Art therapy in transcultural family therapy

The increased existence of foreign culture patterns in the child population calls for transcultural comprehension in child psychiatry. This case report describes transcultural aspects in the therapy of an 11 year-old Moslem girl admitted to a child psychiatric department. Her symptoms were abdominal pain, headache, anxiety, and pretended fever. A family therapeutic approach was used together with elements of art therapy and individual therapy in a successful treatment. The family therapeutic approach was based on art therapy as a part of the communication where cultural symbols were an important part. An interpreter was not used. The cultural context where it is acceptable to overstep the borderline between reality and fantasy is seen as an important healing capacity.I would like to acknowledge my debt and my appreciation to Ebba Ernst, psychologist of the department and supervisor in the therapy of the S. family. I would also like to thank professor Kai Tolstrup and child psychiatrist Torben Marner for stimulating support in the process of writing the article. A grant from Enkefrue Hermansens Mindelegat made the participation in the Krakow Congress possible.     

Promiscuity in the practice of family therapy

Family therapy has continually confronted choices between polarized positions, each one taken up with zeal because it solved an old dilemma but eventually encountering its own limitations. In this article I suggest that we have evolved to a point where, instead of deciding which is better, we can focus on how to use theories, models and techniques as fluid and flexible resources for action in the therapeutic conversation. Doing so focuses our attention on how we can move in and out of various positions, including those that simplify issues and those that embrace complexity. In addition, our attention is drawn to the ways in which we can make choices between following a model as opposed to engaging in spontaneous dialogue. This promiscuous stance can help trainers and therapists answer questions concerning how we make decisions in therapy. Such promiscuity also positions us to confront our images and expectations of what it means to be a professional.     

Perceptions of the therapist in family therapy

Thirty-five families completed ratings describing their perceptions of their therapists. These ratings were then correlated with measures of outcome to assess whether there was a relationship between experiences of the therapist and treatment outcome. Further, the study addresses whether some family members' perceptions are more influential in affecting the course of treatment. The results showed that family members' perception of the therapist does have an impact on treatment outcome, but not all members affect the outcome equally. Further results and their implications are discussed.     

Siblings in family therapy

The participation of siblings in family therapy was studied from case records in 76 consecutive cases attending a child and adolescent psychiatric outpatient clinic. Siblings took part in family therapy in two thirds of the cases. Of these, 76 per cent attended only one or two sessions. A sub-sample of nine families with children below 13 years of age was interviewed. Seven out of 10 evaluated siblings had psychiatric symptoms of some severity at the onset of therapy compared to two after, and all had fewer symptoms after therapy compared to before (p<0.01). Most families thought it relevant for both parents and siblings to take discussing their children's behaviour in front of them and wanted the opportunity of also talking to the therapist without the children being present.     

Countertransference in family therapy

The intent of this article is to describe the importance of one psychoanalytic concept, countertransference, in family treatment by a review of the literature on the subject. Case illustrations will then be used to show how the supervisor of a family treatment case elicited the countertransference in order to move the therapy forward. Some thoughts with regard to training will be offered.     

Mystery in family therapy

Existential approaches to family psychotherapy are considerably different from the problem centered approaches to treatment which are currently so popular in the field. Gabriel Marcel's distinction between a problem centered and a mystery centered understanding of life is utilized to overview the basic and deep differences between existential and problem centered approaches to family treatment.     

Redefinition in family therapy

Abstract

In the wider context of an epistemological renewal, the author describes the possibility of a redefinition of therapy from that of an intervention focused on the patient to one of an opportunity for participation and growth of a group which shares a common history. The author speaks of the necessity of giving alternative meanings to the presenting symptoms, citing examples from his work with families.     

Children in family therapy

The distinctive skills of child psychotherapy can be utilized in the development of a form of conjoint family therapy especially applicable to the field of child psychiatry. It is suggested that the engagement of children in the process particularly enhances the specific characteristics and potentialities of this form of treatment.     

Consultation in family therapy

Abstract

This paper addresses the issue of the use of consultants by experienced family therapists. The authors discuss the need for consultation under different circumstances and review a number of models currently being utilized. Emphasis is placed on preparing the clients for the consultation, providing background information to and preparing with the consultant for the session(s), and transferring “power” to the consultant and back again to the primary therapist.     

Contemporary family therapy in the United States

Major issues in contemporary family therapy in the United States are described. Issues from outside the field impacting family therapy include health care reform, family 'values', multiple forms of 'family', and the growing aging population. Issues within the field include the challenge of social construction theory, the decline of the expert, the feminist critique, sensitivity to culture, rediscovering individuals within families, focus on strengths and resources, a both–and attitude toward collaboration with other professionals, emphasis upon the person of the therapist, and convergence of 'schools' of family therapy. Therapists in the United States are also opening up the private process of therapy through reflecting teams, including clients in therapist thinking, multi-family groups, and through psychoeducational groups. Finally, attempts to bridge the gap between research and practice are analyzed.     

Theme-focused family therapy: the inner emotional world of the family

This paper is an account of a method of family work developed for social workers in social services departments which allows them to work with the emotional impact on children and adults of traumatic events in family life. Theme-focused family therapy has been designed to meet the needs of the families and also to enable social workers and their supervisors to develop both psychodynamic and systemic perspectives m their work with families. It is a staged approach, moving from individual work to a structured family interview through to a series of theme-focused family sessions. It is phased in this way both to facilitate the development of a therapeutic attachment between social worker and family and to take account of the crises that can interrupt planned work in social services departments. Theme-focused family therapy is carried out in partnership with families, and gives children a voice and a leading role in the therapeutic process. The approach is illustrated with a case example.     

Application of family therapy theory to complex social issues: using the WebQuest in family therapy training

This paper describes how the WebQuest is used to foster critical thinking and application of theory to complex social problems in a Master's level class on contemporary family therapy theories. The issue of child trafficking and prostitution is explored through the web‐based inquiry learning where scaffold learning is provided. Scaffolding includes resource links and guidance on cognitive and social skills, which are provided to facilitate the learner's development. The WebQuest design includes the task, the process and the evaluation rubrics. Student feedback on the WebQuest was positive and included increased motivation in learning, critical thinking and global awareness.     

Re-editing family mythology during family therapy

Family mythology includes false or edited beliefs about the present which may be coupled with family legends which support those beliefs. Families are particularly likely to use their histories dys-functionally if they either see the present as an exact replication of the past or, in contrast, deny that the past has any relevance whatever. Re-editing myths involves enabling families to alter their relationships and their self perceptions. This allows a fresh exploration of the past; a process which can support and encourage further change. Case material is used to illustrate this.     

Medical family therapy: an emerging arena for family therapy

This paper describes an important recent development in American family therapy. Medical family therapy uses a biopsychosocial systems model to work with families who have a member with a chronic illness or disability. The authors maintain that family therapy has tended to embrace the mind–body split and to view itself too narrowly as a mental health specialty. Medical family therapists work collaboratively with physicians and other health professionals to help families achieve a sense of agency and communion in facing some of the greatest challenges that life brings.     

Transcultural family therapy

Conventional family therapies such as Structural, Systemic, Satirian, Adlerian and Dreikursion seem to be marked by cultural biases and give an indication of one single culture orientation. These seem to represent the cultural majority norms and values in acting as oppressive tools in a multi cultural society. Most of these therapies are derived from theories reflecting intrapsychic factors that are white middle class concepts, neglecting the multi culturaUsocia1 contexts in family therapy. “Ethnic minority families” from non Western Countries often experience more problems than families from Western Countries in the areas of education, immigration, employment and health. The cultural expectations are full of contradictions and ethnic minorities feel handicapped both socially and culturally in the task of growth and development. Western family therapy has failed to address these issues.     

Restorying family therapy

This article describes a multi-systemic model of therapy developed by the author over the past decade and summarizes the main products of this project: Explication of key family systems notions, strategic family play therapy, multi-systemic therapy, and culturally-competent family therapy. The model incorporates beyond the family system, culture, wider ecosystems, psychodynamics, and the individual's neuropsychological, cognitive, and socio-emotional development. The model enables the therapist to design flexible multimodal interventions.