A record-keeping format for training systemic therapists

Training in systemic therapy necessitates a structured approach to teaching systemic thinking. The Systemic Therapy Sessions Summary Form, a record-keeping method, is presented as a tool for enhancing training in systemic therapy. The purpose of this form is to provide the structure for the trainee to develop circular hypotheses, to connect reflexively the assessment and intervention components of therapy, and to maintain a sense of the evolving nature of therapy across sessions. A case example illustrates the use of this record-keeping format.     

The Anorectic Process in the Family: A Six-Stage Model as a Guide for Individual Therapy

This article presents a conceptual framework for individual treatment with chronic anorectic patients. In the first part of the article, the six-stage model for the anorectic process developed over the past years by M. Selvini-Palazzoli and her team is briefly explained. After presenting the model, we then discuss some related concepts, namely, "family game," "rule," and "strategy." Finally, the therapeutic technique in individual treatment is discussed. Two basic assumptions underlie this technique: first, the therapeutic relationship is instrumental, its main purpose being to improve the patient's personal relations outside therapy; second, the focus of the treatment is on the strategic incapacity of the patient who is caught up in and unable to cope with the "concealed family game."     

Systemic crisis intervention as a response to adolescent crises: an outcome study

The present study demonstrates the safety and effectiveness of an outpatient program designed to respond to adolescent-precipitated crises by mobilizing and restructuring the family's kinship system. Families of 75 adolescents at risk for hospitalization were followed up to 24 months after treatment with Systemic Crisis Intervention. Measures of offspring and family functioning, suicidal behavior, institutional use, and treatment costs are presented. Results clearly demonstrate the safety, effectiveness, and economic viability of Systemic Crisis Intervention.     

Systemic Optimism — Systemic Pessimism: Two Perspectives on Change

Therapists have a mandate to bring about change, and family therapists appear to have unusual leverage to fullfill such a mandate, that is, to facilitate changes rapidly and effectively. Because and in spite of this mandate, the very notion of change deserves critical reflection. The history of ideas and our clinical experience teach us that changes may be problematic. They may come too fast or too slowly, may endure or fade away, may turn out to be desirable or undesirable, equitable or inequitable, and may, when further consequences and larger systems levels are taken into account, be beneficial or disastrous. This essay examines some of the problematical and contradictory aspects of change and delineates two perspectives on change--systemic optimism and systemic pessimism.     

The transition to parenthood: II. Stability and change in marital structure

At 1 year postpartum, 22 of 38 couples demonstrated the same level of marital competence as they had prenatally, 14 couples demonstrated deterioration in their marital relationship, and 2 couples were improved. At each of four levels of marital competence, there was a trend for the couples to demonstrate the same relationship response to parenthood. Highly competent relationships remained at high levels of competence. Competent but pained relationships were most vulnerable to regressive change in structure. Dominant-submissive, complementary relationships tended to remain stable at that level. Dominant-submissive, conflicted or severely conflicted relationships were most unpredictable and stability, regression, and improvement were seen. These findings are explored for possible correlations and are discussed from the perspective of several current models of family development.     

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.     

General self-esteem of adolescents from ethnic minorities in The Netherlands and the reflected appraisal process

This article examines the question of how the lack of differences in general self-esteem between adolescents of ethnic minorities and Dutch adolescents can be explained. Attention is focused on the reflected appraisal process. It was found that for adolescents of ethnic minorities there is a significant relationship between general self-esteem and the perceived evaluation of family members, and no such relationship with nonfamily members. For the Dutch adolescents the findings are the opposite, which may explain why adolescents of ethnic minorities in general do not have lower general self-esteem, despite low status, prejudice, and discrimination.