Family therapists and families of cult members

One to three million bright young adults have been or are presently involved with “deviant religions,” also known as cults. They, or their families, frequently seek therapeutic aid during or after the involvement, but too few psychologists or other therapists in private practice are adequately prepared to help them. To remedy the situation, information is presented on cults in general, cult members, and families of cult members.     

Family therapy as a treatment for children: a critical review of outcome research.

The value of family therapy as a treatment for child psychopathology is considered by reviewing pertinent outcome research. Fourteen studies that met three criteria are included in the review: (a) a child or adolescent was the identified patient or referral; (b) therapy included at least one parent and the child; and (c) outcome was evaluated in terms of the child's symptoms. There are major shortcomings in most of the available data, with only two well-controlled studies. Some empirical evidence does exist that family therapy is an effective treatment for children; the data from studies of adolescents are especially encouraging. However, insufficient data are available for comparing the relative merits of conjoint family treatment and individual child therapy. If the value of family therapy as a treatment alternative or, ideally, as the "treatment of choice" for a referred individual child is to be established, more and better controlled comparative outcome studies will be necessary. Suggestions for future research are presented emphasizing the need for a developmental perspective by recommending, for example, the use of factorial designs in which the intervenaction of treatment and age can be analyzed.     

Videotaped simulated families as a tool in family therapy outcome research

Twenty-two therapists who had treated 57 families in brief conjoint family therapy under supervision responded to a videotaped simulated family as if they were treating it. Their responses were audiotaped and coded on a system devised for this study. Positive relationships were found between the ratings of expertise based on the coding system, and independent ratings of the treated families' satisfaction with treatment and the status of the presenting symptoms 6 months after termination. Videotaped simulated families are potentially useful as standardizable methods of revealing individual differences in therapists for family therapy outcome research.     

Family therapy and ultra-orthodox Jewish families: a structural approach

Most ultra-orthodox Jewish families live in tightly knit communities in which there is religious and cultural congruence between the structure of their communal organizations, their families, and the way individual members construe their world. Without excluding other family therapy models, this paper points to striking links between strictly orthodox Judaism and aspects of structural family therapy which suggest the latter may be particularly applicable to members of this ethnic minority. Therapeutic issues are illustrated with examples.     

Family therapy and incomplete families

Much of the literature in family therapy refers to the clinically orientated work with well-motivated families using specific techniques. This article briefly outlines the two main theoretical stances within family therapy as a whole, and describes three categories of incompleteness in families with particular reference to the idea of 'masked' incompleteness. This is illustrated by five case examples which show some of the common difficulties of working with families whose disturbance includes a masked incompleteness. The inadequacies of a singular treatment approach with such families are outlined, and it is suggested that the 'systems' approach in particular has limitations and possible contra-indications in such circumstances. It is argued that the more eclectic and pragmatic approach described, whilst remaining within the boundaries of family therapy as a whole, is likely to offer a more effective consideration of the long term needs of such families.     

Family therapy with black families

Family therapy in Britain must develop to encompass the external reality of family life. Living in a racist society dominates the lives of all black families. Family therapists need to acknowledge and address this before intervening in the family system. This paper offers personal and professional experiences, confrontaion, structured exercises and general and specific principles for work with black families. Minimal and positive goals are advocated so that practitioners do not feel paralysed by the enormity of the task.     

Family therapy with one-parent families

In this article the author introduces an integrative approach to family therapy with one-parent families. This includes a diagnostic framework built on the developmental stages of the family, critical areas, and—most importantly—specific settings and therapeutic strategies based on the assumption that one-parent families can raise children as successfully as other families, but in a different manner.The term one-parent families is used in this article, although it is not the correct expression, simply because no child has only one parent. The term binuclear families does not fit with all of them, and single-parent-led families seems to be ambiguous but quite cumbersome to use.     

Family therapy by default: developing useful fall‐back positions for therapists

This article looks at some of the effects on practitioners of the increasing complexity and variety of ideas within the family therapy field. In adopting the currently popular notion of ‘default position’ from information technology, I argue that therapists can easily feel that their work has a random quality to it. I examine how our own default positions can be based on force of habit, a quest for novelty or the effects of stress. Some suggestions are offered for how we can more accurately go about choosing ideas that will be of help to the families with which we work and to ourselves.     

Family therapists, community, and civic renewal

In this article, we review family therapy's history regarding community concerns and broader societal issues; offer a model of levels of therapists' involvement with communities and community systems; and propose that family therapists join the citizen activation movement by becoming catalytic partners with families in communities. We call for a new kind of community practice that is driven less by therapist-defined problems and professional expertise, and more by community-defined problems and families' own expertise.     

Disclosure of father-child sexual abuse: Dilemmas for families and therapists

Following disclosure of father-child sexual abuse, family members are faced with significant dilemmas related to the abuse disclosure and to the future of familial relationships. The resolution of these dilemmas has an impact on the resulting family structure as well as the therapist's stance, the therapeutic process, and therapeutic goals. This paper presents clinical issues that arise in relation to father/perpetrator and mother responses to the dilemmas they face following their child's disclosure of abuse. Clinical case examples are used to illustrate several resolutions that families reach following disclosure of abuse. The cases illustrate the systemic functioning of families and the impact that family members' decisions have on the therapeutic process.This paper was sponsored in part by a grant from the U. S. Department of the Navy. Names of clients were changed by the author to protect their identities.     

Family therapy and social control with incestuous families

The family therapy and social control model describes first the relationship between unplanned change and developmental growth. With many families, the family therapist works to both provoke change and encourage growth. However, some out-of-control families present a level of danger to a family member that outside controls, such as child protective services, must be used. This model clarifies the complementary but independent roles of family therapy and social control in helping out-of-control families. Intervention with incestuous families is presented as illustrative of the model.My thanks to the staff of Child Protective Services, the Juvenile Court, Yuma Police Department, Yuma County Sheriff's Department, Adult Probation Department, and the staff and group members of Yuma County, Arizona Parents United for showing that shared concern about the well-being of children can make a real difference in working with families. My appreciation to William C. Nichols, EdD, Elora Cornille and Dale Brotherton for their helpful suggestions on a earlier version.     

Using the Family Paper Sculpture for education,therapy, and research

The Family Paper Sculpture is a semi-projective task useful in family life education, in clinical work with families, and in research involving family system variables. Families or individuals are asked to make a picture of the family using round disks for individuals, red and black strips to show similarities and differences among individuals, and boundary markers to show individuals who are separate, or pairs, or groups of individuals who belong together. Examples are given which demonstrate the value of the technique for educational, therapeutic, and research purposes.She is on leave from the University of Houston-Clear Lake, Houston, Texas, where she is an Associate Professor of Behavioral Sciences.The research reported here was supported in part by grants from the (U.S.) National Institute of Mental Health.     

The impact of methodological factors on child psychotherapy outcome research: A meta-analysis for researchers

Two recent meta-analyses have generated evidence for child and adolescent psychotherapy effects. However, critics note that such meta-analyses often include studies with methodological shortcomings which might invalidate their results. In the present study, we explored whether the results of the most extensive child/adolescent meta-analysis might have been influenced by such methodological variables, focusing on internal validity and external validity factors. Together, these factors accounted for two-thirds as much variance as the substantive factors (e.g., type of therapy, age) in the original metaanalysis. This suggests that relative to these therapy and child-characteristic variables, methodological factors have a substantial, though smaller, impact on metaanalysis results. In general, increased experimental rigor was related to larger effect sizes; this argues against the hypothesis that methodologically weak studies have led to an overestimate of therapy effects. No significant interactive relations were found between validity factors and predictors of outcome; this suggests that the relations noted in previous metaanalyses between outcome and various variables were notdistorted by the validity factors tested here.The research described here was supported in part by grants from the North Carolina Department of Human Resources, Division of Mental Health, Mental Retardation, and Substance Abuse Services (41626), and from the National Institute of Mental Health (1 RO3 MH38450). The authors gratefully acknowledge the assistance of Todd Morton, who provided reliability coding.     

Solution-focused brief therapy: a review of the outcome research

Solution-focused brief therapy (SFBT) is a new and increasingly used therapeutic approach that focuses on helping clients construct solutions rather than solve problems. The approach evolved in a clinical context amid many anecdotal reports of success from both therapists and clients, but it has not been subjected to controlled empirical testing until very recently. In this article we critically review all of the controlled outcome studies of SFBT to date (N = 15) to assess the extent to which SFBT has received empirical support. Five studies were well-controlled and all showed positive outcomes--four found SFBT to be better than no treatment or standard institutional services, and one found SFBT to be comparable to a known intervention: Interpersonal Psychotherapy for Depression (IPT). Findings from the remaining 10 studies, which we consider moderately or poorly controlled, were consistent with a hypothesis of SFBT effectiveness. We conclude that the 15 studies provide preliminary support for the efficacy of SFBT but do not permit a definitive conclusion. Our critique highlights areas where methodology in future studies can be strengthened to provide more conclusive evidence of SFBT efficacy.     

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.     

Family interaction and communication deviance in disturbed and normal families: a review of research.

Recent family interaction studies are reviewed with an emphasis on looking for dimensions along which disturbed and normal families differ. Several areas of consistency in the literature were found, including: family coalition patterns, patterns of conflict, flexibility versus rigidity, family effectiveness and efficiency, and deviant styles of communication. It was concluded that several measures reliably discriminate disturbed from normal families and that one type of measure in particular is a reliable predictor of thought disorder in offspring. Implications for clinical practice and future research are discussed.