention programme.
• Steps [synthesis]:
  1. Ask the harmed person, through her own circle or therapist, what repair would matter.
  2. Turn it into specific, observable actions with a timeframe.
  3. Review them in circle.
  4. Check effect with the harmed person separately.
• Example language (illustrative): "What would she notice in the next month that told her you meant it?"
• Watch for: symbolic gestures standing in for stopping the harm; financial reparation used as leverage. It is working when the harmed person reports a change.

4.15 Mobilising the circle as a resource against institutional oppression

• Purpose / when: when a member faces discrimination or structural barriers. The circle acts collectively [source: H2005 p.114]. The source examples:
  • Men financially supported a member's legal action over police harassment.
  • Peers encouraged a father to consider alternative paths for his children.
  • Fluent peers helped a member with a language barrier at work to secure pay and benefits.
• Steps [synthesis]: name the barrier; ask who in the circle has knowledge, connections or skills; agree on specific help; report back.
• Example language (illustrative): "Who here has dealt with HR in English as a second language? What did you wish someone had done for you?"
• Watch for: boundary and dual-relationship problems, and dependence. The clinician coordinates; members act.

4.16 Letter of empowerment

• Purpose / when: for a person who was harmed or silenced, to claim voice toward a family member who hurt them, once enough support and safety are in place. The client writes a letter to the family member concerned [source: H2005 pp.114–116].
• Steps:
  1. Draft the letter with the same-gender circle and sponsor. It should name what happened, its effect, what the writer now knows about the context, and what she wants or no longer accepts [synthesis on content].
  2. Read it in circle.
  3. The writer decides whether to send it, read it in a session, or keep it.
• Case (paraphrased from H2005): Couple work with Sylvia included family-of-origin work. She and her sister confronted their father about his drinking and about sexualising them. After Sylvia divorced and came out, she wrote him a letter of empowerment.
• Example language (illustrative): "This letter is not to get him to change. It's to say out loud what you know now. What do you want him to hear even if he never answers?"
• Watch for: sending before the writer is ready, or contact that exposes her to retaliation. Sending is optional. It is working when the writer feels ownership whatever the response.

4.17 Circle letter or offer to a family member

• Purpose / when: to show collective support for an empowered client and offer the other person a route into accountability. In Sylvia's case, her men's circle wrote to her father offering ongoing contact. He declined to meet and turned down every offer. The authors held that the empowerment process still worked collectively [source: H2005 p.115].
• Steps [synthesis]: the circle drafts the letter together. The empowered client approves it. It is sent with the client's consent. Process the outcome in circle, whatever it is.
• Watch for: framing the work as a failure if the recipient refuses. The support given is the outcome.

4.18 Family-of-origin confrontation within couple or family work

• Purpose / when: when past abuse in the family of origin shapes the present relationship [source: H2005 pp.114–115].
• Steps [synthesis]:
  1. Prepare each confronting person in same-gender work.
  2. Agree what will be said and what outcome is hoped for.
  3. Confirm the confronting person can leave at any time.
  4. Have sponsors or circle members present for support.
  5. Debrief afterward.
• Watch for: retraumatisation, family retaliation and splits between siblings. Stop the session if the confronted person turns to intimidation.

4.19 Couple and family sessions witnessed by the community

• Purpose / when: occasional sessions inside the culture-circle phase. Sessions held with community members present widen the family's audience and support [source: H2005 p.109; H2008 p.11].
• Steps [synthesis]:
  1. Set the session agenda in the separate gender circles first.
  2. Invite sponsors and selected members.
  3. Hold the session.
  4. Ask the witnesses for brief reflections.
  5. Debrief each partner afterward in their own circle.
• Watch for: conjoint work with a violent partner where the victim is not safe to speak. Do not hold the session until a separate safety assessment supports it [synthesis].

4.20 Rituals

• Purpose / when: rituals are listed among circle tools [source: H2005 p.109]. Their content is not described in the sources [uncertain]. If you use them, design them with the family, for example to mark a completed accountability phase or a member becoming a sponsor. Do not borrow sacred ceremonies from other cultures [synthesis].

4.21 Coaching men in emotional expression and shared domestic labour

• Purpose / when: in men's circles. Supervisees are taught to help clients, especially men, express fear and sadness, and to address the "second shift" of household and care labour [source: H2008 p.13].
• Steps [synthesis]:
  1. When anger appears, ask what came before it.
  2. Have men name fear, shame or grief in the circle.
  3. Ask for an inventory of household and care tasks: who does what, and how many hours.
  4. Set concrete redistribution tasks and review them.
• Example language (illustrative): "Before you got loud, what were you afraid would happen?" or "List everything that had to happen for dinner and bedtime last night. Who did each one?"
• Watch for: emotional talk used to get sympathy instead of taking responsibility.

4.22 Referral to linked programmes

• Purpose / when: when a member needs focused work beyond the circles. In one case a man was encouraged to join a date-rape prevention programme [source: H2005 p.114]. Batterer intervention, substance treatment, legal advocacy and immigration services are synthesised extensions [synthesis].
• Steps: name the need, give a warm referral, get consent to share information, and keep the client in circle unless the referral replaces it.

4.23 Therapist and trainee self-work (training procedures)

• Purpose / when: for clinicians adopting the model. Therapists are subject to the same three processes as clients [source: H2008 pp.12–15].
• Steps (Hernández's supervision competencies, paraphrased):
  1. Share the philosophy of supervision through readings and discussion.
  2. Identify trainees' needs and explain how the model meets them.
  3. Build critical consciousness: observe first, then join socio-education.
  4. Coach the trainee's own cultural genogram and compare it with clients' genograms.
  5. Push trainees toward areas they know least. In one example, a Latina trainee was moved off Spanish-speaking-only caseloads [source: H2008 p.12].
  6. Discuss parallel process.
  7. Observe culture circles, then co-facilitate them.
  8. Present with supervisors at professional and activist conferences.
  9. Staff use accountability letters among themselves when there is harm, for example one postdoc speaking for another [source: H2008 p.14].
• Watch for: supervision power going unexamined. Hernández notes that power in training is not fully theorised and that there are no stage markers of competence [source: H2008 pp.15–16].

5. Handling problems

The sources say little about problems. Guidance is marked [source] where it comes from them and [synthesis] where it is my own.

• Family members decline to take part, or refuse repair. Keep working with those who stay. When Sylvia's father refused every contact, the circle's offer and her letter still counted as collective empowerment [source: H2005 p.115]. Tell clients early that the outcome does not depend on the other person agreeing [synthesis].
• Challenges and pushback in groups, such as "this is political, not therapy" or "you're attacking men". Receive challenges respectfully and keep them in the dialogue, rather than overriding them [source: H2005 p.111]. Concretely [synthesis]:
  • Reflect the objection.
  • Ask the circle, especially sponsors who once held the same view, to respond.
  • Return to the client's own genogram material rather than arguing theory.
• Minimising, blaming the victim, or using culture as an excuse ("in my culture men decide") [synthesis].
  • Distinguish culture from the domination practised in its name.
  • Bring in voices from within that culture who challenge it. The authors used videotapes of Muslim sponsors and Arab feminists in this way [source: H2005 p.111].
  • Use the rights-versus-privileges exercise (4.12).
  • Never accept cultural relativism as a reason to tolerate violence. The CCM's stated stance is accountability for batterers alongside empowerment for victims and children [source: NCJRS abstract].
• Domestic violence safety [synthesis; the sources describe no written safety protocol] [uncertain].
  • Screen each partner separately at intake.
  • Assess lethality risk with a validated structured tool used by your service.
  • Make safety plans with victims privately.
  • Keep the gender circles separate. Do not hold conjoint or witnessed sessions until the victim, assessed alone, says it is safe and there is no current coercion.
  • Coordinate with advocates, probation or the court where a case is mandated.
  • Follow mandatory reporting where children are exposed.
  • Never share what a victim has disclosed with the perpetrator's circle.
• Shame or overwhelm in the circle, for example during cultural genogram work, a public legacy presentation, or survivors hearing men's accounts [synthesis].
  • Slow down and move the material back to the same-gender group.
  • Let the person pass.
  • Have a sponsor sit with them.
  • Make all public disclosure voluntary.
  • Offer an individual check-in.
  • Screen for trauma symptoms and refer for trauma-focused treatment where needed, alongside the circles.
• Non-attendance or non-adherence to letters and reparations [synthesis].
  • Ask the sponsor to call.
  • Review the barrier in circle: work shifts, childcare, transport, immigration fears.
  • Break the task into smaller steps.
  • For mandated men, keep attendance and completion records factual and do not soften them.
• Sponsor problems: collusion, rescuing, boundary crossings, or sponsors taking on too much [synthesis].
  • Hold regular sponsor supervision.
  • Have a written role agreement.
  • Reassign the sponsor when there is a dual relationship.
  • Remove the sponsor role if a sponsor's own abuse comes to light.
• Ruptures between therapist and client around social location, for example a client of color dismissed by a white therapist, or a gay client's experience minimised. Hernández treats these as material for supervision and accountability. In one case a gay trainee's view of a lesbian couple was taken as expertise rather than dismissed, and staff use accountability letters among themselves [source: H2008 pp.13–15]. With clients [synthesis]:
  • Name the rupture.
  • Own your part, with a short spoken or written accountability.
  • Ask what repair would help.
  • Bring the issue into team consultation.
• Confidentiality in multi-family groups [synthesis].
  • Get written group agreements at intake.
  • Explain the limits: mandatory reporting, court involvement, and the fact that other members cannot be legally bound.
  • Take particular care with immigration status and sexual orientation.
  • Let clients choose what goes to the community circle.
• LGBTQ+, nonbinary or trans clients and the gender-separated format. The model includes sexual orientation and homophobia in its content [source: H2005; H2008]. How IFS places nonbinary or trans clients is not described [uncertain]. [synthesis] Ask the client which circle fits. Do not assign by sex recorded at birth. Prepare the circle so that heterosexism is challenged rather than performed.
• Clients who want individual therapy only, or private-practice settings without a community [synthesis].
  • Explain the rationale for community-based work.
  • Offer a stepwise route: individual or couple sessions that use cultural genograms, critical-consciousness questions and accountability or empowerment letters, while you build or refer to a group.
  • Be transparent that this is a partial adaptation.
• The work stays intellectual and does not reach behaviour [synthesis]. Move from questions about the clip to questions about last week. Require one concrete reparation or empowerment action per month, and track it in circle.
• Risk of overload on clients with less power, for example asking oppressed clients to educate the group about their oppression [synthesis]. Keep the work of explaining with the therapist team and sponsors, not with the most marginalised member.
• Suicide or self-harm risk emerging in circles [synthesis]. Follow standard risk assessment and safety planning in an individual meeting. Where needed, carry out lethal-means counselling on safe storage and removal. Inform the team. Do not process acute risk only in the group.

Sources

Sources:

• Hernández, P., Almeida, R., & Dolan-Del Vecchio, K. (2005). Critical consciousness, accountability, and empowerment: Key processes for helping families heal. Family Process, 44(1) (CSUN-hosted PDF) [H2005]
• Hernández, P. (2008). The cultural context model in clinical supervision. Training and Education in Professional Psychology, 2(1), 10–17 (Leeds-hosted PDF) [H2008]
• Council on Contemporary Families: interview with Rhea V. Almeida on Liberation Based Healing Practices [CCF]
• NCJRS abstract: Addressing culture in batterers intervention: the Asian Indian community as an illustrative example, Violence Against Women 5(6), 1999, 654–683. The page did not show the authors; the article is usually attributed to Almeida & Dolan-Del Vecchio [uncertain] [NCJRS abstract]
• Ryu, E. (2010). Sponsoring change in self and others (doctoral dissertation, Drexel University), record and abstract [Ryu 2010]
• UT News (2010). UT School of Social Work co-sponsors annual Liberation-Based Healing Conference [UT news 2010]
• Hernández, P., Siegel, A., & Almeida, R. (2009). The cultural context model: How does it facilitate couples' therapeutic change? JMFT, 35(1), 97–110 (bibliographic record only)
• Ackerman Institute: alumni lecture recap, Rhea Almeida on critical consciousness (background only)
• Case, M. E. (2008). Intimate partner violence and couple therapy: An integrative approach (Pacific University thesis record) (record only)

Further reading (not drawn on) [uncertain]:

• Almeida, R. V., Dolan-Del Vecchio, K., & Parker, L. (2008). Transformative Family Therapy: Just Families in a Just Society. Allyn & Bacon. This is the fullest primary account of the model.
• Almeida, R. V. (Ed.) (2019). Liberation Based Healing Practices.
• Almeida, R. V., & Durkin, T. (1999). The cultural context model: Therapy for couples with domestic violence. Journal of Marital and Family Therapy, 25(3).
• Almeida, R., Woods, R., Messineo, T., & Font, R. (1998). The cultural context model: An overview. In M. McGoldrick (Ed.), Re-Visioning Family Therapy. Guilford.
• Hardy, K. V., & Laszloffy, T. A. (1995). The cultural genogram. JMFT. Cited via H2008.
• McGoldrick, M., Gerson, R., & Shellenberger, S. (1999). Genograms: Assessment and Intervention. Norton. Cited via H2008.