Patterns of Response to Out-of-focus Slides of Families with an Emotionally Disturbed Member

Mutual facial recognition was studied in thirty families with and without a disturbed member. It appears that families with a markedly disturbed child have idiosyncratic modes of mutual recognition, particularly in the case of the mother, whereas families without a disturbed member or with a moderately disturbed child do not display idiosyncratic patterns. Although the sample is very small, there is a suggestion that families with a disturbed parent have patterns of recognition that are entirely different from those of the other families in the study.     

Lack of acknowledgment in the family Rorschachs of families with a child at risk for schizophrenia.

Lack of acknowledgment, a characteristic of the direct interactions of families of schizophrenics, was found also to characterize the Family Rorschach interactions of families whose disturbed, non-psychotic adolescents were assessed at high risk for schizophrenia on the basis of parental communication deviance. The same high-risk families had unbalanced interaction patterns as reflected in three measures of family structure.     

An investigation of the use of nocturnal dream reports as diagnostic indices in the assessment of family problem solving

This study investigated the use of series of nocturnal dream reports to diagnose patterns of family functioning. Five families (twenty one subjects) collected a total of 126 dreams. A Treatment Group consisted of two families undergoing family therapy whilst a Non-Treatment Group, comprising three families, was drawn from a population ranging from severely disturbed to superior family functioning. The manifest content of the dreams was analysed, qualitatively and quantitatively. The presenting problem, case history, therapeutic processes and outcome were unknown to the dream researcher. The family therapist was blind to the dream content and dream analysis. Each family was independently rated by the therapist and the dream researcher. The agreement between the two assessments was highly significant. In addition, the problem areas, family transactions and treatment outcome were correctly identified by the dream researcher. It was concluded that analyses of dream series reflect the problem areas encountered by a family system. Implications for therapeutic strategies are discussed.     

Family therapy and outcome: Relationships between therapist and family styles

This study examined therapeutic outcome for a group of 175 clinic families divided into levels of family competence and style, and, later, into seven clinical groupings. The division into these groups was based on the level of rated Competence and Style determined by using the Beavers Systems Model. Therapists also rated their level of Openness/Sharing Strategy, Power Differential, and Partnership with the family at the third session. Results indicate that more competent families who fared well in therapy had therapists who formed a partnership, disclosed strategy, and employed a minimal power differential with the family. The most disturbed families, and those with a Centrifugal style, did better with therapists employing a high power differential and lower levels of openness and partnership. The study also presented the distribution of individual diagnoses by family groups. Implications for family therapists, including the value of family assessment, are provided.     

Perceived Parental Attitudes and Family Concepts of Disturbed Adolescents,Normal Siblings and Normal Controls

This study tested the hypotheses that disturbed adolescents perceive lower parental attitudes (positive regard, empathic understanding, genuineness and unconditional regard) than are perceived by their normal siblings and normal controls; that normal siblings do not differ from normal controls on these variables; that levels of perceived attitudes are positively related to family concept measures of adjustment and satisfaction; and that attitudes perceived in one parent are positively associated with those perceived in the other. The hypotheses were substantially confirmed. In contrast to both normal groups, the disturbed adolescents failed to show positive relationships between maternal attitudes and the family concept measures and between perceived paternal and maternal attitudes.     

ABSTRACTS OF LITERATURE

This is a clinical study attempting to discern differences in parental behavior toward children considered "normal" (that is, having never received special psychological, educational or legal attention). Sample was 25 children (11 boys and 14 girls) ages 10 to 11, from upper middle class families with both parents living at home. Families were rated on a family task, children on adjustment using the Briston Social Adjustment Guide. Children were divided into three categories—adjusted, middle, and disturbed—with nine in the first group, eight each in the second and third. Significant differences were found between the adjusted and the disturbed groups for parental behavior during the family discussion task. Disturbed mothers were found to be "over-prominent and over-attentive"; disturbed fathers were withdrawn.     

With Onions and Tears: A Multidimensional Analysis of a Counter-Ritual

“Family rituals” and “family myths” are useful concepts for understanding some of the behavior of disturbed families and hence for planning therapeutic interventions. A case of a family of a schizophrenic patient is described in which a “counter-ritual” involving onion-peeling to induce tearing was invented. The intervention addressed the family's inappropriate laughter and denial of sadness and seemed to lead to therapeutic gains for the identified patient and the family. This counter-ritual, as an indirect affect-inducing experience, is analyzed from a variety of perspectives and a partial parallel is drawn to an Iranian cultural ritual. A suggestion is made that more light may be shed on the mechanisms and structures of myths and rituals in families by drawing on studies of myths and rituals in ethnography. “Counter-ritual” is offered as a general concept for a type of active family intervention that involves inventing and employing rituals antithetical to pathological ones engaged in by some families.     

Psychoanalysis and family therapy: Freud's Dora case reconsidered

Freud's Dora case is considered from the perspective of family therapy. Her illness is homeostatic; it holds two disturbed fractured families together. Freud considered his analysis a failure; from a systems point of view it was a partial success. His challenging technique is similar to that of modern family therapists. The theories of change underlying family therapy and psychoanalysis are compared. There are many similarities. They are mutually compatible disciplines, working at different levels.     

Perception of Cognitive Ability in Families of Adolescents

The families of 20 hospitalized adolescents were compared with a control group of 20 non-pathological families on the accuracy with which family members could predict each others' performance on two tests of intellectual ability. Accuracy of prediction was measured by the discrepancies between actual scores obtained by each family member and the scores other family members predicted he or she would obtain. The control and experimental groups were found to differ significantly on socioeconomic status and intellectual ability, and when these variables were controlled, a covariance analysis revealed no significant difference between the groups on accuracy of predictions. The results suggest that variables other than psychopathology must be taken into account in explaining apparent differences between healthy and disturbed families on measurements of interpersonal judgments. Implications for research and family therapy are discussed.     

Pictorially displayed family patterns as an assessment instrument

The performance of a pictorial assessment instrument and suggestions for clinical application are described. The stylized family illustrations include the following patterns: normal family, detouring, two-generational enmeshment, three-generational enmeshment, parental child, undermined mother and chaotic family. Ninety-eight individuals, five years or older, in twenty families selected depictions most like their own families. Siblings of patients alone or siblings combined with fathers chose the same pattern type as the family therapists 75 and 64% of the time, respectively. These concordances were significant statistically. Clinical uses include identifying promising therapeutic resources and facilitating transitions to systems and relationship issues.     

Relationships between adult attachment representations and family ritual quality: a prospective, longitudinal study

Meaningful family rituals have been associated with positive outcomes for families and children. No studies, however, have investigated predictors of family ritual quality, the identification of which would be important for understanding why some families create and enact meaningful family rituals while others lack rituals or have problematic rituals. We propose that adult attachment security may be an important predictor of family ritual quality because family rituals may provide a sense of stability and cohesiveness for the family. The purpose of this study was to examine relationships between adult attachment representations and the quality of family rituals, using a prospective, longitudinal design. Prior to the birth of their first child, 125 couples completed the Adult Attachment Interview, and a subsample of 70 mothers and 62 fathers completed the Family Rituals Questionnaire when their first child was 7 years old. Different patterns of relationships between attachment representations and family rituals were found for mothers and fathers. Maternal Insecure Attachment was associated with higher routinization of family rituals. Being in a couple with mixed attachment classifications (e.g., one Secure partner and one Insecure partner) was related to a pattern of low routinization and low meaning for family rituals. The results of this study are interpreted in terms of two patterns of rituals that have been described by clinicians--rigid ritualization and underritualization, and suggestions for working with these ritual patterns in families with Insecure attachment are provided.     

A "good enough" separation: some characteristic operations and tasks.

Perhaps there are advantages, at this stage of our knowledge, to be looking for the adaptive mechanisms of divorcing families where children are involved, rather than focusing primarily on concepts of risk, dysfunction, and disaster. Perhaps what is truly remarkable is that divorcing families are not more disturbed, given the stigmatization, the uncharted nature of this complex upheaval with little normative frame, and diminished financial resources. As a modest offering in this regard, a 3-year longitudinal study is presented of a nonclinical postseparation family with an adolescent who neither entered nor required treatment. Specifically, their successful resolutions invented for dealing with day-to-day divorce dilemmas and challenges are explored.     

Family Relations Test Responses of Retarded Readers: Reliability and Comparative Data

The Family Relations Test (FRT) was administered to 46 retarded readers and readministered after a 3-week interval. Test-retest reliabilities were in the .70s, .80s, and .90s for major response classifications. Responses of the retarded readers were similar in configuration to those reported for other clinic groups and normal Ss but not to response patterns of institutionalized emotionally disturbed children. Future research may need to consider children's perceptions of family relationships in the context of parental and sibling data. Specific tactics for future research are suggested.     

How One Family Perceives Another: The Relationship Between Social Constructions and Problem-Solving Competence

This paper delineates a rarely studied but important family process: how a family perceives and understands the relationships in other families it knows. We hypothesize that these perceptions of other families are fundamental components of a family's shared construing of its social world. Families differ in how they perceive other families, specifically, and in their approach to construing or apprehending their social world, generally. We have hypothesized that these general differences also play a crucial role in shaping the style and competence of family problem-solving. A family's approach to any problem depends upon how it construes or interprets the social context of that problem. Using these general concepts of family life, we construct specific hypotheses linking family problem-solving and interfamily perception. We describe methods for measuring both family problem-solving and how a family perceives other families. Findings confirm our major hypothesis: A family that searches for underlying and subtle patterns in a problem-solving situation will develop a more differentiated and organized conception of other families.     

Therapy with Families in China: Cultural Factors Influencing the Therapeutic Alliance and Therapy Goals

Rapid economic and social development in China is producing opportunities for a better standard of living for many families but also is associated with significant stress. Family therapy is one of the forms of mental health services that have become increasingly available. Western-derived models of family therapy are being used and adapted to meet the cultural traditions and needs of Chinese families. This article describes a variety of Chinese cultural factors that can influence the establishment of therapeutic alliances with family members (communication styles, collectivist values, family roles, and structure) and those that can shape family therapy interventions by addressing contextual factors affecting Chinese families (economic development, migration patterns, academic pressure, and changing gender roles for women). Suggestions are offered for using cultural sensitivity to address these factors tactfully to build strong therapeutic alliances and help families cope with significant life stresses.     

Aging family caregivers: policies and practices

This review examines later life family support for adults with developmental disabilities from a life course perspective that takes into account social trends and changes in service patterns and in attitudes of families. Key issues addressed include: (1) trends affecting family caregiving, (2) health and social outcomes of life-long caregiving, (3) support needs of families, (4) family support policies and practices, and (5) recommendations for a research and policy agenda. Research examining outcomes of life-long caregiving has shown that most families adapt well to having a family member with disabilities. However, some families are at risk for poorer physical and mental health outcomes. These include cultural minorities and families of adults with behavioral challenges. Caregiving does seem to have a negative impact on maternal employment and family income as mothers often give up or cut back on employment to care for a child with developmental disabilities, who is more likely to continue living in the family home throughout adulthood than other adult children. Federal and state initiatives are addressing issues of family support through both the developmental disabilities and aging service systems.     

Power and influence in the environment of family therapy

This paper explores some of the ways in which family therapy theory and practice limits an appreciation of the contexts of families and family therapists. It focuses particularly upon how the rules which underline patterns of relationships in social systems are made and maintained more by one part of a system than by another, and considers this (a) within families, (b) within various aspects of the social environment of families, and (c) within the organizational contexts of family therapists. It then proposes that the systemic thinking which family therapists apply to families is potentially applicable to wider contexts including international relationships.     

Power and influence in the environment of family therapy*

This paper explores some of the ways in which family therapy theory and practice limits an appreciation of the contexts of families and family therapists. It focuses particularly upon how the rules which underlie patterns of relationships in social systems are made and maintained more by one part of a system than by another, and considers this (a) within families, (b) within various aspects of the social environment of families, and (c) within the organizational contexts of family therapists. It then proposes that the systemic thinking which family therapists apply to families is potentially applicable to wider contexts including international relationships.     

Family interactions in black, lower-class families with delinquent and nondelinquent adolescent boys

The interaction patterns of 32 black, lower-class family triads (mother-father-son), divided into two equal groups by the son's delinquency status, were assessed across self-report and observational measures of family affect, conflict, and dominance. In support of previous research with white, middle-, and lower-middle class families, the results generally indicated that families with delinquent boys were less warm and more conflictual than families with nondelinquent boys. Relative to parents of nondelinquents, parents of delinquents were more conflictual on expressive family issues than on instrumental issues. In addition, the results showed that the content of the family interaction task (expressive vs. instrumental) influenced observed patterns of intrafamily dominance. The theoretical and practical implications of these findings are discussed.     

ABSTRACTS OF LITERATURE

Schizophrenia is due to a combination of genetic and environmental factors. The author asserts that there has previously been an error in conceiving the patient as being molded completely by external circumstances. In fact, it is the patient's behavior, which is a transformation of family irrationality, that constitutes schizophrenia. In 75 per cent of cases of schizophrenia seen by the author in private practice, the mother did not fit the image of the so-called “schizophrenogenic mother.” In this technique for teaching family therapy, the students take the roles of the family. Procedures, selection of players, formulating the problem, the value of the experience, and ground rules are described. This is a case report and follow-up over nine years of an alcoholic woman. The patient and husband were treated for 35 sessions by cotherapists in conjoint marital therapy. Although there was improvement in the family patterns and in drinking behavior during the treatment, the improvement did not last after termination. The case suggests that marital therapy in the absence of other treatment interventions is ineffective in changing the long-run course of women alcoholics. Based on the author's practice on an inpatient unit that specializes in the study of aggressive behavior, he describes family dynamics and treatment when the identified patient suffers from “episodic violent behavior.” The sample focuses on adolescents, most of whom had episodes of suicidal behavior and who had some evidence of “organic involvement.” Typical family patterns include overly close alliances by the adolescent with one or both parents and transmission by parents of inconsistent values regarding aggression. Family therapy is seen as the preferred treatment approach and emphasizes family ways of handling dyscontrol episodes and the responsibility of the patient for his or her actions. No results are reported. This study attempts to link family variation and core relationships in types of families with the mental health of children. Sample was from a black, poor, urban community defined in terms of the adults present in the home. Eighty-six family types were found falling into ten major classes. Measures of mental health in children were done on psychological well-being of the children and on Social Adaptational Status. Results indicate that family type is strongly related over time to child's SAS and his or her psychological well-being. Mother-alone families entail the highest risk in terms of social maladaptation and psychological well-being of the child; the presence of certain second adults has important ameliorative functions—mother/grandmother families being nearly as effective as mother/father families, with mother/stepfather families similar to mother-alone in regard to risk. Inferences from this data and implications and interventions are discussed. This is a clinical essay on the role of family therapy for black families. In addition to the usual family stresses, black families are subject to the additional strain of discrimination. Support is achieved mostly from the family and from the kinship network, rather than the community. Treatment strategies for this situation are proposed. This essay reviews recent regulations concerning consent procedures and protection of privacy as they apply to children and their families. Rigorous sample selection, nearly complete follow-up, and objective assessment of outcome are virtually impossible at this point. It is concluded that compliance with current “subjects' rights” regulations sometimes seems potentially more harmful to the subjects than the research itself. One case example is presented in support of the hypothesis that brief family therapy has the potential to lead to individual personality changes that are long-lasting. The identified patient was a 15½ year old boy with the symptom of having a falsetto voice. Father, mother, and child were seen in twelve family therapy sessions with changes in the boy's self-image documented in “man-figure” drawings. Nine-month follow-up revealed no recurrence of the presenting symptom and an improvement in social and familial relationships of the identified patient. This is another in a series of papers from a divorce-counseling project. The focus in this paper is on preventive clinical interventions developed for children of various ages in divorcing families. Developmental assessment was achieved with a “brief” history from the parents, detailed information from school, and “direct observation” of the child. This paper covers treatment strategies, interventions, failures, therapist's role, and professional dilemmas in divorce counseling of 60 families with 131 children between the ages of 3 and 18 at the time of divorce. The technique of counseling was to see one parent and child separately by the same therapist three to six times over a three-month period. This is a research study to provide data on the question of whether the disturbed behavior of parents with a schizophrenic child preexists or is a response to an identified patient's pathology. Method was to administer a conceptual task called the Twenty Questions Task individually to each family member and to the family as a unit with a sample of 36 schizophrenic families, 13 non-schizophrenic controls, and 38 normal controls. Results “indicated that far more schizophrenic sons than control sons were much more efficient individually than with their families.” A number of schizophrenic sons performed competently as individuals, but the subsequent performance of parents and sons together on the same task was generally inferior to that of the son alone. Results suggest that the parental behavior plays a part in the etiology of schizophrenia.