Single-Case Experimental Designs in Family Therapy Research: Limitations and Considerations

Recent authors have encouraged the use of single-case experimental design in family therapy research. However, several issues related to the application of these designs have not been addressed. The present article suggests that the applicability of single-case methods to family therapy research may be limited. The first issue raised is the general lack of adequate dependent measures of family interaction that fulfill the requirements of the single-case experimental designs. Suggestions for development of appropriate measures are given. Second, the necessary reliance on relatively weak single-case designs often allows only relatively weak conclusions. Finally, the strategy of beginning the single-case study of family functioning and family therapy in laboratory settings is suggested.     

Family Characteristics and Posttraumatic Stress Disorder: A Follow-Up of Israeli Combat Stress Reaction Casualties

This study assessed the role of family status and family relationships in the course of combat-related posttraumatic stress disorder (PTSD). The sample consisted of 382 Israeli soldiers who suffered a combat stress reaction episode during the 1982 Lebanon War. Results showed that one year after the war married soldiers had higher rates of PTSD than did unmarried soldiers. Furthermore, higher rates of PTSD were associated with low expressiveness, low cohesiveness, and high conflict in the casualties' families. Theoretical, methodological, and clinical implications are discussed.     

Individual Marital Therapy: A Critical Reappraisal

The belief that individual marital therapy (IMT) is an ineffective form of treatment for marriage problems and markedly inferior to the conjoint approaches has become almost an article of faith in family therapy circles. This position was originally advanced in the influential reviews of the research literature conducted by Gurman and Kniskern, and their conclusions have been cited in numerous other articles. This paper re-reviews the research studies purportedly supporting this conclusion and finds almost all of them to be invalidated by gross flaws in design and implementation. It is argued that from the highly inadequate evidence available, no conclusions can be reached concerning either the absolute or relative effectiveness of IMT.     

Quantifying Family Process:Issues in the Analysis of Interaction Sequences

The analysis of behavior sequences can be a useful technique for understanding family process and has been increasingly employed as a result of developments in family theory. Some of the most popular sequential analytic methods are reviewed, and problems of applying these methodologies to investigations of family interaction are discussed. Independence-of-observations, nonstationarity, and autocontingency are differentiated as three distinct types of serial dependence. In addition, issues concerning the choice of data type, analysis of low base rate behaviors, and the decision as to whether to correct for base rates are considered. Guidelines are presented for dealing with each of these issues in the context of the research or clinical question being addressed.     

The Ramsay Family in Virginia Woolf''s To the Lighthouse: A Study of Arrest at Stage Three of Family Development as Delineated in Solomon''s "A Developmental, Conceptual Premise for Family Therapy"

The five stages of family development and their phase-specific tasks as delineated by Michael A. Solomon in an article that appeared in this journal (1973) are given dramatic representation by Virginia Woolf in her novel To the Lighthouse (1927). The novel begins with the Ramsay family system arrested at the third stage of development; and it is only after the death of Mrs. Ramsay that the remaining family members begin to attend to the phase-specific tasks of stages four and five, and family development commences.     

Family Secrets:

Family secrets are examined in a two-part article. Part I explores the dynamics of secrets in the relational context. Terminology is proposed for different types of family secrets as well as for different roles within the relational context. Guidelines for identifying family secrets are presented, and typical patterns accompanying or underlying secrets are explored. Different stances toward secrets are discussed, with particular emphasis on ethical issues. Finally, individual and relational consequences of secrets are proposed. Part II extends this discussion to the management of family secrets in marital and family therapy. Ethical and strategic dilemmas facing the therapist are examined as are consequences of secrets in treatment. A particular therapeutic stance is recommended and illustrated with examples of both reparative and preventive applications.     

A Single Intervention: A Visit to the Family

The following letter is reported unchanged except for disguised names. Concern with repairing disrupted relationships of adult members of a family with their own parents has been a matter of growing interest to a number of family therapists; Bowen (1), Boszormenyi-Nagy (2), and Framo (3), among others have stressed the importance of sending family members back to their families of origin. This report makes no effort to formulate the process in any particular theoretical framework (i.e., as reestablishing connectedness after an “emotional cut-off” or rebalancing a ledger of fairness, or whatever) but is intended only to illustrate the kind of outcome one may hope for in prescribing such a maneuver. It is offered simply as a clinical note. The letter needs little prefatory explication. Mr. Jack Newburgher had been a patient in psychoanalytic treatment for four years, with a quite successful outcome. On two occasions in the course of his therapy a joint session had been held with Mr. Newburgher and his wife, Muriel, when changes in his behavior had precipitated crises in the marital relationship. His therapy had terminated about two years before the visit referred to in the letter. Mr. Newburgher had called and asked for a joint consultation with Muriel about an acute family problem they were experiencing. Some — not all — of the background material was described, not nearly as coherently as it is reported in Muriel's letter, but in sufficient detail to make it plain that she was in distress about having to withdraw completely from her parents and that their family was in disarray as a consequence of her distress. The acuteness of the emotional disturbance, against a background of a lifelong adversary relationship between Muriel and her father and a history of ten years of illness on her fathers' part, suggested that the distress was the product of Muriel's anxiety and guilt over a decision to cut herself off completely from her parents. As a consequence, Muriel was urged to visit her family of origin, with the caveat that she might indeed discover them to be malignantly self-centered people indifferent to their effect on her and her family, but that she would at least have the gratification of having tried. The reference to “speaking French” was to the therapist having suggested that, on the other hand, she might find that her parents expressed their feelings in a different modality from her definitions of how feelings should be expressed, much as though their native tongue were French and she were insisting that they must speak to her in English.