Improvisational therapy: Evolving one's own clinical style

This article offers an invitation to develop one's own unique clinical style, relying less on institutionalized schools of therapy and more on the therapist's own natural resources. An emphasis is placed upon understanding therapy as art, trusting one's imagination, and maintaining a healthy irreverence for professional politics.     

Supervising the person of the therapist: Issues,challenges and dilemmas

A major critical issue in marriage and family therapy today is the professionalization of the discipline. Thus the focus on training individuals for a career in marriage and family therapy necessitates the revisitation of the debate over personal growth versus skill development. The trend toward training the person of the therapist, however, would suggest that the field is moving toward the integration of self awareness and skill in the therapeutic system. With the popularization of training the person of the therapist comes other issues, challenges, and dilemmas for the field, including the crucial issue of training gender and culturally sensitive therapists. The potential for creating dual relationships when training the person of the therapist is both a dilemma and a challenge.     

Sado-masochism as a defense against merging: Six case studies

This paper reports on several patients who use sado-masochism as a defense against an unconscious wish for and fear of merging. The sado-masochism can be expressed as a sexual perversion or in a difficult ungratifying interpersonal relationship. These relationships have some of the quality of addictions in that the patients have a compulsive need to continue them and find it extremely difficult to leave them. Therapy must focus on helping the patient become more separate, rather than on other problems which may also be present. Initially, the therapist needs to take an educational stance in regard to the process the patient must complete, rather than the more traditional analytic stance.     

Stories for therapy: The right story to the right person at the right time

In the postmodern information era with its increasing complexity and demands on my time, I find storytelling increasingly attractive. The right story told to the right person(s) at the right time in the right way can powerfully define and shape both individuals and the systems into which they organize themselves. As interventions go, I find stories to be relatively high impact, low-risk, parsimonious, and user-friendly. This paper contains some of my favorite teaching stories and describes why and how I use them as both a family therapist and teacher of family therapy.     

The recovering female alcoholic: A family affair

Supported by a review of relevant literature and a case study, the author argues that family therapy intervention enhances the likelihood of a female alcoholic's positive prognosis. With a basis in systems theory, family therapy views the family as a system and, hence, perceives the alcoholism as a symptom of that family. A profile of the female alcoholic, how her drinking affects her family, and the role that family therapy plays in the recovery process are examined.     

Long term marriages in Sweden: And some comparisons with similar couples in the United States

This international, five-country long term marriages study of couples who have been married, or unmarried and cohabiting, for 20 years or longer is designed to study, among other things, marital satisfaction. This first report of the Swedish part of the study reports on a Swedish version of the self-rating Dyadic Adjustment Scale (DAS) used to investigate self-rated marital satisfaction. The couples describe high marital satisfaction and a high sense of coherence (SOC) compared to other groups. Contrary to other studies, no differences were found between men and women regarding SOC. The differences between them, that describe high relative to low marital satisfaction, pertain to matters of recreation, sex, life philosophy, time spent together, and frequency of quarrels. The men reported greater marital satisfaction than the women.     

A Playroom Observation Procedure to Assess Children with Mental Retardation and ADHD

Forty-two children (ages 6 to 12 years old) with moderate mental retardation to borderline intellectual functioning were studied in a laboratory playroom setting to determine whether children identified as ADHD (attention deficit hyperactivity disorder) or controls differed on activity and attentional measures. Children with ADHD were further divided into ADHD + conduct problems (ADHD + CD) and ADHD-only subgroups (with an ADHD-combined group comprising children of both subgroups). An interval recording system was used to code observations of independent play and a restricted academic task. Results indicated that the ADHD-combined group was significantly more vocal and engaged in a significantly greater number of toy changes than controls during independent play. Significant group differences were also noted during the restricted academic task, with the ADHD-combined and ADHD + CD groups more off-task and engaging in a greater number of toy touches than controls. Discriminant analyses found independent play measures to predict group membership in 70 percent of cases (ADHD-combined vs. controls), but in only 64 percent of cases using measures from the restricted academic task. No significant findings resulted when the ADHD subjects were further divided into two subgroups. Despite some inconsistent findings, such laboratory-based observations may be of value in the diagnosis of ADHD in children with moderate mental retardation to borderline intellectual functioning.     

Beliefs about stories: Parents' and therapists' explanations of childhood difficulties

Therapists and parents were given vignettes describing the behavioural and emotional difficulties of two nine-year-old children and were asked to rate the importance of a number of possible explanations for such difficulties. Broad agreement was found between parents and therapists, but also there were a number of significant differences. Parents endorsed more child centered explanations and put greater emphasis on physical and developmental factors, while therapists endorsed relationships factors and saw the beliefs of other family members as important. Therapists who were parents showed a pattern of responses that lay between those of parents and non-parent therapists.     

MFT trainee adjustment to program lifestyle stress: The TAPS scale

The 30-item Trainee Adjustment to Program Stress (TAPS) scale was developed to measure lifestyle stress of family therapy trainees. Initially, 70 items were generated from propositional statements based on four constructs. Following pilot testing, 329 out of 900 (37%) student members of the American Association for Mariage and Family Therapy (AAMFT) returned TAPS questionnaires. Internal consistency reliability analyses and principal components and factor analyses produced a final 30 item TAPS scale appropriate for use in family therapy training programs. Reliability and validity measures are reported.