Effecting Third Order Change in Therapy Using Socioculturally Attuned Family Therapy to Address Power and Create More Loving and Equitable Relationships

In this episode, Carmen discusses her work in family therapy and her Socioculturally Attuned Family Therapy. Carmen shared that she entered the field when there were feminist critiques of family therapy and a focus on power in the therapeutic relationship. She explained that she went to Loma Linda University to direct the family therapy doctoral program, and worked with Douglas Huenerardt, Ph.D. doing cotherapy. They invited students to observe, and their goal was to be able to articulate the work they were doing, and later finalized it into a research study. She explained that the model that evolved out of that work was named Socioemotional Relationship Therapy. Later, she moved to Oregon to teach at Lewis and Clark College, and worked with Teresa McDowell, EdD, LMFT, and wrote the textbook, Socioculturally Attuned Family Therapy, with Teresa and Maria Bermudez, Ph.D., LMFT. We discussed how Carmen’s background in sociology led her to always be thinking about sociocultural aspects and how they play out in relationships. She explained that Teresa introduced the idea of Third Order Thinking or Third Order Change to her, which goes beyond the Systemic concept of Second Order change, to bring awareness to the therapist and client of how the sociocultural system the relationships are embedded in and influence their experiences. She also discussed how this helps therapists be aware of how they are accountable for possibly unknowingly reinforcing and repeating larger societal patterns. Carmen discussed the Socio-Emotional Relationship Therapy Model and how it is influenced by experiential, structural therapy, and social constructionist theory and technique, while centering sociocultural awareness. She discussed how emotions are the window into the larger context by helping us see the thinking that is happening and how that thinking may be a product of social-cultural influences. She also discusses the role of power in the model, and being aware of how that determines what is important, what is valued and the meaning of things, and seeing how power plays out in the couple or family dynamics. She explained that they operationalize relational equity as the Circle of Care, which consists of four parts: 1) Mutual Vulnerability - openness and willingness to admit mistakes, safe to express one’s sensitivities, 2) Mutual Attunement - that each person is aware of the other person and their needs, as often the person with more power is less attuned, 3) Mutual Influence - whose interests are organizing the relationship and whether there is a willingness to be influenced, and 4) Shared Relational Responsibility - where both are taking responsibility for the wellbeing of the relationship. Carmen discusses how when these are balanced, there is a more equitable relationship, and by the therapist’s awareness of power, they can support the changes in the relationship to be more equitable and mutually supportive. Carmen Knudson-Martin, Ph.D., LMFT is a professor emerita in the Marriage, Couple, and Family Therapy program at Lewis and Clark College. Her scholarship focuses on how the larger social context influences health and well-being and how therapists can address the inequities that result. Carmen especially loves working with couples and is widely recognized for her work regarding gender, marital equality, and relational health. She is a founder of Socio-Emotional Relationship Therapy, an approach that attends to the ways couple interaction, emotion, and socio-cultural context come together in clinical process. Carmen’s teaching and practice are based on her conviction that how therapists conceptualize client concerns is an ethical issue and that clinical practices have consequences that are never neutral. Carmen is an AAMFT approved supervisor and licensed MFT. She served as an associate editor of the Journal of Marital and Family Therapy, vice-president of the Family Process Institute, board member of the American Family Therapy Academy (AFTA), and president of the California Division of the American Association for Marital and Family Therapy (AAMFT-CA). She is currently editor of the AFTA Springer Series in Family Therapy. Prior to coming to Lewis and Clark, she directed family therapy programs at Loma Linda University in Southern California, Montana State University, and Valdosta State University in Georgia.