A developmental perspective on the use of metaphors in family therapy

Because families generally consist of individuals at various developmental levels, family therapists require interventions that are effective regardless of an individual's developmental status. Although metaphor has proven particularly beneficial in therapy, it may be ineffective in families with preschool children who have yet developed sufficient cognitive capacities and knowledge for understanding metaphors. Previewing, a prospective technique derived from interaction between parent and infant, may be used for communicating metaphors about future change to individuals regardless of developmental level. Previewing provides knowledge about development and stimulates the cognitive skills necessary for viewing the present as a metaphor for the future.     

Moving targets: A developmental framework for understanding children's changes following disasters

This paper proposes a developmental framework for disaster studies with children that allows researchers to explore the interaction between developmental change (defined as change that is extended, self-regulated, qualitative, and progressive) and cataclysmic change. It outlines three levels of analysis related to disasters: 1) observing the harm of disasters in the context of age-related changes in children, 2) demonstrating how children are restored to age-typical developmental trajectories following disasters, and 3) investigating how specific disaster experiences are integrated over time with children's ongoing developmental processes, such as their understanding of self and their views of the world. The paper identifies existing studies at each level of the framework, outlines how these levels of analysis can be used in constructing developmental models of disaster response, and offers suggestions for expanding disaster research into additional developmental areas.     

Just for Women? Feminist Multicultural Therapy with Male Clients

Feminist multicultural therapy is an integrative approach to psychotherapy that emphasizes a systems-level understanding of psychological distress and the process of therapeutic change. In the present exploratory study, the experiences of feminist multicultural therapists working with male clients were studied using Consensual Qualitative Research (CQR) (Hill et al. 1997). Phone interviews were conducted with eight female practicing licensed or license-eligible therapists who had worked with at least one male client in the past 6 months. Consistent with the theoretical approach, all of the therapists interviewed expressed their belief that psychological symptoms can be seen as a reaction to a loss of power or related to the effects of an oppressive system. Additionally, the therapists believed that this theoretical model is broad enough to be used with varying types of intersecting social identities. The findings illustrate the ways in which the counseling approach may work similarly across genders, as well as ways in which one’s therapeutic approach may be altered when working specifically with men. Implications for therapists who work with male clients (both the rewards and the challenges) as well as for researchers who wish to study the application of therapeutic interventions with men are discussed.     

发展瀑布效应:儿童认知功能与社会适应领域的研究

发展瀑布效应指的是在复杂的发展过程中各种交互作用或相互作用的累积结果,这种发展的累积效应导致跨越不同水平、领域、系统或者不同世代的传播效应。本文阐述了研究者利用发展瀑布效应解释儿童认知功能与社会适应领域的发展时采用的不同模型,介绍了儿童认知功能与社会适应领域的发展瀑布效应,最后对发展瀑布效应在这两个领域的研究方法与应用价值进行了总结与展望。     

Family Bereavement and Cultural Diversity: A Social Developmental Perspective

This article offers an integrative, interdisciplinary model of bereavement as a family developmental process that unfolds in cultural context. A critique of cultural assumptions highlights the culture-bound nature of prevailing North American practices, which view grief as an isolated individual experience and emphasize detachment from the dead as a way to promote recovery. Death and grief precipitate two kinds of family change, both guided by culture yet uniquely experienced and interpreted by individual families: 1) recreating the family without a key family member; but capable of coping with both existing and new tasks; and 2) incorporating the death into an ongoing but irrevocably altered family life-cycle developmental process. In supporting family change after a death, family therapists need to collaborate with grieving families in examining the goodness of fit between their unique circumstances and the bereavement expectations of their community and culture. Four case examples are presented, two of which will apply this social developmental model to emphasize transformations of attachment to the deceased — rather than detachment — that will support the ongoing family development of grieving families.     

Family therapy and the notion of accountability: With reference to trends in individual psychotherapy

Family therapy both overseas and within Australia has seen a rapid rise in popularity and general acceptance as an important therapeutic intervention. Along with the growth in interest, however, has come an increased demand for accountability. The foundation stone for the accountability issue surrounds the questions of therapy efficacy. How effective is family therapy, and, indeed, if it is effective, what are the active elements or ingredients which facilitate positive client change? Three groups, in particular, have vested interests in questions relating to the effectiveness of family therapy: researchers, therapists, and consumers. Although both researchers and therapists, for a variety of reasons, have been concerned with the effectiveness of treatment for some time, it has only been relatively recently that there has been a concerted push from various sections of the consumer group, including administrators, legislators, and policy makers. The consumer group is now providing pressure on professionals as to what we have done, and are doing, to demonstrate that family therapy really “works.”     

心理治疗中的同化模型

同化模型是一个有关心理治疗改变过程的理论构想。它融合了多家理论观点, 形成一个用于解释心理治疗一般改变过程的整合性框架。依据此模型, 针对治疗改变过程提出八个可以预期的发展阶段。一系列有关同化模型的研究已经对模型及其发展序列进行了验证, 并提供了实证性的支持。同时发现不同疗法的同化过程模式存在差异; 不同疗法对处于不同同化阶段的当事人具有不同的效果。在研究主题的细化方面, 已有研究开展了同化阶段的标识研究、同化阶段的子阶段研究; 并拓展向不同障碍类型、不同治疗方法的当事人, 以及新的研究领域(如药物治疗, 移民丧失)。在未来的研究中, 可以进行跨文化的研究来对此模型进行验证, 也可以对模型有关治疗改变线性过程的潜在假设进行验证, 或针对声音方面展开深入研究。     

Change: How do we recognize it?

The paper seeks to examine the working assumptions that guide us as therapists engaged in the attempt to facilitate change in families. It summarizes a piece of preliminary research based on the responses of a group of therapists working in different agencies. A questionnaire on change was developed and given to the therapists followed by a group discussion.
The results suggest that therapy teams, and families, have common sense ideas about:

• the beginning, and end of a period of change;

• types of change—those falling into four categories; of behavioural, structural, communication and experiential.

Our results suggest that difficulties in therapy may be associated with a failure amongst the therapists in a team to negotiate their mutual assumptions about change. In addition the process of therapeutic change is seen as involving a negotiation between the family and the therapists about what will count as change.
The data were gathered from a group of therapists attending a local meeting of the Association for Family Therapy in Plymouth.     

Beliefs about stories: Parents' and therapists' explanations of childhood difficulties

Therapists and parents were given vignettes describing the behavioural and emotional difficulties of two nine-year-old children and were asked to rate the importance of a number of possible explanations for such difficulties. Broad agreement was found between parents and therapists, but also there were a number of significant differences. Parents endorsed more child centered explanations and put greater emphasis on physical and developmental factors, while therapists endorsed relationships factors and saw the beliefs of other family members as important. Therapists who were parents showed a pattern of responses that lay between those of parents and non-parent therapists.     

Themes in Therapist Development During the First Three Months of Clinical Experience

The results of a qualitative research study designed to better understand the developmental processes active in beginning therapists during the first three months of clinical contact is reported. Thirteen beginning therapists were asked to complete a monthly log describing experiences impacting their clinical work and themselves as therapists during their first three months of client contact. Data analysis revealed that the primary developmental theme active during this period of time is the development of therapist confidence. Two additional themes, the development of an internal gauge on which to evaluate current experiences and the development of boundaries around the self as a professional, were also found to be active during this time. These additional themes support the development of therapist confidence. Implications for training and research are identified.     

Therapist gender and the same-sex puberty age psychotherapy group

Puberty is considered to be the most difficult developmental period to conduct psychotherapy. Group psychotherapy has special appeal for pubescents because of the anxiety experienced in individual psychotherapy with adults, and the mutual identification and support experienced with groups of same-sex peers. Although pubescents readily form cohesive groups, the emotional stress for the group therapists is intense and many therapists are reluctant to take on such groups. Close attention to the principles of developmental ego psychology suggests that pubescent groups will be more effective if conducted by group therapists of the same sex as the patients.     

西方心理分离的研究回顾

近几十年来,家庭对儿童青少年心理发展的影响受到众多研究者的关注,国外家庭研究和治疗领域的许多研究者进行了大量有关心理分离的研究。心理分离即个体与家庭在心理上的分离并形成个体化的程度。文章从心理分离的界定、心理分离的理论背景（Mahler发展阶段理论、Bowen家庭系统理论）、心理分离的测量方法、心理分离研究现状这几方面对现有研究进行了综述,并做了简要评述,最后阐述了西方心理分离的研究对我国家庭研究与治疗的启示,并对未来的研究进行了展望     

Racial/ethnic disparities in therapist effectiveness: a conceptualization and initial study of cultural competence

As a result of mental health disparities between White and racial/ethnic minority clients, researchers have argued that some therapists may be generally competent to provide effective services but lack cultural competence. This distinction assumes that client racial/ethnic background is a source of variability in therapist effectiveness. However, there have been no direct tests of the therapist as a source of health disparities. We provided an initial test of the distinction between general and cultural competence by examining client racial/ethnic background as a source of variability in therapist effectiveness. We analyzed cannabis use outcomes from a psychotherapy trial (N = 582) for adolescent cannabis abuse and dependence using Bayesian multilevel models for count outcomes. We first tested whether therapists differed in their effectiveness and then tested whether disparities in treatment outcomes varied across therapist caseloads. Results suggested that therapists differed in their effectiveness in general and that effectiveness varied according to client racial/ethnic background. Therapist effectiveness may depend partially on client racial/ethnic minority background, providing evidence that it is valid to distinguish between general and cultural competence.     

The Debate: A Strategic Technique

This paper describes the work of a strategic team that came out from behind the one-way mirror. A debate among the team is enacted before the family as a strategy for change. The case of a family that refused to provide information illustrates an application of this method. The debate among the therapists represents a dilemma that is a strategically constructed isomorph of the family situation. From this position, therapists have the option of changing levels between themselves and the family, asking the family to help solve the therapists' dilemma so that they in turn can be free to help the family. The combination of the debate and the change of levels between the therapists and the family creates a therapeutic neutrality for the family. From their meta position, they observe the therapists' struggle to solve the family's problem, which is re-presented as a problem among the therapists. This perspective offers the family the choice of more adaptive solutions to their own dilemma.     

Parenting as relationship: a framework for assessment and practice

Parenting tends to be framed as a set of actions directed toward the child rather than as a relationship. This article helps therapists, parent-educators, and researchers conceptualize parenting as a socioculturally embedded relationship. The authors apply the relational orientations typology (Silverstein, Bass, Tuttle, Knudson-Martin, & Huenergardt, 2006) to parent-child relationships. The typology addresses two dimensions: whether the focus is on the child's meeting parental expectations or on expectations of mutuality and whether power between parent and child is expected to be symmetrical or asymmetrical. Four relational orientations are described: (1) rule directed, (2) position directed, (3) independence directed, and (4) relationship directed. These relational orientations describe the nature of the reciprocal relationship between parent and child and offer a framework from which to address parenting issues. A case illustration shows how the relational orientations framework helps therapists incorporate a larger systems/relational perspective into what was originally framed primarily as a child behavior problem.     

Fusion,Compression, Diversion,and the Workings of Paradox: A Theory of Therapeutic/Systemic Change

This paper describes a geodynamic balance theory of family process. It attempts to synthesize temporal/spatial patterning, movement, interpersonal structure, and the family developmental process. The family system is portrayed in terms of the pattern of interpersonal orbits among its members and the interface between these and “external” systems such as friendship networks, neighborhoods, and therapists. It is proposed that therapeutic/systemic change can be induced through either of two interventional mechanisms: diversion (e.g., behavioral techniques, restructuring, differentiating) or compression (e.g., paradoxical technique, returning home, grief work). Such processes share a number of similarities with analogues from the physical sciences. These formulations may assist clinicians in determining the most appropriate operations and directions for treatment.     

On doing research: the dream and the reality

The principal concern of this essay is to offer practical and personal guidance to professional therapists who wish to engage in research in family therapy. It is not a paper about research design or experimental/observational/survey methods; rather the focus is upon the experience of engaging in research. It attempts to destroy a few common myths about researchers, research, and the motives of researchers and those whom they research. Research is seen as a continuing and evolving process (rather than a product) which can intrude in many aspects of the individual's life; it can affect motives, working relationships, organizational composure, personal family life, and personal self-esteem. Research is thus like most other forms of employment. Research, as an activity, must be seen in terms of systems dynamics, resistance to change, and hopefully, in terms also, of self-actualization and the refreshment of professional parts that other addictions cannot reach.
Recommendations are made for the structuring of research activity, in the light of the research model presented.     

Experiencing level in the process of group development

The Experiencing Scale, a process research instrument used to assess the process of self-exploration in psychotherapy, was applied to both clients and therapists in group psychotherapy. The instrument was used to study the process of development in the group as a whole, and to study how individual patterns of self-exploration are affected by the group's developmental process. Initial results exemplify how the scale can be used to explore these processes. At the whole group level, the scale reflects change points or shifts in the group's development from one phase to another. At the individual level, comparison of data between individual members reveals a charcteristic turn-taking pattern of self-sexploration in phase three of the group's development.