A Structural Approach to the Single-Parent Family

Although the single-parent family is becoming a predominant family structure, there is a surprising scarcity of articles discussing its typical problems or detailing specific therapeutic approaches. This paper attempts, first, to list some core problems encountered by all single parents and, second, to present a sequence of therapeutic approaches geared toward dealing with these problems.
Structural theory, with its emphasis on subsystems, generational boundaries, and organizational patterns, provides a framework for viewing the built-in vulnerabilities of the single-parent family unit. Minuchin's ( 3 ) emphasis on generational boundaries and the problem of enmeshment underlies the theoretical and therapeutic approach presented here. I have drawn heavily on Haley's ( 2 ) idea that the therapist must be an authority, a problem-solver, and a teacher. Finally, the emphasis on creating new organizational patterns is most thoroughly explored in Aponte's ( 1 ) discussions of "underorganized families" (many of whom are single-parent families).     

A Narrative Approach to Child and Family Therapy in Africa*

Professional family therapy in Africa is heavily influenced by theories and principles of Western family practice. Its practice structure and philosophies are however grounded on African family values and the principles and orientations of traditional African psychology. This paper presents a clinical report that illustrates adaptations we make to incorporate compatible aspects of narrative family practice in African and Western cultures. A summary of African family values and child psychology intended as a background perspective is provided. The paper is significant against the background of the current need for forging multiculturally relevant healing methods that fit well with the globalized nature of the contemporary world. Augustine Nwoye, PhD, is Associate Professor and Chairman, Department of Psychology, Kenyatta University, Nairobi, Kenya (amnwoye@avu.org). Professor. Nwoye has developed an African paradigm for mental health and, in particular, for family and couple therapy. He also has experience in dealing with stress and multiple losses, especially surrounding HIV/AIDS within an African context. *An earlier version of the paper was presented to the members of staff and students of the Faculty of Education, University of Cambridge, England, UK, and the initial version was presented to the members of the Family Therapy Program of the Faculty of Medicine of the University of Calgary, Calgary, Canada. I wish to thank Dr. Colleen McLaughlin (University of Cambridge) and Professor Karl Tomm (University of Calgary) for their invitation, assistance, time, attention, and suggestions.     

The Anorectic Process in the Family: A Six-Stage Model as a Guide for Individual Therapy

This article presents a conceptual framework for individual treatment with chronic anorectic patients. In the first part of the article, the six-stage model for the anorectic process developed over the past years by M. Selvini-Palazzoli and her team is briefly explained. After presenting the model, we then discuss some related concepts, namely, "family game," "rule," and "strategy." Finally, the therapeutic technique in individual treatment is discussed. Two basic assumptions underlie this technique: first, the therapeutic relationship is instrumental, its main purpose being to improve the patient's personal relations outside therapy; second, the focus of the treatment is on the strategic incapacity of the patient who is caught up in and unable to cope with the "concealed family game."     

A Cognitive-Behavioral Approach to Family Therapy

Although cognitive behavioral spectrum approaches with individual children are plentiful and demonstrate effectiveness, cognitive behaviorally oriented clinicians are frequently left to their own devices when it comes to treating families. Cognitive behavioral family therapy is a relatively recent development and there are precious few reports of its clinical use. This article presents a conceptual foundation and clinical rubrics for the practice of cognitive behavioral family therapy. Basic theoretical background information is presented and places the therapeutic processes and procedures in a proper context. Session structure in cognitive behavioral therapy is illustrated and the way it propels therapeutic momentum and adds focus to each session is explained. Rudimentary processes of self-monitoring, self-instruction, rational analysis, and behavioral enactment are described and augmented with case material. Finally, the conclusion offers directions for further theory building, research, and clinical practice.     

A Feminist Approach to Family Therapy

Although family therapy recognizes the importance of the social context as a determiner of behavior, family therapists have not examined the consequences of traditional socialization practices that primarily disadvantage women. The unquestioned reinforcement of stereotyped sex roles takes place in much of family therapy. A feminist therapy orientation that considers the consequences of stereotyped sex roles and the statuses prescribed by society for females and males should be part of family therapy practice. This paper describes the ways in which family therapists who are aware of their own biases and those of the family can change sexist patterns through applying feminist principles to such areas as the contract, shifting tasks in the family, communication, generational boundaries, relabeling deviance, modeling, and therapeutic alliances.     

Toward a Synthetic Approach to the Rorschach: The Case of a Psychotic Child

Much Rorschach research on case material focuses on the utility of a single scoring system, set of variables, or scale in isolation from other systems, scales, or perspectives. This approach fails to acknowledge the complexity of the Rorschach and to reflect the manner in which sophisticated clinicians select and synthesize various perspectives during the clinical inference and decision-making process. A case of a psychotic child is presented to illustrate the utility of a synthetic approach to the Rorschach. The strengths and weaknesses of various Rorschach perspectives in addressing specific diagnostic issues is explored through the case material.     

Applying a Family-Ecosystemic Model to Reunite a Family Separated Due to Child Abuse: A Case Study

Family reunification following the removal of a child due to child abuse is a challenging process. In this case study the authors demonstrate the success of a family-ecosystemic intervention for achieving the reintegration of an adolescent into her family following a court-imposed separation. The SET (Structural Ecosytems Therapy) model was used to: (1) repair family bonds, (2) build collaborations among the agencies involved in overseeing the child's welfare, and (3) build an alliance between the mother and agency personnel. This case study suggests that facilitating such collaborations can be helpful in the evaluation and follow-through of high risk cases.     

A Child With Autism Spectrum Disorder Teaches Siblings to Skateboard: Effects on Sibling Skills and Family Social Behavior

Abstract

Children with autism spectrum disorder (ASD) may have few common activities with their siblings who do not have ASD, and this can limit their opportunities for social play. In this study, we used a multiple-baseline across skills design to assess the effects of a boy with ASD following an activity schedule to teach his favorite activity of skateboarding to his two siblings who do not have ASD. Family social behavior was also measured before and after sibling training. After training by the boy with ASD, both of the siblings’ skateboarding skills improved, and measures of family social behavior also increased. Results suggest that sibling relationships may benefit when a child with ASD teaches siblings to play.     

Child Sexual Abuse: A Multidisciplinary Approach to Case Management

Treatment for child victims of sexual abuse is a complex and sometimes lengthy process involving members of numerous social service agencies. Coordination of services can be accomplished through the use of a multidisciplinary team approach to case management. The author provides information about the roles of various team members as well as suggestions for organizing a child sexual abuse multidisciplinary team.     

Perceived Intrafamilial Connectedness and Autonomy in Families With and Without an Anxious Family Member: A Multiple Informant Approach

Perceived intrafamilial “emotional connectedness” and “autonomy” were investigated within families with and without an anxious family member using a multiple informant approach. The sample consisted of 32 mothers with a current anxiety disorder and 56 controls, their partners, and their anxious and nonanxious teenage children. No differences were found with respect to the perceived family relationships of family members with versus without anxious mothers. However, compared with nonanxious adolescents, anxious adolescents perceived less autonomy in relation to both parents. Mothers of anxious adolescents also perceived their children to be less autonomous toward them and their partners, than mothers of nonanxious adolescents. In contrast with “autonomy,” “emotional connectedness” was not reported to be different between families with and without an anxious adolescent. Agreement among family members and the importance of perceived individual autonomy in the development of anxiety are discussed.     

A Sensory Integrative Approach to the Psychotic Child

Current knowledge provides ample evidence of widespread neurological and developmental impairments underlying the behavior of psychotic youngsters. Occupational Therapy can now assess, treat, and make "sense" of the psychotic child's disturbed systems. A case study of a severely disturbed, self-abusing, childhood schizophrenic patient is presented. The treatment process and behavioral changes are discussed and augmented with statistical analysis.     

A Family Therapeutic Approach to Transgenerational Traumatization

The phenomenon of transgenerational traumatization has currently become widely recognized and described, although the task of disentangling the underlying interactional mechanisms remains a difficult one. These transgenerational mechanisms were first detected in families of the survivors of the Holocaust, but they may be equally prominent in families of parents who have been traumatized in other ways, for example, as victims of child neglect and abuse, as orphaned children, or during military service. In cases in which parents have themselves been subjected to early parental deprivation, one or more children may become projectively identified with a parent's (posttraumatic) "bad child"-self, whereas the parent him/herself has identified with — enacts the role of — the idealized internal "martyr" parent. A case study is presented describing the individual and family therapeutic treatment of a woman who, as a child, had been traumatically separated from her parents.     

Direct Open Supervision: A Team Approach

Created in the absence of one-way mirror facilities, Direct Open Supervision combines elements of live supervision with team participation in training family therapists. The theory and application of this approach to direct supervision are described.     

Low-Income Families With Potential Adolescent Gang Involvement: A Structural Community Family Therapy Integration Model

The purpose of this article is to propose a community structural intervention for low-income families who present to therapy with the concern of an adolescent at risk for gang involvement. Families are affected by multiple interacting systems. In congruence with systems theory, changing a part of the system will essentially affect the interrelated parts of the system. The proposed intervention utilizes structural family therapy and community family therapy as a model to impact change at the family system, its interrelated systems, and the system at which the family is embedded.     

The Coping with Stress Model: A Counseling Approach for Families with a Handicapped Child

The authors describe a cognitive-behavioral model for coping with stress that counselors can use as the basis for family assessment and personalized intervention. The model, assessment procedures, and appropriate counseling strategies are discussed. Translation of the model into clinical practice is examined with families of handicapped young children. A brief case study is provided to illustrate the model's usefulness for counselors.     

A Cognitive-behavioral Approach to Reconstructing Intergenerational Family Schemas

This article suggests the use of cognitive-behavioral techniques, namely cognitive restructuring combined with family-of-origin sessions, for reconstructing intergenerational family schemas. A case example portrays the use of the techniques as an effective intervention for addressing ingrained schemas, such as in the case of spousal abuse.Portions of this article were drawn from a lecture provided to the University of London’s Institute of Psychiatry at the Maudsley Hospital, UK in August of 2005. The author wishes to acknowledge Mr. Eric Frey and Ms. Katherine Adams for their assistance with the literature search.