Promiscuity in the practice of family therapy

Family therapy has continually confronted choices between polarized positions, each one taken up with zeal because it solved an old dilemma but eventually encountering its own limitations. In this article I suggest that we have evolved to a point where, instead of deciding which is better, we can focus on how to use theories, models and techniques as fluid and flexible resources for action in the therapeutic conversation. Doing so focuses our attention on how we can move in and out of various positions, including those that simplify issues and those that embrace complexity. In addition, our attention is drawn to the ways in which we can make choices between following a model as opposed to engaging in spontaneous dialogue. This promiscuous stance can help trainers and therapists answer questions concerning how we make decisions in therapy. Such promiscuity also positions us to confront our images and expectations of what it means to be a professional.     

Using family therapy ideas with parenting groups in schools

The author describes his experience of using ideas from family therapy with groups of parents in two urban schools in the United States.     

Rhetorical theory and family therapy practice

The study found that a connection exists between rhetoric and therapy because both fields are interested in using language as a tool for generating change. Persuasion is viewed as inherent in human communication, even though people do not necessarily intentionally attempt to persuade others. Following a brief (but detailed) explanation of the theoretical stance which informs the implementation of rhetorical techniques in therapy, three pragmatic exemplars are offered to demonstrate the employment of two classical rhetorical concepts, the parastasis catalogue and syncrisis.The authors are grateful to Sandra Kodner, MS for her participation in the development of this project.     

Stress and coping in the practice of family therapy: a British survey

A sample of 171 members of the Association for Family Therapy (UK) was surveyed and data obtained on their general level of experienced stress, the sources and levels of experienced stresses they encountered in their practica, and the professional and private coping strategies they used to mitigate the effects of these stressors. The results indicate that stress can be experienced in all practice contexts, with important factors in its overall configuration being personal/professional worth and agency expectation. Family therapists appear to prefer coping strategies of a more social nature and there is an ambivalent attitude towards'therapy for therapists'.     

Revisiting confidentiality: observations from family therapy practice

Confidentiality has long been recognized as a critical legal and ethical principle for the committed, value‐based practitioner. Vital principles (such as confidentiality) become manifest in material practices and in the language of professional and societal narratives. This articulation into specific practices and performances requires a pragmatic process that transforms the abstract into real‐world activities. This imperfect process has the potential of including the derived practices that in certain ways may extend the principle in unintended or unwanted directions. In the case of confidentiality, the actual practices of confidentiality may be both emancipating and inhibiting – they may protect as well as isolate. Our purpose is to revisit the idea of confidentiality and to deconstruct the way it functions in both positive and negative manners in clinical work.     

The therapist's inner conversation in family therapy practice: some ideas about the self of the therapist, therapeutic impasse, and the process of reflection.

In this article, a distinction is made between the outer therapeutic conversation and the therapist's inner conversation. The therapeutic conversation is a circle of meaning in which both the therapist and the clients play a part. The therapist's inner conversation is described as a negotiation between the self of the therapist and his role. In this process of negotiation the therapist has to take seriously, not only his observations, but also what is evoked in him by these observations, that is, images, moods, emotions, associations, memories, and so on. Furthermore, therapeutic impasse is conceptualized as a paralysis of the circle of meaning and of the therapist's inner conversation. A process of reflection is proposed as a way out of the impasse. In that process, the inner conversation of the therapist is externalized with the help of an outsider. In the final part of this article, a case study illustrates the importance of these ideas for the family therapy practice.     

The practice of community family therapy

This paper presents a summary of the basic theories and methods of Community Family Therapy (CFT), a relatively new therapeutic approach developed in response to the need for effective intervention in treating low-income, urban families. CFT operates outside of the traditional therapeutic box, successfully combining family therapy techniques with developmental and motivational theories, community mental health, social work, economic development, and community mobilization strategies. CFT utilizes a dualistic approach in which both client and therapist become involved with the same three levels of engagement. Specifically, the client strives for: (a) personal and family change and growth-level 1, (b) accessing community resources-level 2, and (c) leadership development and civic action-level 3. Also, CFT calls upon therapists to strive for: (a) personal growth and maturation-level 1, (b) collaboration with community resources for professional support-level 2, and (c) operation as a "citizen therapist," through civic action and volunteer services-level 3.     

Attachment narrative therapy: integrating ideas from narrative and attachment theory in systemic family therapy with eating disorders

This paper proposes that recent developments in attachment theory, especially the move to the study of representations, offers some helpful new directions for systemic family therapy. Some of the findings of a close association between early attachment experiences and the coherence of the narratives are reviewed. It is suggested that this offers a useful link for systemic approaches in showing how early interactions in families promote not only particular emotional attachment patterns, but also shape the content and style of the narratives that are formed. These implications are then explored in the context of work with anorexia nervosa. It is suggested that commonly observed patterns, such as avoidance of conflict and apparent difficulties in discussing relationships and feelings, is consistent with transgenerational experiences of insecure/avoidant attachments. Some implications for systemic therapy with families are outlined and an illustrative case study is offered.     

Family law issues in family therapy practice

Abstract

The American Journal of Family Therapy is pleased to innaugurate this new section with the intent of being at the cutting edge of the interface of the interrelationship of family law and family therapy. We introduce this endeavor with several articles on child custody-an arena of crucial concern in both disciplines. One article is a summary of child custody laws extant throu hout the United States. to commend it psychologically and legally. The third item, in keeping with the theme, is a speculative fable about joint custody written by a matrimonial attorney who practices family mediation and who has training as a family therapist. It captures the tenor of the times. The second article discusses a model for child custody ev a f uations, which has much     

The therapist's self in dialogical family therapy: some ideas about not-knowing and the therapist's inner conversation

In this article, the focus is on the therapist's self, which will be in line with Bakhtin's thinking, viewed as a dialogical self. First, the dialogical view of the self is situated in the context of psychology's traditional focus on the individual self. Then, leaning on Bakhtin and Volosinov, the self is described as a dialogue of multiple inner voices. Some of the implications of this concept for family therapy practice are examined, focusing especially on the therapist's participation in the therapeutic process and on the therapist's inner conversation. The author argues that not-knowing does not only refer to the therapist's receptivity and respect but also implies that the therapist is aware of his or her experience and reflects on how his or her inner conversation might inform and enrich the therapeutic conversation. Finally, these ideas are illustrated with a brief clinical vignette.     

Family law issues in family therapy practice

Abstract

The FAST represents a vast improvement over other figure placement techniques (FPTs). It offers an assessment procedure that measures both cohesion and power, assesses several family levels, allows for interpretation and comparison of individual and collective perceptions, and yields a more complex view of family dynamics by providing information regarding family organization across situations. Further, the FAST allows clinicians to hypothesize about treatment prognosis, plan systemic interventions, and monitor structural transformations that occur during therapy. As structural and developmental theories seem to be two of the more commonly recognized perspectives across disciplines (as evidenced by the types of relational additions in the soon-to-be-published DSM-IV), the FAST has the potential to become an interdisciplinary diagnostic and empirical link. Recommendations are noted here to maximize the potential of the FAST as a theoretically grounded and psychometrically sound family instrument.     

Evidence-based practice in family therapy and systemic consultationChild-focused problems

Evidence for the effectiveness of family therapy and family-based interventions from critical literature reviews and controlled trials is considered for families with children and adolescents who present with various difficulties. The evidence supports the effectiveness of family therapy as an effective treatment either alone or as part of a multimodal or multisystemic treatment programme for child abuse and neglect, conduct problems, emotional problems and psychosomatic problems. Implications for practice, training and continuing professional development in the field of family therapy are discussed.     

Family therapy without the family: a framework for systemic practice

This paper contrasts the basic tenets of systemic thinking with some guiding principles of the psychodynamic approach, and outlines specific techniques which family therapists can use when seeing individuals. It is argued that a useful systemic framework can be maintained if the therapist aims to keep the therapy system 'open' for relevant others to join at any time.     

Audit and family systems consultation: evaluation of practice at a child and family centre

This audit of practice at a child and family centre included a 16-month case note review covering 319 cases, a postal survey of 45 families and an interview survey of ten GPs who typically referred cases to the centre. The audit furnished information from three different perspectives on the referral process, the consultation process, and outcome for clients attending the centre. The referral rate was about one new case per day and peak referral times were the beginning of the autumn and winter school terms. Almost half the referrals came from GPs; the remainder were largely from Paediatrics, Education and Social Services. Most clients were seen within two months. Half of the families referred had serious psychosocial difficulties including multiple problem members, multi-problem children, multi-agency involvement, psycho-educational difficulties, child protection problems or child placement difficulties. The majority of cases received six hours of consultation. Families where child abuse had occurred or families containing a multi-problem adolescent received a more intensive service. Between a half and three-quarters of cases had positive outcomes as rated by staff and parents. The service was viewed by GPs to be highly satisfactory. On the negative side, many parents felt ill-prepared for the consultation process and most children did not enjoy the experience.