Nature of marital relations among chronic pain patients

Fifty-two chronic pain patients and their spouses were evaluated for their marital relations utilizing the FACES III. In most areas of family functioning the couples provided evidence of difficulties and demonstrated a significant level of agreement about the nature of the problems. On the circumplex model the couples were functioning at the mid-to extreme-range. This study suggests that marital difficulties among chronic pain sufferers may indeed be pervasive.     

Using the Family Paper Sculpture for education,therapy, and research

The Family Paper Sculpture is a semi-projective task useful in family life education, in clinical work with families, and in research involving family system variables. Families or individuals are asked to make a picture of the family using round disks for individuals, red and black strips to show similarities and differences among individuals, and boundary markers to show individuals who are separate, or pairs, or groups of individuals who belong together. Examples are given which demonstrate the value of the technique for educational, therapeutic, and research purposes.She is on leave from the University of Houston-Clear Lake, Houston, Texas, where she is an Associate Professor of Behavioral Sciences.The research reported here was supported in part by grants from the (U.S.) National Institute of Mental Health.     

In defense of strategic therapy

The practice of strategic therapy has raised a number of critical issues and has stimulated criticism of various sorts. Among the criticisms leveled at strategic therapy are that it involves the taking of too many risks, that it is deceptive, that it is controlling and manipulative, that it is disrespectful, and that it is superficial and narrow. Each of these five major areas of concern is discussed and addressed with case examples to illustrate a rationale and justification for the use of these less conventional methods.     

The child sexual abuse victim: Assessment and treatment issues and solutions

Particular attention is given in this paper to the assessment process with child sexual abuse victims and recommendations are made regarding practical issues both in the assessment and the treatment phases of therapeutic work with child victims.     

Self-centeredness and the adult male perpetrator of child sexual abuse

Self-centeredness has been identified as a quality of the adult male perpetrator of child sexual abuse, but little or no effort has been expended toward defining the concept clearly. In this paper, the research literature on the perpetrator and psychoanalytic writings on narcissism are reviewed for the purpose of developing a comprehensive definition of self-centeredness. Literature related to the social and developmental context of child sexual abuse also is discussed. In the final section of the paper, implications for primary prevention and treatment are drawn.This is a revised version of a paper presented at the Groves Conference on Marriage and the Family, July, 1986, in London, England. Support for the paper was provided through the Minnesota Agricultural Experiment Station and the Faculty Summer Research Fellowship Program, Graduate School, University of Minnesota.     

Elder abuse by family caregivers: Processes and intervention strategies

This study of 104 family caregivers who provided care to 119 elderly kin discusses the stress and conflict that can result when the older person, the caregivers, and the family are unprepared to fulfill the caregiving tasks. Sources of stress that contribute to physical and psychological abuse of the elderly are examined. Suggestions such as setting guidelines, establishing support groups, providing respite and household care, and increasing awareness about the aging process and elder abuse are offered as mechanisms for preventing abusive interactions and increasing the quality of life for the elderly and their families.Revision of a paper presented at the 1986 Groves Conference on Marriage and the Family, London, England.     

Using psychodynamic concepts in strategic family therapy: A suicidal adolescent case

This paper describes the treatment of a suicidal adolescent with strategic family therapy. The cotherapists conceptualized the case psychoanalytically and systemically. They propose that their understanding of psychodynamics enhanced their ability to tailor their interventions to the family's unique style and capacities. Rather than dismiss psychodynamic concepts as irrelevant to strategic family therapy, they maintain that an appreciation of individual members' ego strengths, defenses, affects, and unacknowledged impulses leads to the construction of more effective metaphors and a set of interventions more isomorphic to family patterns.     

Cultural tensions in strategic marital therapy

Whether the elements of a good marital relationship are universal is the question addressed in this case study of therapy with a couple who were culturally different from the therapist. The conflicts between the therapeutic strategies, which were based on a strategic therapy model, and the customs of the couple from a foreign culture, made it difficult to evaluate whether the therapist was on target with interventions. On one hand, therapists need to guard against being misled into believing that customs are cultural imperatives which never can be changed. On the other hand, they need to be aware of the impact and possible ramifications of challenging long-held, culturally-based beliefs and behaviors. The following case study details the dilemmas faced by a therapist working with an Asian-Indian couple who presented themselves as being bound by their cultural background and heritage.Grateful acknowledgement is made by the author to Etienne Phipps, PhD, whose comments give direction and substance to all my work.