Sharon Fitzgerald, Ph.D., is a 2019 graduate of the PhD Program in Marriage and Family Therapy at Antioch University, New England

Dissertation Committee:

  • Kevin Lyness, PhD, Committee Chair
  • Megan Murphy, PhD, Committee Member
  • Barbara Andrews, PhD, Committee Member


home-based family therapy, professional agency, professionalism, reflective practice, professional role

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Since the 1980’s there has been a proliferation of home and community-based mental health services developed to meet the needs of families with children with severe emotional or behavioral problems as an alternative to residential or institutional placement (Macchi & O’Connor, 2010; Zarski, Pastore, Way, & Shepler, 1988). Despite this long history, home-based family therapists are still trying to define best practices for home-based family therapy (HBFT). In the literature, the management of professional roles has been defined as a practice element worthy of attention. For instance, in an analysis of home-based programs, researchers identified providers having multiple roles as one of nine program elements that were effective in preventing placement of youth with behavioral and mental health needs (Lee et al., 2014). However, studies of clinicians providing HBFT indicate that multiple roles and associated boundary issues often present ethical challenges (Snyder & McCollum, 1999; Stinchfield, 2004; Worth & Blow, 2010). A constructivist grounded theory methodology was followed to address the question: How do marriage and family therapists manage multiple professional roles in the context of providing home-based family therapy? Twelve MFTs with experience in HBFT participated in semi-structured interviews, contributing their experience and knowledge to the construction of a pragmatic model of being professional and cultivating professional agency. Six agentic practices were identified, labeled as reflective, communicative, adaptive, proactive, relational, and sustaining practices. This model contributes to understanding professionalism in home-based family therapy and adds to the broader discussion of managing multiple roles other multi-disciplinary settings.


Sharon Fitzgerald

ORCID Scholar ID# 0000-0002-1237-8110