Psychosis and multiple family group therapy

Despite the growing evidence base for the effectiveness of family intervention in the treatment of individuals suffering from a psychotic disorder, in practice only relatively few mental health teams use family approaches when treating and managing those with schizophrenia or other psychoses. This paper describes a pragmatic model, which may be used in addition to other ongoing treatments, such as medication, CBT or single family therapy. It was developed jointly by clinicians and service users over the past few years. It consists of regular multiple family group work, with six to eight families attending simultaneously, and aims to involve families directly in the treatment, rehabilitation and recovery of their members suffering from psychotic disorder.     

Attachment-based classifications of children's family drawings: psychometric properties and relations with children's adjustment in kindergarten.

Investigated an attachment-based theoretical framework and classification system, introduced by Kaplan and Main (1986), for interpreting children's family drawings. This study concentrated on the psychometric properties of the system and the relation between drawings classified using this system and teacher ratings of classroom social-emotional and behavioral functioning, controlling for child age, ethnic status, intelligence, and fine motor skills. This nonclinical sample consisted of 200 kindergarten children of diverse racial and socioeconomic status (SES). Limited support for reliability of this classification system was obtained. Kappas for overall classifications of drawings (e.g., secure) exceeded .80 and mean kappa for discrete drawing features (e.g., figures with smiles) was .82. Coders' endorsement of the presence of certain discrete drawing features predicted their overall classification at 82.5% accuracy. Drawing classification was related to teacher ratings of classroom functioning independent of child age, sex, race, SES, intelligence, and fine motor skills (with p values for the multivariate effects ranging from .043-.001). Results are discussed in terms of the psychometric properties of this system for classifying children's representations of family and the limitations of family drawing techniques for young children.     

Redecision family therapy: Its use with intensive multiple family groups

Abstract

Intensive multiple family group therapy combines the advantages of group therapy with those of time-limited, goal-oriented approaches. Using the Redecision Family Therapy model further refines the technique by integrating the seemingly disparate methods of intrapsychic and systemic therapy. In this paper we describe our 10-year experience with this model, elaborate on the model itself and discuss the results of an outcome survey.     

The representation of depth in children's drawings of a table

Willats (1977) analysed developments in the drawing of a table in terms of the projection system in which the table top was represented, and concluded that representation of depth in drawing goes through a series of discrete stages, each of which can be identified with a projection system. A partial replication of Willats' study is presented here, using a much larger sample. The relationship between age and use of projection system found by Willats was in general supported. Not all the “stages” were found to be discrete, however, and an examination of the way in which the table tops were drawn shows that whilst the majority of older children appeared to use perspective, they did not use it correctly. A method is given by which tables that are drawn as if from a central viewpoint can be formally classified. It is concluded that development in the understanding of the representation of depth is not very closely linked to development in the use of projection systems.     

Training staff in multiple family therapy in a children's psychiatric hospital: from theory to practice

This article describes a systematized method for training clinical staff from a variety of mental health professions while implementing supportive, process‐oriented multiple family therapy (MFT) in a children's psychiatric hospital. The model uses a step‐by‐step approach based upon learning objectives specific to the theory and practice of MFT for each stage of the process. External consultants skilled and experienced in MFT supported tuition in the initial stages. The method employs seminars with theoretical and experiential components, highlighting the major conceptual features of group, family therapy and MFT. Advanced stages of the training model include experiential learning in small groups and ongoing peer group supervision with live families. The systematic procedure has relevance for ongoing supervision, research and best standards of clinical practice in the hospital.     

The use of structured experiences in family therapy

Structured experiences such as sculpting, psychodrama, rôle-play and growth games are frequently used in family therapy. This article puts forward a framework for the use of structured experiences which can be used in the context of a family session to ensure that the family will gain the maximum learning and change. Use of the framework is illustrated with examples from practice.     

Sexual ambiguity in children's human figure drawings

Four hundred sixty-one children in grades 5-9 drew a person and indicated the sex of their human figure drawing. A significant number (8%) of children were unable to classify their drawings as to sex; the frequency of uncertainty did not vary with grade or sex of child. Inability to determine the sex of one's own drawing is hypothesized to be a conceptual rather than a perceptual problem, and to reflect uncertainty about the essence of sexual identification.     

Eliciting children's thinking in families and family therapy.

In this article, I introduce a way of talking between a therapist and children, which aims to be more adaptive to the family therapy context than the modes of communication with children often reported by individual psychotherapists. Although the recent increase in articles concerned with the role of children in family therapy is welcomed, I suggest that the common recommendation of the use of "play" and nonverbal methods of communication with young children can at times introduce its own constraints on a child's thinking. A method of engagement in "dialectical" conversations with children is described, and illustrated with verbatim case examples. It is argued that this offers one route to a discourse commonly used between children, and one that acknowledges their capacity to think.     

The effect of affective characterizations on the size of children's drawings

Previous research has yielded conflicting findings about the existence and the direction of the size changes which occur in children's drawings when they are asked to draw topics which have been given an affective characterization. The present study was designed to investigate whether children scale up the size of drawings of topics which have been given a positive characterization, and scale down the size of drawings of topics which have been given a negative characterization. The participants were 258 children aged between 4 and 11 years who completed three drawings of either a man, a dog or a tree. Each child drew a baseline drawing of a neutrally characterized figure, and two further drawings of a positively and a negatively characterized version of the same figure. It was found that the children drew the positively characterized topics larger than the neutrally characterized topics, and reduced the size of the negatively characterized topics relative to the baseline drawings. These patterns occurred at all ages and with all three drawing topics. Two possible explanations of the findings are discussed: the operation of an appetitive‐defensive mechanism in children, and the acquisition of pictorial conventions.     

Graphic indicators of pedagogic style in Greek children's drawings

311 Greek children's drawings of classroom life were employed to investigate the diagnostic validity of this measure in identifying teachers' pedagogic style. The sample was divided into three age groups, 6-, 8-, and 10-yr. olds, who were asked to draw pictures of themselves and their teachers in their classroom. Drawings were scored using as criteria the four graphic indicators (ratings of size, detailing, centrality, and social distance) proposed by Aronsson and Anderson in 1996. Analysis showed three out of the four indicators discriminated teacher-centered vs student-centered pedagogic style. More specifically, in the teacher-centered setting children drew the teacher of dominant size, in a central position, and as remote, while in the student-centered setting the teacher was depicted closer to the student, in a less central position, and less emphasized relative to the student. The findings are discussed with respect to the absence of age-related effects and the possibility of using children's drawings of classroom life as a measure for tapping into children's representations of pedagogic style.     

The inner group: Its manifestation in drawings and in the actual group

This article presents an analysis of drawings together with information regarding the person's biography and style of participation in the group. The symbolic rendering in condensed visual form sheds light on our understanding of the specific individual's inner group and related mode of behavior in the real group. The rich clinical material offers a new source of insight into this important realm of group studies.She is Professor at the Hebrew University, Jerusalem, founder and first President of the Israeli Group-Analytic Society, honorary Member of the French Group-Analytic Society (Paris); and full Member of Group-Analytic Society (London).