Mankind and Kind Men: an agenda for male family therapists

This article examines some of the gender issues involved when male therapists interview women, children and other men. It looks at issues in the family life of male therapists which have parallels with therapy, and offers some practical suggestions for beginning to overcome obstacles of gender in therapy.     

Family Secrecy in Family Therapy Practice: An Explorative Focus Group Study

The aim of this focus group study was to explore the experiences of family therapists working with family secrecy. Our study highlights that family secrets present important and compelling challenges for family therapists. Furthermore, our study reveals that there seem to be some basic strategies family therapists use in dealing with these challenges in therapy sessions. One basic strategy is that family therapists try to guard their position of being a trustworthy therapist for each family member by avoiding becoming stuck in family secrecy. Furthermore, therapists explore ways to guide the family toward the disclosure of the secret in order to alleviate the toxicity of the secrecy. This highlights the importance of the systemic model and how influential this perspective is in family therapy practice. Some participants, however, have in addition a second strategy they sometimes use: talking with the family about secrecy without aiming to disclose the secret. In the discussion section of the article we reflect on the possibility that in the strategic choices family therapists make conceptual issues might be involved. Furthermore, we stress the importance of further research.     

Thinking,Doing, and the Ethics of Family Therapy

In this article, we examine how family therapists develop their capacity to make ethical decisions in clinical practice. We present an approach to clinical ethics that builds upon, and integrates the central features of, professional training and development in family therapy itself. We also explore the similarities and differences between the theoretical, top-down approach of bioethics, with its emphasis on “principled decision making,” and the clinical, pragmatic, bottom-up approach discussed here.     

Warriors,authors and baseball coaches: the meaning of metaphor in theories of family therapy

This article examines the metaphors family therapists use in their theories to reveal aspects of the theories which are not explicitly stated, using Whitaker's symbolic experiential therapy, Minuchin's structural therapy and White's narrative therapy as examples. Such examination, drawing on social constructivist understandings of metaphor and meaning making, reveals that Minuchin's metaphors of family as organism and therapist as artist and warrior emphasize the family as relatively holistic and the therapist as relatively interventionist. In contrast, Whitaker's metaphor of family as ecological system or team and therapist as coach emphasizes the interdependence and context sensitivity of the family and relative powerlessness of the therapist to impose change. Finally, White, reflecting his explicitly post‐structural commitment, uses the metaphor of therapy as a journey undertaken with a map and as therapy as an act of re‐narrating a story.     

Screening for Physical Violence in Couple Therapy: Methodological,Practical, and Ethical Considerations

Over two-thirds of clients in family therapy clinics engage in some form of physical violence against their partners within the year prior to the initiation of therapy. However, family therapists are aware of only a small proportion of these cases. The purpose of this article is to enhance the ability of family therapists to detect marital violence. We examine client and therapist reasons for why physical violence is not detected. We then review various methods to screen for the presence of physical violence, especially the Conflict Tactics Scales. Finally, indicators of life-threatening violence are presented to help family therapists detect cases that require immediate intervention to protect the partner whose life may be in danger.     

How to be a postmodernist: a user's guide to postmodern rhetorical practices

Family therapists are being encouraged to adopt a postmodern approach to therapy and knowledge. Postmodernism is more than a set of beliefs that therapists can either accept or reject; it is an approach to the construction of truth that eschews many of the forms of argumentation, such as appeals to logic or evidence, characteristic of earlier writing in family therapy. In this paper we present some of the alternative rhetorical strategies used by contemporary family therapy and family therapy texts in the construction of novel truths. These strategies include: writing in the first person; making qualified or conditional assertions; implying rather than stating truths; 'delegitimizing' conflicting views; and ignoring disagreement. We discuss the value of these strategies in maintaining the authority of therapists and commentators on therapy in the face of the widespread incredulity towards metanarratives, such as science, that characterize postmodern society.     

Ideas that handicap therapy with young people

A review is done of ideas that handicapped therapists, particularly therapists of young people defined as schizophrenic, and were abandoned over the last twenty years. It is suggested that therapists currently seek theories that lead to success and avoid theories that lead to failure. The criteria for an effective theory of therapy are offered. Past ideas and theories are described in terms of meeting the criteria. Included in the review of unfortunate ideas for the therapy of mad young people are the organic theory, the psychodynamic theory, and those aspects of systems theory and double bind theory which were not helpful. How therapists recovered from these ideas is discussed. A contemporary theory of family oriented theory which meets more of the criteria of an effective theory of therapy is suggested.This paper, in a somewhat different form, was presented at the meeting Beyond the Double Bind in March, 1977. It will also appear as a chapter in a forthcoming book on the therapy of disturbed young people.     

Transparency and self-disclosure in family therapy: dangers and possibilities

Therapy is a paid intimate relationship that thrusts clients and therapists into navigating personal and professional boundaries. When, where, why, and how is it appropriate and ethical for family therapists to be transparent, and when is it damaging? Theorists take varied stances from Haley's position of tight boundaries around therapist disclosure—whether in treatment or training—to the narrative viewpoint that therapists should be transparent about models of therapy, personal values, and life experiences that inform their practice and beliefs. However, these positions are not research based, and theorists who support disclosure offer few guidelines other than general statements. This article examines the history of ideas about disclosure in six major family therapy models, and the dangers and possibilities of transparency. It looks at the research on self‐disclosure in individual therapy and whether and how it could apply to family therapy. Guidelines are proposed that take into account the multiple social identities of therapists and clients, and issues of safety and transparency.     

Connectedness versus separateness: applicability of family therapy to Japanese families.

This article, a product of the two authors' multicultural experiences, contrasts British and Japanese families in order to examine the applicability of the Western model of family therapy to Japanese families and therapists. Areas where the Western model is incompatible are identified, and modifications to fit the Japanese indigenous model are suggested. The most significant difference in value systems between the two cultures is the Japanese preference for connectedness. The Japanese person is seen as a part of the embedded interconnectedness of relationships, whereas British norms prioritize separateness and clear boundaries in relationships, individuality, and autonomy. This value orientation is manifested in the Japanese language, hierarchical nature of the family structure, the family life cycle, and the implicit communication style. Systemic thinking, which deals with the pattern of relationships, is valid for all families regardless of cultural differences. But therapists should note that the preferred direction of change for Japanese families in therapy, is toward a process of integration--how a person can be effectively integrated into the given system--rather than a process of differentiation. An authoritative therapist style, the use of individual sessions, silence, and other nonverbal techniques are relevant to bringing about the desired change toward better integration of the individual with his or her networks.     

What we say we do: results of the 1997 UK Association of Family Therapy Members Survey

This study represents the first UK national survey of family therapists and systemic practitioners. The aim was to provide demographic information of systemic practitioners/family therapists and also to describe their clinical practice. The sampling frame used was the UK Association of Family Therapy membership list and all members were sent a postal questionnaire. The response rate was 33% with 495 out of 1500 questionnaires returned. Among the major findings were: systemic practitioners/family therapists are most likely to work for an NHS trust, to use family therapy techniques/systemic ideas predominantly, and to treat a broad range of client issues. They are also most likely to work with families, and therapy is relatively short term (five to eight sessions) regardless of whether they treat families, couples or individuals. Most family therapists/systemic practitioners use some measure of outcome, although frequently this will be feedback from clients. Supervision is sought by the majority of AFT members. In spite of some methodological limitations, the study provides interesting insights into the training and practice of UK family therapists and systemic practitioners which appears to differ in some respects from our American colleagues. It also provides a baseline for future surveys, making it possible to describe the developments of family therapy and systemic practice in this country.     

Introducing Novice Therapists to “Go-Between” Techniques of Family Therapy

The training of family therapists requires that learning objectives and expectations be specified in empirical terms so that the trainer and trainee can achieve clear goals, identify areas of progress, and meet the special needs of the trainee. This paper articulates the competencies, objectives, and criteria for evaluation used during a time-limited training program for therapists involved in family therapy research conducted at Centennial School of Lehigh University.     

Ethical? Toward whom?

Comments on the original article, "Nonrational processes in ethical decision making" by M. D. Rogerson et al (see record 2011-19198-001). Among the many insightful points made by Rogerson, Gottlieb, Handelsman, Knapp, and Younggren (October 2011) regarding nonrational processes in ethical decision making, one deserves further explication: Many of psychologists' ethical decisions lead to actions done to someone. Unfortunately, frameworks and models of ethical decision making frequently neglect this fact by implying that the decisions happen in the abstract, but in truth, these decisions often affect a specific recipient. Importantly, the characteristics of that specific recipient, especially as perceived by the psychologist, can have a powerful impact on the process of ethical decision making (Caughron et al., 2011). It would be wise to add such a hypothetical to the list of specific questions that Rogerson et al recommended psychologists ask themselves: Would I make the same ethical decision if the person(s) toward whom the decision is directed had different characteristics?     

International Family Therapy: A View from Kyoto, Japan

"International family therapy" is an emergent field within (or overarching) the field of family therapy. At this stage, it can be described as the collecting and sharing of experiences by family therapists from different countries. Recent publications (7) gather information principally from Western cultures in which systemic family therapy has grown over the past thirty years. Japan is of particular interest to Western practitioners because it is a highly successful, post-industrial culture that differs markedly from the West. Familiar family therapy interventions often work for unfamiliar reasons, and different goals are often needed in order to respond to apparently similar family problems. An expanded sense of choice around strategies for family life and family therapy that such diversity implies is the primary contribution that this maturing, international family therapy movement can make to family therapy.     

Illness, Family Theory, and Family Therapy: I.Conceptual Issues

This article examines and clarifies controversies about the concept of illness in the field of family therapy. We contend that illness, as traditionally understood in all cultures, is a relational, transactional concept that is highly congruent with core principles of present-day family theories. Family therapists need not buy into a biotechnical, reductionistic reframing of illness as disease. Rather, it is more appropriate to conceptualize and work with illness as a narrative placed in a biopsychosocial context. Such a narrative includes how shared responsibility for coping and for finding solutions can take place, without becoming involved in disputes about causal models.     

The reentry female student in marriage and family training

The challenges of feminist family therapists of gender bias in family therapy training and practice models need to be considered in relation to the predominance of reentry women in masters degree programs in marriage and family therapy. This article describes a developmental training model that incorporates feminist-informed values into curriculum, program policies, instructional strategies, and program structure. The model builds on the assumption that gender-associated behaviors of both sexes have contextually determined value. Training for the appropriate application of gender-associated behaviors rather than for their inclusion or exclusion can increase female reentry student flexibility and self-confidence.     

Psychodynamic Psychotherapy Process Research: A quick ride through what you should know about process (research)

This paper gives an overview of psychoanalytic process research, which brings to light the complexity of psychotherapy sessions. This complexity is so rich that many instruments intended to make the process measurable failed in the past because they initially used a strategy of complexity reduction. This method however did not help to further our understanding of the complexity involved. Three former presidents of the Society for Psychotherapy Research (Stiles, Hill, Elliot 2015) decided to solve the following equivalence paradox: many therapies work successfully though they all follow different theories, produce a heterogeneity of processes and often enough a misfit between what theories maintain to be a good process and their realization in the treatment room. As theories are often compared to maps, a driver would wonder which route to take. But therapists‐as‐drivers go undaunted ‐ and nevertheless achieve their goals together with their patients. Norcross and Wampold (2018) found that good therapists invent new therapies with every new patient. They hypothesize that it is because of conversation. This is in accord with the 3 former presidents’ proposal to return to detailed single case analyses including the micro‐analytic power of conversation analysis of which a few insights are outlined in this article.     

Recapturing the Person in the Therapist: An Exploration Of Personal Values, Commitments, and Beliefs

The authors encourage an approach to personal exploration that attempts to recapture the person in the therapist. Person in the therapist training is aimed at helping therapists discover or re-capture their own values, beliefs, and personal ethics. A personal approach to theory development and the practice of therapy is offered and discussed. Activities to recapture the person in the therapist focus on developing a personal theoretical orientation, exploring the values of family therapy theories, and exploring the values of the stance of the therapist in the therapy session. The authors offer their own personal beliefs throughout the article and encourage further development of these issues.Co-director of The Re-Authoring Center and a PhD student in Marriage and Family Therapy at Iowa State UniversityCo-director of The Re-Authoring Center and a PhD student in Marriage and Family Therapy at Iowa State University     

The Search for the Source of Epistemic Good

Knowledge has almost always been treated as good, better than mere true belief, but it is remarkably difficult to explain what it is about knowledge that makes it better. I call this "the value problem." I have previously argued that most forms of reliabilism cannot handle the value problem. In this article I argue that the value problem is more general than a problem for reliabilism, infecting a host of different theories, including some that are internalist. An additional problem is that not all instances of true belief seem to be good on balance, so even if a given instance of knowing p is better than merely truly believing p , not all instances of knowing will be good enough to explain why knowledge has received so much attention in the history of philosophy. The article aims to answer two questions: (1) What makes knowing p better than merely truly believing p ? The answer involves an exploration of the connection between believing and the agency of the knower. Knowing is an act in which the knower gets credit for achieving truth. (2) What makes some instances of knowing good enough to make the investigation of knowledge worthy of so much attention? The answer involves the connection between the good of believing truths of certain kinds and a good life. In the best kinds of knowing, the knower not only gets credit for getting the truth but also gets credit for getting a desirable truth. The kind of value that makes knowledge a fitting object of extensive philosophical inquiry is not independent of moral value and the wider values of a good life.     

The psychotherapy of genetics

The evolution of genomic science and its effect on medicine and health care offer opportunities for family therapists to participate in the comprehensive care of patients and families with genetic disorders. This article provides an overview of what we now know about the psychological and interpersonal experience of patients and families facing some of these illnesses. Case examples illustrate the process of decision-making about testing and treatment, and the importance of understanding developmental issues and transgenerational family dynamics in any related psychotherapy. Challenging emotional issues include managing anger, ambivalence, and guilt; challenging interpersonal issues include dealing with differing coping and communication styles, decisions about disclosure and secrets, and conflict resolution. Family-oriented interventions include individual, couple, and family therapy, and psychoeducational groups. Recommendations are made for family therapists to participate as part of the genetic healthcare team.     

Culturally sensitive therapy? Examining the practice of cross‐cultural family therapy

This article is drawn from a research project that examines cross‐cultural family therapy sessions in order to consider what constitutes culturally sensitive practice. A discourse analytic approach was adopted in the analysis of three sessions from two families where the family and the therapists originated from different ethnic backgrounds. This article is based around part of the research findings connected to one of the families, and focuses upon the ways in which ‘culture’ is talked about in therapy (the term ‘culture’ will be referred to in inverted commas in order to acknowledge its complexity as is emphasized in this article). This allows for an examination of the cultural assumptions that we hold as therapists, which are enacted in therapy with effects on all participants and upon the course of the therapy. The value of qualitative research methods in examining the cultural assumptions we bring to therapy is highlighted as one way of improving culturally sensitive therapeutic practice, especially with regard to therapist reflexivity.