Family Therapy With Irish-Americans

This paper presents a paradigm for understanding the cultural values and family patterns of Irish-American families and offers suggestions for clinical intervention. Families' correspondence to the model described will depend upon their level of acculturation, socioeconomic status, and other contextual factors. The paradigm suggests a number of issues that may create difficulties for the therapist and for the family in therapy. In general, behavioral techniques, Bowen systems therapy, and strategic interventions may be more useful than techniques emphasizing expression of emotions in therapy or direct attempts to alter communication or family behavior in therapy sessions, as used in structural therapy.     

Family therapy with delinquents: a critical review of the literature

A critical review of the theoretical and outcome studies on family therapy with delinquents is presented. Assessment of the theoretical developments reveals that families of delinquents may be distinguishable from other families by their interactional sequences and processes. The available outcome studies within the field indicate that family therapy is viable for interventions with this population, with behavioral, structural, strategic, and communication approaches receiving the most support, but more specific and robust evidence is still needed. Trends in the research and critical issues are identified and used to provide suggestions for future research and practice.     

Using the Michigan State University Family Therapy Questionnaire for Training

The development of the Michigan State University Family Therapy Questionnaire (MSU/FTQ) is described and a case example given of its use as a training tool. The MSU/FTQ is a relatively exhaustive list of 74 generic, structural, strategic, brief, and trans-generational family therapy interventions culled from the literature and translated into layperson's language. The marital and family therapy client uses it to provide feedback about the effectiveness of therapy by assessing those things theorists consider important about behavior maintenance and systemic change, indicating whether or not specific interventions occurred and their importance.     

Expanding Uses of the Telephone in Family Therapy

The telephone has been used as an instrument for live supervision. This article describes innovative uses of the telephone by a family therapy training team, including (a) strategic calls to the therapist; (b) calls from the team to family members; and (c) calls between family members. Case examples describing the interventions and their impact are given. Both training and therapeutic benefits are discussed.     

A Review of Family Therapy in Residential Settings

This article provides an overview of the history of family involvement in residential treatment as well as a synthesis of the research showing family-centered interventions and outcomes for youth in residential settings. There are many methods for engaging families in residential treatment that are discussed in the literature; however, there is a significant gap as the field has not yet identified specific family therapy approaches that demonstrate efficacy in working with youth and their families in this particular setting. A review of the literature over the past 10 years will highlight the emerging family therapy models being utilized in this setting, which include multiple-family group intervention, family-directed structural therapy, and narrative family therapy. The article will also include a discussion of three major, well-established theoretical approaches that have been found to be effective in working with youth with conduct issues and show promise in treating youth and families in the complex setting of residential treatment: brief strategic family therapy, multi systemic therapy, and functional family therapy.     

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.     

Paradoxical Communication as Interpersonal Influence

This paper is concerned with the strategic uses of paradoxical communication in therapy. Eight more or less distinct uses of paradoxical communication are described, and the proposition is put forward that the paradoxical interventions associated with the Milan group differ from those described by Haley and the Palo Alto group only in that they appear to be designed to influence simultaneously the behavior of several family members. The currently popular idea that such interventions should, or even can, be based on a systemic hypothesis, if “hypothesis” is understood in its usual sense as a statement amenable to empirical testing, is explicitly questioned.     

Outcome studies of family therapy in child and adolescent depression

There is surprisingly little good-quality evidence for the effectiveness of family systemic interventions with child and adolescent depression given the prevalence of depression and the demonstrated association with a range of family factors. What studies there are suggest the possibility of family therapy being an effective intervention but more research is needed before firm conclusions may be drawn. Family interventions may be more effective in children than in adolescents and where other family members are depressed. It is possible that family interventions continue to bring about improvement in symptoms after cessation of treatment. What research there is evaluates older structural models of therapy: there is a real need for more evaluation of newer models of practice.     

The Adult Attachment Interview and observed couple interaction: implications for an intergenerational perspective on couple therapy

One of the assumptions of intergenerational family therapy is that how a person thinks and talks about family-of-origin experiences has important implications for current family relationships. The Adult Attachment Interview (AAI) is a measure of attachment security based on how coherently the person can discuss attachment experiences in childhood. This study examined the relationship between attachment security, as measured by the AAI, and couple interaction, as measured by the Georgia Marriage Q-Sort (GMQ), in a sample of 28 couples in therapy for relationship problems. During a conflict resolution discussion, those individuals who were less coherent in discussing their family of origin expressed more negative affect, less respect, less openness, more avoidance, and less willingness to negotiate when interacting with their partner. No evidence of intra-couple effects or "buffering" was found. The findings support a key assumption of intergenerational approaches to family therapy and suggest that applying attachment theory is a promising direction for refining and developing new interventions for couples.     

A beginner's guide to the problem-oriented first family interview

The large volume and diversity of family therapy resources can often confuse trainees who are in need of more abbreviated guidelines for managing their clinical responsibilities. This paper presents a structured outline of a problem-oriented first family interview for the family therapy supervisor and the beginning family therapist. We view the first interview as an integrated process including the important tasks preceding and following the initial family meeting. After the goals that shape the work of the first interview are described, a step-by-step guide to the twelve phases of the interview is presented: telephoning; forming hypotheses; the greeting; the social phase; identifying the problem; observing family patterns; defining goals; contracting; checklist; revising hypotheses; contacting the referral person; and gathering records. This approach to the first interview integrates a variety of structural and strategic procedures. The guide, intended for use in conjunction with close supervision, may serve as a foundation on which beginning therapists can build their unique styles.     

Once a princess,always a princess: A strategy for therapy with families of rape victims

Reconstitutive interventions for victims of rape involve more than discussion of cognitive and emotional responses to the traumatic events of the rape and the post-traumatic anxiety and depression. Many victims and families of victims are not able to reconstruct a supportive functional system after they have been violated by rape. This paper presents a strategic ritual which can be used with the raped family to facilitate this reorganization and restitution of their integrity.Through the use of a short metaphorical story and symbolic ritual, each individual member and the family as a whole can experience, reexperience, and redecide how they will respond to this traumatic event through open expression of their emotions and responses. Reintegration of their responses and shared life crisis enable them to respond to one another in ways not open to them previously.     

Family members' perceptions of live observation/supervision: An exploratory study

This ex post facto survey examined 75 client family members' perceptions of live observation/supervision of family therapy at a university clinic. The results seem to reflect the subjects' general satisfaction with the process, although this general satisfaction did not significantly predict outcome on either family or therapist goal attainment scores. Family members whose therapists were female reported greater satisfaction with the process than those with male theapists, although no differences by therapist gender were found on either therapist or family goal attainment scale scores. Open-ended responses suggested that some family members were aware of the purposes of certain strategic team interventions. Implications of findings for the practice and research of live supervision and/or observation are discussed.The authors would like to acknowledge the aid of Judith Myers Avis, Marcia Brown Standridge, Cleveland Shields, Linda Stone Fish, and Joseph Wetchler in various aspects of this research project.     

Narrative Solutions: Using Preferred View of Self to Motivate Individual and Family Change

This article describes refinements of the Narrative Solutions approach to individual and family therapy we first presented in Family Process 22 years ago. The centerpiece of this integrative (narrative‐strategic) model is “preferred view of self,” or the constellation of qualities people would like to see in themselves and have others see in them. We assume that problems generally involve one or more people mismanaging discrepancies or “gaps” between preferred views of self and either their actual behavior or how they see others seeing them and their behavior. Because clients are motivated to resolve such discrepancies, we use specifiable conversational strategies to help people (a) be clear about their preferred view of self, (b) notice gaps or discrepancies, and (c) summon resources to manage these gaps more effectively. Positive clinical effects of these strategic conversations can be rapid and dramatic. Case examples highlight applications to child and family problems, and we discuss some challenges and future directions for the Narrative Solutions approach.     

Predictors of treatment attendance among adolescent substance abusing runaways: a comparison of family and individual therapy modalities

This study explored and compared predictors of session attendance among substance abusing runaway adolescents and their parents using three manual‐driven interventions: ecologically‐based family therapy (EBFT), motivational enhancement therapy (MET), and the community reinforcement approach (CRA). Individual and family‐level variables, as well as time between intake and first session were used as predictors of session attendance. Adolescents (N=179) between the ages of 12–17 years old were recruited from the only runaway shelter in Columbus, Ohio. The findings showed that adolescents assigned to EBFT were more likely to attend at least one therapy session than those assigned to either CRA or MET. Fewer days between intake and the first therapy session were associated with higher family therapy attendance. Overall, individual and family factors predicted therapy attendance but these factors differed depending upon the treatment modality.     

Family Relationships and Counselling

During the last ten years, family therapy has developed a number of distinctive schools of work. Four such schools—structural, strategic, the Milan school, and psychoanalysis - are described, and their importance to British workers is examined. Comments are offered on a variety of issues likely to face those engaged in family therapy in the coming decade.     

Implementing Family-Based Musical Interventions in Family Therapy: A Mixed-Methods Research

Although rarely used by family therapists, musical interventions have the potential to become a more common technique in family therapy. Music’s unique therapeutic properties engage families, including young children and adolescents, in a meaningful, therapeutic, “here-and-now” creative process. Musical interventions act as catalysts, enable direct communication, and augment authentic communication patterns in a playful atmosphere. The purpose of this explanatory mixed-methods research was to obtain a greater understanding of the clinical applicability, therapeutic value and future implementation of a musical intervention carried out by family therapists in a family therapy context. The study explored the outcomes of 35 participating family therapists who attended a designated workshop on a structured family-based musical intervention, 18 of whom then applied 38 family-based musical sessions focused on family roles in their clinical work. The results illustrate the family-based musical intervention is a noteworthy tool for family clinical assessment and treatment, easily applicable in a variety of private and public settings with diverse populations. Musical instruments used as intermediary objects are potent vehicles for growing family awareness, functioning, and congruence, as well as inducing opportunities for change. The family-based musical intervention manifests the potential of an interdisciplinary, holistic, biopsychosocial approach to promoting individual and family wellbeing. The article also addresses ethical considerations and implications for family therapy training and education programs.