A Method of Co-Therapy for Schizophrenic Families

This paper describes a model of treatment for families in which one child has been given the diagnosis of schizophrenia. Male and female therapists adopt structured roles that are used as a paradigm for exploring family patterns. The paradigm employs a three-generational hypothesis that defines schizophrenia as a lifelong, restricting mode of relating, involving the primary family triad, that makes the child vulnerable to repeated psychotic episodes. Therapy is directed at the difficulties of autonomous development within the family by focusing on differentiating the relationship between nuclear and extended family members, expecially defining and strengthening generational and sexual boundaries. The second focus of therapy is on the resolution of issues of separation and loss, with attention to unresolved mourning in the family of origin and the concomitant stress in giving up the infantile relationship with the index child in the nuclear family. Stages of therapy will be described including: (a) initiation of therapy, (b) breaking of fusion, (c) repair of alienation, and (d) solidifying the marital alliance and generational boundaries. Case illustrations will be included.     

Developmental perspectives and family therapy: The marital life cycle

Developmental perspectives have been part of family therapy for more than two decades with a primary focus on the family life cycle and individual development. Most efforts at recognizing a marital life cycle have subsumed marital tasks under rubrics based primarily on parental roles. This paper offers a marital life cycle based on marital development with specific tasks for each of four stages-the marital breakup and remarriage phases are not included here-and provides implications for therapy.     

Remarriage Among the Elderly: Characteristics Relevant to Pastoral Counseling

ABSTRACT

Family counseling has long been an important aspect of pastoral counseling. With recent trends toward increasing remarriage among older persons, pastoral family counseling will take on an additional dimension. This study provides information concerning motivation and attitudes toward remarriage, behavior during the interim period, adjustment to remarriage and the impact of remarriage on family relationships.     

Family contexts as cognitive networks: A structural approach of family relationships

With the permanence of strong emotional bonds between adults and their siblings and parents, with the rise of divorce, with the extension of remarriage, and with the development of pseudo-kinship ties, complex family groupings have emerged. Orientational family members (Kuhn, 1964) are likely to be perceived as being included in relatively large and unbounded family contexts. To deal with the complexity of those contexts, one needs to develop an approach that makes it possible to analyze many relationships in a single model. Such an approach is presented in this article, which considers family contexts as cognitive networks (Marsden, 1990). To illustrate how statistical and graphical network methods can be applied empirically to those contexts, perceived relationships among orientational family members of 25 female students were analyzed in relation to balance theory (Heider, 1958).     

Premarital Predictors of Remarital Quality: Implications for Clinicians

This paper presents a review of the research literature from 1980 to present on the premarital predictors of remarital satisfaction and stability (quality). The predictive factors are organized with an ecosystemic theoretical model using three general predictor categories: background and context factors (e.g., stepchildren), individual traits and behaviors (e.g., attachment to an ex-spouse), and couple interactional processes (e.g., couple consensus). Major factors related to lower remarriage quality include the roles of stepchildren, stepfamily complexity, emotional attachment to an ex-spouse, serial marriage, and economic strain. Predictors related to higher remarital quality include couple consensus on important topics, social support from family and friends, and financial stability. Implications for couple therapy before remarriage are discussed.     

The Aged Are Family Members

Research reveals that the notion of the aged being abandoned or dumped by families is a myth. In general close ties and mutually responsible behavior continue. For those engaged in family treatment, older families and intergenerational relationships are a clinical frontier. Practitioners have the opportunity to experience and observe, in depth, the emotional quality and meaning of intergenerational relations. Older family members may play important roles in the family dynamics. It is hypothesized that their inclusion when appropriate in the treatment of younger families can be a preventive measure to forestall cyclical repetition of pathological relationship patterns. Just as family therapists are committed to the premise that many nuclear families are capable of psychological growth and change, they must become aware that aged family members have similar capacities. If intergenerational relationships are modified then family members in all the generations could be benefited.     

Remarital Issues in Couple Therapy

Abstract

Remarriage and cohabitation after divorce are becoming societal norms. Given the increasing numbers of these couples, mental health professionals will encounter them in their clinical practice. There are unique issues associated with remarriage (e.g., role and boundary ambiguity, unrealistic expectations) that can hinder the family reorganization process and exacerbate typical communication problems experienced by couples. Therefore, therapists must have knowledge of these challenges to provide the most effective treatment. A brief overview of the remarriage and stepfamily literature, and recommendations for clinicians are presented.     

Family ties after divorce: long-term implications for children

Drawing on the data from the longitudinal Binuclear Family Study, 173 grown children were interviewed 20 years after their parents' divorce. This article addresses two basic questions: (1) What impact does the relationship between parents have on their children 20 years after the divorce? and (2) When a parent remarries or cohabits, how does it impact a child's sense of family? The findings show that the parental subsystem continues to impact the binuclear family 20 years after marital disruption by exerting a strong influence on the quality of relationships within the family system. Children who reported that their parents were cooperative also reported better relationships with their parents, grandparents, stepparents, and siblings. Over the course of 20 years, most of the children experienced the remarriage of one or both parents, and one third of this sample remembered the remarriage as more stressful than the divorce. Of those who experienced the remarriage of both of their parents, two thirds reported that their father's remarriage was more stressful than their mother's. When children's relationships with their fathers deteriorated after divorce, their relationships with their paternal grandparents, stepmother, and stepsiblings were distant, negative, or nonexistent. Whether family relationships remain stable, improve, or get worse is dependent on a complex interweaving of many factors. Considering the long‐term implications of divorce, the need to emphasize life course and family system perspectives is underscored.     

Family Communication and Genetic Counseling: The Case of Hereditary Breast and Ovarian Cancer

In familial breast/ovarian cancer, the information that the proband is able to supply about other family members is of critical importance for genetic counseling. This frequently requires family communication. Forty-six women attending a cancer genetics clinic were interviewed as part of a longitudinal study. Nearly all reported affected maternal, rather than paternal relatives, which may indicate lack of awareness by women with paternal histories. There was also much more communication among female relatives. Mothers, where they were still alive, were key figures in supplying family information. Although the majority of the sample contacted at least one relative regarding counseling, most named a relative with whom they did not feel able to communicate on this subject. Probands balanced the perceived obligation of passing on information with that of not causing alarm. Communication, both obtaining and giving information, was impeded by adoption, divorce and remarriage, family rifts, and large age gaps between siblings.     

Functional relationships in the nuclear and extended family: A 16‐culture study

This study investigated the relationship between culture, structural aspects of the nuclear and extended family, and functional aspects of the family, that is, emotional distance, social interaction, and communication, as well as geographical proximity. The focus was on the functional aspects of family, defined as members of the nuclear family (mother, father, and their children) and the extended family (grandmother/grandfather, aunt/uncle, cousins). Sixteen cultures participated in this study, with a total number of 2587 participants. The first hypothesis, that the pattern of scores on the psychological measures and the behavioral outcomes are similar across cultures, an indication of cultural universality, was supported. The second hypothesis, that functional relations between members of the nuclear family and their kin are maintained in high‐affluent and low‐affluent cultures, and that differences in functional relationships in high‐ and low‐affluent cultures are a matter of degree, was also supported by the findings. The results suggest that it is less meaningful in cross‐cultural family studies to ask questions about the structure of the family, than to ask about the functional relationships between members of the nuclear family and their kin. In looking only at the nuclear family, one focuses only on those residing in the household, but ignores those important members of the extended family who may reside nearby and their significant relationships with the members of the nuclear family.     

The Family Covenant and Genetic Testing

The physician-patient relationship has changed over the last several decades, requiring a systematic reevaluation of the competing demands of patients, physicians, and families. In the era of genetic testing, using a model of patient care known as the family covenant may prove effective in accounting for these demands. The family covenant articulates the roles of the physician, patient, and the family prior to genetic testing, as the participants consensually define them. The initial agreement defines the boundaries of autonomy and benefit for all participating family members. The physician may then serve as a facilitator in the relationship, working with all parties in resolving potential conflicts regarding genetic information. The family covenant promotes a fuller discussion of the competing ethical claims that may come to bear after genetic test results are received.     

Family Boundaries in Transition: A Search for Alternatives

This paper attempts to clarify Minuchin's concept of family boundaries and to modify the original definition to one based on social systems concepts that are neutral with respect to pathology. The authors distinguish between logical and physical conceptualizations of “boundary” and differentiate the broad metaphor of family boundaries into proximity (i.e., interpersonal boundaries) and hierarchy (i.e., generational boundaries). Assuming that the nature of a relationship is reflected by the extent of overlap or sharing of interpersonal territories, Wood ( 14 ) adapted Goffman's ( 2 ) concept of territorial preserve to encompass six types of territories family members may share to a greater or lesser extent, reflecting the family's pattern of proximity. The family's hierarchy is reflected by who is “in charge,” parents or children. We explore the process of boundary reorganization in families in transition, offering a nonstatic and health-oriented view of boundary permeability. Using the anthropological concept of “rite of passage,” we suggest an alternative view of stressful transitional events such as marriage and divorce. We illustrate with examples the reorganization of proximity and hierarchy that occurs during periods of transition.     

Family Members as Boundary Managers: Behaviors that Promote and Limit Service Members’ Involvement in Daily Family Life

When military service members deploy, they move outside the immediate boundary of their families. However, because boundaries are permeable, service members remain a psychological part of their families in spite of their physical absence. The extent of service members’ continued involvement in daily family life is likely tied to their non-deployed family members’ actions to manage this boundary. In the current study, we were interested in identifying non-deployed family members’ actions to either promote, or limit, service members’ involvement in daily family life during deployment. These actions by family members constitute boundary management behaviors. We collected qualitative data from a sample of Army reservists (N = 13) and their household family members (N = 15). Findings indicated that family members used a variety of boundary management behaviors during deployment, some of which promoted reservists’ involvement, and others which limited it. In addition, boundary management behaviors varied by who they targeted, their intentionality, and their implications for reservists’ well-being. Findings illustrate the value in equipping military families with language that enables them to communicate openly about the significance of their boundary management behavior over the course of deployment so that they may arrive at a balance between stretching and restricting boundaries that best suits their unique needs.     

When Work, Family And Friendship Collide

Mandi’s sister was diagnosed with breast cancer and was referred to our Familial Cancer Program. The young age of diagnosis, characteristics of the cancer and family history suggested genetic testing and Helen was the genetic counselor involved throughout the testing process. In relaying this personal and professional story we have tried to describe the issues we faced and how we negotiated some of the difficulties when the boundaries between our many roles of family member, friends, colleagues and professionals became blurred.     

The Married Professional Woman: An Examination of Her Role Conflicts and Coping Strategies

A group of 232 married women doctors, lawyers and professors were surveyed about their attitudes toward their roles and how they cope with role conflicts. Close to half of the women reported that it was impossible to rank the relative importance of their family and career roles, and a majority of women stated that they often experienced strains between these roles. Coping strategies such as having family members help with chores, having family members help resolve role conflicts, reducing standards within certain roles, considering personal interests important, and scheduling and organizing activities carefully were found to be significantly related to satisfaction. It is suggested that married professional women who develop effective coping strategies will find the challenge of combining a profession and a family a rewarding one.     

Entry and Emergent Agendas of Adults Visiting an Aquarium in Family Groups

ABSTRACT

Understanding visitors' agendas is important in providing insights about learning experiences in informal settings, particularly if we consider learning to be both a product (what they learn) and a process (how they learn it). Accordingly, a handful of studies have investigated the impact of visitors' agendas on learning. However, little attention has been directed to investigating the impact of individual and collective agendas on the nature of the visit experience for the adult members of family groups, or the dynamics and evolution of these agendas during and after a visit to an informal setting. This article examines the roles that personal agendas play in shaping and framing the aquarium experiences of the adult members of 13 family groups visiting the Vancouver Aquarium Marine Science Centre in Canada. It explores the dynamic and changing character of entry and emergent agendas within the family group context and the factors that constitute and shape such agendas. The roles of these agendas in the overall on-site learning experience of the adult members of the participating family groups, and the longitudinal impact of the aquarium visit are further discussed.     

Psychosocial factors affecting custodial and visitation arrangements

This article reviews psychosocial factors that may influence the custodial and access arrangements for children during separation, divorce and remarriage. Custodial arrangements for children following the divorce of their parents are discussed. Elements to consider in determining the custodial arrangement that provides for the best interests of children include child, adult, interpersonal and social environmental factors. It is recommended that all of these factors be considered in drafting a custodial agreement that will serve the best interest of children following a marital and family breakup or remarriage.     

Gender Role Attitude Malleability in the Context of Divorce and Remarriage: A Longitudinal Growth Curve Perspective

Suggestions from structural symbolic interactionism are that gender role attitudes are malleable—able to change and be redefined over the course of adult development—at the individual-level, particularly in relation to significant experiences. Using longitudinal growth modeling, this study examined how divorce and remarriage affect gender role attitude growth across a 20-year period (N = 1731). Remaining in a first marriage was related to a slight, but significant decline in traditional attitudes. Divorce was associated with a slight acceleration in the decline in traditional attitudes, while remarriage was associated with a slower rate of decline in traditional attitudes. As such, transitions out of the institution and roles of marriage were related to more egalitarian attitudes, but transitions into remarriage were associated with attitudinal shifts similar to those in first marriage. Evidence is also presented related to the possibility that attitudinal shifts toward more egalitarian may precipitate divorce for some. Implications for theoretical refinement are given.     

Impact of joint versus sole custody and quality of co-parental relationship on adjustment of adolescents in remarried families

The effects of legal custody arrangement and quality of the co-parental relationship on the adjustment of adolescents in remarried families was examined. Joint custody was associated with better relationships with step-parents and more family cohesion. Girls in sole custody families and boys in joint custody families reported high anxiety. Girls in sole custody families reported the remarriage to have a negative effect on their relationships with their custodial biological parents. Hostility in the co-parental relationship was associated with more loyalty conflicts and more increase in psychosomatic and psychosocial problems around the time of the remarriage.