Power and influence in the environment of family therapy*

This paper explores some of the ways in which family therapy theory and practice limits an appreciation of the contexts of families and family therapists. It focuses particularly upon how the rules which underlie patterns of relationships in social systems are made and maintained more by one part of a system than by another, and considers this (a) within families, (b) within various aspects of the social environment of families, and (c) within the organizational contexts of family therapists. It then proposes that the systemic thinking which family therapists apply to families is potentially applicable to wider contexts including international relationships.     

Behavioural family therapy and the influence of a systems framework

A family approach using the techniques of behaviour modification, to a family presenting with problems of encopressis in a five-year-old boy, is described. The usefulness of taking a broader analysis of the context of the behaviours targeted for modification under the impact of systems theories is emphasized. A one-year follow-up after treatment demonstrated both symptomatic and family changes.     

Power,family therapy,and the systemic-organismic paradigm

How is the concept of power integrated into the systemic organismic paradigm? Power concepts, especially Kantor and Lehr's six dimensions of distance regulation mechanisms, are related to several models of family therapy. Power is found to be a part of the Gestalt formation process of Perls, a process of dynamic selfregulation. Each family therapy model is regarded as part of an integrating process. A theory of conflict strategy and of integration strategy in therapy is developed. The article is intended to promote comparison and exploratory discussion around different models of family therapy.     

The influence of family environment and child temperament on work/family role strain for mothers and fathers

This study examined the additive effect of structural variables, child characteristics, and the family environment on mothers' and fathers' work/family role strain. Differences between mothers and fathers on these variables were also examined. The sample consisted of 36 dualearner families whose children had been in daycare from infancy through 4 years of age. Structural variables included work schedules and time spent with child for mothers only, fathers only, and both parents together with child. Child characteristics included temperament and health. Family environment variables included different components of the family environment (conflict, cohesion, expressiveness, organization, and control) and parenting daily hassles. Results showed that mothers' time with child and caregiving for child were greater than fathers'. Mothers reported more expressiveness in the family and more daily hassles with children than fathers. Mothers' level of role strain was also significantly higher than fathers'. For mothers, role strain was associated with hours away from home, child sociability, family conflict, and daily hassles resulting in an R² of 0.57. Fathers' role strain was associated with family expressiveness, organization, and their wives' daily hassles resulting in an R² of 0.37. Data suggest that mothers' and fathers' role strain may be driven by somewhat different factors. For women, aspects of the family and the child and work hours accounted for a considerable portion of the variance while for men, only aspects of the family environment were associated with their level of role strain. Copyright © 2003 John Wiley & Sons, Ltd.     

Art therapy in transcultural family therapy

The increased existence of foreign culture patterns in the child population calls for transcultural comprehension in child psychiatry. This case report describes transcultural aspects in the therapy of an 11 year-old Moslem girl admitted to a child psychiatric department. Her symptoms were abdominal pain, headache, anxiety, and pretended fever. A family therapeutic approach was used together with elements of art therapy and individual therapy in a successful treatment. The family therapeutic approach was based on art therapy as a part of the communication where cultural symbols were an important part. An interpreter was not used. The cultural context where it is acceptable to overstep the borderline between reality and fantasy is seen as an important healing capacity.I would like to acknowledge my debt and my appreciation to Ebba Ernst, psychologist of the department and supervisor in the therapy of the S. family. I would also like to thank professor Kai Tolstrup and child psychiatrist Torben Marner for stimulating support in the process of writing the article. A grant from Enkefrue Hermansens Mindelegat made the participation in the Krakow Congress possible.     

Perceptions of the therapist in family therapy

Thirty-five families completed ratings describing their perceptions of their therapists. These ratings were then correlated with measures of outcome to assess whether there was a relationship between experiences of the therapist and treatment outcome. Further, the study addresses whether some family members' perceptions are more influential in affecting the course of treatment. The results showed that family members' perception of the therapist does have an impact on treatment outcome, but not all members affect the outcome equally. Further results and their implications are discussed.     

Promiscuity in the practice of family therapy

Family therapy has continually confronted choices between polarized positions, each one taken up with zeal because it solved an old dilemma but eventually encountering its own limitations. In this article I suggest that we have evolved to a point where, instead of deciding which is better, we can focus on how to use theories, models and techniques as fluid and flexible resources for action in the therapeutic conversation. Doing so focuses our attention on how we can move in and out of various positions, including those that simplify issues and those that embrace complexity. In addition, our attention is drawn to the ways in which we can make choices between following a model as opposed to engaging in spontaneous dialogue. This promiscuous stance can help trainers and therapists answer questions concerning how we make decisions in therapy. Such promiscuity also positions us to confront our images and expectations of what it means to be a professional.     

Genes and family environment in familial clustering of cancer

Familial clustering of a disease is defined as the occurrence of the disease within some families in excess of what would be expected from the occurrence in the population. It has been demonstrated for several cancer types, ranging from rare cancers as the adenomatosis-coli-associated colon cancer or the Li-Fraumeni syndrome to more common cancers as breast cancer and colon cancer. Familial clustering, however, is merely an epidemiological pattern, and it does not tell whether genetic or environmental causes or both in combination are responsible for the familial clustering. Familial clustering may be due to genetic predisposition to the disease, but exposure to environmental factors — shared by members of some families, but not by members of other families — may also cause familial clustering and hence mimic genetic inheritance in the study of nuclear families. Based on assumptions regarding the individual steps in the biological process starting with exposure to carcinogens and ending with death from disseminated cancer we suggest that genetic and environmental factors may both be involved in most of these steps. The present paper focuses on research methodologies necessary to discriminate between the effect of genes and family environment in the development of cancer.     

Consultation in family therapy

Abstract

This paper addresses the issue of the use of consultants by experienced family therapists. The authors discuss the need for consultation under different circumstances and review a number of models currently being utilized. Emphasis is placed on preparing the clients for the consultation, providing background information to and preparing with the consultant for the session(s), and transferring “power” to the consultant and back again to the primary therapist.     

Children in family therapy

The distinctive skills of child psychotherapy can be utilized in the development of a form of conjoint family therapy especially applicable to the field of child psychiatry. It is suggested that the engagement of children in the process particularly enhances the specific characteristics and potentialities of this form of treatment.     

Mystery in family therapy

Existential approaches to family psychotherapy are considerably different from the problem centered approaches to treatment which are currently so popular in the field. Gabriel Marcel's distinction between a problem centered and a mystery centered understanding of life is utilized to overview the basic and deep differences between existential and problem centered approaches to family treatment.     

Countertransference in family therapy

The intent of this article is to describe the importance of one psychoanalytic concept, countertransference, in family treatment by a review of the literature on the subject. Case illustrations will then be used to show how the supervisor of a family treatment case elicited the countertransference in order to move the therapy forward. Some thoughts with regard to training will be offered.     

Siblings in family therapy

The participation of siblings in family therapy was studied from case records in 76 consecutive cases attending a child and adolescent psychiatric outpatient clinic. Siblings took part in family therapy in two thirds of the cases. Of these, 76 per cent attended only one or two sessions. A sub-sample of nine families with children below 13 years of age was interviewed. Seven out of 10 evaluated siblings had psychiatric symptoms of some severity at the onset of therapy compared to two after, and all had fewer symptoms after therapy compared to before (p<0.01). Most families thought it relevant for both parents and siblings to take discussing their children's behaviour in front of them and wanted the opportunity of also talking to the therapist without the children being present.     

Redefinition in family therapy

Abstract

In the wider context of an epistemological renewal, the author describes the possibility of a redefinition of therapy from that of an intervention focused on the patient to one of an opportunity for participation and growth of a group which shares a common history. The author speaks of the necessity of giving alternative meanings to the presenting symptoms, citing examples from his work with families.     

Families and family therapy in Germany

The author describes some of the effects of decades of life under a dictatorship for East Germans and the effects on family life and family therapy of changes following the recent reunification of Germany. A case example illustrates some intergenerational family problems associated with the changes. Contrasts are drawn between East and West Germany and family therapy's present stage of development is depicted in both parts of the reunified country. Germany has approximately 10,000 trained family therapists, a minority of whom work in private practice. The largest amount of family and couples therapy is performed in agencies.Portions of this material were first presented in a poster session at the American Association for Marriage and Family Therapy annual conference in Miami Beach, 1992.     

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.