Contrasting four major family therapy paradigms: implications for family therapy training

Four major paradigms of family therapy are contrasted: affective-experiential, structural, strategic and Milan. The differences are defined according to the way in which therapists think and behave in relation to their premises about change, and they are discussed under the following headings: historical roots and understanding of symptom formation; therapists' stance and techniques used in change; focus, goals and locus of change; and time perspective in change. Some suggestions are made with regard to training family therapists based on the differences that emerge when contrasting these models of family therapy.     

Further explorations in empowerment theory: An empirical analysis of psychological empowerment

Developed empowerment theory and replicated previous research on citizen participation and perceived control. Few investigators have designed studies that specifically test empowerment theory. This research further extends a theoretical model of psychological empowerment that includes intrapersonal, interactional, and behavioral components, by studying a large randomly selected urban and suburban community sample and examining race differences. Results suggest that one underlying dimension that combines different measures of perceived control may be interpreted as the intrapersonal component of psychological empowerment, because it distinguishes groups defined by their level of participation in community organizations and activities (behavioral component). The association found between the intrapersonal and behavioral components is consistent with empowerment theory. Interaction effects between race groups and participation suggest that participation may be more strongly associated with the intrapersonal component of psychological empowerment for African Americans than for white individuals. Implications for empowerment theory and intervention design are discussed. The authors express appreciation to Steven Rosenstone who was the Principal Investigator for the Detroit Area Study from which the data for our study is based. We also thank Deborah A. Salem and the anonymous reviewers for their thoughtful comments on earlier drafts of this paper.     

Genetic counseling for deaf adults: Communication/language and cultural considerations

It has been estimated that at least 50% of congenital or early onset deafness loss has a genetic etiology. Genetic services have traditionally been utilized by hearing parents of deaf children. Deaf adults could also greatly benefit from genetic counseling services. However, many deaf adults do not seek genetic services due in part to the communication/language and cultural differences of this group. Deaf people communicate in various ways including the use of sign language, oral communication, writing, or a combination of these modes. Also, while some deaf individuals are part of the hearing culture, others are part of the Deaf culture which has its own language, values, and traditions. Culturally Deaf individuals do not see themselves as handicapped or disabled. The genetic professional's awareness of the communication/language and cultural needs of this group, as well as their agency's responsibilities under section 504 of the Rehabilitation Act of 1973, may increase the accessibility of genetic services and contribute to the provision of successful genetic counseling for deaf adults.Throughout this paper, the term deaf will be used to denote a person who audiologically has a hearing loss which may range from mild to profound and may be sensorineural, conductive, or mixed. However, the term Deaf is used to denote cultural deafness.     

The family void: treatment and theoretical aspects of the synchronous family paradigm

The synchronous paradigm is a model of families whose members remain uninvolved and disconnected from each other yet somehow maintain relatively unvarying or even rigid patterns of behavior. In the synchronous paradigm, calm agreement and harmonious unity of action are valued above all. The concept of synchronous operation was first formulated by Constantine to solve certain theoretical problems growing out of the work of Kantor and Lehr. The theory has been elaborated upon through linkages established with other clinical and theoretical models of family dysfunction. Clinical experience in treating synchronous families has now contributed more detailed and practical understanding. Clinically, disabled synchronous families may present as bland, boring, or even death-like. They may have considerable difficulty accommodating to necessary developmental changes or to the demands of life crises, employing a variety of strategies to maintain the appearance of synchrony at the expense of adaptation. Their ability to ignore change and to absorb interventions can tax the abilities of even the most creative and energetic therapist. On the other hand, the quiet efficiency of the family and the social sensitivity of its members can be strong assets. Awareness of their strengths and special vulnerabilities can help the family therapist work more effectively with synchronous families.     

“Marital trap analysis”—incompetence,complementarity, and success traps: Identifying potential future dysfunctions based on a couple's current collusive agreements

This paper describes three types of traps or collusive marital agreements-incompetence traps, complementarity traps, and success traps-in which the mates renounce or forgo competent functioning in vital areas of marital roles and experience. It is suggested that responsible clinical work with the couple should include a careful evaluation of such traps and the potential breakdown or dysfunction inherent in each one, and a decision as to whether or not to attempt therapeutic penetration into such collusive agreements even before the couple complain directly about their arrangement.     

Book reviews

Current Psychology -     

Marital dissolution and distress in a psychiatric population: A longitudinal design

There has been interest in recent years in the relationship between marital distress and psychopathology. It has been rare, however, for investigators to follow patients after their release from the hospital and observe the course of their marital relationships. The present study included patients meeting criteria for three DSM III DISORDERS (MAjor depressive, bipolar, and schizophrenic) and a normal control sample, all of whom are participants in an ongoing longitudinal study of children at risk for psychopathology (Stony Brook High-Risk Project; Weintraub & Neale, 1984). Marital Adjustment Test (MAT; Locke & Wallace, 1959) scores were collected on patients at entry into the project (Phase I) and at a three year follow-up (Phase II). Course of marriage was defined as negative if the couple's marital adjustment was rated as poor at Phase II or resulted in divorce or separation at Phase II. It was found that only the depressed group differed from the normal group in having significantly worse course of marital relationship; 84% of the depressive couples showed a “negative” course of marital change over time. However, all three patient groups had significantly higher rates of divorce by Phase II. MAT scores at Phase I successfully predicted course of marital relationship for all diagnostic groups. Implications for aftercare of psychiatric inpatients are discussed.     

Suicide and rurality in urban society

Recent findings suggest that suicide increases with rurality, but research on rural suicide leaves many questions unanswered. This study specifies problems of community organization as a reason for expecting a positive effect of rurality on the suicide rate. A multiple regression analysis of county data shows that rurality has a substantial positive effect and is, in fact, the best predictor of the suicide rate among several variables selected from the previous literature. Additional research is needed to test the interpretation that rurality contributes to an incomplete, fragmented form of community organization which influences the suicide rate by disrupting primary relationships.     

To commit or not commit to human life: Children of victims and victimizers—All

The author discusses the impact of the Holocaust on both the children of victims and victimizers and reports on empirical researches conducted among Israeli student health professionals and others as to how ready they, the people of the victims, are to approve of and to participate in various programs and events which take the lives of helpless others, and reports disturbing results. He concludes that making a commitment to human life is the single most important task for all of us.