Art therapy in transcultural family therapy

The increased existence of foreign culture patterns in the child population calls for transcultural comprehension in child psychiatry. This case report describes transcultural aspects in the therapy of an 11 year-old Moslem girl admitted to a child psychiatric department. Her symptoms were abdominal pain, headache, anxiety, and pretended fever. A family therapeutic approach was used together with elements of art therapy and individual therapy in a successful treatment. The family therapeutic approach was based on art therapy as a part of the communication where cultural symbols were an important part. An interpreter was not used. The cultural context where it is acceptable to overstep the borderline between reality and fantasy is seen as an important healing capacity.I would like to acknowledge my debt and my appreciation to Ebba Ernst, psychologist of the department and supervisor in the therapy of the S. family. I would also like to thank professor Kai Tolstrup and child psychiatrist Torben Marner for stimulating support in the process of writing the article. A grant from Enkefrue Hermansens Mindelegat made the participation in the Krakow Congress possible.     

Siblings in family therapy

The participation of siblings in family therapy was studied from case records in 76 consecutive cases attending a child and adolescent psychiatric outpatient clinic. Siblings took part in family therapy in two thirds of the cases. Of these, 76 per cent attended only one or two sessions. A sub-sample of nine families with children below 13 years of age was interviewed. Seven out of 10 evaluated siblings had psychiatric symptoms of some severity at the onset of therapy compared to two after, and all had fewer symptoms after therapy compared to before (p<0.01). Most families thought it relevant for both parents and siblings to take discussing their children's behaviour in front of them and wanted the opportunity of also talking to the therapist without the children being present.     

Children in family therapy

The distinctive skills of child psychotherapy can be utilized in the development of a form of conjoint family therapy especially applicable to the field of child psychiatry. It is suggested that the engagement of children in the process particularly enhances the specific characteristics and potentialities of this form of treatment.     

Countertransference in family therapy

The intent of this article is to describe the importance of one psychoanalytic concept, countertransference, in family treatment by a review of the literature on the subject. Case illustrations will then be used to show how the supervisor of a family treatment case elicited the countertransference in order to move the therapy forward. Some thoughts with regard to training will be offered.     

Mystery in family therapy

Existential approaches to family psychotherapy are considerably different from the problem centered approaches to treatment which are currently so popular in the field. Gabriel Marcel's distinction between a problem centered and a mystery centered understanding of life is utilized to overview the basic and deep differences between existential and problem centered approaches to family treatment.     

Redefinition in family therapy

Abstract

In the wider context of an epistemological renewal, the author describes the possibility of a redefinition of therapy from that of an intervention focused on the patient to one of an opportunity for participation and growth of a group which shares a common history. The author speaks of the necessity of giving alternative meanings to the presenting symptoms, citing examples from his work with families.     

Re-editing family mythology during family therapy

Family mythology includes false or edited beliefs about the present which may be coupled with family legends which support those beliefs. Families are particularly likely to use their histories dys-functionally if they either see the present as an exact replication of the past or, in contrast, deny that the past has any relevance whatever. Re-editing myths involves enabling families to alter their relationships and their self perceptions. This allows a fresh exploration of the past; a process which can support and encourage further change. Case material is used to illustrate this.     

Medical family therapy: an emerging arena for family therapy

This paper describes an important recent development in American family therapy. Medical family therapy uses a biopsychosocial systems model to work with families who have a member with a chronic illness or disability. The authors maintain that family therapy has tended to embrace the mind–body split and to view itself too narrowly as a mental health specialty. Medical family therapists work collaboratively with physicians and other health professionals to help families achieve a sense of agency and communion in facing some of the greatest challenges that life brings.     

Transcultural family therapy

Conventional family therapies such as Structural, Systemic, Satirian, Adlerian and Dreikursion seem to be marked by cultural biases and give an indication of one single culture orientation. These seem to represent the cultural majority norms and values in acting as oppressive tools in a multi cultural society. Most of these therapies are derived from theories reflecting intrapsychic factors that are white middle class concepts, neglecting the multi culturaUsocia1 contexts in family therapy. “Ethnic minority families” from non Western Countries often experience more problems than families from Western Countries in the areas of education, immigration, employment and health. The cultural expectations are full of contradictions and ethnic minorities feel handicapped both socially and culturally in the task of growth and development. Western family therapy has failed to address these issues.     

Restorying family therapy

This article describes a multi-systemic model of therapy developed by the author over the past decade and summarizes the main products of this project: Explication of key family systems notions, strategic family play therapy, multi-systemic therapy, and culturally-competent family therapy. The model incorporates beyond the family system, culture, wider ecosystems, psychodynamics, and the individual's neuropsychological, cognitive, and socio-emotional development. The model enables the therapist to design flexible multimodal interventions.     

Gender in family therapy supervision

While gender has taken its place as a fundamental construct in family therapy theory, little has been written about gender in family therapy supervision. This paper attempts to redefine gender as it pertains to families, family therapy, and family therapy supervision; call attention to aspects of gender as they apply to training in family therapy and family therapy supervision; and suggest ways that family therapy supervisors can sensitize themselves to issues of gender so that they can be more effective in supervision.The author gratefully acknowledges her husband, Victor Nelson, STM, and Eric McCollum, PhD, for their comments on an earlier draft of this paper and for helping with the idea that men are raised to fix things, women to make them better.     

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.     

Engagement techniques in family therapy

A number of basic engagement techniques in family therapy are identified and illustrated. These include (1) techniques that enable the therapist to achieve a position of influence with family members or to gain entry into the family system, (2) techniques utilized in teaching the family how to behave in the therapy setting, and (3) the tactics the therapist may use to manage difficult moments in the session. Issues in the relationship between technique and the theory and practice of family intervention are also examined.A videotape (Wells, R.A., & Page, M.H.Engaging the Family in the Helping Process: Basic Techniques. Pittsburgh, PA: UIRC, 1979) is available from the author. Discussion with such colleagues as Patrick McNamee, Larry Pacoe, Mary Page, and Susan Schilling has been invaluable.     

Organizing concepts in family therapy

Abstract

Harry Stack Sullivan (1953, p. 11) spoke fondly of the time when therapy would become “easy.” By that he meant he looked forward to the day practitioners would know precisely what to do to help their clients regardless of the symptoms they presented. He was wise enough to know, of course, that the time he anticipated would not arrive soon, for he said he would be a long-forgotten myth before it came. Those who practice in the third decade after Sullivan's demise know that we are probably no closer to the halcyon conditions he longed for than he and his associates were in the 1940's. In fact, psychotherapy is under stronger attack for lack of precision (effectiveness) now than at any time in the recent past.