SOCIAL CONSTRUCTION THEORY AND THE SATIR MODEL: TOWARD A SYNTHESIS

Abstract

This article synthesizes social construction theory and the Satir approach to family therapy in terms of therapy as a process of cocreation of reality, the use of language and narrative, and the therapist's role as a participant-facilitator. Social constructionism has a tremendous impact on the present ideological shift in family therapy. The Satir model is a powerful approach to family therapy and has had a wide influence on generations of therapists. Although existing literature has well documented the influence of social construction theory on the postmodern school of thinking in family therapy, there is no literature exploring the compatibility of the Satir model with social construction theory. This research presents a theory-building process of the Satir approach to family therapy.     

Navigating Critical Theory and Postmodernism: Social Justice and Therapist Power in Family Therapy

The family therapy field encourages commitment to diversity and social justice, but offers varying ideas about how to attentively consider these issues. Critical informed models advocate activism, whereas postmodern informed models encourage multiple perspectives. It is often not clear how activism and an emphasis on multiple perspectives connect, engendering the sense that critical and postmodern practices may be disparate. To understand how therapists negotiate these perspectives in practice, this qualitative grounded theory analysis drew on interviews with 11 therapists, each known for their work from both critical and postmodern perspectives. We found that these therapists generally engage in a set of shared constructionist practices while also demonstrating two distinct forms of activism: activism through countering and activism through collaborating. Ultimately, decisions made about how to navigate critical and postmodern influences were connected to how therapists viewed ethics and the ways they were comfortable using their therapeutic power. The findings illustrate practice strategies through which therapists apply each approach.     

Tales of a Therapist

ABSTRACT

Historically, theorists and clinicians from various schools of family therapy have discussed therapist self-disclosure in terms of either helping or inhibiting therapeutic progress. Although postmodern language-based theorists and therapists accept and encourage its use, few clinical examples of therapist self-disclosure exist in the family therapy literature. In this paper, a postmodern family therapist working within the language-based tradition describes the use of self-disclosures with a couple. The therapist then reviews the effects of those self-disclosures through the eyes of husband, wife, and therapist.     

Postmodernism versus psychotherapy

‘Postmodernism’has made a substantial impact on various schools of psychotherapy, including family therapy.‘Postmodern’therapists tend to focus on the productive capacities of language, developing narrative styles for their work.‘Postmodern’family therapy is differentiated from modernist approaches by its disavowal of truth claims and its encouragement of alternative‘voices’or narratives. In this paper, it is argued that this represents too narrow an approach to psychotherapy and to postmodernism. Postmodernism takes as a central concern the limits of symbolization, so a postmodernist therapy would deal primarily with failures of language. Language-based therapeutic procedures such as those to be found in family therapy are consequently not postmodernist. This state of affairs should be welcomed, as a truly‘postmodern’mode of therapy would probably celebrate irrationality.     

A Both-And Approach: An Application of Narrative Interventions from a Modern Perspective

A contentious debate between the modern and postmodern epistemologies continue to wage on since the rise of constructivism and social constructionism in the 1990s. This debate has led to both modern and postmodernists falling into an either/or mindset. Others have proposed a solution, the both-and approach, that emphasizes integration of different therapeutic camps. Intentionality is a core component of this approach, as therapists must understand how employed interventions flow from the epistemology and theoretical orientation under which they operate. Another core component of this approach is tailoring the integration to the specific context of the client case. With this understanding and tailoring, therapists can utilize methods across the modern/postmodern divide, as they will coherently flow from their original epistemology and theoretical orientation. Applying methods from both modernism and postmodernism, then, enhances therapists’ therapeutic repertoire, allowing for more opportunities to adapt treatment to each client case. Altogether, the quality of services improve and the amount of clients therapists can help increases as well. This paper will provide an application of the both-and approach to a case study to provide an example of how the said method can be employed in therapy.

     

Honouring our great grandparents: towards a rhetorical analysis of family therapy

This paper argues that family therapy is an inherently and inescapably rhetorical activity, although its connections with rhetoric have remained largely ignored and the implications for practice unexplored. An uncritical acceptance of a range of postmodern ideas has led many family therapists to ignore the power of their therapeutic rhetoric. The paper offers rhetorical analysis as a tool to help family therapists to reflect on the rhetorical power of their practice and thereby to exercise this power more responsibly.     

Family therapy and the politics of evidence

This article situates family therapy in the politics of evidence-based practice. While there is a wealth of outcome research showing that family therapy works, it remains on the margin of mainstream therapy and mental health practice. Until recently it has been difficult to satisfy 'gold standards' of randomized control research which require manualization and controlled replication by independent investigators. This is because systemic family therapy is language-based, client-directed and focused on relational process rather than step-by-step operational techniques.
As a consequence family therapy is an empirically supported treatment unable to join the evidence-based club. The politics here concerns what is 'evidence', who defines it and the limitations of a scientist-practitioner model. Therapy is art and science and its research needs to be grounded in real-life clinical practice. Common factors such as personal hope and resourcefulness and the therapeutic relationship contribute more to change than technique or model.
While arguing for a wider definition of science and evidence it is politic to seek evidence-based status for family therapy. Family therapy is a best practice approach for all therapists where systemic wisdom helps to decide what to do with whom when . A systemic-practitioner model is informed by quantitative and qualitative research and holds modern and postmodern perspectives in tension, a stance I call paramodern . Family therapy is both scientific and systemic; it is a science of context, narrative and relationship.     

The Primacy of Discourse in the Study of Gender in Family Therapy

Family therapists and scholars increasingly adopt poststructural and postmodern conceptions of social reality, challenging the notion of stable, universal dynamics within family members and families and favoring a view of reality as produced through social interaction. In the study of gender and diversity, many envision differences as social constructed rather than as “residing” in people or groups. There is a growing interest in discourse or people's everyday use of language and how it may reflect and advance interests of dominant groups in a society. Despite this shift from structures to discourse, therapists struggle to locate the dynamics of power in concrete actions and interactions. By leaving undisturbed the social processes through which gendered and other subjectivities and relations of power are produced, therapists may inadvertently become complicit in the very dynamics of power they seek to undermine. In this article, we argue that discourse analysis can help family therapy scholars and practitioners clarify the link between language and power. We present published examples of discourse analytic studies of gender and sexism and examine the relevance of these ideas for family therapy practice and research.     

Cognitive-Behavior Family Therapy: Contemporary Myths and Misconceptions

The field of couple and family therapy has grown in the direction of expanding its horizons by looking toward innovative ideas and whatever works to facilitate change. Despite its demonstrated track record with a broad range of behavioral and emotional disorders, the cognitive-behavior therapies (CBT) may have been underutilized by couples and family therapists unlike some of the more traditional and postmodern approaches. This article explores some of the basic tenets of the cognitive-behavioral approach with families and proposes it as both a useful intervention tool as well as a theoretically compatible model to systemic approaches. In addition, a number of contemporary myths and misconceptions are discussed that may be precluding CBT's utilization by therapists in the field.     

Whatever happened to biology? Reconnecting family therapy with its evolutionary origins

This article argues for a rapprochement between family therapy and biological science. In spite of the prevailing tendency nowadays to write biology out of the story of family therapy, it has played a central historical and conceptual role in the origin of our discipline. Family therapists may have done themselves and their patients a disservice by distancing themselves from the discipline of biology; ignorance of modern biological ideas may be a serious handicap in the practice of therapy. The gap between contemporary biology and the kind of postmodern thinking currently favoured by many therapists is not as great as it appears, and may be bridged.     

The real problem for postmodernism

This essay is a critique of postmodernism and its relationship to family therapy. It is argued that the strengths of a postmodern approach (its relativism and narrative focus) are not unique but shared by traditions, modern and antiquarian, which the advocates of postmodernism now seek to displace both in the academy and the clinic. The negative baggage of accepting the emerging postmodernist orthodoxy is created, in the main, by the abandonment of a realist ontology. A variety of points are made about the relationship between postmodernism and general systems theory to highlight this point. At the end, critical or sceptical social realism is offered as a positive alternative to naïve realism or postmodernism. Some notes are made in conclusion about the implications of the essay's arguments for family therapists.     

Discourses in the Mirrored Room: A Postmodern Analysis of Therapy

A postmodern approach is used to examine the discourses that circulate in the therapy room. Dominant discourses support and reflect the prevailing ideologies in the society. Three ready examples concern gender relations: the male sex drive discourse, the permissive discourse, and the marriage-between-equals discourse. I point out how the therapy room is a mirrored room that can reflect back only the discourses brought to it by the family and therapist. There is a predetermined content in the conversation of therapy: that provided by the dominant discourses of the language community and culture. I suggest that therapists need to develop a reflexive awareness if muted discourses are to enter the mirrored room.     

Using Scaling to Facilitate Ethical Decision-Making in Family Therapy

Ethical decision-making in family therapy is inherently complex, as it requires therapists to balance competing needs of multiple individuals and subsystems. Scaling offers a potential means of helping facilitate such decision-making, by encouraging attendance to the likely impact of various courses of action on individuals and subsystems as related to each of the core ethical principles underlying psychotherapeutic practice. This article explores the potential use of scaling in family therapists’ ethical decision-making through case examples. Benefits and risks of such an approach are reviewed.     

A Systems Approach to Sex Therapy with Gay Male Couples

SUMMARY

Sex therapy with gay male couples is difficult for many family and relationship therapists. Family therapists lack knowledge of the nature of sex therapy, gay male culture and sexuality, the dynamics of gay male couples, and the sexual issues gay male couples are likely to bring to sex therapy. Countertransference also makes sex therapy with gay male couples difficult for some family and relationship therapists. This paper addresses those issues and then explains a systems approach to sex therapy with gay male couples.     

Constructing Cultural Competence: Perspectives of Family Therapists Working with Latino Families

This article focuses on developing an understanding of how nine therapists working with Latino families construct the idea of cultural competence in the counseling room. In-depth interviews were conducted and analyzed yielding five themes in cultural competence from the therapists' perspectives: the use of language in therapy; the impact of social class, gender, and power on the therapeutic relationship; immigration and culture clash; definitions of family; and unique constructions of cultural competence. The therapists'narratives in this study are best understood through a postmodern paradigm suggesting that the field of psychotherapy needs to move beyond a “checklist” modernistic approach to developing cultural competency.     

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.     

International Family Therapy: A View from Kyoto, Japan

"International family therapy" is an emergent field within (or overarching) the field of family therapy. At this stage, it can be described as the collecting and sharing of experiences by family therapists from different countries. Recent publications (7) gather information principally from Western cultures in which systemic family therapy has grown over the past thirty years. Japan is of particular interest to Western practitioners because it is a highly successful, post-industrial culture that differs markedly from the West. Familiar family therapy interventions often work for unfamiliar reasons, and different goals are often needed in order to respond to apparently similar family problems. An expanded sense of choice around strategies for family life and family therapy that such diversity implies is the primary contribution that this maturing, international family therapy movement can make to family therapy.     

Thinking and Working Relationally: Interviewing and Constructing Hypotheses to Create Compassionate Understanding

In the initial interviews of family therapy sessions, the therapist faces the challenge of obtaining and organizing the information that is most relevant toward understanding the essential concerns that families and couples bring to therapy. This article describes the process of clinical interviewing and case conceptualization used in training family therapists at the Ackerman Institute for the Family. This approach helps the therapist bring forward, and organize, specific information into relational hypotheses, or systemic‐relational conceptualizations, that allow both family members and the therapist to understand presenting problems within their relational contexts. While always provisional, relational hypotheses help anchor the therapist in a systemic‐relational frame and provide a conceptual through‐line to guide the ongoing work of the therapy. The process of interviewing and the construction of clear and complex conceptualizations of presenting problems are illustrated through case examples.     

Rhetorical processes in therapy: the bias for self–containment

This paper argues that therapy tends to reproduce a particular version of personhood, identified by Sampson's notion of the self–contained indi–vidual. The self–contained individual is a contemporary Western construction, which requires a denial of the interactive processes that permit its appearance and idealization. Focusing on constructionist therapies, it is argued that therapists use rhetorical strategies to more or less systematically argue for self–containment as a preferred way of being. These rhetorical manoeuvres render different aspects of self–containment plausible, practicable and 'real', while alternative versions of the self and behaviour are discursively minimized, becoming less plausible in the process. An analysis of two family therapy sessions is then used to illustrate these processes. It is suggested that therapy may reproduce Western ideals about being human.