Media reviews

Abstract

Dr. H. James Lurie, reviewer of the videotape “Sybil's Plight” is Clinical Professor of Psychiatry and Behavioral Sciences at the University of Washington School of Medicine, in Seattle. His expertise in the development of training and educational audio-visual materials, as well as his long teaching experience with both primary care physicians and family therapists, makes his assessment especially valuable. The importance of family concepts in the treatment and management of patients and families who must cope with chronically disabling medical illnesses has reached a new level of concern, and has resulted in renewed interest in the fields of consultation-liaison and family medicine.

—I.A.

Sibyl's Plight, black and white videotape, Library, Western Psychiatric Institute and Clinic, 3811 O'Hara Street, Pittsburgh, PA 15213.     

Continuing education and training

Abstract

The conference on Innovations in Family Life Styles presented in March of this year by the Long Island Chapter of the American Association of Marriage and Family Therapy highlights the importance of a sociological and nonpathological perspective toward the family which is of critical importance for therapists. Only with such a perspective can one reasonably approach the tasks of marriage and family therapy, and the new awareness which is then possible for both therapists and families often leads to unexpected growth in unpredictable directions.

Dr. George Meyer, who chaired the conference, and who is Associate Professor of Psychology at Suffolk County Community College provides us with a rich review of the keynote address by Dr. Graham Spanier, and with cogent summaries of the other three presentations on the program.

—I.A.     

Sexual counseling and therapy

Abstract

This article is an edited version of four interviews conducted with Dr. Ivan Boszormenyi-Nagy in the Spring of 1980. The interviews ranged in content from Dr. Nagy's early training and influences to the theoretical and clinical foundations of contextual family therapy. This article focuses on the major constructs of contextual family therapy. Since this approach is often viewed as highly theoretical and conceptual in nature, it may be helpful to the practitioner to see how Dr. Nagy uses these constructs in a clinical situation. As a practitioner, I have found his theory extremely useful in conceptualizing the family system, and also in developing a treatment strategy. Hopefully, the questions asked of Dr. Nagy in these interviews will be of interest to other family therapists who are concerned with the clinical aspects of family therapy theories.     

A Systems Approach to Sex Therapy with Gay Male Couples

SUMMARY

Sex therapy with gay male couples is difficult for many family and relationship therapists. Family therapists lack knowledge of the nature of sex therapy, gay male culture and sexuality, the dynamics of gay male couples, and the sexual issues gay male couples are likely to bring to sex therapy. Countertransference also makes sex therapy with gay male couples difficult for some family and relationship therapists. This paper addresses those issues and then explains a systems approach to sex therapy with gay male couples.     

Labeling: A study of an “autistic” child

Abstract

In this issue we are able to present reports from two very different meetings which, nevertheless, have particular significance for the developing field of family therapy, particularly as it relates to theory and practice. The first is a report by Professors Jeanne L. Thomas and Cecil J. Simons of West Virginia University on the eighth biennial conference on Life-Span Developmental Psychology, held in May 1982, in Mor-gantown, West Virginia. This conference was one of a series sponsored by West Virginia University since 1970 dealing with theoretical and empirical issues in the study of life-span human development. This particular conference highlighted two themes involving the impact of specific historical context on family development as well as the influence of the family on the individual's own experience of these historical events. This kind of broad and in-depth exploration of the multiple factors involved in the historical as well as the personal context of an individual's development promises to provide exciting new opportunities for clinicians and teachers in our field.

The second report from James E. Durkin, Ph.D., of Lincoln University deals with a recent conference on Epistemology, Psychotherapy, and Psychopathology in Houston, September 1982, sponsored by the Houston Galveston Family Institute. Outstanding theoreticans and clinicans in the field of family therapy and systems theory were present, and their exciting discussions have been put into an interesting framework by Dr. Durkin, who has his own way of integrating these issues based on his long work in the application of general systems theory to the field of group psychotherapy. —I. A.     

Interview with mara selvini palazzoli and giuliana prata

Abstract

As anyone who has encountered her in person or through her writings knows, Mara Selvini Palazzoli is an impressive woman. 1 found her to be powerful, attentive and, most of all, intellectually restless impatient with psychotherapeutic approaches that work slowly or not at all, with the reluctance of family therapists to undertake thorough training, and with my inability to understand immediately some of her explanations.

Giuliana Prata, in contrast, is quiet, stable, ready to supply the correct English word or to expand on one of Palazzoli's comments. She seems ideally suited to her job of conducting the intensive telephone interview required before a family comes to the Milan Family Institute.

Although I had corresponded with Mara Selvini Palazzoli before our interview in Milan on March 30, 1982, I had not sent her any actual questions. Nevertheless, showing a certain prescience, she launched into an answer to my first question before I had a chance to voice it! That question was: Would you talk about your evolution from psychoanalyst to family therapist to paradoxical therapist SEB     

Research & clinical exchange

Abstract

Question: Family therapists are often called upon to do consultations to schools about children having social and educational difficulties. In what ways is the family therapist's role different when he or she is called in to consult as an “outsider’ to the school system about a particular child whom he or she does not know, compared to being called upon by the school for advice about a child who is already being seen in treatment by that therapist?     

Emotionally Focused Family Therapy and Play Therapy Techniques

Emotionally Focused Family Therapy provides a framework for understanding children's behaviors in terms of attachment needs of comfort and support. However, when working with young children, play therapy is often developmentally preferred over “talk therapy.” By integrating play therapy techniques within an Emotionally Focused Family Therapy theoretical framework, therapists can help parents understand and meet their child's needs for affection and comfort. This article will discuss how play therapy techniques can be integrated with an Emotionally Focused Family Therapy theoretical framework for work with young children and their families.     

Continuing education & training

Abstract

Two important continuing education conferences are highlighted in this section. The first was held in New York in November, and was organized and is being reported by Anita Menfi, Director of the Family Studies Section, Bronx Psychiatric Center, New York. Since 1964 this center has trained therapists, supervisors and administrators who function within the mental health system, with a focus on a systems approach towards patients, their families, the service agencies that assist them, and the community in which they live. The conference keynote speaker, noted anthropologist Ray Birdwhistell headed a faculty of experienced family therapists who led multiple workshops on the theme, The Clinical Challenge of Working with Families in Today's Community.

The second conference held in December in Phoenix, Arizona was organized by Jeffrey Zeig, a Director of the Milton H. Erickson Foundation, and is reported by Miriam Cohen, a resident psychiatrist at Good Samaritan Hospital, who participated in the conference. Keynote speakers Jay Haley and Carl Whitaker led a large faculty presenting over 50 papers in a tribute to the life and work of Milton H. Erickson. Of special interest to our readers is the application of Erickson's ideas to family treatment. Haley has written widely on this, and Leveton and Lustig among others presented their understanding and application of Ericksonian principles.     

An experientially based inductive approach to learning about family therapy

Abstract

The numerous and diverse approaches to the practice of family therapy pose a critical dilemma to practicing family therapists confronted with selecting a direction of study to further enhance their own professional knowledge and skill bases. This paper describes and evaluates a five-phase training model which facilitates practitioners' choices in regard to model selection by providing them with an opportunity to compare their own therapeutic belief and action systems with those of family therapists oriented to one of three historically prominent models of family therapy.     

A Family Therapist's Guide to Bipolar III: Antidepressant-Induced Mania or Hypomania

This article explores the phenomenon of hypomania and mania induced by the treatment with antidepressants, sometimes called bipolar III. Family therapists need to be aware of this phenomenon because estimates are that between 3–10% of depressed individuals may be at risk for developing hypomania or mania when treated with antidepressants. The article discusses implications for family therapists, including their role in the prevention and early detection of antidepressant-induced mania or hypomania.     

Book reviews

Abstract

Family Therapy of Drug and Alcohol Abuse, by Edward Kaufman and Pauline N. Kaufmann. New York: Gardner Press, 1979, 276 pages, $24.95.

Family Therapy: An Interactional Approach, by Maurizio Andolfi. New York: Plenum Press, 1979, 170 pages, $19.95.

The Family: Evaluation and Treatment, edited by Charles K. Hofling and Jerry M. Lewis. New York: Brunner/Mazel, 1980, 324 pages, $17.50.

Individual and Family Therapy: Toward an Integration, by Fred M. Sander, M.D. New York: Jason Aronson, Inc., 1979, 235 pages, $20.00.

Disorders of Sexual Desire and Other New Concepts and Techniques in Sex Therapy, by Helen Singer Kaplan. New York: Brunner/Mazel, 1979, 237 pages, $17.50.

Medical Sexology, edited by Roman Forleo, M.D. and Willy Pasini, M.D. Elsevier/North-Holland Biomedical Press, 1980, 664 pages, $44.50.

Group Psychotherapy and Personality: Intersecting Structures, by Henry Kellerman. New York: Grune &; Stratton, 1979, 345 pages, $19.50.     

Book Review

Abstract

Over the past 20 years, the clinical evaluation of family systems has been spearheaded by Robert Beavers and his colleagues at the Southwest Family Institute in Dallas, Texas. Out of their research and clinical work has evolved the Beavers System Model for Family Assessment (BSM). The BSM is a collection of three instruments the first of which was the Beavers-Timberlawn Family Evaluation Scale (1972) featured in the widely popular book, No Single Thread (Lewis et al, 1976). The Centripetal/Centrifugal Family Style Scale shortly followed (1974), and more recently (1983) the Self-Report Family Instrument was added to the BSM. Although the focus of the following critique is on the Beavers-Timberlawn Family Evaluation Scale (BT), the measure is designed to be used in conjunction with the other scales to more fully identify the health/competence of a particular family.     

Supervisors' and Supervisees' perceptions of the effectiveness of family therapy supervisor interpersonal skills

Abstract

This study surveyed a randomly selected group of Approved Supervisors of the American Association for Marriage and Family Therapy (n=318) and their supervisees (n=299) on their perceptions of the effectiveness of several supervisor interpersonal skills. Both supervisors and supervisees had high ratings for the majority of the interpersonal skills and rated “respects the supervisee” most effective. Trends in supervisors' and supervisees' responses were assessed for (a) theoretical orientation, (b) supervision setting, (c) gender, (d) number of years supervising family therapists (for supervisors), and (e) number of years practicing family therapy (for supervisees).     

The rescuing therapist: A duplication of the pathogenic family system

Abstract

Rescuing is a saving behavior occuring in pathogenic families which is often duplicated by family therapists. Rescuing, if not confronted and explored, leads to frustration and burn—out in families and therapists. This paper explores the dynamics of rescuing behavior in families, how it is replicated by a therapist's attempts to rescue, and how the impetus for these attempts are derived from the therapist's own family of origin. The value of exploring the need to rescue is demonstrated by use of a case example. Countertransference issues and their resolution through the conscious differentiation between rescuing and real help are also explicated.     

Custody Evaluations: Critical Contextual and Ethical Considerations

The area of custody evaluation is fraught with anxiety and tension for parents and children as well as therapists. This article encourages the use of a set of lenses that explores individual and family members' relationships within a variety of contexts. To advance the reader's understanding, a model employing various levels and domains will be presented and described. A variety of critical ethical issues, and challenges often encountered by therapists are also examined.     

Sexual Abuse Litigation

Summary

Practicing psychologist Janet Sonne and attorney Julian Hubbard illuminate how the different aims and languages of psychotherapy and law can be either an asset or a liability in the emotionally-charged environment of sexual abuse litigation. Properly understood, these differences can optimize the ability of each professional to assist their common client, the sexual abuse survivor, in the litigation process and beyond. Dr. Sonne reviews the psychological and behavioral sequelae of childhood sexual abuse and identifies six elements of the client's psychological functioning key to the litigation process, as well as posing questions for the attorney's self-evaluation for the unique demands of sexual abuse litigation. Mr. Hubbard then addresses what survivors and therapists need to know about the litigation process, exploring dynamics of legal strategy that can exacerbate the client's psychological problems. In the final section, both offer tips to enhance professionals' focus on education and communication as a means to better serving the sexually abused client.     

SOCIAL CONSTRUCTION THEORY AND THE SATIR MODEL: TOWARD A SYNTHESIS

Abstract

This article synthesizes social construction theory and the Satir approach to family therapy in terms of therapy as a process of cocreation of reality, the use of language and narrative, and the therapist's role as a participant-facilitator. Social constructionism has a tremendous impact on the present ideological shift in family therapy. The Satir model is a powerful approach to family therapy and has had a wide influence on generations of therapists. Although existing literature has well documented the influence of social construction theory on the postmodern school of thinking in family therapy, there is no literature exploring the compatibility of the Satir model with social construction theory. This research presents a theory-building process of the Satir approach to family therapy.     

What Is Unique About Supervising Couple Therapists?

Abstract

What is unique about supervising couple therapists? To answer this question I highlight three important therapeutic processes in CT and their accompanying supervisory implications. The first process, the attending to values and beliefs about the meaning of coupling to couples and therapists and its influence on CT, is facilitated by supervisors who help supervisees uncover values and beliefs about coupling. The second process, developing the therapeutic alliance which has a unique complexity in CT, is facilitated by the processing of the therapeutic alliance in supervision and discovering ways of strengthening it. The final process, attending to emotion prevalent in CT, is facilitated by supervisors who assist supervisees in becoming comfortable with the expression of emotion and work with it constructively in CT. After briefly describing each process and why it is viewed as important in CT, I suggest ways supervisors can assist supervisees' becoming more proficient in them. An abbreviated supervision illustration ends each section.     

An Inter-Rater Reliability Study of Parental Alienation Syndrome

The dual purpose of this study was to first test the acceptance of the concept of parental alienation among therapists, and secondly, to assess the validity of parental alienation as a syndrome among therapists who are familiar with this phenomenon. The study measured the independent variable, symptoms of parental alienation syndrome, and the dependent variable, therapists' perception of the syndrome.

The respondents analyzed five cases using Dr. Richard Gardner's differential diagnosis chart built into a questionnaire for the potential alienator and the child. For the measurements of reliability and inter-rater reliability, the researcher used Microsoft Excel and Kendall's coefficient of concordance.

The findings showed a significant level of concordance among raters in all five cases except in Case 2, where there was a lower consensus on the presence of parental alienation syndrome or meeting Dr. Gardner's criteria due to the complexity of the case presentation. Similarly, findings also reflect the relatively recent discovery of this phenomenon, evidenced by some level of apathy from the general population of therapists to get involved.

The completed surveys were from therapists familiar with parental alienation syndrome, which indicated their level of understanding of the phenomena and how their views differed from other therapists who were unfamiliar with PAS. The data gathered from the completed surveys was sufficiently reliable to suggest a wider study for the purpose of classification in the next edition of the DSM.