The educational therapy contribution to a family systems approach

This article draws on the experience of one specialist education unit to demonstrate the usefulness of engaging families directly in the treatment of children showing difficulty in managing tasks and relationships in school. It will look at the overlap of psychoanalytic and systemic ideas and show how theory and practice from both 'schools of thought' allow for a fuller understanding of blocks to school success and also support the family and child in their efforts to 'defeat' a difficulty. I look in particular at the way a psychodynamic focus on a child's inner world can work alongside the systemic focus on family structure, hierarchy and history.     

A family systems approach to grief

This article blends two important viewpoints on grief: a stage theory on the individual's grief and the family systems literature on grief. A case study is examined from both the individual and systemic viewpoints. Pastoral implications for intervention with the case study family as a system are noted. The theological questions which the family and pastor face are also discussed.     

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.     

Long-term family therapy: A developmental approach

The emphasis in family therapy literature on brief therapy has given a false sense of what family therapy can accomplish. While it has helped to develop different theories of change and refine techniques to deal with resistance, it has caused many clinicians to mistake technique for treatment. A long term developmental approach is advocated in which the family therapist is the general practitioner rather than the specialist. This paper is the result of a 30-year caseload in which there was a group of multi-therapy families.     

Gestalt approach to family therapy

Abstract

Gestalt psychotherapy is presented as a synthesis of a number of psychological traditions. Two particular techniques are described in detail: the empty chair technique which is a strategy that focuses on the parents' internalized object relations which are played out between themselves and with their children; and the Gestalt experiment which is a strategy that focuses on the contact boundaries between family members.     

A family systems approach to conciliation in separation and divorce

This paper argues for a family systems approach to families who are in conflict during the process of divorce, particularly in relation to custody and access for their children. The concept of 'conciliation' as a brief method of intervention is both defined and discussed and principles and skills are identified. The influence of the context within which conciliation is practised and in particular, the power which the conciliator holds, or is perceived by the family to hold, is also discussed. These ideas are illustrated by case examples.     

A family systems approach to child–parent separation: 'developmental closure'

This paper presents a family systems model for considering the interactive events that occur when a child and parent move towards closing their relationship and separating. This process typically involves the child being 'received into care' and is identified as developmental closure . Different stages of this process are exemplified clinically and the therapeutic principles that guide work with families struggling with such difficulties are outlined.     

Selective mutism in children: A structural family therapy approach to treatment

When children refuse to speak in some social settings, but can understand and speak in other settings, the diagnosis of selective mutism must be considered. A review of the literature describes the disorder, the various types of mutism, and related family dynamics. A family systems approach to treatment using structural family therapy is suggested. The case history presented illustrates one type of mutism as well as the family rules and hierarchy which appeared to be maintaining it. Structural and strategic family systems theory techniques that were used to move the family toward resolution of this problem are discussed.Diane Wolf Tatem, MA, MS, completed graduate work in marriage and family therapy at New Mexico State University, Las Cruces, NM. She is employed at Life Management Center of El Paso's Child Development Services and also has a private practice in marriage and family therapy in El Paso, Texas. Robert L. DelCampo, PhD is a professor of family science at New Mexico State University and maintains a private practice with Associates for Marriage and Family Therapy in Las Cruces, NM. Please address all correspondence to Dr. DelCampo at Box 3470, New Mexico State University, Las Cruces, NM, 88003-3470.Appreciation is expressed to Dr. Charles Huber, New Mexico State University in Las Cruces, for his insightful critique of the final draft of this paper. This paper was presented at the Texas Association for Marriage and Family Therapy Annual Conference, January 25–29, 1995 in Dallas, TX.     

Elective mutism in children: A family systems approach

Abstract

Elective mutism in children is a relatively rare symptom which is more prevalent in the kindergarten population and has a higher incidence among immigrant families. Treatment strategies for this silent symptom include speech therapy, behavior modification, psychoanalytic, psychotherapeutic, family systems and a combination of these approaches. This paper reviews the types of elective mutism and proposes common characteristics of elective mutists' families. The potential for a redefinition of the term “elective mutism” is examined. It is concluded that family dynamics are an integral part of the elective mutism problem and need to be considered in a comprehensive treatment plan.     

Gender and family therapy: Adding a bi-level belief systems component to assessment

This article proposes that most couples requesting therapy describe gender socialized patterns as part of their relationship issues. Adding a component to assessment derived from principles of strategic and systemic family therapies and post-modernist feminist psychology which examines the couple's gendered belief system context is described. The belief system context is identified as the family's epistemology about gendering at the family belief system and sociocultural belief system level contexts. Three dimensions of the gendered belief system and a method for assessing the functionality of the belief system are discussed.     

Writer's cramp: A behavioural approach

The history of the treatment of writer's cramp by behaviour therapy is reviewed, and the theoretical assumptions underlying aversive treatment are criticized. The natural history of the disorder is reviewed, including the author's recent research in Student Health Centres. Some special observations are made on the disorder's peculiarities of incidence, both with regard to age of onset and the ethnic or geographical origins of what appears to be a significant minority of patients. Three approaches to studying aetiology are discussed, the neurological, psychopathological and the learning theory of orientations. Some suggestions are offered for further research embracing both experimental psychology and neurological investigation.     

Anorexia nervosa: the treatment of a male case with combined behavioural and family therapy

The successful treatment of a case of anorexia nervosa in a 14-year-old boy is described in this paper. The treatment comprised an initial month-long hospital-based behavioural weight gain programme. Concurrently a family evaluation was conducted. Family therapy, involving the parents only, was conducted over a subsequent four month period. The management of a relapse four months after the termination of treatment is described and information obtained at 9 and 16 month follow up is presented.     

A structured approach to disengagement in family therapy with child-focused problems

The aim of this paper is to describe a structured approach to managing the disengagement process. Six distinct disengagement scenarios are first outlined. Thereafter, phasing out therapy, dealing with family belief systems concerning the permanence of improvements and relapse management are discussed. Ways in which disengagement from specific episodes of therapy may be construed as part of an ongoing therapeutic relationship and the practicalities of recontracting for further episodes of therapy, handing over cases, and referring cases on to other professionals are considered. An approach to therapeutic failure analysis is presented. Finally, ways in which disengagement may lead to significant loss experiences are discussed.     

Extreme itching treated by a family systems approach

A case study is presented in which a 16-year-old daughter developed extreme itching and scratching behavior that was triggered by the occurrence of manifested parental conflict. The daughter's scratching also served the family function of helping the parents avoid marital conflict. Family treatment consisted of helping the parents manifest, negotiate, and resolve marital conflict issues in front of the daughter so that she could experience the benefits of dealing with a family conflict in a functional way. This approach had helped the daughter decrease her anxiety about conflict situations which, in turn, has resulted in a significant decrease in her itching and scratching behavior. In addition, the parents report an improved marital relationship now that the daughter's itching no longer occurs and no longer interrupts the parents' attempts to negotiate marital conflict issues.1979, Fall     

Extreme itching treated by a family systems approach

A case study is presented in which a 16-year-old daughter developed extreme itching and scratching behavior that was triggered by the occurrence of manifested parental conflict. The daughter's scratching also served the family function of helping the parents avoid marital conflict. Family treatment consisted of helping the parents manifest, negotiate, and resolve marital conflict issues in front of the daughter so that she could experience the benefits of dealing with a family conflict in a functional way. This approach has helped the daughter decrease her anxiety about conflict situations which, in turn, has resulted in a significant decrease in her itching and scratching behavior. In addition, the parents report an improved marital relationship now that the daughter's itching no longer occurs and no longer interrupts the parents' attempts to negotiate marital conflict issues.