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.     

Heat and Violence: New Findings from Dallas Field Data, 1980–19811

Research in both laboratory and field settings has suggested a link between thermal stress and violent behavior, and both linear and curvilinear models have been investigated. A dearth of field studies prompted the analysis reported here, which is based on data for some 10,000 aggravated assaults occurring the City of Dallas in 1980 (a summer of severe heat stress) and 1981. This analysis replicates and extends certain aspects of recent work by Anderson and Anderson (1984) relating to the so-called linear and curvilinear hypotheses. Thermal stress is measured in two ways: a Discomfort Index (DI), which takes into account the influence of humidity acting in concert with temperature, and ambient temperature. Regression analyses were performed in two stages. In the first, data for all neighborhoods and all days of the study period were combined into ambient temperature and DI models. At the second stage, models differentiated between the three levels of neighborhood socioeconomic status. With weekend controlled, DI and ambient temperature were significant independent variables in the ‘overall’ model and in medium and low status neighborhoods. However, when linear effects were controlled, the curvilinear measures were never significant. The analysis generally tended to confirm Anderson and Anderson's suggestion that a reduction of aggression with increasing temperature does not appear to occur within the normal range of temperatures. This analysis further suggested that the hypothesized curvilinear effect is weak, if not entirely absent, even during conditions of extreme heat.     

Family system functioning: behavior in the laboratory and the family treatment setting

The Family System Functioning (FSF) scale is a new instrument for measuring dimensions of the intrafamilial environment thought to be important in recovery from major psychiatric illness. Modest statistical correlations were obtained when FSF ratings of laboratory-based family interactions were compared with researcher-guided therapist ratings of FSF based upon the family's behavior in family therapy sessions during the subsequent month. The data from these two settings provide support for the validity of some of the scales. Because of the modest size of the correlations, however, behavior in the laboratory setting may not always be an accurate indicator of how the family will behave in the early weeks of family therapy.