Psychoanalysis and systems in family therapy

This paper describes three frames of reference for understanding family function. The three frames are (1) The Life-cycle of the Family, (2) The Intergenerational, Historical Aspects of the Family, (3) The Interactional Structure of the Family. It is suggested that these three frames can provide a detailed formulation of family functioning and disturbance in order to plan rational foci, strategies, techniques and aims of family therapy.     

Stress and coping in the practice of family therapy: a British survey

A sample of 171 members of the Association for Family Therapy (UK) was surveyed and data obtained on their general level of experienced stress, the sources and levels of experienced stresses they encountered in their practica, and the professional and private coping strategies they used to mitigate the effects of these stressors. The results indicate that stress can be experienced in all practice contexts, with important factors in its overall configuration being personal/professional worth and agency expectation. Family therapists appear to prefer coping strategies of a more social nature and there is an ambivalent attitude towards'therapy for therapists'.     

Engagement and recruitment for family therapy research in community settings

Based on the recruitment experience in a family therapy research project with heroin addicts, this paper explores the difficulties of researcher networking with other social service agencies. Concepts from contextual family therapy are used to explore four general areas that contribute to successful intra-agency relationships: 1) Evaluating the nature of larger system relationships; 2) identifying the resources and needs of a clinic; 3) joining with the counseling staff; and 4) addressing the impact of public policy and ideology on clinic life. A case of engaging one clinic is presented and nine guidelines for engaging large community settings for participation in family therapy research are offered. These areas are considered in light of the relational dynamics that arise when working with multiple social service systems.An earlier version of this paper was presented at the American Family Therapy Association conference in Washington, DC, June 1986. The authors are grateful to the recruitment staff of the Intergenerational Family Therapy Project: Guillermo Lopez, Bart Rubin, Sharara Godfry, and Armando Chenyek. This research was supported in part by a grant to Guillermo Bernal from the National Institute on Drug Abuse (DA03543).     

The family of later life: Strategies and interventions

The concerns of the family of later life have only recently become evident. Unlike other age groups, when problems of an elder surface, they almost always involve other family members. Family members tend to become highly involved, alter their lives, and offer support. All this provides a ready condition for family pathology to assert itself. Accordingly, three common strategies used by families of later life are presented and discussed. The effect on the whole family system is stressed. Also, two therapeutic interventions are presented. Since problems related to elders are particularly resistant to therapy, these two interventions are designed for well family members. Case material is presented.     

Reactance,Attribution, Equity,and the Help Recipient1

The relevance of social psychological theory for understanding the helping relationship from the recipient's perspective and for designing efficient and humane helping systems is examined. Negative feelings associated with seeking or receiving help may occur when recipients feel threatened with loss of freedom (reactance), interpret their help-seeking as a sign of inadequacy (attribution), or feel uncomfortably indebted (equity). Studies supporting each of these theories, and a program of research which contrasts helper vs. recipient-initiated assistance, are reviewed. Findings suggest that helper-initiated aid leads to higher utilization of services and better recipient feelings. These results are interpreted as supporting attribution in contrast to reactance theory concepts. A field study in a welfare setting extends laboratory findings, and shows that current practice which requires welfare recipients to initiate requests for service may effect savings via lowered requests for service at the expense of recipients who really need help but are inhibited from requesting it.     

同胞冲突及其解决:家庭子系统的影响

同胞冲突是指在一个完整的家庭中, 具有相同生身父母的两个或多个人在行为、目标或活动上所表达出的不相容, 其通常表现为争吵和敌对情绪以及相互间的攻击行为。父母干预同胞冲突的方式分为孩子中心策略、控制策略和不干预策略。家庭系统理论指出, 家庭是一个有等级结构的、动态的系统, 这个系统中的子系统(包括父母婚姻关系、亲子关系和同胞关系)是相互联系、相互影响的。基于这一理论, 探讨家庭子系统对同胞冲突的影响, 整合建构同胞冲突的理论假设模型, 以便从多路径的角度去分析同胞冲突的产生机制。未来的研究需要对同胞冲突及其相关概念进行区分或整合, 关注父母干预同胞冲突的方式的影响因素, 并且以发展的眼光去看待同胞冲突。     

Stress and family health

This study investigates the difference between perceived everyday individual stress and levels of family health. Subjects completed the Family Adaptability and Cohesion Scale (FACES III), the Derogatis Stress Profile, and a personal data form. Quota sampling of 121 subjects was used to obtain 25 subjects in each of three groups: balanced, mid-range, and extreme family types. Individuals identified as members of mid-range families reported less overall stress than balanced or extreme family members. Significant differences appeared between the balanced and mid-range groups. Balanced individual family members reported slightly higher levels of stress than extreme family members.     

Short Paper Section The reliability of video viewing of family therapy interviews*

The use of video-taped material is common in family therapy practice and training. It is assumed that the video material conveys the same impression as when the interaction is viewed ‘live’. In this study the same eight interviews were viewed by two groups of experienced therapists, one group ‘in vivo’ and the other ‘via video’. The groups were required to rank concepts derived from Structural Family Therapy as relevant to each of the interviews. On six of the eight interviews there was substantial agreement in the ranking of concepts by the two groups lending general support to the assumption that judgements of family interactions are not influenced by the medium through which they are observed.     

Teaching the family life cycle: A guide for a workshop using simulated families

Abstract

An experiential technique for teaching the Family Life Cycle is presented. Participants are asked to create simulated families and are assigned a series of structured exercises that focus the emotional, developmental, and systemic issues of each Family Cycle stage. Directions for each exercise, questions designed to develop observation skills, and discussion of specific workshop issues are also included.     

What the family brings: gathering evidence for strengths-based work

Families attending child and adolescent mental health (CAMH) services are often assumed to have problems in key areas such as communication, belonging/acceptance and problem-solving. Family therapy is often directed towards addressing these difficulties. With increasing emphasis in family therapy and human services fields over the last decade on identifying and building from strengths, a different starting point has been advocated. This paper describes a large survey of the self-reported pre-therapy functioning of children and families using a public CAMH service (n=416). Before commencing family therapy parents identified family strengths across a range of key areas, despite the burden of caring for children with moderate to severe mental health problems. This evidence supports theoretical and clinical work that advocates a strengths perspective, and highlights how resilience framed in family (and social) rather than individual terms enables a greater appreciation of how strengths may be harnessed in therapeutic work.     

Problem-solving training for family caregivers of women with disabilities: A randomized clinical trial

ObjectiveTo examine the effectiveness of an individualized problem-solving intervention provided to family caregivers of women living with severe disabilities.DesignFamily caregivers were randomly assigned to an education-only control group or a problem-solving training (PST) intervention group. Participants received monthly contacts for 1 year.ParticipantsFamily caregivers (64 women, 17 men) and their care recipients (81 women with various disabilities) consented to participate.Main outcome measuresCaregivers completed the Social Problem-Solving Inventory – Revised, the Center for Epidemiological Studies Depression scale, the Satisfaction with Life scale, and a measure of health complaints at baseline and in three additional assessments throughout the year.ResultsMultilevel modeling was used to conduct intent-to-treat analyses of change trajectories for each outcome variable. Caregivers who received PST reported a significant linear decrease in depression over time; no effects were observed for caregiver health or life satisfaction. Caregivers who received PST also displayed an increase in constructive problem-solving styles over the year.ConclusionsPST may benefit community-residing family caregivers of women with disabilities, and it may be effectively provided in home-based sessions that include face-to-face visits and telephone sessions.     

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.     

Structural family therapy with Mexican-American family systems

Characteristics of traditional Mexican-American families with consequent family rules that affect these family systems are discussed along with selected clinical cases. The specific cases discussed involve: (1) interactions with family of origin in intercultural marriages, (2) intracultural differences in levels of acculturation and traditional family rules, and (3) extended family impact in response to severe life crisis. The development of therapeutic processes from structural and strategic family therapy approaches, which reflect appreciation for cultural differences and strengths, is suggested.This material was presented at the annual meeting of the Texas Association for Marriage and Family Therapy, January, 1994, San Antonio, TX.     

Parallel short forms of the family of origin scale: Evidence of their reliability and validity

Two parallel short forms of the Family of Origin Scale were developed from data provided by 69 women and 63 men who completed the full Family of Origin Scale along with a variety of measures of family-of-origin characteristics. Data on the reliability and validity of the short forms are provided and discussed. The results indicate that both short forms are strongly and significantly correlated with each other and with the full-scale version of the FOS and that they share its reliability and validity characteristics to a very high degree.     

Marital interaction, family organization, and differences in parenting behavior: explaining variations across family interaction contexts.

Family systems theories remind us that, in two-parent families, children encounter their parents in multiple family configurations, including parent-child dyads and mother-father-child triads, or whole families. There are, however, relatively few empirical investigations of differences in parenting behavior which tend to emerge when a dyad is transformed into a whole family unit. Using a sample of 82 families with a kindergarten-age child, the present study offers support to earlier studies reporting that mothers' and fathers' parenting behavior differs when observed in dyadic and whole family interaction sessions. The present study then turns to examining explanations for these differences in parenting behavior. Limited support was found for the hypothesis that observations of marital interaction are associated with differences in parenting behavior across family interaction contexts. Family level assessment of adaptive organization was found to explain differences in fathers' parenting in the dyad and when the entire family is together, but not differences in mothers' parenting behavior. The clinical and methodological implications of these findings are discussed.     

Problem-solving training via videoconferencing for family caregivers of persons with spinal cord injuries: a randomized controlled trial

Objective

To examine the effectiveness of an individualized problem-solving intervention delivered in videoconferencing sessions with family caregivers of persons living with a spinal cord injury (SCI) and possible contagion effects on care recipients.

Design

Family caregivers were randomly assigned to an education-only control group or an intervention group in which participants received problem-solving training (PST) in monthly videoconference session for a year.

Participants

Sixty-one caregivers (54 women, 7 men) and their care recipients (40 men, 21 women) consented to participate.

Main outcome measures

The Social Problem-Solving Inventory-Revised was administered to caregivers. Caregivers and care recipients completed the Inventory to Diagnose Depression, the SF-36 and the Satisfaction with Life scale at pre-treatment, 6 months and 12 months.

Results

Twenty-eight caregivers discontinued the study and their follow-up data were unavailable at the final assessment. Older caregivers were more likely than younger caregivers to remain in the study. Intent-to-treat analyses projected a significant decrease in depression among caregivers receiving PST; efficacy analyses indicated this effect was pronounced at the 6th month assessment. ITT analyses and efficacy analyses revealed that care recipients of caregivers receiving PST reported gains in social functioning over time.

Conclusions

Community-based, telehealth interventions may benefit family caregivers and their care recipients, but the mechanisms of these effects are unclear. Attrition and sample issues should be considered in future studies with these populations.     

The spouse subsystem in the family context: couple interaction categories

Within a semi-structured family interview (the McMaster Stuctured Interview of Family Functioning), several questions focus on intimate areas of the marital relationship. How couples answer these questions provides a window into their style of communication around potentially stressful issues. Viewing their videotaped interactions while noting their gaze patterns, dialogue, tension, and attitude, produced the following categories: Adaptive, Stable, Co-operative, Disengaged/anxious, Parallel, or Failing. Inter-observer relability was high, and the categories were related in meaningful ways to a self-report questionnaire, the McMaster Family Assessment Device, completed independently by each parent.     

Measurement of higher-order family dimensions across self-report and behavioral observational methods

This study used a community sample of 192 intact families to examine two issues related to conceptualization and measurement of family functioning. First, a confirmatory factor model supported the adequacy of using dyadic-level self-report measures (e.g., mother-child, child-father) to identify three family level constructs of Family Affect, Family Control, and Family Shared Activity. Second, data derived from behavioral observations during dyadic interactions identified two factors, Family Positivity and Family Negativity. Correlations among the self-report and behavioral observation factors indicated high Family Positivity was significantly associated with higher Family Affect and lower Family Control, and Family Negativity was significantly associated with lower Family Affect and with lower Family Shared Activity. Findings are discussed in terms of limitations and directions for research.