Professional Politics and the Concepts of Family Therapy, Family Consultation, and Systems Consultation

At a time when an increasing number of professionals are calling themselves "family therapists," many teachers and theorists in this field are troubled that the term "family therapy" no longer adequately characterizes the concepts or activities of the field. Recently, clinical, political, and economic circumstances have emerged that suggest the need for alternatives to the role of "family therapist." By adding the roles of family consultant and systems consultant, we can open up new options for ourselves and our clients. During initial contacts with families, agencies, and other professionals, we can heighten our therapeutic potential by proceeding with consultative stocktaking, not starting with therapy. Family consultation also can assist in redirecting therapy when a new problem or an impasse develops, in focusing on competency rather than on pathology, and in engaging constructively with families that have a physically or mentally ill member.     

Structure, Self-Regulating Sequences, and Institutional Third Parties in Therapy: The Veterans Administration as a Model

This article examines the structural organization and sequences of interaction among therapists, institutions, and patients and their families that contribute to the problem of institutional dependence. Our contention is that when patients have become dependent on an institution for the livelihood and/or for the stability it represents, they are only one part of a systemic relationship characterized structurally by enmeshed boundaries, and sequentially by self-regulating feedback loops. We use this premise to outline the nature of the enmeshed transactions in patient-therapist, patient-institution, and therapist-institution relationships. Family interfaces with this triad are also addressed. Sequentially, we outline the interactions among patient, family, therapist, and institution that lead to hierarchical incongruities. These sequences tend to produce self-regulating feedback loops that perpetuate and maintain the structure of the system and its patterns of interaction. The final part of this article demonstrates how we strategically use a therapy team to manipulate the hierarchical incongruities and, hence, the recursive complementarity, that characterize the interactions between and among the members of this suprasystem. Besides manipulating the role of the therapist through team intervention, we also present several paradoxical and structural interventions that have been helpful when institutions have become third parties to therapy.     

Normative mid-life concerns among Vietnam veterans with post-traumatic stress disorders: Some preliminary empirical findings

Most Vietnam veterans are now in the mid-life years. Veterans suffering from post-traumatic stress disorder (PTSD) may find that mid-life concerns both precipitate and exacerbate their PTSD symptomatology. Preliminary research with four groups of adult males supports this notion. A cross-sectional study with nonveteans, Vietnam era noncombatants, Vietnam combat veterans not in treatment, and Vietnam veterans in treatment for PTSD suggests that the mid-life issues of affiliation, identity, demonic guilt, and work may be the most problematic. Implications for treatment are discussed.     

A Systems Theory Conceptualization of Incest

In this paper, father-daughter incest is examined from the perspective of general systems theory. Three characteristics of an open system--information exchange with the environment, negentropy, and dynamic homeostasis--are described and examined with respect to the functioning of incestuous families. Two case studies of families with father-daughter incest illustrate the tendency of these families to be more characteristic of the "closed" end of the continuum. The role of the environment in the origin and maintenance of the incestuous symptom is also examined. Implications for treatment are presented within the context of this theoretical perspective.     

The Missing Triad: The Case of Two-Child Families

Families, as they grow, become more complex in their psychosocial development. They also become more complex in their dyadic/triadic structure through the simple addition of another child. This article traces some of the structural changes that families undergo with the entry of each new child. It also raises several questions about how these very structures may, in turn, influence development of the children. By comparing two- and three-children families with different dyadic/triadic structures, these questions offer some basis for possible future research, as well as some speculation for the clinician.