Structural Family Therapy for Children of Divorce: Case Reports

Structural family therapy techniques for treating families with a parental divorce in which a child is symptomatic are described. The family configurations considered are: mother, child, and maternal grandparents; overprotective mother and child; helpless and mildly neglectful mother; father; new family formation; and couples who divorce and marry new spouses.     

Developing the Individual: Life Skills and Family Therapy

Two bodies of literature on life skills and on family therapy have developed from different sources but have interesting similarities. Life skills comes from training and educational thinking, and concentrates upon the skills of and strategies for coping. Family therapy focuses upon the disturbance of an individual as symbolic of the dynamics of the family, but has at its roots a more-or-less explicit model of what constitutes an effective family, where the interactions can be readily understood in life-skill terms. The two approaches are compared and contrasted.     

Borderline Personality Disorder,Divorce and Family Therapy: The Need for Family Crisis Intervention Strategies

Recent literature reviews, point out the lack of crisis intervention and crisis prevention programs that are in existence to address crises experienced by first-degree and divorced family members of Borderline Personality Disorder (BPD) probands. The focus of such intervention programs should be to facilitate the improved ability of the first-degree and divorced family members to manage and transcend the unstable family environment. Correlations between personal instability and frequency of psychosocial crises have been examined, as well as the ripple effect of frequent individual crises on family environments. Reviews of current therapeutic interventions, as well as a synthesis of practical family therapy interventions focusing on breaking the cycle of dysfunctional multi-generational family environments are also examined.     

Child Access and Visitation Following Divorce: A Growth Area for Marriage and Family Therapy

Recent federal legislation encourages states to increase noncustodial parents' access and visitation with their children following separation or divorce. The State of Iowa Department of Human Services Bureau of Collections commissioned a pilot study to provide a beginning picture of how parents and professionals experience the child access and visitation process. Two midsized urban centers and a rural community were studied. A total of 14 divorced parents and 16 professionals who work with divorced individuals were interviewed using a 2-hour focus group format. Study findings identified problematic themes regarding child access and visitation, potential solutions, and suggested services to address these problems. The services suggested by the study all fall within the professional expertise of marriage and family therapists. A primary finding of the study was the need for therapy and mediation focused on relational issues.     

Divorce Therapy in Context

Abstract

Partners trying to decide whether to continue or end their marriage rely on the expertise of therapists to help them evaluate their alternatives. Research on what predicts divorce and what consequences divorce has for parents and children is reviewed so therapists are informed in the guidance they give clients. Attention is given to the environmental context of marriage as well as its interior quality. Implications for therapists doing divorce therapy in the context of a “pro-marriage” climate are also discussed.     

Meeting the Needs of Evidence-based Practice in Family Therapy: Developing the Scientist-practitioner Model

Effective models of clinical training have been and continue to be a primary topic of discussion in the field of family therapy, particularly given the needs of evidence-based practice. This article outlines the major historical and contemporary struggles of one such model of clinical training and practice: the scientist-practitioner model. Throughout the article, the principles of the scientist-practitioner model and evidence-based practices are compared and contrasted. Suggestions for overcoming the contemporary challenges faced by the scientist-practitioner in a family therapy practice or in an educational environment are discussed.     

Adolescent Adjustment to Parental Divorce: An Investigation from the Perspective of Basic Dimensions of Structural Family Therapy Theory

This study, conducted within the framework of concepts of structural family therapy, examined the relationship of four family-based, clinical dimensions to the adjustment of 45 adolescents during the first 18 months of parental separation. There were two samples of mother-custody families: an Aided group that applied for treatment, and an Unaided group of paid volunteers. The inclusion of this variable addressed a major methodological deficit of previous studies. There was a significant association between perceived postseparation family structure and adolescent adjustment, demonstrating that individual adolescent adjustment is contingent on structural features of the contemporary postseparation family. Further, Aided families were perceived as more chaotic, disengaged, and enmeshed than Unaided families, while Aided adolescents were characterized by more behavior problems than Unaided adolescents. This suggests that divorce, as an unscheduled transition, might be within the realm of adaptation for many families and adolescents and is not necessarily "disastrous."     

Family Therapy with a Multiparental/Multispousal Family

This article examines therapy with a Bedouin-Arab family from the Negev, Israel, which consisted of 69 members: a husband, 8 wives, and 60 siblings. The husband, who lived with his youngest wife, paid little attention to his other wives and their children. There was considerable competition, hostility, and jealousy among the wives; no communication between the co-wives or the children of different wives; and a variety of behavioral and psychosocial problems among family members. I describe the varied strategies and systems involved in family therapy. The main strategies were to establish good relationships among the co-wives and to build a coalition among them, including the youngest wife, through group therapy in a medical clinic. A secondary strategy was using the children's problems to get the husband involved in the therapy. With improvement of the children's functioning, and with reduced intra-subfamily hostility, the husband's relationships with his children and wives improved.     

Families Leaving Family Therapy After One or Two Sessions: A Multiple Descriptive Case Study

A multiple case study design was used to discover something of the experiences of families, therapists, and members of the reflecting team of the first and or second session of family therapy in an attempt to answer questions regarding why families drop out after only one or two sessions. It was found that the families attending these sessions found them to be ineffective in assisting them to re-author the stories of their lives. There many reasons for this being the case.     

On the Boundary: Family Therapy in a Long-Term Inpatient Setting

This paper presents a paradigm of family therapy in a long-term inpatient setting. After reviewing literature commenting on the necessity of attending to the needs of families of inpatients, the essential functions of inpatient treatment are discussed and an approach to family therapy, related to and reflecting those functions, is developed. Four functions of inpatient family therapy are delineated: joining, support, intervention, and validation. What distinguishes these from similar functions in outpatient treatment is the family therapist's position on the hospital-family boundary.     

Family Therapy Training: An Evaluation of a Workshop

This article describes the methodology and results of an evaluation of family therapy training workshops. Cognitive skills were measured by written answers about a case history and intervention skills by the rating of videotaped interviews. Improvement was found on both variables, but cognitive and intervention skill levels and development were not related. These results have implications for training and job selection procedures.     

Group Processes in Family Therapy: a Psychoanalytic Approach

This paper describes a model of family therapy that draws on experiences and theories of psychoanalysis as applied to individuals and groups. It suggests concepts that help to understand and work with the family as a system. A brief example is given to illustrate the effort to engage with the patients' immediate feelings in the session in relation to each other and the therapist.     

Medical Family Therapy: Charting a Course in Competencies

The skills and training medical family therapists need to be effective in their work is an underdeveloped area in the literature. Training programs in Medical Family Therapy (MedFT) currently vary in duration, intensity, and focus of material and most of this is due to the minimal research done on what core competencies are needed. The results presented in this paper are the product of a larger modified Delphi (Dalkey in Studies in the quality of life, Lexington Books, Lexinton, MA, 1972) study designed to reach consensus regarding the current definition, scope, and practice of MedFT. Thirty-seven experts in MedFT participated in this two-phase investigation. What resulted and will be reported on in this article are the training requirements and recommended core competencies for the practice of MedFT. Participants indicated that 12 academic course content areas and 13 core competencies should be required of those seeking training in MedFT. Recommendations for MedFT core competencies at the master??s, post master??s, and doctoral levels, as well as advancements for future research, are described in detail.