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.     

Gender, Power, and Relationship Ethics In Family Therapy Education

Awareness and sensitivity about gender issues have central positions in family therapy education. Traditionally gender relationships have been treated as either a reflection of cultural values and norms or as a dynamic of the way that men and women deal with the other sex. This paper presents the findings of a qualitative study that examines the meaning and enactment of gender issues in the supervisory process in family therapy. Based on that study, the authors developed a strategy for raising issues of gender equity in clinical training and describe the effects of that strategy on one practicum.Professor of Family and Child Sciences and the director of the Interdivisional Program in Marriage and Family Therapy at Florida State UniversityAn associate professor of Family and Child Sciences and the co-director of the Family Policy and Research Unit in the Family Institute at Florida State University     

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.     

The formalization of family therapy training—issues and implications

This paper highlights the emerging debate, particularly evident in the U.K. and Australasia, regarding the desirability of more formalized training programmes for family therapy. The professionalization of family therapy is under way. The implications of this process for training structures, the role of the family therapist, the nature of family therapy associations and thus the ultimate goals of family therapy are summarized. Alternative models of training structures, their ideological bases and the implications of these alternatives for the nature of an association and the family therapy process are then briefly discussed. In summary, some priorities for a desired model of family therapy training are listed for discussion.     

The treatment of psychological trauma from the perspective of attachment research

This paper looks at the implications of attachment research for the treatment of psychological trauma. This is particularly important in the field of family therapy given that PTSD both impacts on the immediate family system and can be transmitted down the generations. After an initial review of current research in the field, the paper focuses on the assessment and treatment of PTSD, emphasizing the importance of integrating techniques from different models that enable clients to modulate their emotions as part of the therapeutic process. The paper concludes by emphasizing the importance of support and supervision for the therapists in order to avoid secondary traumatization.     

The Anorectic Process in the Family: A Six-Stage Model as a Guide for Individual Therapy

This article presents a conceptual framework for individual treatment with chronic anorectic patients. In the first part of the article, the six-stage model for the anorectic process developed over the past years by M. Selvini-Palazzoli and her team is briefly explained. After presenting the model, we then discuss some related concepts, namely, "family game," "rule," and "strategy." Finally, the therapeutic technique in individual treatment is discussed. Two basic assumptions underlie this technique: first, the therapeutic relationship is instrumental, its main purpose being to improve the patient's personal relations outside therapy; second, the focus of the treatment is on the strategic incapacity of the patient who is caught up in and unable to cope with the "concealed family game."     

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.     

Couple and Family Therapy Within the Current Pan-Canadian Context

Canadians take numerous approaches to couple and family therapy due in part to Canada’s diversity of people and geography, as well as the influence of the health care context, a central facet of our national identity. Tracing back to Nathan Epstein, the founder of family therapy in Canada, there continues to be a strong tradition of couple and family therapy within Canada which has international reach. Formal training in family therapy, as well as couple/marital therapy occurs largely outside of the scope of degree granting programs and university settings. The American Association for Marriage and Family Therapy has a strong presence in Canada, with six divisions across the country. Popular models of practice for Canada’s couple and family therapists include cognitive-behavioral therapy, solution-focused therapy, narrative therapy, emotionally-focused therapy, and Bowenian/intergenerational therapy. A growing number of training opportunities are becoming available across Canada, and the practice of couple and family therapy is becoming institutionalized as one of the core competencies for professions such as psychiatry. In this article, we examine the context of family therapy in Canada by examining its history, the unique accreditation standards, qualifications and organizations associated with family therapy, the relationship between couple and family therapy, and future directions for this field of practice.     

Family therapy for childhood depression: researching significant moments

This paper is a qualitative family therapy process study which is part of a larger European-based outcome study comparing family therapy to child psychotherapy plus parent support for depressed children and their families. The family therapists and two clinical supervisors from the original study formed themselves into a research team to study the process of therapy with twelve families. Therapists selected the significant moments from fifty-nine sessions, and were then interviewed by the research team using a standard protocol to investigate the therapists' own thinking about the significant moments. Applying a thematic analysis, the significant moments were clustered into eleven themes. The paper discusses the rationale for this model of research, which is well suited for clinical teams, and the application of the themes to therapeutic work with depressed children and their families.     

RECONSIDERING RESEARCH ON DIVORCE, FAMILY LIFE CYCLE, AND THE MEANING OF FAMILY

This article analyzes functionalist and normative assumptions about marriage, divorce, family, and gender in developmental models of family life cycle. An interdisciplinary review of the literature in family development, family sociology, and family therapy reveals how a deficit comparison model implicitly informs the discourse in the study of single-parent families, women who are alone, and the adjustment of women and children to divorce. A feminist critique of family life cycle as the prevailing conceptual model in family development and therapy is presented, and postmodern definitions that deconstruct the concept of family are discussed. Future perspectives for research on family life and form are considered in terms of new action theory that considers divorce as a mode of resistance and change for women and families.     

Family therapy with adolescent offenders: A collaborative treatment strategy

Abstract

An intervention strategy is presented which can be used with families of adolescents who continue breaking the law despite improvement of family functioning during therapy. The strategy emphasizes collaboration between the therapist and juvenile justice system in stopping the child's law-breaking behavior in the shortest amount of time. The treatment strategy is suggested as a specific intervention to be used only when conventional family therapy strategies have failed to promote the cessation of the adolescent's law-breaking behavior. As such, it is suggested as a strategy to be used in conjunction with family therapy rather than as a comprehensive treatment approach in itself.     

A Case of Functional Urinary Retention: The Use of Family Play Therapy

This case presents a technique for doing family therapy in families with young children. In family play therapy, the entire family plays together, allowing full participation of even the youngest children in the therapeutic process. Standard family therapy interventions in the latter part of each session make use of family interaction patterns and unconscious processes revealed during the earlier play. In the case presented here, the technique was successfully applied to a family with a 3-year-old son who had functional urinary retention. This case also provided an opportunity for interdisciplinary collaboration between the separate Child and Family Services at a major teaching hospital.     

Art therapy in transcultural family therapy

The increased existence of foreign culture patterns in the child population calls for transcultural comprehension in child psychiatry. This case report describes transcultural aspects in the therapy of an 11 year-old Moslem girl admitted to a child psychiatric department. Her symptoms were abdominal pain, headache, anxiety, and pretended fever. A family therapeutic approach was used together with elements of art therapy and individual therapy in a successful treatment. The family therapeutic approach was based on art therapy as a part of the communication where cultural symbols were an important part. An interpreter was not used. The cultural context where it is acceptable to overstep the borderline between reality and fantasy is seen as an important healing capacity.I would like to acknowledge my debt and my appreciation to Ebba Ernst, psychologist of the department and supervisor in the therapy of the S. family. I would also like to thank professor Kai Tolstrup and child psychiatrist Torben Marner for stimulating support in the process of writing the article. A grant from Enkefrue Hermansens Mindelegat made the participation in the Krakow Congress possible.     

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.     

Values and Ethics in Family Therapy

This article is an introduction to this special issue on values and ethical issues in family therapy. The author discusses the historical context for the rising interest in these issues in family therapy, describes the rationale for this special issue, and presents a framework for analyzing the core values of the prominent models of family therapy. The ethical debate over use of paradoxical techniques in family therapy is used as an illustration of a values clash between different models of family therapy.     

Family Therapy in the Forbidden City: A Review of Chinese Journals From 1978 to 2006

This article provides a glimpse into the development of family therapy in China, by reviewing family therapy articles written in Chinese and published in journals in China that are not, therefore, readily accessible to the international community. A content analysis of journals published between 1978 and 2006 revealed 199 family therapy articles in 109 Chinese journals. Most of the studies were conducted by psychiatry or medical professionals, and were based on general systems theory or a systemic family therapy model. The articles focused on the promotion of family therapy theories and interventions in China, but did not specify the application of theory to specific clientele or symptoms. After the year 2000, a threefold increase in the number of family therapy publications was noted. These papers included the introduction of additional theories, but did not include critical assessment of the applicability of Western family therapy models to Chinese families. The researchers noted an absence of articles that identified Chinese approaches to family therapy, and a paucity of papers on gender, professional reflection, and the therapy process. The article concludes that there is room for improvement in the quality of family therapy publications in China, and that gains may be made by interdisciplinary collaboration among academics and practitioners.     

Live Supervision in Family Therapy and Social Facilitation Effects: A Case Study with Physiological Measures

In this case study a family therapy trainee is treating a family during a live supervision session while wearing a blood-pressure monitor. The data are used to illustrate the paradox inherent in live supervision from a social facilitation theory standpoint: While the peer group is considered essential to the process of supervision by some models, the presence of observers and coactors is hypothesized to give rise to negative social facilitation effects which may inhibit the acquisition of complex skills and prolong the training phase of the professionalization process.     

Maps and mapmaking: Developing the systemic paradigm of family functioning

This paper presents the Systemic Paradigm of Family Functioning (SPFF) as an organizing framework for integrating models of family therapy. Therapists can use the SPFF to understand and integrate existing models of family therapy and to create their own personal models of family therapy. The SPFF framework highlights the interrelationships among the four generic models which dominate the field of family therapy. Personal models of family therapy are based on maps of family functioning derived from one of these more generic models.     

Narrative process modes as a bridging concept for the theory, research and clinical practice of systemic therapy

This article is concerned with the relationships which hold between the clinical practice and the theory of family therapy; and between these and academic research. These relationships are seen as tenuous and thin because, in the first place, there is a lack of rigorous theoretical underpinning; and second, the research methods employed do not fit in with current family therapy practice, and with the theory that underlies this practice. The role of the concept of narrative process modes is proposed as a bridging and mediating one. The external, internal and reflective narrative process modes are seen as relevant from the point of view of family therapy process research, and the clinical practice of marital and family therapy.