Further Thoughts on Second-Order Family Therapy — This Time It's Personal

A series of articles has recently appeared in which implications of second-order cybernetics for the practice of family therapy have been discussed. In this article, we attempt to advance the discussion by addressing ideas that we think have not been adequately emphasized thus far. Specifically proposed are ideas about conditions that might facilitate the emergence of consciously pragmatic strategy informed by the kind of systemic wisdom that delicately balances natural systems without the benefit of human planning. It is argued that a shift in the personal habits of knowing and acting that typically organize individual human experience is required. After attempting to specify what this shift might involve, implications of these ideas for the practice of family therapy and for human action in general are discussed.     

The use of the self in group leadership: a relational perspective

This article, written from a relational perspective, describes a shift that is taking place in the thinking of many psychodynamically oriented psychotherapists regarding the practice of therapy and the implications it has for group therapists. The shift, from one-person to two-person and multi-person theory, has particular importance for group leaders since it recommends making the subjective involvement of the therapist in the interactional field of the group much more a part of the treatment process. Theory and research on the use of countertransference, non-interpretive interventions, humor, and spontaneity by the leader are reviewed and vignettes are presented to illustrate the application of these ideas. Guidelines regarding the application of such ideas in group therapy are also discussed.     

Honouring our great grandparents: towards a rhetorical analysis of family therapy

This paper argues that family therapy is an inherently and inescapably rhetorical activity, although its connections with rhetoric have remained largely ignored and the implications for practice unexplored. An uncritical acceptance of a range of postmodern ideas has led many family therapists to ignore the power of their therapeutic rhetoric. The paper offers rhetorical analysis as a tool to help family therapists to reflect on the rhetorical power of their practice and thereby to exercise this power more responsibly.     

Race,racism and systemic supervision

The idea of ‘race’ and the social reality of racism have gained increasing attention in family and systemic psychotherapy. This article seeks to extend this attention by focusing upon the influence of race and racism in the supervision of family and systemic psychotherapy. The way in which the idea of race might be conceptualized is discussed, before looking at how race and racism have been addressed in the field. Attention is then turned to systemic supervision, focusing upon the ideas generated about how supervisors might position themselves in relation to these issues, the implications this might have for the supervisory relationship and the relationships between supervisees and client families. It is proposed that by virtue of the supervisor's position of power over the supervisee, it is the supervisor's responsibility to initiate conversations about race and racism. A proposal for this task is outlined, which recognizes that these conversations are ongoing. A concluding assertion is made that such conversations should form part of the evaluative process for trainee supervisors.     

Lesbians,gay men and family therapy: a contradiction in terms?

This paper seeks to review the history of discussions about lesbian and gay male sexuality in family therapy theory and practice. It examines whether homophobic and heterosexist attitudes are present in family therapy thinking. Possible connections are explored between attitudes towards lesbian and gay issues and the professional backgrounds of family therapists, wider debates on homosexuality within society, and conceptualizations of the family life cycle. The question of why relatively little has been written on the issues raised by lesbians, bisexuals and gay men in therapy is discussed. The implications of this oversight on practice are addressed and suggestions made for future work.     

The crucial roles of attachment in family therapy

This paper's aim is to enable family therapists from whatever approach to address family attachments during their work. It explores the role of attachment in the family, and how to enable therapists to increase security in the family so that family members can solve their own problems during and after therapy. The article gives a brief overview of the nature of family attachment relationships and the influence of secure and insecure attachments within the family and their narrative styles. This is described in language that a therapist might readily hold in mind and share the ideas in dialogue with families. The paper discusses the interplay between insecure attachments and other family problems, such as parental conflict and disagreements over authority. It also discusses ways of establishing a secure therapeutic base and the influence of the therapist's own attachment style. The implications for family therapy practice are described and illustrated by work with a specific family.     

Objective Evaluation of the Process and Effects of Analytic Group Psychotherapy with Adolescent Girls

This article, written from a relational perspective, describes a shift that is taking place in the thinking of many psychodynamically oriented psychotherapists regarding the practice of therapy and the implications it has for group therapists. The shift, from one-person to two-person and multiperson theory, has particular importance for group leaders since it recommends making the subjective involvement of the therapist in the interactional field of the group much more a part of the treatment process. Theory and research on the use of countertransference, noninterpretive interventions, humor, and spontaneity by the leader are reviewed and vignettes are presented to illustrate the application of these ideas. Guidelines regarding the application of such ideas in group therapy are also discussed.     

The therapist's self in dialogical family therapy: some ideas about not-knowing and the therapist's inner conversation

In this article, the focus is on the therapist's self, which will be in line with Bakhtin's thinking, viewed as a dialogical self. First, the dialogical view of the self is situated in the context of psychology's traditional focus on the individual self. Then, leaning on Bakhtin and Volosinov, the self is described as a dialogue of multiple inner voices. Some of the implications of this concept for family therapy practice are examined, focusing especially on the therapist's participation in the therapeutic process and on the therapist's inner conversation. The author argues that not-knowing does not only refer to the therapist's receptivity and respect but also implies that the therapist is aware of his or her experience and reflects on how his or her inner conversation might inform and enrich the therapeutic conversation. Finally, these ideas are illustrated with a brief clinical vignette.     

Family therapy ‘lite’? How family counsellors conceptualise their primary care family work

A number of current developments in the field potentially provide opportunities for preventative relationship and family interventions to be integrated into primary care. In this context, it is important to understand what family counselling is and how it might differ from family therapy. Thus, this paper investigates how the service of one low-intensity family counselling provider, Relate, is conceptualised and practised by counsellors on the ground. Questions about practice were posed to five focus groups of family counsellors and these were analysed using thematic analysis. The findings suggest that Relate family counselling is seen as ‘family therapy lite’, with a flexible, eclectic and integrative use of concepts and techniques within a systemic framework. Implications of this conceptualisation of family counselling for training, practice and research are discussed.     

Epistemic Contradictions in Counseling Theories: Implications for the Structure of Human Experience and Counseling Practice

Theories of counseling process are founded on a logical contradiction in that they are simultaneously objectivist and constructivist in nature. Because this epistemic tension is present across diverse theories and has persisted throughout the history of counseling theorizing, the author argues that it has implications for the structure of human experience. These ideas are examined, and applications to counseling practice are discussed.     

‘Radical Interpretation’ and the Assessment of Decision‐Making Capacity

The assessment of patients' decision‐making capacity (DMC) has become an important area of clinical practice, and since it provides the gateway for a consideration of non‐consensual treatment, has major ethical implications. Tests of DMC such as under the Mental Capacity Act (2005) for England and Wales aim at supporting autonomy and reducing unwarranted paternalism by being ‘procedural’, focusing on how the person arrived at a treatment decision. In practice, it is difficult, especially in problematic or borderline cases, to avoid a consideration of beliefs and values; that is, of the substantive content of ideas rather than simple ‘cognitive’ or procedural abilities. However, little attention has been paid to how beliefs and values might be assessed in the clinical context and what kind of ‘objectivity’ is possible. We argue that key aspects of Donald Davidson's ideas of ‘Radical Interpretation’ and the ‘Principle of Charity’ provide useful guidance as to how clinicians might approach the question of whether an apparent disturbance in a person's thinking about beliefs or values undermines their DMC. A case example is provided, and a number of implications for clinical practice are discussed.     

Evaluating Therapists' Practices in a Postmodern World: A Discussion and a Scheme

The social constructionist ideas currently reshaping the practice of family therapy are also relevant for supervision. However, if, as postmodernists assert, there is no privileged, expert position, how can supervisors evaluate their trainees? This question — a most pertinent one for university-based supervision, where evaluation is necessary and constant — is addressed both theoretically and pragmatically in this article. Ethical issues are explored, and an evaluation form, developed by the authors for use in a family therapy doctoral program, is presented and discussed.     

Family therapy research: Comment on “research as a family therapy intervention technique”

Wright's emphasis on and illustration of the use of family therapy research as a unique intervention technique for therapy is an important contribution to the practice literature. Equally important, however, is the isomorphic shift in focus of the family therapy researcher. Rather than focusing only on process or outcome research, family therapists should become more interested in their clients as research subjects. Though rarely discussed in the family therapy literature, the competencies of family therapists as researchers and the utility of research in a family therapy context is critical to being a well-rounded professional. Examples are provided of how this emphasis is being introduced in a PhD family therapy program.     

Introduction: Using Techniques via the Therapeutic Relationship

In this work, we have the opportunity to hear people’s most private concerns, worries, distress, and share in their hopes, aspirations, and dreams for the future. The work involved in the practice of cognitive behavior therapy; our knowledge, theories, techniques, and strategies are practically useless if we are unable to relate to our clients. Relational attributes were incorporated as part of the defining features essential to therapeutic change in the seminal guide for cognitive therapy (A. T. Beck, Rush, Shaw, & Emery, 1979). Conceptualizations of “collaboration” and “empiricism” have since been misconstrued with the construct of the working alliance in the past, although both have unique distinctions and implications for practice. This article presents an introduction to a special series in Cognitive and Behavioral Practice, which illustrates the vital role of collaborative empiricism within culturally responsive CBT, through the structure of the therapy session, cognitive case conceptualization, self-monitoring, interventions focused on cognitive change, and exposure to emotions and situations. We invite you to join with us in considering the extent to which the ideas shared herein are relevant for your work with clients. It is also our hope that you will consider evaluating and incorporating the utility of these ideas in your therapy.     

The confusion about epistemology and "epistemology"--and what to do about it

The epistemology debates within the field of family therapy have become relatively infrequent in the last year or so, perhaps as a consequence of the confusion they have generated for many family therapists. This article maintains that the primary reason for the confusion is a failure to distinguish clearly between the conventional meaning of the term epistemology, which concerns the nature of knowledge, and the unconventional meaning given the term in family therapy, which concerns the nature of what we know. It is proposed that the confusion can be diminished by understanding the relationship between the two meanings, which are here distinguished as epistemology (meaning 1) and epistemology (meaning 2) respectively. Particular attention is given to the logical consequences of adopting a position on epistemology (meaning 1)—e.g, is the knower capable of knowing an independent reality, or does the act of knowing make its own reality?—or on epistemology (meaning 2)—e.g., is causality linear or nonlinear?. The relevance and implications of these problems for the theory and practice of family therapy are discussed.     

Reflections during a study on family therapy with drug addicts

This article presents ideas and reflections emerging during a project on family therapy with drug abusers. Initially inspired by the writings of Stanton and Todd on the subject, the project developed into a recursive and self-reflective process, characterized by increasing doubts about the usefulness of categorization of families, of pre-planning therapy, and of the therapist as an "expert." The limitations of approaches that emphasize the importance of understanding the family structure as the basis for changing it are discussed, particularly with respect to how they decrease therapist flexibility and may block the family's finding their own solution. Alternative approaches to practice and research are also discussed, bearing on ideas particularly formulated by theoreticians and practitioners inspired by second-order cybernetics.     

Constructivism and Family Therapy

Personal construct and family systems theories can profit from an exchange of ideas concerning the relationship between their personal and interpersonal aspects of construction. This article examines three possible points of contact between the two orientations. First, we suggest that personal construct psychology could profit from addressing the important contributions of the family context to the development of each individual's system. Second, we address the impact of the person's constructions on the larger family system. Third, we suggest that the family system itself develops a system of shared constructions that define and bind its identity and interactions. Each of these areas of interface carries implications for therapy, and specific intervention techniques corresponding to each of these are discussed.     

A theoretical frame of reference for family systems therapy? An introduction to Luhmann's theory of social systems

The starting point for this paper is that family therapy lacks a theoretical frame of reference of its own; thus a stepwise search for such a frame of reference is described. First, social systems are defined as communication systems. Second, it is shown in what way a family can be seen as a social system. With the help of the theory of social systems of the sociologist Luhmann, a theoretical frame of reference for systems therapy is drafted. Finally, we hint at the implications such a theoretical framework could have for clinical practice.     

General practitioners and family therapy—a dialogue

General or family practice and family therapy seem natural allies but few general practitioners are doing family therapy or consciously using the ideas derived from it. This paper explores some of the reasons why this relationship has not been consummated.     

Applying Delphi methodology in family therapy research

The Delphi technique, which is increasingly seen in family therapy publications, encourages the articulation of refinement in family therapy practice and theory. Combining both quantitative and qualitative methodology, this technique involves consideration of information that might otherwise have been overlooked. Due to lack of clarity on this approach, a dilemma exists in applying this research procedure in family therapy. To remedy this deterrent, this paper reviewed 11 studies and outlined use of the technique in regard to design, procedure, and sampling.