ABSTRACTS OF LITERATURE

A discussion of family therapy emphasizing the indications for and the goals of this type of treatment. Differences between family and group therapy are presented with the suggestion that group treatments exists for individual improvement and growth and family treatment for improvement of relationships and growth of the family unit.     

Facilitating marital intimacy through self-disclosure

Abstract

Intimacy is one of several interpersonal dimensions which describe the quality of a marital relationship. An operational definition of intimacy is presented. Evidence that a lack of intimacy is associated with nonpsychotic emotional illness, marital maladjustment and family dysfunction is reviewed. A technique is described which facilitates marital intimacy through self-disclosure. Evidence is presented that cognitive self-disclosure is a major determinant of a couple's level of intimacy. The assumption is made that facilitating cognitive self-disclosure will increase intimacy with subsequent improvement of neurotic symptoms and marital maladjustment. A case is presented which demonstrates that a structured technique for selfdisclosure of relevant assumptions in a reciprocal manner to a supportive listener can facilitate a couple's level of intimacy. The role of self-disclosure, modeling and cognitive restructuring as therapeutic factors are discussed.     

Family therapy with adolescent offenders: A collaborative treatment strategy

Abstract

An intervention strategy is presented which can be used with families of adolescents who continue breaking the law despite improvement of family functioning during therapy. The strategy emphasizes collaboration between the therapist and juvenile justice system in stopping the child's law-breaking behavior in the shortest amount of time. The treatment strategy is suggested as a specific intervention to be used only when conventional family therapy strategies have failed to promote the cessation of the adolescent's law-breaking behavior. As such, it is suggested as a strategy to be used in conjunction with family therapy rather than as a comprehensive treatment approach in itself.     

The child's participation in family therapy: A review and a model

A major gap in family therapy, the treatment of children and adults together, is addressed. The literature on the children's participation is reviewed and a model which systematizes their involvement is presented. The full participation of the child necessitates the use of play. To create a context of play without alienating the rest of the family, action-promoting methods are used. These methods are implemented through family activities and role playing, which are followed by discussion. The advantages, the indications, and the contraindications to the use of action in family therapy are presented.     

Casework towards the family re-integration of a sexually abusive father—a single case study

A family is presented where sexual abuse of one child had occurred but the family wished to stay together. Work with the family over 3 years, during which time the father served a prison sentence, is described.
The problems, for professionals as well as the family, in deciding when a family is safe are discussed.     

The centrality of values in families and family therapy

Values are discussed in terms of development, nature, and implications for family therapy. Clinical examples are used to demonstrate concepts and a model is presented which depicts how the various leverages utilized in family therapy relate to family values. Individual development, cultural heritage (legacy), the nuclear family system, and the contemporary context are described as factors which interact to form values. A case is made for conceptualizing values as central to family therapy relative to engaging families, intervening in families, and evaluating therapeutic impact.     

ABSTRACTS OF LITERATURE

Two case examples are presented in support of the hypothesis that family therapy is useful in situations in which the identified patients are students at a university counseling center. The core dynamic issues focus around separation from parents. It is felt that the family therapy is a useful adjunct to the individual psychotherapy.     

Unilateral family therapy for alcohol abuse: A working conception

Abstract

Unilateral family therapy is presented as a new mode of family therapy in which intervention is directed toward changing the behavior of an uncooperative family member through working with a cooperative member as mediator. In this initial exposition of the unilateral approach, it is applied to the problem of endeavoring to reach and change an uncooperative alcohol abuser through giving therapeutic assistance to a cooperating spouse. A working conception of this mode of therapy is presented based upon the authors' current clinical research in this area. Directions for further research and development are identified.     

Creating a Secure Family Base: Some Implications of Attachment Theory for Family Therapy

The aim of this article is to make attachment research findings available in a form that family therapists can use. In attachment theory, parents are conceptualized as providing a secure base from which a child can explore. Family therapists, however, need a systemic concept that goes beyond the parent/child dyad. The concept of a secure family base is proposed, in which a network of care is made available for all family members of whatever age so that all family members feel secure enough to explore, in the knowledge that support is available if needed. Factors that contribute to the security or insecurity of the family base are outlined. The overall aim of therapy is to establish a secure family base from which the family can explore new solutions to family problems both during and after therapy. The role of the therapist is to help to resolve conflicts that threaten relationships, and to explore relevant belief systems that may be contributing to a sense of insecurity. The conceptual framework presented allows for an integration of family therapy techniques and ideas into a coherent whole. A new school of family therapy is not proposed.     

The Prevention of Rehospitalization of Adolescents and Young Adults

This paper presents a family-oriented therapy approach for the prevention of rehospitalization of adolescents and young adults with diverse diagnoses. The dilemma of the family is presented in terms of the incongruities evident in the organizational hierarchy of these families. The main premise is that if the hierarchy is corrected so that the parents are jointly in charge of the youth and the extended kin cooperate, rehospitalization can be prevented. A therapeutic strategy is presented with the emphasis on overcoming the family's attempt to avoid a hierarchy in which the parents are in charge of the family.     

Rationale and directions for an increased emphasis on the therapeutic relationship in family therapy

This paper argues the need for an increased emphasis on the therapeutic relationship in family therapy. The ways in which the field of family therapy has eschewed the importance of the therapeutic relationship are discussed. Therapeutic alliance research from the field of individual psychotherapy and research on the importance of relationship factors to family therapy are reviewed. Suggestions for family therapy theory, practice, and research are presented.An earlier version of this article was presented at the 1992 Western Canadian Conference on Family Practice.     

Evaluating family therapy: a comparison of the Milan and problem solving approaches

This paper describes a study comparing the Milan approach with problem solving family therapy. Twenty families were assigned to one of the treatments and data were collected assessing symptomatic (first order) and systemic (second order) changes. The results showed that families in both treatment groups achieved favourable changes in their presenting symptoms. Those families receiving the Milan approach showed a statistically significant improvement in second order changes compared with the problem solving group. Issues relating to treatment outcome, first and second order changes and methodology are presented.     

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.     

Museum tours in genogram construction: A technique for facilitating recall of negative affect

Anger museums, hurt museums, and loss museums are presented as a technique for facilitating recall whenever clients appear to have difficulty remembering family relationships and the affect with which these relationships were invested. The purpose of the recall is to facilitate the process of differentiation. Museum tours are presented as a technique for helping individuals re-enter and re-view their own history within the context of the functioning and relationships of the family of origin. Museum tours in genogram construction are an attempt to achieve what Bowen referred to as discrimination between the emotions and intellect, i.e. the process of differentiation.     

Family Systems: Morphostasis and Morphogenesis,or “Is Homeostasis Enough?”

The role of family homeostasis in Conjoint Family Therapy is reviewed and examined from the standpoint of the Sociocultural Systems framework as presented by Buckley. Sociocultural Systems concepts are presented, and an attempt is made to relate them to a view of the family. It is concluded that the concept of homeostasis by itself is insufficient as a basic explanatory principle for family systems and that it may limit both our expectations for families and our approaches to helping families. The concepts viability, positive feedback processes, morphogenesis, and "variety" are presented and emphasized as important for a more tenable conceptualization of the family system in our society today. An attempt is made to relate these concepts to some of the clinical family literature and to examine the implications of these concepts for mental health and educational approaches to the family.     

Mothers and Children Together

Summary

Treatment groups for both mothers and children together who have experienced mother assault is a unique therapeutic milieu which has been underutilized in the treatment field. This article presents a 10-week feminist-informed family systems group model as part of a treatment approach for children exposed to family violence and can be used with families of children from pre-school to adolescence. This model provides a context in which the experience of family violence can be debriefed, and issues related to trauma, safety, secrecy, and post-abuse family restructuring can be addressed by family members together. In addition, play and art therapy based interventions are presented and are tailored for the beginning, middle, and end of the group process.     

Multi-agency family systems

The term 'multi-agency' family is preferred to 'disorganized' family. Multi-agency family systems present special problems of the relationships (a) within the family, (b) between family and professional network, (c) among members of the professional network and (d) between family, network and treatment centre to whom the family is referred. Pressures on the family and professional workers can create a locked system which prevents natural development of the family or effective problem solving by the workers. A systems approach to such problems is presented which includes consultation to the family/professional network system.     

The transition to parenthood: I. The rating of prenatal marital competence

This article is the first of three that will present data from the Timberlawn Psychiatric Research Foundation Young Family Project, a study of the development over time of competent family systems. The Project is briefly described and findings are presented from the initial data collection period. The operational definitions of marital competence and the Continuum of Marital Competence are presented, and the data are interpreted to suggest that the spouses' levels of individual psychological health, their agreement on values, and their socioeconomic status are related to the level of marital competence. The level of prenatal marital competence at Time 1 is used as an independent variable with which to predict both changes in marital structure and incorporation of the child into the family system at 3 months and 1 year postpartum. The results of these analyses will be presented in two subsequent articles.     

Beyond the “Psychosomatic Family”: A Biobehavioral Family Model of Pediatric Illness

This article proposes a multilevel systems model of the interactive biological, psychological, and social processes in childhood illness. This heuristic model can organize the investigation of pathways and mechanisms by which these levels influence one another. A pivotal feature of this biobehavioral family model is the construct of responsivity, which is conceptualized at both family (interpersonal responsivity) and individual (biobehavioral reactivity) levels. Individual biobehavioral reactivity is proposed as a bidirectional pathway by which family patterns and disease processes influence one another. Illustrative clinical material and relevant research are presented with recommendations for future study. This model integrates individual and family-level theory and thus has the capacity to bridge the fields of psychosomatics, pediatrics, behavioral medicine, and family systems medicine.     

Stages in the Family Therapy of Adolescents

Family therapy is considered from the systems point of view as a process with a series of stages including definitive beginning and end points. The stages are identified as crisis points in family therapy - i.e., moments in the therapy process when the equilibrium of the family is upset and when stress reactions among family members are most likely to be intense. Since times of crisis also provide special opportunities for growth and change, they can be utilized therapeutically provided the therapist is knowledgeable about the kinds of upheavals that a family may experience and the time sequence in which they may occur. Eight such crisis points and their relation to therapeutic intervention are presented. The purpose of this paper is to outline the role of the crisis as therapeutic opportunity in the course of family therapy.