Media reviews

Abstract

Dr. Maurizio Andolfi is Director of the Family Institute in Rome, Italy. He was trained in family therapy in the United States and now frequently returns to give seminars and demonstrations of his particularly gifted systems approach in the treatment of families, and in supervision of family therapists. Dr. Joel Bergman, a member of the senior faculty at the Ackerman Family Institute, reviews two of Andolfi's videotapes dealing with the supervisory process, and illustrated by actual clinical material.

The mirroring and reduplication of patterns often occurs when systems interface. Family dynamics repeat themselves across generations, and therapists and therapeutic teams easily become enmeshed in the powerful intricacies of family systems. The work of Andolfi highlights the importance of using the therapist's self-experience to illuminate and effect change in the family interactions, and the awareness of the contextual complexities of the supervisory process provides further possibilities for more enlightened intervention.—I. A.     

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 & 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.     

Nathan w. ackerman as a therapist and individual: An interview with donald bloch and kitty la perriere

Abstract

In June 1984 the Eastern Virginia Family Therapy Institute sponsored a two-day conference with Paul Watzlawick which is reviewed in this issue by Robert Smith with an absorbing depth of focus, and a uniquely stimulating viewpoint. The puzzle of the persistence of behavior as well as the change of behavior has long intrigued philosophers and therapists, as well as other tacticians and strategists. The work from Palo Alto which was begun by Bateson, Jackson, Haley and Weakland has been carried on by Watzlawick and Fisch and others. This excellent review gives both theoreticians and clinicians a current perspective and challenge. -I. A.     

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.     

Continuing education and training

Abstract

Great attention has traditionally been paid to the problems of engagement in family therapy, and to initial moves by the therapist to establish a contract and clearly define the working relationship and goals. Additionally, the early tasks of assessing the areas of family difficulty and of grasping the family dynamics are usually given prominent attention. The course of therapy during that “middle phase” has too often been neglected; yet, it can be one of turbulence, of confusion, and of abrupt discontinuations, or circular redundancies. In the conference reported here, Dr. Carlos Sluzki gives a broad view of that hazardous terrain, and with theoretical and clinical clarity shares the long experience of a noted theoretician and teacher with others who also travel on that therapeutic journey.

The conference chairpersons, George J. Meyer and Robert Scherb have also provided us with succinct and interesting summaries of the seven workshops which followed Dr. Sluzki's presentation.     

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.     

Behavior modification in marriage counseling

Abstract

Telephone cotherapy via three-way conference call of symbolic-experien-Hal family therapy is presented in a way that captures the spirit of a great pioneer, Carl Whitaker, M.D. The problems of the family, the process of therapy, and the beginning and ending are presented in a manner intended to bring the reader inside the experience. There are particular focuses on the use of family political power by both family therapists and an anguished family member in mobilizing the family for therapy. Impact is demonstrated in helping a family who felt hopeless become hopeful. The family attained a family spirit.     

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.     

Family measurement techniques

Abstract

This is the first issue in which the Family Measurement Techniques section appears in The American Journal of Family Therapy. I hope that you, the readers of the journal. will find it helpful in your clinical work with couples and families. In each issue, instruments, procedures and assessment techniques will be reviewed by clinicians who have expertise in the areas of marital/family measurement and evaluation. Reviewers have been asked to consider two issues: instrument construction and clinical utility. Instrument construction deals with the theoretical underpinnings of the technique or procedure, the adequacy with which major theoretical concepts and constructs have been operationalized, the sampling procedures used in instrument construction, and the reliability and validity of the measurement technique. Clinical utility deals with issues of importance for practicing therapists, for example, length of time required for administration and scoring, degree of expertise or training needed for administration and interpretation, and overall clinical utility of the measure.

I hope that the information provided in these reviews will make it easier for the busy practitioner to select instruments for use in assessment, diagnosis and outcome evaluation.     

Resiliency: A shift in our perception?

Abstract

As our clients often underestimate their own resources and potential, do helpers fall victim to the same phenomena? This article contends that helpers are often overly attentive to client deficits and pathology to the detriment of acknowledging family and other client strengths and resources brought into the therapeutic arena. Much of our professional training results in an overreliance upon pathological lenses which is to the disadvantage of both client and helper. Family therapists must remain vigilant to not becoming seduced into the attractive web of “pathologizing.” Experiences that heightened this awareness for the author are described, followed by illustration of the importance and benefit of therapists becoming more sensitive to the study of human resiliency.     

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?     

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.     

Using circular questions to explore individual family member experiences of youth gender dysphoria in Australia

Abstract

Background: The number of young people reporting gender dysphoria is increasing worldwide, with gender dysphoria known to affect everyone in the family in unique ways. Previous research has highlighted the importance of family support and understanding; however, much less is known about individual and collective family member experiences, particularly for siblings under the age of 18?years.

Aims: This study sought to identify, describe and interpret individual family member experiences of youth gender dysphoria using semi-structured interviews, incorporating circular questioning, within a whole of family, clinical and wider social context.

Methods: Thirty-five individual family members living in Australia (nine young people aged 12-17?years experiencing gender dysphoria, 10 mothers, eight fathers, and eight siblings aged 11-17?years) were interviewed, exploring positive and negative experiences of youth gender dysphoria, within and outside of the family. Family relationships, support and healthcare experiences were also explored.

Results: All participants reported a mixture of positive and negative experiences of youth gender dysphoria. Levels of acceptance tended to change with the duration of transition, with most family members adapting with time. Siblings reported mixed experiences within the same family, with some struggling to adapt. Most family members felt that including the whole family in the healthcare of the young person was important, although dependent on individual circumstances and family context. Specialist gender care experiences were unanimously positive, although services were considered difficult to access.

Discussion: Family members reported shared and individual positive and negative experiences of youth gender dysphoria across social contexts. Accepting and facilitating gender transition for young people appeared to improve individual and family functioning. Most participants valued a whole of family approach within specialist healthcare. The use of circular questioning in the study helped dispel assumptions and facilitated curiosity for others’ experiences in the family.     

Family Consulting: A New Role for Therapists

A new model for psychological practice entitled, "Family Consulting" is proposed. It is defined as a long-term, intermittent approach to working with families based on a developmental/non-pathological perspective. The specific format of intervention is described in detail. A brief review of the life-span perspective of development, the family life-cycle literature, and object relations family therapy, which serve as the building blocks of the model is provided. The role that family consulting can play in today's managed mental health care environment is discussed.     

Responding to Blame in Family Therapy: A Constructionist/Narrative Perspective

Blaming events (N=25) were identified in seven interviews conducted by prominent theorists who espouse a constructionist or narrative approach to family treatment. Congruent with this perspective, we used conversation analysis (Gale, 1996) and the grounded theory method of constant comparison (Corbin & Strauss, 1990) to identify the therapists’ behaviors and strategies following blame expressed by family members. Results indicated three core categories or themes of therapists’ responses to blame?Ignoring/Diverting, Acknowledging/Challenging, and Reframing?subsuming 17 individual codes (e.g., challenging all-or-none thinking, highlighting neutral information, interrupting, focusing on competence). The most frequent code was focusing on the positive.     

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     

Using Genograms Creatively to Promote Healthy Lifestyles

ABSTRACT

Family therapists have used Genograms as an assessment tool for years to examine the interactions and relationships of family members across generations. This article discusses how a therapist can use a genogram creatively to help clients examine the impact of family relationships on healthy and unhealthy lifestyle patterns and how those relationships may be influencing the manner in which clients are currently managing their lives. The integration of a creative genogram can assist clients in recognizing inherited health-disease risks, learned lifestyle patterns, and parental behavior modeling. This technique can assist clients in developing a healthier lifestyle.