Action models—learning by doing

The aim of this workshop was to demonstrate experientially how action models can be used: to highlight particular themes; to study ongoing interactional patterns of the family system; to allow patterns of behaviour and communication to emerge along with the consequences of that pattern; to focus on the process rather than the content; to find the strengths and resources of the family; and to offer the opportunity of practising new skills and to gain insight through experience. Action techniques are specific acts or actions the therapist engages in to implement a strategy. Action is a deliberate intervention which will provide material shared with the family and therapist. Five different experiential exercises were demonstrated for use in family therapy training or in family therapy sessions.     

Orthodoxy in family therapy practice as servant or tyrant

This paper considers some of the pitfalls of a single-model approach to family therapy. It does not argue a 'right' way of practising family therapy, but proposes that the therapist needs to have available a range of approaches on which to draw. This also raises certain problems for training in family therapy, which are highlighted. A case is discussed in the light of a number of perspectives, to demonstrate how approaches can be used in complementary fashion. Finally, reference is made to some of the agency constraints which also make it difficult to practise any one model in a 'pure' form.     

Keeping connected: Family therapists' experiences of working online during the COVID-19 pandemic

For this qualitative study, eight family therapists were interviewed about their experiences of practising online during the pandemic. Findings are organised using a framework of problems, possibilities, resources and restraints (PPRR, Neden & Burnham, 2007). Despite variation in therapist confidence in online practice, all participants found new possibilities in this way of working, including connecting family members across distance, increased co-construction within therapeutic relationships and engaging clients who would not usually attend appointments. Therapeutic alliance was generally possible to establish online, though felt more challenging with whole families than individuals. Problems and restraints included therapist fatigue, risk and safety management, and attuning to nuanced expression of emotion. Implications for practice and future research are proposed. It is suggested that systemic practice has unique qualities to offer the field of online psychotherapy.     

Soul pain and the therapeutic use of ritual

Abstract

This paper will explore the relationship between ritual and transformation. It will show how a therapist and a monk work together to create sacred spaces in which individuals can experience transformation of and through their personal histories, linking their past, present and future to address their soul pain through ritual.

It is illustrated with case studies which will demonstrate the phases of ritual work which are collectively important as part of the psycho-dynamic therapeutic process.     

King Tiger and the roaring tummies: a novel way of helping young children and their families change*

Therapy with young children and their families poses special challenges for the therapist. In particular, it is important for the therapist to meet the child at his or her ‘view’ of the world. King Tiger is a special helper who can assist the therapist in this task. Once the idea or existence of King Tiger has been introduced to the child and family in therapy, the therapist can commence writing letters and stories to the child on King Tiger's behalf. These written interventions can affect the entire family. The paper will examine some of the useful and creative techniques that can be incorporated into King Tiger therapy. A case example will illustrate how King Tiger can work as a co-therapist.     

The Use of Rituals in Grieving for a Miscarriage or Stillbirth

Abstract

Preparation for their changing roles in family and society, as well as readying their intimate space for the arrival of an infant, totally engage expectant parents. Miscarriage or stillbirth may bring on a grief storm that strips away many tender roots and branches of new life in the community that the parents have been nurturing. Creation and participation in a grief ritual can bring the grieving parents to a healing resolution. This article describes the healing efficacy of ritual, its elements, and how a compassionate therapist can create one in collaboration with grieving clients.     

The therapist's inner conversation in family therapy practice: some ideas about the self of the therapist, therapeutic impasse, and the process of reflection.

In this article, a distinction is made between the outer therapeutic conversation and the therapist's inner conversation. The therapeutic conversation is a circle of meaning in which both the therapist and the clients play a part. The therapist's inner conversation is described as a negotiation between the self of the therapist and his role. In this process of negotiation the therapist has to take seriously, not only his observations, but also what is evoked in him by these observations, that is, images, moods, emotions, associations, memories, and so on. Furthermore, therapeutic impasse is conceptualized as a paralysis of the circle of meaning and of the therapist's inner conversation. A process of reflection is proposed as a way out of the impasse. In that process, the inner conversation of the therapist is externalized with the help of an outsider. In the final part of this article, a case study illustrates the importance of these ideas for the family therapy practice.     

Respect and the Confucian concept of Li (ritual propriety)

ABSTRACT

This paper specifically deals with the relation between respect and li禮in the Confucian context. Li has both negative and positive sources. On the positive level, ritual propriety enables one to express internal moral and religious feelings, especially respect, reverence and humility. Furthermore, this work investigates into the relevant feelings and acts of respect and ritual propriety, as well as meaningful critiques of ritual, in an attempt to clarify the genuine expression of ritual propriety that helps to actualize human inner moral and religious approaches.     

Family Therapy for the Historian?— The Case of William James

Family therapists disagree over the utility of historical reconstruction for treatment. Following either a behavioral or a psychoanalytic paradigm, theorists insist that history is irrelevant or essential to the treatment process. This paper demonstrates how a variety of family therapy concepts were used in his historical research into the life of the family of William James, the American psychologist and philosopher (1842–1910). This is offered as evidence both that family theory has a contribution to make to the writing of history and that the historical process is important to family therapy. It is suggested that clinical actuality calls forth interventions within both paradigms, often by the same therapist with the same family. The alternatives need not be mutually exclusive, though theory-building is clarified by talking as if the therapist were confronted by an either/or choice.     

Re-Membering Spirituality

Ritual has been used as a therapeutic tool within family therapy for nearly two decades. Our understanding of ritual has been drawn from studies of cultures in which all life was viewed as sacred. However, common use of ritual in therapy lifts ritual out of its sacred context and secularizes it. Blending some of the key thinking in feminist theology with feminist psychology can help women reconnect with a perspective on the sacred that is empowering. Reimbuing ritual with the sacred and expanding its use in therapy make it a powerful healing process for women.     

The Relationship of the Self of the Therapist to Therapy Process and Outcome: are Some Questions Better Left Unanswered?

Gurman (1987) has challenged the field of marital and family therapy to answer questions concerning the relationship of the therapist to outcome. An examination of conceptual and empirical literature regarding the relationship of the self of the therapist to process and outcome in marital and family therapy discloses that empirical evidence for such relationship is not persuasive. The author constructs a crucible for the field of marital and family therapy.     

Parting gifts: termination rituals in group therapy

A patient's termination from group therapy is a powerful experience for the departing patient, the therapist, and all group members. Unless the feelings evoked are channeled into constructive expression, they may undermine this potentially valuable phase of both the departing patient's group treatment and the life of the group as a whole. A termination ritual, styled by a particular patient according to his or her own need, therapy goals, and personality may help the patient achieve a more clearly defined sense of self. The authors suggest that the group therapist's careful attunement to and thorough exploration of the significance of any termination ritual or gift will help to extract maximum therapeutic benefit for the departing member and the group as a whole.     

Death in the Family: Adapting a Family Systems Framework to the Grief Process

This paper presents a framework for adapting a family systems approach to the grief process. The framework places the bereaved and therapist in the larger context. The therapist builds a relationship around each family member's unique experience with death, and uses the grief timeline to facilitate timely systemic interventions. This perspective helps the therapist navigate pitfalls and remainstrategically positioned to address grief sensitively and effectively in psychotherapy.     

Child and family therapy: A collaborative approach

Abstract

When a child is the identified patient, people often expect individual sessions to be a part of treatment. Yet, family therapists routinely violate this expectation by working with children solely in the context of the family. This article discusses how the therapeutic process can be facilitated by conducting at least a small number of individual sessions with children. Such behavior by the therapist communicates to children, parents, and involved referral sources a respect for their opinions and lays the groundwork for cooperation. The advantages and disadvantages of such an approach are discussed.     

The Consultation-Demonstration Interview

In recent years the consultation-demonstration interview, in which a family is interviewed before a workshop, has become increasingly prevalent. While this method of presenting the therapist's style of interviewing can be an exciting and valuable learning experience, it can also lead to a sense of boredom and disappointment. In some instances, the experience can be traumatic, especially for the family and the guest therapist. Common pitfalls in the organization and planning of the interview are explored, and a number of specific recommendations are made for attempting to maximize the potential in this interview process. Written to both the planner and the leader of the workshop in family therapy, this paper is based on the author's personal experience.     

Family Rituals

Family rituals, consisting of celebrations, traditions, and patterned family interactions, are defined and illustrated in this paper. The power of ritual practice in families is explained by three underlying processes — transformation, communication, and stabilization — concepts whose roots lie in anthropology and ethology. We propose that all families struggle with finding a suitable role for rituals in their collective lives but their actual achievement varies greatly. Commitment to ritual and adaptability of ritual practice throughout the family life cycle are important considerations. The utility of these concepts in the assessment and treatment of families is discussed.     

'But they aren't motivated …' issues concerned with encouraging motivation for change in families

This article is an attempt to provide some frameworks for understanding aspects of the context of families which support or constrain motivation for change. A theme of the entire paper is that ambivalence is normal and that it is therefore useful to regard families both as motivated to change and motivated to maintain stability. Part I focuses particularly upon family–referrer– therapist relationships and Part II upon family–therapist relationships. Part I begins with an exploration of the idea of motivation as a process and outlines the usefulness of the concept of ambivalence. Its main focus however is upon the importance of considering referrers when attempting to assess the motivation of family members for change.
Part II considers the relationship between the family and the therapist and takes account of some important aspects of the contexts of both. It ends with a summary of some experiential exercises which enable one's personal understanding of motivation issues to develop.     

Avoiding Colonizer Positions in the Therapy Room: Some Ideas About the Challenges of Dealing with the Dialectic of Misery and Resources in Families

Some authors have argued that certain acts of family therapists—despite their best intentions—may represent a form of colonizing the family. When acting as a colonizer, a therapist is understood as becoming overly responsible for the family and focusing too strongly on change. In so doing, the therapist disrespects the family's pace, and neglects their own resources for change. This paper aims to highlight the need for therapists to be hypersensitive both to the resources of families entering therapy as well as to the impact of prevailing ideologies on their own positioning in the session. The kind of sensitivity advocated here is dialectical in the sense that every family is understood as having potentials promoting dynamism, happiness, and well-being as well as potentials contributing to stagnation, unhappiness, and misery. In this article, using illustrations from clinical practice, we present some ideas for resisting the tendency by the therapist to assume a colonizing position as a professional solver of problems for families. Our main aim here is to redirect the therapist toward connecting with the family's suffering, as well as with the resource repertoire it has developed for navigating and negotiating its way through life.     

Treating the Doll's House Marriage

The Doll's House, a common pitfall for family therapists, is an extremely unequal relationship in which one spouse's incompetence is required or encouraged by the other. This pattern of marriage is common in a sick population and is chosen by people with clear individual pathology. It may be stable and satisfying, but it is crisis prone. Doll's Houses are likely to be disrupted by the arrival of children, financial reverses, and, most important, the intrusion of another person upon whom the Doll is dependent and who sets out to equalize the marital relationship. A well-intentioned therapist with an intolerance for pathology can destroy the marriage. Therapy seems more successful when the therapist respects the basically unequal framework the couple has chosen and works toward greater understanding and respect for unique individual needs within that framework.     

Family theory and the scientific method

The evolution of family interactional research reveals a transformation from the theoretical concerns of a novel cybernetic paradigm to methodological problems of a prior mechanistic one. This change can be understood, within a cybernetic perspective, as an example of the characteristic functioning of adaptive systems attempting to maintain themselves unchanged under changed circumstances. A turn to a focus on method results in theoretical self-correction and the implicit retention of a mechanistic paradigm. This eliminates those most novel aspects of family interactional research that suggested the beginning of a cybernetic paradigm. A mechanistic methodology for family interaction research can be understood as an analogue to ritual in social systems. A primary attribute of ritual, sanctity, self-reflexively defines certain basic premises as unquestionable. By this, it regulates the beliefs of those who act it out, and eliminates the most radical novelty that confronts these beliefs. The evolution of family interactional research and its changing relationship to its methodology is an example of this process, the introduction and rejection of novelty by self-regulating systems. In this case, a challenge to the basic premises of a mechanistic paradigm is subverted, using its method as the arbitrator of validity in family interactional research.