焦虑障碍的系统式家庭治疗

焦虑障碍是最常见的心理障碍之一.其具有症状重、病程慢、复发率高、社会功能明显缺损等特点,给个人、家庭和社会造成了巨大的负担.家庭环境因素在焦虑障碍的发病、转归和预后方面都起到重要作用.本文介绍了国内外关于焦虑障碍患者家庭特点和家庭互动模式的研究结果.系统式家庭治疗作为一种家庭治疗模式,具有其独特的治疗理念和方法,国内外研究结果表明系统式家庭治疗用于焦虑障碍具有良好疗效.今后,还应该运用更加多元化的研究方法探讨中国焦虑症家庭动力学特点和家庭功能,并采用更加严格的随机对照设计,进一步证实系统式家庭治疗对焦虑障碍的治疗效果.     

Involving the family in the evaluation and treatment of the child patient: A psychodynamic approach

The purpose of this article is to provide psychotherapists with a tool for family evaluation using the basic principles of psychodynamic work; and to introduce a transitional format for therapists who have practiced family evaluations in their training institutions and now need to adapt this model to the private practitioner's office. A case example illustrates: (1) Use of the therapist's unconscious for diagnosis of the child and its family, (2) joining the family's intersubjective space, and (3) use of play and therapist's neutrality as ways that the psychodynamically oriented clinician involves the family in the evaluation and treatment of the child.     

Structural family therapy with Mexican-American family systems

Characteristics of traditional Mexican-American families with consequent family rules that affect these family systems are discussed along with selected clinical cases. The specific cases discussed involve: (1) interactions with family of origin in intercultural marriages, (2) intracultural differences in levels of acculturation and traditional family rules, and (3) extended family impact in response to severe life crisis. The development of therapeutic processes from structural and strategic family therapy approaches, which reflect appreciation for cultural differences and strengths, is suggested.This material was presented at the annual meeting of the Texas Association for Marriage and Family Therapy, January, 1994, San Antonio, TX.     

Family Therapy in France: A Brief Overview

The major issues in contemporary family therapy in France are described: Difficult beginnings, the practice of family therapy today, training and professionalisation, organization for family therapy, journals and publishing, and perspectives for family therapy in France.A psychiatrist, Head of Hospital Psychiatric and Mental Health Center near Paris (Ville Evrard. France 93330) and a family therapist     

The Present State and Future of Symbolic-Experiential Family Therapy: A Post-Modern Analysis

Symbolic-experiential family therapy (SEFT) is facing an important phase in its development. With the death of Carl Whitaker, it is not certain in which direction SEFT will be headed. This paper describes some of the challenges that SEFT presently faces and what can be done to surmount them. It is proposed that SEFT theorists and therapists concentrate on the post-modern components of the theory. By moving in a post-modern, constructionist direction, SEFT will be developing with a current trend in family therapy, allowing SEFT to continue as an important family therapy model.     

The Voices of Therapists and Children Regarding the Inclusion of Children in Family Therapy: A Systematic Research Synthesis

In 1970, Nathan Ackerman challenged the field of marriage and family therapy to actively involve young children in the family therapy process. How has the field of marriage and family therapy responded to his challenge? Using a systematic research synthesis to review and critique the non-empirical and empirical literature in the area of children in family therapy, the author discovered that the field of marriage and family therapy has not responded to Ackerman's challenge in the way he may have hoped for nearly three decades ago. A summary of the literature's findings is provided and recommendations for future research, as well as implications, for the field of marriage and family therapy are discussed.     

Family Physicians and Family Therapists: Understanding the Interdependent Synergism

This article, written by a family physician and a family therapist, is designed to identify differences between these two cultures that may serve as stumbling blocks to successful meeting of occupants of these two worlds. With the differences identified and described, various notions and suggestions are offered in an effort to promote more successful bridging between these two groups. There is little question about the synergistic impact that can be engendered for recipients of their care should this bridging be successfully navigated. The present day realities in healthcare make this an idea whose time has not just come, but rather seems imperative.     

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.     

Family-of-Origin,Sexual Attitudes,and Perceptions of Infidelity: A Mediation Analysis

Abstract

The purpose of this study was to examine the influence family of origin and sexual attitudes have on perceptions of infidelity through a mediation analysis to test whether sexual attitudes mediates the relationship between family of origin attitudes and perceptions of infidelity. Results indicated that family of origin attitudes were linked with higher permissive sexual attitudes and lower perceptions of infidelity. Additionally, results indicated an indirect link between family of origin attitudes and perceptions of infidelity through sexual attitudes. These findings align with previous research examining how family of origin influences the occurrence of infidelity and provides insight to helping professionals as they address infidelity in romantic relationships.     

The Drama of Couples Therapy

In the author's view, the intensity of couples/family treatment arises from a suppressed acknowledgment of reciprocity, of interconnectedness among family members, beyond the often familiar dynamics of blaming and deprivation. Eliciting a recognition of profound interdependence raises anxiety, and stands in opposition to culturally prescribed concepts of autonomy and independence. To this end, a dramaturgical model of couples/family is proposed and discussed, involving the therapist's participation as director, witness or audience, and protagonist.     

Family therapy and outcome: Relationships between therapist and family styles

This study examined therapeutic outcome for a group of 175 clinic families divided into levels of family competence and style, and, later, into seven clinical groupings. The division into these groups was based on the level of rated Competence and Style determined by using the Beavers Systems Model. Therapists also rated their level of Openness/Sharing Strategy, Power Differential, and Partnership with the family at the third session. Results indicate that more competent families who fared well in therapy had therapists who formed a partnership, disclosed strategy, and employed a minimal power differential with the family. The most disturbed families, and those with a Centrifugal style, did better with therapists employing a high power differential and lower levels of openness and partnership. The study also presented the distribution of individual diagnoses by family groups. Implications for family therapists, including the value of family assessment, are provided.     

The recovering female alcoholic: A family affair

Supported by a review of relevant literature and a case study, the author argues that family therapy intervention enhances the likelihood of a female alcoholic's positive prognosis. With a basis in systems theory, family therapy views the family as a system and, hence, perceives the alcoholism as a symptom of that family. A profile of the female alcoholic, how her drinking affects her family, and the role that family therapy plays in the recovery process are examined.     

Family Secrets: The Case of the Patient Kept in the Dark

The author examines the position of a child from whom important matters in his or her own life or key events in the family have been kept secret, outlines criteria by which the decision whether or not to unveil the secret should be made, and urges colleagues to gather more data and examine further family secrets.     

Beyond the Frying Pan: Addressing Work Issues with Women in Therapy

In recent years, mental health practitioners have been exploring how women are balancing work and family. Given how this issue affects womens experiences in the corporate world and at home, marriage and family therapists are attempting to consider this concern as they treat female clients individually and within relational systems. Few articles and studies have examined the issues female employees face in the workplace and how the issues influence the therapeutic process. In this article, the authors examine the organizational, sociological, and cultural challenges women deal with at work and apply these areas to the therapeutic context. The authors present a case study of a female client enduring a difficult work situation, discussing how to view and approach this case from a feminist family therapy perspective.     

Textbooks in Accredited Marriage and Family Therapy Programs

Although choices of required textbooks are important decisions in developing a course curriculum, faculty in marriage and family therapy training programs have few convenient resources to guide curriculum development. This article presents results of a survey of textbook selections of accredited marriage and family therapy programs within a regional affiliate of AAMFT. The five programs surveyed listed 108 different titles used in their curriculum. Only 12 texts were used by two programs, and only one text was used by more than two programs. This article presents the textbook selections by the six curricular areas of COAMFTE accreditation standards. The wide variety of textbooks used by programs leads us to conclude that no consensus exists about what textbooks best represent the core knowledge of marriage and family therapy. The body of knowledge taught in accredited marriage and family training programs reflects a distinct and autonomous body of knowledge.     

Fostering Client Creativity in Family Therapy: A Process Research Study

Creativity has been shown to enhance problem solving, and to increase flexibility and adaptability—qualities associated with positive therapeutic outcomes. Literature related to therapist and/or client creativity is primarily anecdotal. Empirical literature addressing how therapists can facilitate the creativity of their clients in family therapy is scarce. In this study, the researchers used process methodology to code the behavior of therapists and clients in 31 videotaped family therapy sessions. Results show a significant positive correlation between interventions that induce positive affect and the creative client behaviors of optimism and playfulness.     

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.     

Family history and gender roles: Critical factors in practitioners' views of family interactions

This study examined practitioners' perceptions of family and individual family member functioning in relationship to family roles, gender of family leadership, beliefs about the consequences of maternal employment, and paternal division of responsibility in practitioner family of origin. Practicing counselors and mental health therapists rated two videotaped family interviews, one demonstrating a matriarchal style of family interaction and the second a patriarchal style. Findings indicated that practitioners were vulnerable to view a patriarchal style of family interaction as more healthy in comparison to a matriarchal style and that their perceptions of family members were related to personal beliefs about the consequences of maternal employment and to personal family history. These and other findings suggest that practitioners may be prone to errant perceptions and misguided intervention related to personal history and attitudes.     

Reconsidering the Factor Structure of the Beavers Interactional Scales: Do External Ratings Mirror Self-Reports?

Factor analytic studies indicate that family relationships assessed by self-reports may be most clearly and parsimoniously differentiated along three dimensions, namely, Affective Expression, Behavioral Control, and Shared Activity. The present study explored the question of whether this were true of family ratings by outside parties. Confirmatory factor analysis was used with three data sets (n = 97, 91, and 95; N = 283) employing the Beavers Interactional Scales of family functioning. Multicollinearity of the observed variables was a pervasive problem. When the redundancy of the observed variables was pared down so that there were two observed variables for each latent factor, these three factors in oblique relationship provided a good fit to the observed data.