Therapy with greek families living in Australia

Language and cultural differences can pose barriers to effective intervention in migrant families in conflict. Family therapy approaches can provide some useful strategies for overcoming these obstacles. A family therapy approach can (1) emphasize the value of utilizing natural network support systems; (2) provide a model which helps clarify communication problems arising in the relay of information through a third person acting as an interpreter; (3) underline the importance of non-verbal and process aspects of family communication; (4) suggest techniques for negotiating, joining, and finding commonalities of family experience between a therapist and family of different ethnic background. The therapist needs to develop sensitivity to both the universal and specific ethno-cultural structures, norms and problems of families; when this sensitivity is achieved powerful and culturally syntonic healing forces can be released. Examples of successful family therapy interventions in some Greek families in conflict will be given.Originally published inThe Australian Journal of Family Therapy, Vol. 1, No. 2 (January 1980) pp. 62–68. Reprinted here with permission. Title slightly changed from original.     

Introduction to Group-Analytic Psychotherapy by S. H. Foulkes

This article will explore special leader issues that emerge in psychodynamically oriented therapy groups with adult children of alcoholics. Particular focus will be on countertransference feelings that get stirred up in group leaders and techniques for dealing with some of these special dilemmas. Specific issues include (a) assumption of sameness between the therapist and the patient (the therapist assuming that he or she “understands” because of having also grown up in an alcoholic family); (b) the “will to restore,” which may be destructive when the therapist, whose own self-esteem is dependent on the patient's progress in therapy, forces a “rush to recovery” on the patient; (c) other personal issues in the life of the therapist that may also resonate with experiences of the patient; (d) “countertransference goodness and availability” as it affects therapists' abilities to set reasonable limits on their patients, as well as reasonable expectations for themselves; and (e) special issues regarding therapist transparency and self-disclosure.     

The use of children's drawings in multiple family group therapy

This paper describes the advantages, difficulties and techniques of including young children in multiple family group therapy (MFGT). Multiple family group therapy consists of weekly sessions where three or more families meet conjointly with a therapist or cotherapists. Clinical vignettes demonstrate how to use children's drawings with parents to improve family communication. The efficiency of MFGT is compared to family therapy or individual therapy. The effective use of this modality with some children under 10 years is discussed.This research was supported in part by Alcohol, Drug Abuse, and Mental Health Administration Psychiatry Education Branch Grant MH 13882 from the National Institute of Mental Health.     

What Does it Mean to be a Common Factors Informed Family Therapist?

The common factors paradigm in couple and family therapy has gained popularity over the past several decades, leading many therapists to refer to themselves as common factors family therapists. Despite this, no consensus exists on what it means to be a common factors family therapist, or if such a designation even makes sense given that the common factors paradigm is not a model. Synthesizing the existing common factors literature, a case is made for the designation “common factors informed family therapist,” and the following six core principles are outlined that characterize this designation: (1) sees overlap among theories; (2) passionate about theory, not a theory; (3) client centered; (4) monitors hope and the therapeutic alliance; (5) views clients as people rather than objects; and (6) prioritizes healing over therapy. Each of the concepts is discussed in depth, and clinical implications are provided.     

Action models—learning by doing

The aim of this workshop was to demonstrate experientially how action models can be used: to highlight particular themes; to study ongoing interactional patterns of the family system; to allow patterns of behaviour and communication to emerge along with the consequences of that pattern; to focus on the process rather than the content; to find the strengths and resources of the family; and to offer the opportunity of practising new skills and to gain insight through experience. Action techniques are specific acts or actions the therapist engages in to implement a strategy. Action is a deliberate intervention which will provide material shared with the family and therapist. Five different experiential exercises were demonstrated for use in family therapy training or in family therapy sessions.     

Rebuilding family relationship bridges

This paper describes two techniques that the family therapist can use to help families in emotional crisis change and heal. They require the family therapist to persuade family members to view the therapy sessions as a project in building or rebuilding their family relationship bridges. An essential component of these approaches is the value placed by the family therapist on building rather than destroying family relationship bridges. Four themes are suggested as building blocks for healing dysfunctional family relationships: Love, Anger, Loss and Forgiveness. Vignettes of several family problems are presented accompanied by an intervention demonstrating an aspect of family bridge building.     

Therapist orientation,supervisor match,and therapeutic interventions: Implications for session quality in a psychotherapy training PRN

Background: Theoretical orientation is a multifaceted construct that is integral to the process of psychotherapy and psychotherapy training. While some research has been conducted on personal identification with particular schools of psychotherapy, techniques used in psychotherapy sessions, and match between trainees and supervisors in training, there is insufficient information regarding how these may interact with one another. Aim: This study, conducted in a practice research network of trainee therapists, was designed to test whether these variables may be related to one another in predicting session quality. Method: The sample comprised 328 sessions from 26 clients and 11 therapists, with the clients completing session quality measures and therapists completing measures of technique immediately post‐session. Results: Using multilevel linear modelling, the data showed varied results. For behavioural therapy and person‐centred therapy, techniques and orientation were unrelated to session quality in the sample. However, process‐experiential, psychodynamic, and cognitive therapy techniques were all involved in interactions with therapist and/or supervisor orientations. Conclusions: These results suggest that the impact of specific psychotherapy techniques sometimes depends on the orientation of the therapist and/or supervisor. For instance, sessions high in cognitive therapy techniques were only associated with positive outcome when both the therapist and supervisor were highly cognitively oriented. Though preliminary, these results suggest that orientation may be an important variable to consider in training and supervision, especially in the context of other variables.     

A systematic review of the literature on counselling and psychotherapy for the prevention of suicide: 2. Qualitative studies

Scope of review: The paper reports a meta‐synthesis of 13 qualitative studies of counselling and psychotherapy with people at risk of suicide. Publication time span: The studies considered were reported between 1997 and 2006. Publication origin: Seven studies were conducted in the UK, four in the USA, one in Canada, and one in Sweden. Findings: Themes in clients' and therapists' accounts of the process of counselling or psychotherapy were therapist qualities; therapy components; theoretical framework; and therapy techniques. Themes in their accounts of the effectiveness of counselling and psychotherapy were decrease in self‐destructive behaviour, and quality of life. Themes in clients' views of barriers to effective counselling or psychotherapy were therapist characteristics; therapy components; secrecy; and transferring to the real‐life situation. Secrecy was also identified as a barrier by therapists, as were responsibilities of the profession; training; and the nature of suicide and self‐harm. Facilitators of successful counselling and psychotherapy as identified by clients were responsibility; support; and teaching therapy skills to family members, the latter also being identified by therapists.     

King Tiger and the roaring tummies: a novel way of helping young children and their families change*

Therapy with young children and their families poses special challenges for the therapist. In particular, it is important for the therapist to meet the child at his or her ‘view’ of the world. King Tiger is a special helper who can assist the therapist in this task. Once the idea or existence of King Tiger has been introduced to the child and family in therapy, the therapist can commence writing letters and stories to the child on King Tiger's behalf. These written interventions can affect the entire family. The paper will examine some of the useful and creative techniques that can be incorporated into King Tiger therapy. A case example will illustrate how King Tiger can work as a co-therapist.     

An exploratory study into how a sample of a British South Asian population perceive the therapeutic alliances in family therapy

There is currently little research on the therapeutic alliances in family therapy, and even less on those from minority ethnic backgrounds. This paper reports on how British South Asians attending family therapy perceive the alliances, and compares this to the constructs of a newly developed tool – the System for Observing Family Therapy Alliances. Nine participants were interviewed and thematic analysis was employed to analyse the data. The results suggest that certain aspects of the alliances may need more attention when working with this ethnic group. These are safety in front of the therapist and emotional connection to the therapist (including feelings towards the reflecting team and consideration of ethnically matching therapist and client). In general, the quality of the alliance is seen as more important than employing culturally specific techniques. The implications for diversity and family therapy training are discussed.     

Family Therapy in France: A Brief Overview

The major issues in contemporary family therapy in France are described: Difficult beginnings, the practice of family therapy today, training and professionalisation, organization for family therapy, journals and publishing, and perspectives for family therapy in France.A psychiatrist, Head of Hospital Psychiatric and Mental Health Center near Paris (Ville Evrard. France 93330) and a family therapist     

A systemic view of family therapy ethics

A critical review of the literature on family therapy ethics is used to develop the proposition that a more systemic analysis is needed, one that includes the levels of therapist and society as well as patient (family). These ideas are discussed through reexamining the issues of family secrets, therapist deceptiveness, and therapist advocacy of personal (feminist) values.     

Management of religious issues in family therapy

Social scientists have long emphasized the reciprocal relationship between family and religion in society. Yet the family therapy literature is virtually devoid of consideration of religious variables in family life and function. Four major psychosocial aspects of religion in family life are discussed: sacralization, coalitions with the supernatural, religious conflict as a projection of family conflict, and family conflict as a projection of religious conflict. Clinical issues presented include: family therapy in religious and secular contexts, family religious expectations and transference, therapist religious countertransferences, religious identification in family therapy, and family therapy in different degrees of congruence or difference in religious orientation between the family and the therapist. The family therapist must learn how to correctly interpret and appropriately respond to religious issues as they appear in family life and family therapy.     

Family therapy as a rite of passage: play's the thing

Although there is a considerable literature about the nature of family problems and techniques of therapeutic change, little is known about how change in the family therapy setting can be maintained over time. The current paper suggests that important insights into the nature of family therapy can be gleaned by comparison with "naturally occurring" rites of passage. Anthropological analysis of these rites suggests several concepts that may guide the family therapist. These include: (a) the idea of a "therapeutic frame" that marks off the therapy setting; (b) the role of symbolic process and flexibility; (c) the concepts of liminal play and flow as explanations of therapeutic technique and potential; and (d) the relationship between the family in treatment and a wider community. Rites of passage can serve as an important source of comparison and insight into the nature of change in the family therapy setting.     

Dilemmas and countertransference considerations in group psychotherapy with adult children of alcoholics

This article will explore special leader issues that emerge in psychodynamically oriented therapy groups with adult children of alcoholics. Particular focus will be on countertransference feelings that get stirred up in group leaders and techniques for dealing with some of these special dilemmas. Specific issues include (a) assumption of sameness between the therapist and the patient (the therapist assuming that he or she "understands" because of having also grown up in an alcoholic family); (b) the "will to restore," which may be destructive when the therapist, whose own self-esteem is dependent on the patient's progress in therapy, forces a "rush to recovery" on the patient; (c) other personal issues in the life of the therapist that may also resonate with experiences of the patient; (d) "countertransference goodness and availability" as it affects therapists' abilities to set reasonable limits on their patients, as well as reasonable expectations for themselves; and (e) special issues regarding therapist transparency and self-disclosure.     

The manifestation of transference during early psychotherapy sessions: Exploring an alternate data source for therapist narratives in transference research

Introduction: Previous transference studies have compared in‐session client narratives about significant others to in‐session client narratives about the therapist, limiting data to the information that clients are willing to share with the therapist. Method: The first three sessions of 30 therapies with high‐functioning individuals were examined using the Core Conflictual Relationship Theme (CCRT) method. Client narratives about others were drawn from the psychotherapy sessions and client narratives about the therapist were drawn from a Participant Critical Event (PCE) interview conducted after the third session of therapy. Results: Factor analyses of the CCRT components indicated several relational patterns: a complementary pattern of relating characterised by a devaluation of the therapist and idealisation of others; a concordant relational transfer where clients feel bad with both the therapist and others; and as clients experience control issues with significant others, they wish to adopt a submissive stance toward the therapist. The results suggest that the source of therapist narratives may influence the results of transference research.     

Long-term family therapy: A developmental approach

The emphasis in family therapy literature on brief therapy has given a false sense of what family therapy can accomplish. While it has helped to develop different theories of change and refine techniques to deal with resistance, it has caused many clinicians to mistake technique for treatment. A long term developmental approach is advocated in which the family therapist is the general practitioner rather than the specialist. This paper is the result of a 30-year caseload in which there was a group of multi-therapy families.     

Intersubjectively oriented,time-limited psychotherapy with children: how does the therapist evaluate the therapeutic process and what are the therapist’s tasks?

Based on the therapist’s evaluations of three therapies, this research aims to study the therapeutic process in intersubjectively oriented, time-limited psychotherapy with children. A primary objective is to further develop the therapy method. The study comprises therapies with children 6–11 years of age, who had experienced difficult family situations. Each child received 12 therapy sessions. The number of therapy sessions with children and parents was agreed upon beforehand, and the therapeutic objectives were approved by the parents. Each of the therapy processes were evaluated by the therapist by answering three questions and filling in three forms after each therapy session. The forms were: The Feeling Word Checklist; an alliance form for the child; and a process form. The therapeutic alliance and the behaviour of the therapist during the therapy sessions are discussed on the basis of the total material. The following main tasks for the child therapist emerged: structuring the therapy sessions; following the child’s initiatives; participating and cooperating with the child; exploring the child’s expressions; and understanding and regulating emotions.     

Honoring Protective Responses: Reframing Resistance in Therapy Using Polyvagal Theory

Therapists often conceptualize resistance as client behaviors that impede progress; this perspective threatens the therapeutic alliance, especially in couple and family therapy where increased resistance and multiple alliances are present. Polyvagal theory reframes and normalizes resistant behaviors as preconscious, protective responses emerging from our autonomic nervous system. The theory also explains how humans reciprocate safety cues to connect with each other; therapists can use concepts of polyvagal theory to manage their own emotional regulation and foster safety and connection in therapy. Polyvagal concepts deepen our understanding of protective behaviors presenting in couple and family therapy; therapists can help couple and family clients to recognize protective behaviors in their own relationships and facilitate safer connection and engagement. Clinical implications are presented: psychoeducation can help clients normalize and understand their protective processes; therapist presence and immediacy acknowledges and normalizes protective behaviors as they arise; therapist and client self-regulation skills support connection; therapist genuineness is a precondition to client safety; and understanding of polyvagal theory enhances assessment of conflict and enactments in couple and family therapy.