Redecision family therapy: Its use with intensive multiple family groups

Abstract

Intensive multiple family group therapy combines the advantages of group therapy with those of time-limited, goal-oriented approaches. Using the Redecision Family Therapy model further refines the technique by integrating the seemingly disparate methods of intrapsychic and systemic therapy. In this paper we describe our 10-year experience with this model, elaborate on the model itself and discuss the results of an outcome survey.     

Process in family groups

This paper distinguishes process in family groups from process in nonrelated psychodynamic groups. The meaning of process in family groups is elaborated and illustrated in a series of case examples. The author also describes issues pertinent to the treatment of family groups as differentiated from nonrelated groups, including issues around countertransference and termination.     

Interest in and barriers to participation in multiple family groups among head and neck cancer survivors and their primary family caregivers

This study examined interest in and barriers to participation in a multiple family group intervention (MFG) for adult cancer survivors and their family caregivers. The intervention was developed to assist families in coping with the persistent challenges of cancer diagnosis, treatment, and rehabilitation. Eighty eligible families having a member diagnosed and treated for cancers of the head and neck region completed a baseline quality of life survey consisting of standardized psychosocial measures, and then all patients and their families were invited to participate in a day-long multiple family group program. However, despite extensive recruitment efforts and accommodations to address anticipated barriers for nonparticipation, only 15 of the 80 (19%) eligible families agreed to attend the MFG workshop. Post-MFG, participating families reported high levels of program satisfaction and usefulness. These findings are discussed in the context of increasing the use of family-focused interventions in cancer care settings.     

Psychosis and multiple family group therapy

Despite the growing evidence base for the effectiveness of family intervention in the treatment of individuals suffering from a psychotic disorder, in practice only relatively few mental health teams use family approaches when treating and managing those with schizophrenia or other psychoses. This paper describes a pragmatic model, which may be used in addition to other ongoing treatments, such as medication, CBT or single family therapy. It was developed jointly by clinicians and service users over the past few years. It consists of regular multiple family group work, with six to eight families attending simultaneously, and aims to involve families directly in the treatment, rehabilitation and recovery of their members suffering from psychotic disorder.     

Preschoolers' characterizations of multiple family relationships during family doll play.

Investigated 4-year-olds' depictions of family relationships during a semistructured doll play task. Examined developmental and family correlates of these depictions, and their relative stability over a 1-month period. Forty-nine children related stories about happy, sad, mad, and worried families using dolls reflecting their own family configuration. For each story, coders recorded (a) proportion of total story time devoted to each family dyad and (b) number of conflictive, aggressive, and affectionate acts per dyad. Children divided their focus during stories evenly between father-child, mother-child, and father-mother relationships with child-sibling interactions occurring regularly among participants with siblings. Depictions of affection and aggression among family figures were relatively commonplace, related to mothers' reports of family climate, and stable across a 1-month period. Results substantiated preschoolers' awareness and discrimination of intrafamily relationship dynamics and provided some guidelines and cautions to practitioners who employ doll family assessments in their clinical work.     

Sibling rivalry at work; from family to groups

Sibling relationships are ambivalent. They are full of love and hate, and therefore, our most basic wish cannot simply be to get rid of our siblings. Many of the conflicts we find ourselves in, either with friends or within institutions, may need a complex and subtle understanding of sibling dynamics. The famous Controversial Discussions that nearly destroyed the Institute of Psychoanalysis in the early forties could be partly attributed to the unacknowledged and unconscious dynamics of the sibling transferences that swirled around Melanie Klein, Anna Freud and Freud. One of the tasks of therapists is to explore how we all must live within a society, with our contemporaries. This difficulty involves observing that sometimes in therapy we are part of the nursery quarrel itself, rather than superior. And so in adult sibling conflict within an institution, there may be a need for an outside moderator, like a parent, to sort out the quarrel; for when sibling passions are revived at work or in the consulting room, they can knock one sideways with the unmeditated quality of the encounter.     

Attitude of the two religious groups towards family planning

40 Muslim and 50 Hindu male high school teachers, working in the interior parts of the districts of Gaya and Shahabad in India, filled out questionnaires designed to determine attitudes toward family planning. All were married and had more than 1 child. They were ages 26-48. The Hindus were found to have significantly more favorable (p less than .05) attitudes toward family planning than the Muslims. If the statistics reflect reality, it is no wonder the birth rate among Muslims is much higher in India. Both Muslim and Hindu teachers were grouped according to age (below 35 years or above 35 years). While the younger Hindus had significantly more favorable (p less than .05) attitudes toward family planning than the older Hindus, the younger Muslims had only slightly more favorable attitudes (nonsignificant) toward family planning than the older Muslims.     

Using family therapy ideas with parenting groups in schools

The author describes his experience of using ideas from family therapy with groups of parents in two urban schools in the United States.     

The effects of status on identification with multiple groups

Three studies explored the effects of the relative status of the multiple groups of which individuals are simultaneously members. In all studies participants reported their identification and their perception of the status of two groups (either real or experimental) of which they were simultaneously members. Results of all three studies lend support to the hypothesis that reactions to an ingroup are affected not only by the status of that group, but also by the status of another group of which an individual is simultaneously member: Individuals tend to perceive an ingroup as having higher status, and to identify with it more, if they are simultaneously members of a different group which has low rather than high status. Copyright © 2002 John Wiley & Sons, Ltd.     

Therapeutic alliance and progress in couple therapy: multiple perspectives

Therapeutic alliance research in couple therapy using multiple perspectives and longitudinal data has been sparse. This study used structural equation modelling to explore relationships between changes in alliance and in progress from clients' and therapists' perspective in a fairly large sample of couples (N=195) during the initial stage of therapy at an on‐campus training clinic. Self‐rated alliance was measured after sessions 2 through 4 with the Working Alliance Inventory. There was very little change in alliance over the early sessions of therapy, and changes in alliance did not always account for changes in relationship satisfaction. Husbands' perceptions of satisfaction and alliance seem to play an important role in the dynamics of the therapeutic process. Findings suggest a reciprocal relationship between perceptions of alliance and progress in therapy when combining perceptions of therapists and couple clients. Clinical implications and future research are discussed.     

Therapeutic factors in interactional inpatient groups: Results from a Turkish sample

Therapeutic factors in an inpatient group from Turkey are presented. A total of 40 patients were seen over a period of 2 years and each patient was given Yalom's (1983) 60-item therapeutic factor list on discharge. The first four most valued therapeutic factor groups were Catharsis, Existential Factors, Cohesiveness and Hope. There were significant differences in the highly valued factors in different diagnostic groups. Patients with diagnoses of anxiety/somatization and borderline/identity problem preferred factors resembling those in many out-patient studies. The results are discussed in the light of relevant literature.     

Therapeutic processes in peer led and professionally led support groups for caregivers

A comparison of peer led and professionally led support groups for caregivers of frail older persons living in the community demonstrates that both types of groups are effective. Findings reveal that it was the opportunity to ventilate pent-up feelings and emotions, the validation of caregiving experiences, the affirmation of coping abilities, the encouragement for continuing to provide care and cope with the situation, the exploration of alternative caregiving arrangements, the mutual support, and the mutual sharing of information about community resources and coping strategies that appeared to be the most helpful therapeutic ingredients of both types of groups. The greater attention to problem solving work and the learning of specific coping skills in the professionally led groups was not reflected in differential outcomes in the two support group conditions.     

Training and disseminating family interventions for schizophrenia: developing family intervention skills with multi‐disciplinary groups

Family interventions for psychosis are not routinely available, in spite of a robust evidence base, clear policies and guidelines, and requests from service recipients. The reasons for this are complex involving three key groups: service recipients, clinicians and organizations. This paper first of all identifies barriers to implementation in relation to each of these groups. It then outlines a range of strategies that may be employed at a number of levels to bring about change in each of these systems. The strategies are drawn from current research in the area, and from experiences over a seven‐year period in the Meriden West Midlands Family Programme.