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.     

Family coping strategies and the rural Appalachian working poor

Naturalistic research methods were used in this study to collect the voices, ideas, and opinions of rural, working poor, Appalachian families from Southeast Ohio about the stress of poverty in family life and family coping in the face of poverty. This data should be of interest to the professional family therapist who practices with the working poor.     

Live supervision in the postmodern era of family therapy: Issues,reflections, and questions

This article asserts that the family therapy field is approaching an epistemological shift from structuralism and positivism to postmodernism and relativism. The confluence of these movements: feminism, constructivism/constructionism, and cultural relativism is cited as a major impetus for the shift. Live supervision is examined within the context of this transformation, with a discussion of implications for the future.     

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 self-narrative and acute psychosis

The aim of this study was to apply the narrative approach in analyzing family therapy meetings in cases of acute psychosis. The self-narrative is essential in acute psychosis since it is either collapsed or not coherent enough. The results indicate that it is important to create concrete practices that produce stories concerning the patient in relation to others. The self-narrative must be re-authored by the patient even though it is socially constructed. This is achieved by creating multiple perspectives of self-narratives in so-called therapy meetings with the patient, family members, and staff members representing different professionals.     

“Not with me you don't”: A story of narrative practice and dissociative disorder

This paper discusses issues relating to therapeutic practice based upon the narrative metaphor. A case of someone suffering the effects of Dissociative Identity disorder is used to illustrate the difficulties that clients can experience with the “expert” knowledge conception of therapy. The value of the “respectful” and “non-expert” emphasis of Narrative Practice emerges even when the therapist believes that he or she lacks expertise in the client's apparent “condition.” Three themes emanating from the case form the basis for the discussion: the client's experience of being recruited into accepting the diagnostic label of Dissociative Identity Disorder; the effects of being forced to accept a contract to eliminate self-abusive behaviour; and the therapist's dealing with a gun in the therapy room.     

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.