A family systems approach to grief

This article blends two important viewpoints on grief: a stage theory on the individual's grief and the family systems literature on grief. A case study is examined from both the individual and systemic viewpoints. Pastoral implications for intervention with the case study family as a system are noted. The theological questions which the family and pastor face are also discussed.     

Effects of positive youth development programs on school, family, and community systems

A review of efforts at social system change in 526 universal competence-promotion outcome studies indicated that 64% of the interventions attempted some type of microsystemic or mesosystemic change involving schools, families, or community-based organizations in an attempt to foster developmental competencies in children and adolescents. Only 24% of the reports provided quantitative data on the change that occurred in targeted systems. However, studies containing the necessary information produced several mean effect sizes that were statistically significant, and ranged from modest to large in magnitude. These data indicate that attempts to change social systems affecting children and adolescents can be successful. Future work should measure more thoroughly the extent to which the systemic changes that are targeted through intervention are achieved, and investigate how such changes contribute to the development and sustainability of the outcomes that might be demonstrated by participants of competence-promotion programs. The authors wish to thank David Wilson for supplying the macros used to calculate study level effect sizes and Mark Lipsey for supplying the SPSS macros used to weight effect sizes and calculate mean effects across studies. This study was supported in part by a grant from the William T. Grant Foundation (#2212) awarded to the first and last authors.     

A family systems approach to conciliation in separation and divorce

This paper argues for a family systems approach to families who are in conflict during the process of divorce, particularly in relation to custody and access for their children. The concept of 'conciliation' as a brief method of intervention is both defined and discussed and principles and skills are identified. The influence of the context within which conciliation is practised and in particular, the power which the conciliator holds, or is perceived by the family to hold, is also discussed. These ideas are illustrated by case examples.     

A behavioral approach to treating an elective mute in the school

The treatment of a 10-year-old elective mute boy is reported in detail. A learning principles based approach was used in a one-to-one therapeutic setting. Relatively normal speaking patterns were established after 15 months of treatment.     

The rainbow bridge: an approach to family systems via Howards End

Bateson's ideas of artistic expression, the continuity of Art and Science and the nature of Mind are used as cues for the exploration of Howards End, E. M. Forster's novel of family life. Illustrations of systemic concepts are given from the text. Particular relevance is suggested for the use of literary examples in family therapy training and in the development of family systems theory.     

A family/systems approach to illness-maintaining behaviors in chronically ill adolescents

A distressingly significant number of chronic, seriously ill adolescents demonstrate poor medical management of their illnesses through "illness-maintaining behaviors." These behaviors are defined in this article as any action that compromises chronically ill adolescents' care and prevents them from functioning optimally. Current conceptualizations of illness-maintaining behaviors offer explanations that view these behaviors as individually focused, using either psychodynamic or behavioral models. This article, however, presents a family systems model of illness-maintaining behaviors. A therapeutic framework leading to specific intervention strategies is also developed.     

A behavioural and systems approach to family therapy: a position paper

An integrated model of a behavioural and systems approach to family therapy is presented, the main premise being that family interactions are affected by reciprocal determination of cognitions, feelings and behaviours in relation to the environment. Assessment involves a systematic exploration of the interaction and transactional patterns within the family, and the identification of the dysfunctional aspects of such patterns. The main aim of the intervention is to produce change in family behaviour by addressing the important cognitive and affective issues. This entails techniques such as cognitive restructuring, social modelling and operant conditioning which can be used separately, in parallel, or in combination. Whether one or more of these techniques is used depends on the nature of the family's problems and the aims of treatment.     

An ecological approach to child and family clinical and counseling psychology

The ecological model of child and family clinical and counseling psychology considers mental health service delivery within a health maintenance framework, approaching the complexity of children's behavior in a systematic and organized fashion using science-based intervention practices. The service delivery framework integrates assessment, intervention, and motivation at all phases of an intervention. Assessments enhance the participants' and professionals' appraisal, which in turn impact motivation to change. Interventions are sensitive to assessment-based targets and participant motivation. A menu of interventions range from assessment, feedback, and brief interventions to more extensive mental health services, potentially integrated with other community agencies and school settings. The ecological model suggests revisions in the conceptualization of child and adolescent psychopathology, training for mental health professionals, and strategies for the design and testing of interventions. In general, a reformulation of mental heath services for children and families within an ecological framework enhances the potential for integrating science and practice.     

The family empowerment program: an interdisciplinary approach to working with multi-stressed urban families

The family empowerment program (FEP) is a multi-systemic family therapy program that partners multi-stressed families with an interdisciplinary resource team while remaining attached to a "traditional" mental health clinic. The rationale for this model is that far too often, families presenting at community mental health centers struggle with multiple psychosocial forces, for example problems with housing, domestic violence, child care, entitlements, racism, substance abuse, and foster care, as well as chronic medical and psychiatric illnesses, that exacerbate symptoms and impact traditional service delivery and access to effective treatment. Thus, families often experience fragmented care and are involved with multiple systems with contradictory and competing agendas. As a result, services frequently fail to harness the family's inherent strengths. The FEP partners the family with a unified team that includes representatives from Entitlements Services, Family Support and Parent Advocacy, and Clinical Staff from the agency's Outpatient Mental Health Clinic practicing from a strength-based family therapy perspective. The goal of the FEP is to support the family in achieving their goals. This is accomplished through co-construction of a service plan that addresses the family's needs in an efficient and coherent manner-emphasizing family strengths and competencies and supporting family self-sufficiency.     

The Butchers, an eclectic approach to family therapy

The thesis of this paper is that differing theoretical constructs offer a variety of rich approaches when responding to the problems families present. To work exclusively within one theoretical framework is to deny oneself the value latent in other models, and thus restrict one's therapeutic competence. It is suggested that various family therapy models can be worked together without contradiction if they are subsumed in an overriding systems approach. It is also pointed out that the various models have particular capabilities and limitations with differing therapeutic goals. Ten interviews with one family are used to illustrate an eclectic approach in therapy.     

Elective mutism in children: A family systems approach

Abstract

Elective mutism in children is a relatively rare symptom which is more prevalent in the kindergarten population and has a higher incidence among immigrant families. Treatment strategies for this silent symptom include speech therapy, behavior modification, psychoanalytic, psychotherapeutic, family systems and a combination of these approaches. This paper reviews the types of elective mutism and proposes common characteristics of elective mutists' families. The potential for a redefinition of the term “elective mutism” is examined. It is concluded that family dynamics are an integral part of the elective mutism problem and need to be considered in a comprehensive treatment plan.     

A guide to family/school interventions for the family therapist

When presented with a behavioral problem or symptom expression that involves two systems, such as a serious school-related problem, the therapist needs to design an approach that will intervene effectively and expeditiously in both systems. This paper offers a guide to stages of problem escalation and therapeutic intervention that is intended to aid the problem-solver's thinking processes in approaching a troubled situation that involves two systems, the school and the home.     

Involving the family in the evaluation and treatment of the child patient: A psychodynamic approach

The purpose of this article is to provide psychotherapists with a tool for family evaluation using the basic principles of psychodynamic work; and to introduce a transitional format for therapists who have practiced family evaluations in their training institutions and now need to adapt this model to the private practitioner's office. A case example illustrates: (1) Use of the therapist's unconscious for diagnosis of the child and its family, (2) joining the family's intersubjective space, and (3) use of play and therapist's neutrality as ways that the psychodynamically oriented clinician involves the family in the evaluation and treatment of the child.     

A family systems approach to child–parent separation: 'developmental closure'

This paper presents a family systems model for considering the interactive events that occur when a child and parent move towards closing their relationship and separating. This process typically involves the child being 'received into care' and is identified as developmental closure . Different stages of this process are exemplified clinically and the therapeutic principles that guide work with families struggling with such difficulties are outlined.     

Building cardiovascular disease competence in an urban poor Ghanaian community: A social psychology of participation approach

This paper describes conceptual, methodological, and practical insights from a longitudinal social psychological project that aims to build cardiovascular disease (CVD) competence in a poor community in Accra, Ghana's capital. Informed by a social psychology of participation approach, mixed method data included qualitative interviews and household surveys from over 500 community members, including people living with diabetes, hypertension, and stroke, their caregivers, health care providers, and GIS mapping of pluralistic health systems, food vending sites, bars, and physical activity spaces. Data analysis was informed by the diagnosis‐psychosocial intervention‐reflexivity framework proposed by Guareschi and Jovchelovitch. The community had a high prevalence of CVD and risk factors, and CVD knowledge was cognitive polyphasic. The environment was obesogenic, alcohol promoting, and medically pluralistic. These factors shaped CVD experiences and eclectic treatment seeking behaviours. Psychosocial interventions included establishing a self‐help group and community screening and education. Applying the “AIDS‐competent communities” model proposed by Campbell and colleagues, we outline the psychosocial features of CVD competence that are relatively easy to implement, albeit with funds and labour, and those that are difficult. We offer a reflexive analysis of four challenges that future activities will address: social protection, increasing men's participation, connecting national health policy to community needs, and sustaining the project.     

A cooperative approach to the internship in school psychology

The internship program in school psychology in Ohio involves the close and continuing cooperation of the Ohio Department of Education, Ohio Inter-University Council on School Psychology, and field supervisors employed by local school districts. The roles of each are briefly discussed.     

A practical approach to school psychology

Exclusive use of the clinical model in school psychology is impractical. This is discussed in terms of incidence of adjustment problems, psychologist-student ratios, and undesirable side effects that have resulted from sole use of the clinical model. Reasons for implementing developmental and preventive mental health programs in the schools are discussed, and examples of such programs are presented. Some alternatives to the usual ways of handling the remediation of currently existing adjustment problems are suggested.     

The educational therapy contribution to a family systems approach

This article draws on the experience of one specialist education unit to demonstrate the usefulness of engaging families directly in the treatment of children showing difficulty in managing tasks and relationships in school. It will look at the overlap of psychoanalytic and systemic ideas and show how theory and practice from both 'schools of thought' allow for a fuller understanding of blocks to school success and also support the family and child in their efforts to 'defeat' a difficulty. I look in particular at the way a psychodynamic focus on a child's inner world can work alongside the systemic focus on family structure, hierarchy and history.