Gender in family therapy supervision

While gender has taken its place as a fundamental construct in family therapy theory, little has been written about gender in family therapy supervision. This paper attempts to redefine gender as it pertains to families, family therapy, and family therapy supervision; call attention to aspects of gender as they apply to training in family therapy and family therapy supervision; and suggest ways that family therapy supervisors can sensitize themselves to issues of gender so that they can be more effective in supervision.The author gratefully acknowledges her husband, Victor Nelson, STM, and Eric McCollum, PhD, for their comments on an earlier draft of this paper and for helping with the idea that men are raised to fix things, women to make them better.     

Medical family therapy: an emerging arena for family therapy

This paper describes an important recent development in American family therapy. Medical family therapy uses a biopsychosocial systems model to work with families who have a member with a chronic illness or disability. The authors maintain that family therapy has tended to embrace the mind–body split and to view itself too narrowly as a mental health specialty. Medical family therapists work collaboratively with physicians and other health professionals to help families achieve a sense of agency and communion in facing some of the greatest challenges that life brings.     

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.     

Toward an integration of child and family therapy

Current forms of treatment for the symptomatic child are reviewed and analyzed. There are four general approaches to treatment: individual child psychotherapy, conjoint parent-child psychotherapy and counseling, parent therapy and counseling, and conjoint family therapy. Each approach has certain strengths, but in-and-of itself is an incomplete treatment mode. An integration of child and family therapy is recommended, and recent attempts at this integration are described. These include approaches which work within the framework of conjoint family therapy and those which provide concurrent child and family therapy.     

Theme-focused family therapy: the inner emotional world of the family

This paper is an account of a method of family work developed for social workers in social services departments which allows them to work with the emotional impact on children and adults of traumatic events in family life. Theme-focused family therapy has been designed to meet the needs of the families and also to enable social workers and their supervisors to develop both psychodynamic and systemic perspectives m their work with families. It is a staged approach, moving from individual work to a structured family interview through to a series of theme-focused family sessions. It is phased in this way both to facilitate the development of a therapeutic attachment between social worker and family and to take account of the crises that can interrupt planned work in social services departments. Theme-focused family therapy is carried out in partnership with families, and gives children a voice and a leading role in the therapeutic process. The approach is illustrated with a case example.     

Feminism and family therapy—a possible meeting point

This paper centres on the question ‘Is it possible to be a feminist and to practise family therapy?’ We explore the essence of feminism and family therapy and conclude that a style of feminist family therapy is possible. Feminist family therapy has a particular theoretical base and is characterized by a particular combination of practice principles. It also raises general issues for the training and practice of all family therapists.     

Families and family therapy in Germany

The author describes some of the effects of decades of life under a dictatorship for East Germans and the effects on family life and family therapy of changes following the recent reunification of Germany. A case example illustrates some intergenerational family problems associated with the changes. Contrasts are drawn between East and West Germany and family therapy's present stage of development is depicted in both parts of the reunified country. Germany has approximately 10,000 trained family therapists, a minority of whom work in private practice. The largest amount of family and couples therapy is performed in agencies.Portions of this material were first presented in a poster session at the American Association for Marriage and Family Therapy annual conference in Miami Beach, 1992.     

The impact of family functioning on family racial socialization processes

This longitudinal study evaluated the relationship between family functioning and family racial socialization processes in a clinical sample of African American youth referred for drug abuse treatment. Participants were 77 African American adolescents and their parents. Results showed that participants assigned to structural ecosystems therapy experienced a greater increase in family racial socialization processes during treatment than participants assigned to the treatment as usual in community settings condition. Participants in structural ecosystems therapy also demonstrated a greater increase in family functioning than participants in community settings condition, and this improvement in family functioning mediated the relationship between treatment condition and family racial socialization processes. Research and clinical implications are discussed.     

Research as a family therapy intervention technique

The utilization of the research process as an intervention has recently been described in the family therapy literature. However, it is important to draw a distinction between research as intervention and research as a unique family therapy intervention technique. From a family systems perspective, research as an intervention technique may make therapy more palatable for some families. A case study is presented in which this technique created the context for change for a family involved in a chronic illness research project.The author would like to thank Dr. Wendy L. Watson for her participation as a member of the clinical team and Drs. Fabie Duhamel and Wendy L. Watson for their helpful critiques on earlier drafts of this paper.Supported by a grant from the Albert Foundation for Nursing Research.     

General practitioners and family therapy—a dialogue

General or family practice and family therapy seem natural allies but few general practitioners are doing family therapy or consciously using the ideas derived from it. This paper explores some of the reasons why this relationship has not been consummated.     

Indications for selecting family or individual therapy

Indications for either individual therapy or family therapy as treatments of first choice are identified at the initial family assessment.
A family approach is suggested in (1) scapegoating systems where the symptom is essential to the family homeostasis; (2) enmeshed families where communications are confused and diffuse; (3) paranoid-schizoid families where the family denies the symptoms and (4) families in a current acute shared crisis.
Individual treatment is indicated when (1) the patient has suffered traumatic separations; (2) separate help is asked for; (3) the therapist considers individuation necessary and (4) unusual life experience. Clinical examples are given.     

The family as its own reflecting team: a family therapy method

Social research has suggested that people, in general, tend to overestimate their skills and abilities. Interestingly, research has found that peers are better predictors of a person's behaviour than self‐assessment, suggesting that others know us better than we know ourselves. Family therapists should be aware that family members might not give accurate accounts of themselves. In order to overcome this problem, therapists should incorporate peer assessments into therapy. Reflecting teams and videotaping do incorporate peer assessments, yet these methods can be impractical. This article describes a method of family therapy using enactments as a means of setting up the family as its own reflecting team. The method suggests that the family and therapist switch roles several times during the enactment, and then encourages a discussion on the peer observations on how each person addresses a problem in the family. Case examples illustrate how feedback from peers promotes insights.     

Restorying family therapy

This article describes a multi-systemic model of therapy developed by the author over the past decade and summarizes the main products of this project: Explication of key family systems notions, strategic family play therapy, multi-systemic therapy, and culturally-competent family therapy. The model incorporates beyond the family system, culture, wider ecosystems, psychodynamics, and the individual's neuropsychological, cognitive, and socio-emotional development. The model enables the therapist to design flexible multimodal interventions.     

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.     

Multiple family therapy: an overview

In recent years there has been increased interest in working with groups of families systemically. Multiple family therapy is applied in different settings and to a whole range of different presentations. These include work with multi-problem families; with schools, parents and pupils; with adult mentally ill individuals and their families; and with eating-disordered teenagers and their families. Principles and aims of multiple family therapy are presented, specific projects described and trends for future work outlined.     

Rationale and directions for an increased emphasis on the therapeutic relationship in family therapy

This paper argues the need for an increased emphasis on the therapeutic relationship in family therapy. The ways in which the field of family therapy has eschewed the importance of the therapeutic relationship are discussed. Therapeutic alliance research from the field of individual psychotherapy and research on the importance of relationship factors to family therapy are reviewed. Suggestions for family therapy theory, practice, and research are presented.An earlier version of this article was presented at the 1992 Western Canadian Conference on Family Practice.     

Trainee perspectives on their family therapy training

Although research into family therapy training is increasing it has so far mostly focused on the process of the teaching and acquisition of certain concepts and skills. In contrast, the experience of training as family therapists has rarely been investigated. This paper reports on the impact of family therapy training at one training institution in the UK on the personal, relational and professional identities of trainees. Six family therapy trainees were interviewed using semi‐structured interviews at regular intervals over a period of approximately twenty months. Interpretive phenomenological analysis (IPA) was employed to analyse the interviews. The results suggest that participants often found the experience of training as a family therapist overwhelming and de‐skilling, but that it nevertheless provoked a re‐evaluation of some of their established personal, relational and professional identities. In many cases these re‐evaluations seemed to have preceded a process of individuation, of assuming a different or more complex identity.     

Transcultural family therapy

Conventional family therapies such as Structural, Systemic, Satirian, Adlerian and Dreikursion seem to be marked by cultural biases and give an indication of one single culture orientation. These seem to represent the cultural majority norms and values in acting as oppressive tools in a multi cultural society. Most of these therapies are derived from theories reflecting intrapsychic factors that are white middle class concepts, neglecting the multi culturaUsocia1 contexts in family therapy. “Ethnic minority families” from non Western Countries often experience more problems than families from Western Countries in the areas of education, immigration, employment and health. The cultural expectations are full of contradictions and ethnic minorities feel handicapped both socially and culturally in the task of growth and development. Western family therapy has failed to address these issues.