Experiential Family Therapy: An Innovative Approach to the Resolution of Family Conflict in Genetic Counseling

Experiential family therapy is an intuitive approach that utilizes active, multisensory techniques. These techniques, such as role plays and drawings, increase the family's expression of affect and uncover new information. Increased affect and uncovered information stimulate change and growth in the family system. Experiential techniques are especially useful when more traditional, verbal-based communication is not effective. In this article, I will present a pediatric case in which the patient, a 7-year-old boy diagnosed with autism, was referred to the genetics clinic to rule out the presence of an associated genetic disorder. I will then describe a hypothetical second counseling session with the same family and suggest how three experiential family therapy techniques: family drawing, empty chair technique, and continuums might be used in the session to help resolve a marital conflict between the patient's parents.     

Family Therapy with a Multiparental/Multispousal Family

This article examines therapy with a Bedouin-Arab family from the Negev, Israel, which consisted of 69 members: a husband, 8 wives, and 60 siblings. The husband, who lived with his youngest wife, paid little attention to his other wives and their children. There was considerable competition, hostility, and jealousy among the wives; no communication between the co-wives or the children of different wives; and a variety of behavioral and psychosocial problems among family members. I describe the varied strategies and systems involved in family therapy. The main strategies were to establish good relationships among the co-wives and to build a coalition among them, including the youngest wife, through group therapy in a medical clinic. A secondary strategy was using the children's problems to get the husband involved in the therapy. With improvement of the children's functioning, and with reduced intra-subfamily hostility, the husband's relationships with his children and wives improved.     

Reflections on Ways to Create a Safe Therapeutic Culture for Children in Family Therapy

Although a large number of publications in the family therapy field stress the importance of children in family therapy, some authors report that, in practice, many family therapists do not actively involve children in their therapies. In this article, I reflect on the experiential reasons for this exclusion of children. I will consider the importance of the use of the self of the therapist and of the creation of a safe therapeutic culture for the child. Practical suggestions are made of ways to involve children in family therapy. Finally, these ideas are illustrated in a case example of a family therapy with an adoptive family.     

Parent–Adolescent Conflict,Negative Emotion,and Estrangement From the Family of Origin

Adolescence is a developmental period in which parents and children renegotiate roles in light of the children's blossoming individuality and autonomy on one hand and parent–child emotional connectedness on the other hand. The renegotiation process often involves difficulties in communication, which generate tension and conflict and also amplify emotional intensity. In this study, I examined sociocontextual differences between families who maintain contact during the child's young adulthood and those who "repair" the relationship only through separation or detachment. Three waves of panel data I utilized for this investigation reveal that emotional closeness to a parent during adolescence and a rewarding romantic relationship and religiosity during young adulthood play protective roles in maintaining the parent–child relationship beyond adolescence. A parent's alcohol use, high levels of parent–adolescent conflict, family economic hardship during adolescence, and delinquent behavior and depressive symptoms in the adolescent increase the risks for termination of the parent–child relationship. The findings provide evidence for the long-term impact of parent–child conflict and negative emotion during adolescence.     

Marital Conflict by Proxy After Father Kills Mother: The Family Therapist As an Expert Witness in Court

The father killing the mother leaves the children effectively without parents. The extended family from both sides will often intervene to offer a home for the children, or at least to have a say in what arrangements are made for the children and how they are to be brought up. Intensely competitive and hostile feelings between the opposing sets of relatives are commonly aroused, and the children may be caught up in a battle reminiscent of the conflict between their parents, which culminated in the death of their mother. I and my colleagues have, as a team, seen more than 300 children who have lost one parent at the hands of the other, and we have been involved in subsequent custody battles as expert witnesses. Based on this experience and using this context as an example, the issues for the family therapist as expert witness in adversarial Court proceedings are presented. A case is described that illustrates the theoretical exposition — including the effectiveness of family therapy from the witness box.     

The use of children's drawings in multiple family group therapy

This paper describes the advantages, difficulties and techniques of including young children in multiple family group therapy (MFGT). Multiple family group therapy consists of weekly sessions where three or more families meet conjointly with a therapist or cotherapists. Clinical vignettes demonstrate how to use children's drawings with parents to improve family communication. The efficiency of MFGT is compared to family therapy or individual therapy. The effective use of this modality with some children under 10 years is discussed.This research was supported in part by Alcohol, Drug Abuse, and Mental Health Administration Psychiatry Education Branch Grant MH 13882 from the National Institute of Mental Health.     

The complaining client and the troubled therapist: a discursive investigation of family therapy

In this paper I examine two important issues for family therapy research. I attend to the concept of complaints, highlighting the conversational structure they take in a family therapy setting. I do this by outlining how clients construct their complaints and examining how the family therapist receives them. Data is taken from a corpus containing four different families and two different therapists, and is subjected to discursive analysis in order to provide a rich analysis of not just what is happening in the talk but how it is happening. I conclude that complaints are not received as useful to the therapeutic process, despite their constructed importance to the client, and therefore there are wider implications for therapy and professionals more generally, particularly implications for multi-agency communication.     

New branches on the Tree of Knowledge. Challenges for systemic family therapists

Faced with today's challenges, I question whether the framework for family therapy provided by systemic thinking is sufficient when working with children and teenagers. The aim of this paper is not to argue for an eclectic model for therapy, but rather to encourage a critical dialogue between various bodies of knowledge. The paper raises the discussion of how family therapists relate to knowledge external to the therapy field. Contemporary developmental psychology, neurobiology, behavioural genetics and group socialization theory are highlighted as useful bodies of knowledge for family therapists. Examples from clinical practice are used to illustrate this.     

Families-at-risk and home-based intervention: A therapist training model

Home-based family therapy programs are designed to provide intensive family intervention for at-risk children and adolescents. However, examination of the literature reveals limited publications about training therapists for this difficult task. The purpose of this paper is to describe a therapist training model based upon a family-as-context approach to crisis intervention. Specific units covered during the course include: family-as-a-system, structural family therapy, family crisis intervention, family assessment and simulation. It is concluded that the effective prevention of placement for at-risk children and adolescents requires both a home-based family treatment program and a specific therapist training model for family intervention.John J. Zarski, PhD, is a professor in the marriage and family therapy training program at the University of Akron. Carol A. Pastore is program coordinator for the T.I.E.S. program in Canton, OH. A. Lynette Way and Richard N. Shepler are home-based therapists with T.I.E.S. The authors would like to express their appreciation to Professor John West for his helpful comments on drafts of this article.     

Varieties of Perspectives on Creativity: Reply to Commentators

ABSTRACT— In this reply, I concentrate on two broad issues raised by the four commentaries in this issue: the hierarchical model of domains and individual differences in creativity. In the first case, I cite additional research to address the contrast between "hard" and "soft" domains and the application of this contrast to children, adolescents, and noneminent adults. In the second case, I introduce two recent studies to confirm the model's predictions regarding personal creative achievement. I hope that the original article, the commentaries, and this reply will inspire future inquiries into creativity in all its disciplinary varieties.     

Communicative Competence and the Architecture of the Mind/Brain

Cognitive pragmatics is concerned with the mental processes involved in intentional communication. I discuss a few issues that may help clarify the relationship between this area and the broader cognitive science and the contribution that they give, or might give, to each other. Rather than dwelling on the many technicalities of the various theories of communication that have been advanced, I focus on the different conceptions of the nature and the architecture of the mind/brain that underlie them. My aims are, first, to introduce and defend mentalist views of communication in general; second, to defend one such view, namely that communication is a cognitive competence, that is, a faculty, and the underlying idea that the architecture of the mind/brain is domain-specific; and, third, to review the (scarce) neuropsychological evidence that bears on these issues.     

Detriangulation of Absent Fathers in Single-Parent Black Families: Techniques of Imagery

The projection of the mother's unresolved feelings about an absent father onto one or more of her children-often the eldest son expected to assume the role of parental child-is an obstacle frequently encountered in therapy with single-parent Black families. Acknowledgment and resolution of these feelings by the mother is an important step toward reestablishing generational boundaries and improving communication between mother and children. It is suggested that the empty chair procedure and the use of family photographs are two interventions that can be used within the context of structural and/or transgenerational family therapies to help the mother separate her feelings about the absent father from her feelings about her children. Models for the use of both approaches and the potential benefits of each is presented. The successful outcome of either technique may depend, however, on variables in the family's history and the stage of therapy during which the techniques are introduced.     

Marital Conflict and Differential Treatment of Siblings

Sibling differential experience of the family environment has recently come to the forefront of both the family and the developmental literatures. One hypothesized determinant of such treatment is marital conflict. The present report used structural family therapy as a theoretical framework to examine the relation between marital conflict and differential treatment of siblings in a sample of married couples with preschool and elementary-school children. The results did find a significant, though modest, relation between marital conflict and differential treatment, suggesting that positive marital communication in an environment of mutual respect serves to lower the rate of differential treatment of siblings within the family.     

Co-creating change within a child protection system: integrating art therapy with family therapy practice

This paper considers family art therapy intervention using a partnership developed between an art therapist and a family therapist within a child protection system. The aim of this co-working relationship is to bring together skills that can amplify the child's voice within the family, using art as a means of extending the family story. The use of metaphor adds to the repertoire of skills available when working with families, and offers a particular form of communication in which children can more easily engage. By co-working, we also bring together our personal and professional stories, creating multiple ideas and ways of seeing and taking account of differences in the life experiences of individual families.     

The reach of systems theory: A clinician's retrospective, 1984–1993

One of the early family therapists provides a review and analysis of his work in the recent decade (1984–1993), providing also a structure and perspective that connects it with his earliest work in the early 1960s. His work describing the blaming process as a common source of pathogenic relating resulted in a key article in 1984, from which two streams of work and one tributary emerged. A 1984–1989 stream defined a conflict cycle by which therapists might sort out the countless conflicts heard in family interviews, thus aiding diagnosis and treatment. A 1989–1992 stream defined another form of pathogenic relating, learning to be possessed, a learned means of skillfully avoiding blame for wrongdoing which is roughly but usefully defined as The Devil made me do it. The writer concluded that if one became very good at it, learning to be possessed was excellent training for the development of delusional thinking in adolescence and afterwards. Piaget's work suggested that a case could be made for a good match between adult delusional and the problem-solving difficulties of six-to-eight year-old children. During 1992–1993, the author returned to a topic he believes he was the first to introduce and seriously address in family therapy: The problem of defining phases of family therapy (which he wrote about in the early 1970s). Rejecting the traditional beginning-middle-ending model in psychotherapy, he substituted a series of four-interview units, beginning with the engagement series and ending with termination. The early work concentrated on engagement, the recent on termination.Three decades ago family therapy hardly existed, but today it is firmly established among the major psychotherapies. There are tens of thousands of mental health workers familiar with the basic concepts and techniques of the field; and of these, there are several thousand highly skilled practitioners. The field has been both blessed and cursed by the absence of a single father. The blessing has been a rich diversity of viewpoints powerfully enunciated by quite gifted individuals and their disciples. The curse has been factionalism that at times has reached an unusual level of personal vindictiveness, and has encouraged ideologues intent on subordinating the originality and creativeness of the field.Exponents of major viewpoints in the field have, it seems to me, an obligation to continue to enunciate them clearly, to add depth and breadth to those viewpoints whenever possible. As one of the early family therapists, I believe I have such an obligation. In this article I propose to summarize, review, and analyze my work of the past decade, 1984–1993; to add a perspective whenever that may be possible; to relate the work of the recent decade to the work of past decades, whenever possible; to propose a structure for the work of the past decade, and whenever possible to relate that structure to those of previous decades. I am not a writer of books in the ordinary sense, but a writer of articles enunciating particular ideas; and often it has taken several articles to enunciate an idea to my satisfaction. In this article I will attempt to enunciate two streams which flowed from a common source, and also a tributary. It incorporates seven previously published articles.During the preparation of this article I learned of the death in October 1992 of Ernest A. Haggard, who was my chief mentor while I was a graduate student many decades ago at the University of Chicago. Thoughts about Ernie do not seem to leave me. I would like to dedicate this article to his memory.     

From General Laws To Singularities

This article comprises several sections. The first is devoted to an explanation of a number of notions stemming from work by Ilya Prigogine and others on open systems far from equilibrium. As a result of this work, I have been able to stand back from the traditional approach employed in family therapy, that of open systems at equilibrium (the theory of Ludwig von Bertalanffy). The second section describes a clinical example based on elements close to Prigogine's theories. In the third part I develop an approach that--although continuing to draw on Prigogine's work--is much more closely linked to the research I have carried out with Félix Guattari over recent years. In this part I attempt to study a level that, in my view, has too often been left outside the field of inquiry: that of couplings between "singularities" of members of the family system and the therapist. A clinical case is presented in which this "semiotic" level, as Guattari terms it, is used together with that of the "intrinsic rules" of the system. Finally, I propose a few avenues of inquiry and research on the basis of the concepts presented.     

The Use of Teaching Stories in Conjoint Family Therapy

Two general factors have been singled out as being held in common by all types of psychotherapy: an educational, rational factor (often called "content") and a factor operative in the relationship between the therapist and his patient (often called "process"). In the field of family therapy, the non-educational aspects of intervention are sometimes presented in the form of "therapeutic, paradoxical communications" (Haley, Bateson, Jackson, Weakland) or the 'therapy of the absurd" (Whitaker, Malone). In the present paper, I wish to present a form of therapeutic communication, the teaching story, that embodies a unique mixture of both the educational and the paradox, or absurd.     

Family wealth and parent–child relationships

This study examined associations between self-reported family wealth and parent–child relationships, by contrasting three theoretical perspectives on the shape of the association. The study utilized data from the Norwegian part of the “Health behaviour in school-aged children study (HBSC) 2013/2014”, with a sample of 3383 children aged 11–15 years old. The shape of associations between family wealth and parent–child communication were tested using regression spline models with knots at 1 SD below mean family wealth and at 1 SD above mean family wealth. The regression spline models showed that increasing family wealth was associated with easier family communication, clearer family communication, and higher family support. Results revealed that for boys, the association between family wealth and outcomes was stronger for the lower segment of family wealth, than in medium and high segments of family wealth. For girls, the gradient across level of wealth was monotone, with higher parent–child communication and higher family support at higher family wealth. To conclude, the results from this study suggest a nonlinear pattern of inequality in parent–child relationships across the range of family wealth.     

ICTs and Family Functioning: A Study on Portuguese Families with Adolescents and Emerging Adults

Nowadays, information and communication technologies (ICTs) represent an integral part of contemporary family life, introducing changes in families’ functioning. Positive, negative, and mixed aspects of this influence were identified. The present study intends to understand the relationship between ICTs and family functioning among participants from two different family life cycle stages. A total of 157 Portuguese families (307 participants from 97 families with emerging adult children and 169 from 60 families with adolescents) completed measures about the use of ICTs (an adaptation of SEFT/ETEF©) and family functioning (SCORE-15). The number of ICTs and problems related to their use were higher in families with adolescent children. The use of a higher number of ICTs was related to a better level of family functioning in both family groups. However, according to the multiple regression model, the problematic situations related to ICTs use only seem to predict a worse level of family functioning in families with adolescent children. Also, parents and children of each group differed in the number of ICTs used. Some limitations, implications for family therapy, and future research directions are discussed.