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.     

Training in family systems theory: A group experience

This paper describes the utilization of a family-of-origin group experience in clinical training. This model encourages attention to group process as well as content, as members study both theory and their own families. The potential difficulties and boundary issues that arise in such a group experience are addressed. Case examples are presented that illustrate the nature of the process and the student’s response to the experience.     

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.     

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.     

Communication flow and change theory within a family therapy supervision model

This article portrays a model of family therapy clinical supervision using change theory that is most appropriate for use with the videotape, audiotape, case presentation and debriefing from the live session. The most powerful tool during this process is that of communication and assessment of change theorys tools of confidence and conviction. The concepts presented are meant to add an additional dimension to family therapy supervision in cooperation of other theories, not as an end in themselves.Special thanks to Ms. Geri Koncilja of the Informational Technology Center at Colorado State University, Pueblo for illustration and graphic assistance.     

Family of the forest: Fatal enmeshment and other systems issues in the animal world

While the observation of non-human animal behavior has been a major means of developing psychological theories, it has been rarely used by marriage and family therapists to devise or explain systemic ideas. Jane Goodall's multigenerational research on the Flo family of wild chimpanzees in Gombe, Tanzania, as presented in her own and other's writing, and especially in Hugo van Lawick's documentary film,People of the Forest, offers a clear example of how systems concepts' application to animal families may have theoretical, pedagogical, and clinical utility.My thanks to my good friend, Violet Richman, who suggested the subject for this paper.     

Systemic insight in family therapy

Systemic epistemology calls for a concept of Systemic Insight, a restructuring insight that has to do with truly grasping systemic reality. Systemic Insight is action and change-oriented, grounded in the direct systemic experience of the client, and based on the how instead of the why of the relationship problem. Its results affect the whole system. The author elucidates the definition and therapeutic application of this concept, expanding on five major ingredients and illustrating in a verbatim case and commentary specific guidelines for designing interventions which procure Systemic Insight.The concept of Systemic Insight was first presented by the author as a workshop at the European Family Therapy Association International Congress: Feelings and Systems, Sorrento, Italy, November, 1992. I would like to thank Ms. Sara Iwanir, Dr. Haviva Ayal, my co-directors, and especially my husband Ron for his unending support and the helpful out of the profession fresh views.     

The integration of individual and family therapy

It is time to put an end to the separation in training programs between individual and family therapy. Competent therapists should be able to think at an intrapsychic and circular level concurrently. Training programs should maintain their current major focus and develop their minor area of expertise sufficiently so that their graduates can practice both individual and family therapy and choose whichever modality is more appropriate to the case at the time. Bridge concepts, essential differences, and some integrative approaches in individual and marriage and family therapy are discussed.     

Applying Delphi methodology in family therapy research

The Delphi technique, which is increasingly seen in family therapy publications, encourages the articulation of refinement in family therapy practice and theory. Combining both quantitative and qualitative methodology, this technique involves consideration of information that might otherwise have been overlooked. Due to lack of clarity on this approach, a dilemma exists in applying this research procedure in family therapy. To remedy this deterrent, this paper reviewed 11 studies and outlined use of the technique in regard to design, procedure, and sampling.     

The growing pains of family therapy in Singapore

Family therapy in Singapore is both short on history and overdue for development. Through in‐depth interviews with six experienced local family therapists and trainers, this article explores the challenges of family therapy development in Singapore, giving particular attention to practice, supervision, training, and research. Over time, family therapy practitioners in Singapore have gained insights in applying systemic ideas in this pluralistic society where there is a rich mix of race and ethnicity. This article highlights the contribution Singapore's experience of family therapy can make to a more global picture, in view of its rich multicultural context despite significant challenges.     

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 use of interpreters in family therapy with deaf persons

The paper discusses the use of interpreters in family therapy with deaf person families. Issues from the perspective of the therapist, the interpreter, and the family are presented.Portions of this paper were presented at the annual meeting of the Texas Association for Marriage and Family Therapy in San Antonio, TX.     

Recent and emerging trends in marital and family therapy regulation

The number of states in the United States that formally credential marital and family therapists has tripled to 31 during the last decade. This paper reviews and compares the basic licensure and certification requirements in these states, and explores a number of broad issues currently confronting the field of marital and family therapy regulation. Several recommendations for improving the quality of MFT regulation are also provided.president of the Association of Marital and Family Therapy Regulatory Boards.     

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.     

Competences and occupational standards for systemic family and couples therapy

This article reports on the recent government initiative of 2007–2010 to delineate, for the major forms of psychological therapy, expected professional standards of practice and conduct in workplaces (the national occupational standards) and to specify expected levels of competent practice (the competences). The article focuses on the processes and outcomes of this initiative for systemic therapy and its clinical and political relevance. The rationale, research and consultation processes by which these formulations were achieved are described and the outcomes of the work are reported. We also discuss their wider implications, including the various ways in which these achievements might be used and their potential value for the field of systemic family and couples therapy.     

Review and reflections on 40 years of family therapy development in Taiwan

Although the systemic approach is considered to fit Chinese culture, the development of family therapy in Taiwan is recent, starting in 1969, and growing as a treatment modality in Taiwan for the past two decades. To examine this development, this article reviewed 127 locally published family therapy studies published during the years 1969–2009. Content analysis was used to examine these articles and the results clearly showed an increase in the amount of publications during this period. The focus of the studies also shifted from theoretical issues to practical concerns. An analysis of 15 of these articles, which were case reports, suggested a preference for local common practice, for example, a focus on therapist manoeuvres rather than the clients' perspectives, which might have hindered the development of successful practice. The availability of only certain forms of training might also have contributed to the clinical focus of family therapy in Taiwan. The article suggests that greater interest in the therapy process in future will enhance local practitioners' clinical efficacy.     

The structural theory and the representational world

I have attempted to articulate a means of incorporating representational world concepts firmly within the structural theory, while still maintaining their clarity, a view which I believe can be useful both clinically and theoretically. It can facilitate an analyst's working with complex clinical material that reflects conflicts at multiple developmental levels, without forcing a premature commitment to restrictive conceptualizations which could impede his listening to the full richness of the material. In addition, I have argued that the perpetual resurgences of representational world psychologies may be understood as an indication of the need for the inclusion of those phenomena in our theory in a clear and integrated way. Finally, I have presented some basis for suggesting that the drive-defense and the representational world models represent coordinate aspects of the structural theory, each with its vantage points for highlighting and clarifying certain phenomena, but best used complementarily in our observations of psychopathology at all levels of development. I do not believe this represents a totally new view or departure within psychoanalytic thinking. On the contrary, I have assembled, organized, and attempted to make explicit certain understandings which I believe we often apply naturally through the use of empathy and intuitive gifts. In an analysis which is going well, an analyst operating within a drive-defense framework is almost certainly finding some natural way of dealing with self and object issues, even if he does not formulate them explicitly to himself. To set down and make explicit, however, the functions we may much of the time perform without awareness is worthwhile preparation against times of difficulty in understanding a particular case. At those times we need at our disposal as specific, as inclusive, and as illuminating a theory as we can find to assist us. It is that clinical need which has guided me in these attempts at theoretical clarification.