An Application of Brief Therapy to Family Medicine

The Solution-Focused Brief Therapy model has been applied to support families with various problems commonly met at the department of family medicine in a large, urban teaching hospital in Seoul. Korea. Many cases there show a different distribution of problems when compared with a tertiary family therapy center. The majority involve psychosomatic problems, family distress around a chronically-ill member, the loss of a family member, and severe illness, only a few involving drinking problems, family violence, or abuse. The SFBT model meets the seven requirements of Doherty and Baird (1983) for a family therapy model to be useful in a medicine setting.     

Feminism and Family Therapy

Feminism has had a profound effect on contemporary culture and on thinking in most academic fields, including psychoanalysis. Interestingly, until very recently it had made virtually no impact on the theory and practice of family therapy. This paper proposes an explanation for this peculiar phenomenon and argues that family therapy has been considerably handicapped by its insularity from the feminist critique. Utilizing feminist scholarship in psychoanalysis, history, and sociology, the paper analyzes the structural contradictions in family life that family therapists have essentially ignored and then outlines their clinical implications. Key points in the discussion include the argument that systems theory is an inadequate explanatory matrix from which to build a theory of the family, that the archetypal "family case" of the overinvolved mother and peripheral father is best understood, not as a clinical problem, but as the product of a historical process two hundred years in the making, and that power relations between men and women in families function in terms of paradoxical, incongruous hierarchies that reflect the complex interpenetration between the structure of family relations and the world of work. This conceptual model then provides the basis for an analysis and critique of sexual politics as they emerge in the prototypical clinical situation.     

Science and Family Therapy

Family therapists are being exhorted to adopt a social constructionist epistemology and to abandon science as a valid form of knowing. Epistemological objections to science are usually directed at 'positivism', an outmoded view that is largely discredited among practising scientists. Contemporary science, is rather, constructionist, differing from other constuctionist approaches only in ways of arbitrating between world views. Criticisms aimed at science apply to all forms of discourse, including family therapy. I conclude that science has failed family therapy at the practical, not the philosophical level.     

Insurance and Family Therapy

The advent of recent theories of family structure and socially shared psychopathology that have found expression in the practice of family therapy are forcing a re-examination of concepts of individual diagnoses in which the symptoms of an individual family member are viewed as a possible communication from a disturbed family system. In seeking reimbursement for family therapy through health and accident insurance, a problem is occurring because the traditional method of payment is based on the establishment of individual psychiatric diagnoses, and very few companies will insure a family for family therapy. This paper examines the three-part system: insurers, family, and helping professions in relation to the significance of the conflict between traditional concepts of individual psychopathology and recent concepts of socially shared family psychopathology.