Family therapy and psychosomatic illness

The author suggests that clinical experience has developed to the point where the question can be asked, “Is a specific psychosomatic illness responsive to a specific type of family therapy?” Examples such as structural family therapy in childhood diabetes, asthma, pain, and anorexia nervosa; cognitive family therapy in adult chronic pain; and marital group behaviour modification in adult obesity, chronic pain, and myocardial infarction, are critically reviewed. The evidence suggests, but does not yet prove, that specific types of marital and family therapy may be effective in a few specific psychosomatic problems, a useful adjunctive therapy in some psychosomatic problems, and that family assessment is helpful in the management of all psychosomatic problems.     

Fairy-tales and teaching family therapy

This paper sets out to illustrate how well-known fairy-tales can be adapted to serve as a useful teaching tool in family therapy. Familiarity with fairy stories means they can be used as a ready access to common family constellations and dynamics. This may be particularly useful when asked to present an introductory workshop or single lecture to participants unsophisticated in family therapy conceptualizations or practice. Potential clinical applications are also briefly mentioned.     

Tigers are something else: A case for family play

This paper is an attempt to bridge the two worlds of family therapy and filial play therapy, introducing the complementary idea of play in therapy. Family play therapy challenges the idea that play is only useful in the treatment of children. Clinical examples are given and uses of play are discussed, including evaluation, play as a therapeutic tool, and the development of themes. The authors believe that therapists who are willing to be playful offer their clients a new world of therapeutic experiences.     

The complaining client and the troubled therapist: a discursive investigation of family therapy

In this paper I examine two important issues for family therapy research. I attend to the concept of complaints, highlighting the conversational structure they take in a family therapy setting. I do this by outlining how clients construct their complaints and examining how the family therapist receives them. Data is taken from a corpus containing four different families and two different therapists, and is subjected to discursive analysis in order to provide a rich analysis of not just what is happening in the talk but how it is happening. I conclude that complaints are not received as useful to the therapeutic process, despite their constructed importance to the client, and therefore there are wider implications for therapy and professionals more generally, particularly implications for multi-agency communication.     

A Re-Examination of the Current Status and Future of Family Therapy in India

Marital and family counseling has existed in India for many decades. However, the formalized discipline of marital and family counseling/therapy has its theoretical foundation in the West. The purpose of this paper is to present an overview of the need for and the current status of the practice of marriage and family therapy (MFT) in India. Based on our limited experiences we have attempted to prognosticate the future of the profession of family therapy in India by proposing a number of salient issues that we think would be useful discussion points as the development and advancement of family therapy in India is considered.     

New branches on the Tree of Knowledge. Challenges for systemic family therapists

Faced with today's challenges, I question whether the framework for family therapy provided by systemic thinking is sufficient when working with children and teenagers. The aim of this paper is not to argue for an eclectic model for therapy, but rather to encourage a critical dialogue between various bodies of knowledge. The paper raises the discussion of how family therapists relate to knowledge external to the therapy field. Contemporary developmental psychology, neurobiology, behavioural genetics and group socialization theory are highlighted as useful bodies of knowledge for family therapists. Examples from clinical practice are used to illustrate this.     

How to Talk to Christian Clients About Their Spiritual Lives: Insights From Postmodern Family Therapy

Responding to literature calling for the integration of Christian spirituality and postmodern thinking, this article presents a more specific discussion of how postmodern family therapy approaches can be used to open therapy to the spiritual lives of Christian clients. In this article, postmodern family therapy approaches are described and the compatibility of postmodern family therapies and Christian thinking are examined. Finally, we see how a clinical practice based upon postmodern ideas can provide pastoral counselors with useful tools for talking with Christian clients about their spiritual lives. P. Gregg Blanton is Professor of Human Services at Montreat College. He is affiliated with the Pastoral Counseling and Growth Center in Asheville, NC.     

Mind-Body Patterns of Symptom Generation

Effective ways for joining family therapy with other treatment modalities are becoming increasingly important as the efficacy of family therapy gains acceptance in the medical and mental health community. When one interfaces family therapy with medical and psychopharmacological treatments, which find the sources of symptoms within individuals, rather than interpersonal systems, careful attention must be paid to the mind and body relationships that guide interactions between family behavior and the somatic physiology of each family member. We present six mind-body patterns of symptom generation found to be particularly useful for designing multimodality treatments and for communicating the treatment rationale to medical and psychiatric clinicians or to family members. Case examples illustrate their clinical use.     

Reading Against the Lines: Resisting Foreclosure in Therapy Discourse

In this article, it is noted that poststructural ideas can be useful tools in fostering reflexivity and creativity for clinicians. By examining the process of meaning construction, clinicians can detach from repetitive interpretations of therapy discourse that lead to conversational closure. Four strategies for guiding a reading of family therapy interaction are presented: incitement to discourse, deconstruction, normativity, and the cultural grid of intelligibility. These strategies are used to describe examples of marital therapy discourse. By learning to read therapy as discourse, clinicians may critically examine how meaning is constructed and use that awareness to foster therapeutic conversations.     

Relating therapy with individuals, couples and families

This paper introduces a theoretical system within which relating behaviour may be defined, classified and measured. It is emphasized that a person both relates to and is related to by others. Relating may be of a positive or negative kind, and it is argued that the object of psychotherapy is both to eliminate the person's negative relating and enable the person to tolerate the negative relating of others. The term 'interrelating' is used to refer to the combination of relating and being related to of two people. Couple therapy is aimed at correcting the negative interrelating of partners, and family therapy is aimed at improving the interrelating of pairs of family members. A set of questionnaires based upon the theoretical system is introduced. These measure the negative relating of individuals and negative interrelating between individuals, and are proposed as useful adjuncts to individual, couple and family therapy.     

Sexual counseling and therapy

Abstract

This article is an edited version of four interviews conducted with Dr. Ivan Boszormenyi-Nagy in the Spring of 1980. The interviews ranged in content from Dr. Nagy's early training and influences to the theoretical and clinical foundations of contextual family therapy. This article focuses on the major constructs of contextual family therapy. Since this approach is often viewed as highly theoretical and conceptual in nature, it may be helpful to the practitioner to see how Dr. Nagy uses these constructs in a clinical situation. As a practitioner, I have found his theory extremely useful in conceptualizing the family system, and also in developing a treatment strategy. Hopefully, the questions asked of Dr. Nagy in these interviews will be of interest to other family therapists who are concerned with the clinical aspects of family therapy theories.     

Anomic depression and the migrating family

Anomic family depression is a form of depression which occurs in reaction to a disruption in a family's ability to discover a sense of meaning and purpose in life. Anomic depression often occurs during times of family migration where there is an increased danger of a disruption in the family's traditional methods of discovering and experiencing meaning. Existential family therapy utilizing network intervention, social skills training, and existential reflection is frequently a useful form of treatment in this kind of practice situation.James Lantz, PhD, and Karen Harper, PhD, are assistant professors at The Ohio State University College of Social Work and serve as family therapy practitioners and consultants at The Midwest Institute for Advanced Study in Existential Family Study.     

The limits of systems therapy: The problem of intimacy

By placing so much emphasis on systemic thinking, marriage and family therapists have lost sight of the individual within the system. One of the limits of a systemic therapy is its capacity to deal with problems in intimacy, a central problem in marital therapy. A knowledge of individual development is crucial for family therapists. The two themes dealt with in this paper are 1) some concepts of self psychology which can be useful in understanding the fear of intimacy, and 2) at what point, in couples' therapy, it is advisable to shift to individual therapy for one or both partners.     

An Index for Measuring Agency Involvement in Family Therapy

The Progress Index for Family Therapy Programs, an instrument for measuring the relative level of involvement in family therapy by treatment programs, is presented. It was developed as part of a national survey on the use of family therapy for treating drug abuse and includes data from 500 agencies, 76 of which were Community Mental Health Centers. The Index may be useful for assessing extent of family therapy involvement for differing agencies treating different populations.     

Training in family therapy: perceptual, conceptual and executive skills.

This paper presents a comprehensive and detailed outline of family therapy skills to aid in providing a more precise focus in the training of clinicians in family therapy. The skills are based on an integrated treatment model within a systems framework. Four major functions performed by a family therapist are separated and are further differentiated into general therapeutic competencies. Specific perceptual, conceptual, and executive skills are described in the form of instructional objectives and are listed under each competency. Occasional clarifying notes or examples are cited along with particular skills. Clinicians and trainees should find this outline a useful guide in skill development.     

Deconstructing Agnes – externalization in systemic supervision

Externalization is seen in this paper as a valid and useful part of the process of clinical supervision in systemic family therapy training. We offer a discussion on the use of externalization based on an example from a supervision group on a London M.Sc. in Family Therapy. Externalizing practices are located in the context of a postmodern perspective and narrative ideas within systemic family therapy. We explore the use of narrative ideas and the recursive relationship between theory, practice and the subjective experience of the trainee, within the practice of systemic supervision.     

Family Therapy With Irish-Americans

This paper presents a paradigm for understanding the cultural values and family patterns of Irish-American families and offers suggestions for clinical intervention. Families' correspondence to the model described will depend upon their level of acculturation, socioeconomic status, and other contextual factors. The paradigm suggests a number of issues that may create difficulties for the therapist and for the family in therapy. In general, behavioral techniques, Bowen systems therapy, and strategic interventions may be more useful than techniques emphasizing expression of emotions in therapy or direct attempts to alter communication or family behavior in therapy sessions, as used in structural therapy.