The Nomothetic-Idiographic Debate in Family Therapy

This essay introduces the terms "nomothetic" and "idiographic" to characterize the current debate about whether the field of family therapy should accumulate and apply knowledge about patterns of adjustment that hold across different families, or whether the field should consider each family as utterly unique, and should tailor interventions solely on the basis of these unique qualities. Embedded in this debate are the arguments for and against quantitative research, disagreements about the value of clinical prediction and interobserver reliability, as well as the issue of whether therapists can rightfully claim to possess "expert knowledge." The essay begins with the personal-professional anecdote that stimulated me to explore this debate in greater depth. It continues with a brief discussion of the historical context of this debate, particularly noting the parallels between the methodological issues in personality research and those facing family therapy. The nomothetic-idiographic debate in family therapy theory, research, and practice is then described. The essay ends with the suggestion that family therapy view nomothetic and idiographic thinking as complementary, and that the field strive to develop an integrated, "idiothetic" approach to family therapy research and practice.     

Practising family therapy in India: how many people are there in a marital subsystem?

Systemic therapy would appear to be a viable form of treatment for people who exist in cultures that contain complex, extended family systems, such as those found in India. The practice of family therapy in India has evolved from Western concepts. These concepts appear to offer Indian therapists relevant and practical ways of working with families. However, some of these concepts need modifying before they can be used in an Indian context. Indian families may have very different worldviews and ideas of 'self' compared to families in the West, leading to different family organization. The situation can be further complicated by the cultural norms of therapists themselves. Therapists in India are often highly educated, come from upper-middle-class families and have been exposed to different cultures. They increasingly share many of the values of their counterparts in the West. At the same time, they retain aspects of their own cultural heritage, which is also the dominant culture for a large number of the families with whom they work. Thus, not only must Indian family therapists seek to work in culturally appropriate ways; they must also tolerate their own internalized conflicts regarding differing cultural norms. With the use of clinical data, this paper describes some of the personal and professional problems experienced by an Indian family therapist working with Western constructs of family organization.     

Epistemological confusion in family therapy and research

Family therapy began as a movement sparked by a small group of behavioral scientists who challenged the orthodoxies of medical and psychodynamic therapies. This movement signalled the beginning of an epistemological shift, the roots of which can be found early in this century in the physical sciences. As the field has grown and become for many a means of livelihood rather than an experimental thrust, though exploration of epistemological issues has continued, a split has developed in the field that mirrors the epistemological split currently visible in Western society. The predominant reality system of the Western world remains rooted in Cartesian/Newtonian, nineteenth-century mechanistic and reductionistic "common sense," even though the basis for a new, nonmechanistic and nonreductionistic reality system has been emerging in the twentieth century. The juxtaposition of both reality systems in the field of family therapy has produced much confusion. This article attempts to clarify the basis for that confusion.     

Rationale and directions for an increased emphasis on the therapeutic relationship in family therapy

This paper argues the need for an increased emphasis on the therapeutic relationship in family therapy. The ways in which the field of family therapy has eschewed the importance of the therapeutic relationship are discussed. Therapeutic alliance research from the field of individual psychotherapy and research on the importance of relationship factors to family therapy are reviewed. Suggestions for family therapy theory, practice, and research are presented.An earlier version of this article was presented at the 1992 Western Canadian Conference on Family Practice.     

From General Laws To Singularities

This article comprises several sections. The first is devoted to an explanation of a number of notions stemming from work by Ilya Prigogine and others on open systems far from equilibrium. As a result of this work, I have been able to stand back from the traditional approach employed in family therapy, that of open systems at equilibrium (the theory of Ludwig von Bertalanffy). The second section describes a clinical example based on elements close to Prigogine's theories. In the third part I develop an approach that--although continuing to draw on Prigogine's work--is much more closely linked to the research I have carried out with Félix Guattari over recent years. In this part I attempt to study a level that, in my view, has too often been left outside the field of inquiry: that of couplings between "singularities" of members of the family system and the therapist. A clinical case is presented in which this "semiotic" level, as Guattari terms it, is used together with that of the "intrinsic rules" of the system. Finally, I propose a few avenues of inquiry and research on the basis of the concepts presented.     

Professional Politics and the Concepts of Family Therapy, Family Consultation, and Systems Consultation

At a time when an increasing number of professionals are calling themselves "family therapists," many teachers and theorists in this field are troubled that the term "family therapy" no longer adequately characterizes the concepts or activities of the field. Recently, clinical, political, and economic circumstances have emerged that suggest the need for alternatives to the role of "family therapist." By adding the roles of family consultant and systems consultant, we can open up new options for ourselves and our clients. During initial contacts with families, agencies, and other professionals, we can heighten our therapeutic potential by proceeding with consultative stocktaking, not starting with therapy. Family consultation also can assist in redirecting therapy when a new problem or an impasse develops, in focusing on competency rather than on pathology, and in engaging constructively with families that have a physically or mentally ill member.     

Family Therapy Training: The Institutional Base

The papers that follow present the findings of three surveys of the institutional base for training in family therapy. ¹ 1 Names and addresses of all facilities known to provide education in this field as of 1980 are available at a charge of U.S. $10.00; checks are to be made out to Family Process.
The surveys were initiated and conducted independently. To some extent they overlap. This is particularly true of the Bloch and Weiss effort in that it does not limit itself to a sector of the training process bounded by a single discipline, as do the other two papers. Despite some overlap, each paper stands independently; of particular interest are the varied analyses and special emphases each provides. We hope that their publication will stimulate similar studies in the years to come, so that family therapy can take advantage of the observation of its own growth and development. We are accustomed to including ourselves in the field of observation, so far as the family system is concerned; it seems reasonable to extend these perspectives to the more macroscopic field of the institutional development of family therapy. Of particular importance to us, and I believe to science generally, is the opportunity to observe a paradigmatic shift taking place with the development of this new field and the adoption of its associated epistemology by the senior professions of social work, psychology, and psychiatry. Family systems theory and practice have implications that extend beyond their own borders; they can make a significant contribution to the systems revolution that is taking place in science generally. These studies should be of use to practitioners, teachers, and students alike. It seems to me that their implications are clear: that training in family therapy at a sophisticated level is now to be a regular part of the future training of psychiatrists (possibly all physicians), psychologists, social workers, and psychiatric nurses and that, in addition, as a second distinctive career line, there is the new profession of family therapist, with its own entry point and academic pathway. My view is that society will support both lines of career development as far into the future as one can reasonably hope to see. The only logical ending to this will be a shift in the medical model from its present linear definitions of illness and treatment to an ecosystemic, biopsychosocial definition. These describe a historical crosssection through that process.     

Critical Interaction Therapy: Couples Therapy in Combat-Related Posttraumatic Stress Disorder

There is a need for family therapy interventions that are specific to the conditions found in families of traumatized people such as combat veterans. In these families, the historically "real" event of the trauma often continues to exert influence on the family system despite collusive arrangements that serve to keep it hidden. In families of combat veterans, a situation develops whereby the veteran becomes triangulated with a dead buddy without the spouse's knowledge. The discrepancy between past and present emerges in what we call the critical interaction between the spouses. This article outlines a method of couples therapy that attempts to demystify this critical interaction, and begins to integrate the discrepant narratives of each spouse. The establishment of a nascent mutuality of perspective within the couple releases energies that can be directed toward support rather than symptom-formation in the family system.     

Development of Family Therapy in Hong Kong

This paper provides an insight into the development and growth of family therapy in Hong Kong. Family therapy was introduced in Hong Kong in the early 1980s and is now gaining ground. The authors give a historical account of the development of family therapy in Hong Kong, and report on its progress and achievement for the past three decades there. The field has gone through several stages of development. The 1980s were marked by an importation of Western family therapy models, during which overseas expertise was tapped to promote family therapy. The 1990s were characterized by a blossoming of different schools of family therapy on the local scene. Most schools established their own practice centers, and training packages were tailor-made for local use. The 2000s were an important era of family therapy development in Hong Kong. The field has nurtured a new generation of leaders (both academics and front-line practitioners and trainers) who play an essential role in advancing its development. The paper concludes by identifying problems in clinical practice, professional training, and research and knowledge development, and proposes ways of overcoming these difficulties.     

The family empowerment program: an interdisciplinary approach to working with multi-stressed urban families

The family empowerment program (FEP) is a multi-systemic family therapy program that partners multi-stressed families with an interdisciplinary resource team while remaining attached to a "traditional" mental health clinic. The rationale for this model is that far too often, families presenting at community mental health centers struggle with multiple psychosocial forces, for example problems with housing, domestic violence, child care, entitlements, racism, substance abuse, and foster care, as well as chronic medical and psychiatric illnesses, that exacerbate symptoms and impact traditional service delivery and access to effective treatment. Thus, families often experience fragmented care and are involved with multiple systems with contradictory and competing agendas. As a result, services frequently fail to harness the family's inherent strengths. The FEP partners the family with a unified team that includes representatives from Entitlements Services, Family Support and Parent Advocacy, and Clinical Staff from the agency's Outpatient Mental Health Clinic practicing from a strength-based family therapy perspective. The goal of the FEP is to support the family in achieving their goals. This is accomplished through co-construction of a service plan that addresses the family's needs in an efficient and coherent manner-emphasizing family strengths and competencies and supporting family self-sufficiency.     

On Imagination: Reconciling Knowledge and Life,or What Does “Gregory Bateson” Stand for?

This article presents a reading of Gregory Bateson's oeuvre, focusing on his interest in the representational gap between map and territory, and its importance in the development of his redefinition of the concept of "mind," his new discipline called "ecology of ideas," and a methodology congruent to it based on the logics of metaphor. Inquiries on three initial stories from different domains allow the use of homologies between form and content in the article. This reading of Bateson's oeuvre stresses his questioning (like Derrida's) of the metaphysics of presence on which Western philosophy has been mostly based, and of the central role of imagination as a balancing factor for a family therapy that he both contributed to and saw with reservations.     

The (HI)Stories We Live by: Power/Knowledge and Family Therapy in Africa

There is a need to Africanise family therapy so as to serve the interest of local communities. Western approaches to family therapy have been accused of being irrelevant to African contexts. They are seen as forming part of a dominant scientific knowledge which invalidates local folk and cultural psychologies and thereby continuing a historical tradition of oppressive colonial power relations. This paper aims at archaeologising and evaluating such criticism by situating family therapy within different fields of knowledge that have emerged historically and are currently co-existing in Africa. The advantages and disadvantages of dominant family therapy approaches in African contexts are explored by focussing on power relations between different knowledges in Africa. It is argued that many global narratives of family therapy offer congenial companionship to many local African narratives, but that family therapists should pay more attention to local spiritual and political narratives so as to attain more legitimacy and validation by local communities.     

Family Therapy in Poland: Development and Current Perspectives

The authors of the present article describe the historical context of family therapy in Poland and current issues in the field. They highlight the fact that Polish therapists first began to develop the field after coming into contact with family therapy leaders from the United States and Western Europe. With the political breakthrough of 1989, there were new opportunities for multilateral cooperation, attendance at international conferences, and the exchange of experiences. Currently, the work of Polish family therapists, the place of family therapy among other forms of psychotherapy, and the related problems and challenges do not differ from other European nations.     

Does History End with Postmodernism? Toward an Ultramodern Family Therapy*

Although the end of history has often been announced, human thought continues to renew itself, always incorporating, in each of its stages, important aspects of what has come before. In this sense, neither family therapy in general, nor its more particular postmodern orientations, have led to a radical break with the past. Neither can they claim to have reached a comfortable, definitive position. The subjectivist turn that introduced postmodernism into the systemic model has enriched it with important theoretical and practical elements, such as the critique of a therapist's supposed objectivity, circular and reflexive questioning, or the technique of externalization. This article proposes to take the renewal of systemic family therapy farther by addressing still unresolved issues, such as the role of the individual in relational systems, the place of emotions, or the construction of a relational psychopathology. The term "ultramodern family therapy" is proposed until such time as there is agreement upon a better one.     

Transcultural family therapy

Conventional family therapies such as Structural, Systemic, Satirian, Adlerian and Dreikursion seem to be marked by cultural biases and give an indication of one single culture orientation. These seem to represent the cultural majority norms and values in acting as oppressive tools in a multi cultural society. Most of these therapies are derived from theories reflecting intrapsychic factors that are white middle class concepts, neglecting the multi culturaUsocia1 contexts in family therapy. “Ethnic minority families” from non Western Countries often experience more problems than families from Western Countries in the areas of education, immigration, employment and health. The cultural expectations are full of contradictions and ethnic minorities feel handicapped both socially and culturally in the task of growth and development. Western family therapy has failed to address these issues.     

Gender in family therapy supervision

While gender has taken its place as a fundamental construct in family therapy theory, little has been written about gender in family therapy supervision. This paper attempts to redefine gender as it pertains to families, family therapy, and family therapy supervision; call attention to aspects of gender as they apply to training in family therapy and family therapy supervision; and suggest ways that family therapy supervisors can sensitize themselves to issues of gender so that they can be more effective in supervision.The author gratefully acknowledges her husband, Victor Nelson, STM, and Eric McCollum, PhD, for their comments on an earlier draft of this paper and for helping with the idea that men are raised to fix things, women to make them better.     

"Detoxification" of Vietnam War Trauma: A Combined Family-Individual Approach

Treatment with families of veterans suffering from the aftereffects of combat trauma in the Vietnam War often requires a preliminary phase of disjoint treatment, in which family members are seen separately, before conjoint treatment can proceed. In this disjoint phase of treatment, wives and children are introduced to the brutal realities of Vietnam combat experience and to an understanding of its sequelae. This disjoint phase of family therapy detoxifies combat experience so that it can be approached in subsequent conjoint sessions along with more traditional family therapy issues.     

Toward a generative theory of the therapeutic field

In the various models of family therapy, family systems are described as being patterned and programmed in their operations and development. The regularities and patterns found in family life are believed to be the expression of a program that determines the behavior of the family system and each of its members. Therapists holding this view will use "programming methods" in order to map family phenomena, and therapeutic work will consist of disrupting the problematic sequences in a deterministic way. However, if we take into consideration the impossibility of always linking inputs and outputs and the inability to evaluate consistently the behaviors in a system, problems associated with indeterminancy appear. Under such conditions, it may be impossible for therapists to formulate programs of family functioning. Therefore, we have operationalized a set of methodological principles that can be applied in such conditions. In this article we present the theoretical and practical implications for the field of therapy of "nonprogramming methods." A videotaped session is analyzed in order to show the application of the nonprogramming methods in clinical practice.     

家庭抗逆力理论在风险应对领域的应用：演变、价值及挑战

家庭抗逆力理论是近年来风险应对研究领域中被引最高的理论之一。该理论的提出源自McCubbin等人对军人家庭应对战争危机的观察与思考,得益于早期学者对家庭压力和家庭系统理论的探究。经数次修订后,该理论经历了由静态特征到动态变化的发展过程,形成了一个具有较广泛内涵与外延的理论体系。其早期应用集中于创伤修复、家庭压力应对等主题,之后涉及复原力等更丰富的研究议题,已成为临床干预工作的实践导引和COVID-19大流行以来国家和社会、家庭和个体层面“危机事件—适应能力”关系的重要解释机制。其应用面临来自元理论研究、方法学及跨文化与社会变迁观点的挑战。未来研究应明晰概念与整合模型、使用混合方法与制定评估指标体系、强化家庭抗逆力理论的本土化研究与构建中国特色家庭抗逆力理论体系。     

Teaching symbolic-experiential family therapy: The personhood of the teacher

This article explores issues in teaching symbolic-experiential family therapy to psychiatric residents. Six controversial contextual issues that arise in teaching any school of family therapy in this setting are presented. Then, the author distinguishes between content and process dimensions in teaching symbolic-experiential family therapy. This distinction helps to clarify the muddle often attendant to attempts to teach this particular area. A major point, to paraphrase Whitaker's famous dictum, is that Teaching symbolic experiential family therapy resides in the personhood of the teacher.