Ethics and family therapy: the case management of family violence*

All family therapists, and especially Milan-style systemic therapists, have been trained to take a neutral stance regarding family issues, based on a circular causality model of family interaction. Therefore, when therapists deal with family violence, their ability to perceive individual responsibility for unethical behavior is weakened or suppressed. In fact, this ability is the primary tool in developing effective treatment planning in cases of family violence: The actively physically abusive man needs to be in individual and/or group therapy, not conjoint or family therapy. The ethical judgment of the therapist is what determines the limits of family therapy.     

Considering justice: an exploratory study of family therapy with adolescents

Feminist approaches to therapy with adolescents emphasize an empowering focus on the strengths of adolescents while simultaneously insisting that therapists become aware of their own biases toward today's adolescents. However, a review of the family therapy literature finds little mention of feminist approaches for addressing injustices (e.g., family scapegoating, negative societal views of adolescents, and gender oppression) that arise in family therapy with adolescents. Therefore, this study explores clinical approaches and resources suggested by a surveyed group of self-identified feminist family therapists. In addition, we also recommend several approaches and resources that will aid family therapists in creating a more just climate for family therapy with youth.     

A perfect fit: connecting family therapy skills to family business needs

The purpose of this article is to encourage family therapists to become more interested in family business practice. It does so in three ways: (a) highlighting the number of therapists already involved in family business issues; (b) showing the parallels between family business and family therapy by applying family business research findings to couples therapy; (c) discussing how family therapists already have the practice wisdom to be effective in working with family business clients. Limitations of this practice are also discussed along with suggestions for overcoming them.     

The theory,structure, and techniques for the inclusion of children in family therapy: a literature review

Many barriers prevent therapists from including young children in family therapy, despite the theoretical belief that every family member should be present. Although there is a wealth of literature describing how to include children, the information has not been compiled in a way that is easily accessible to therapists. In this article, we report the findings of an exhaustive and systematic literature review of 64 publications, published between 1972 and 1999, related to including children in family therapy. The purpose of this article is to offer therapists a succinct compilation of theoretical, structural, and practical aspects as well as a comprehensive listing of specific techniques for including children in family therapy.     

Personal Reflections of A Family Therapist*

In this informal paper I discuss my personal evolution as a family therapist, developments in the field, the politics of a systems approach in conventional settings, resistances to family and marital therapy by other professionals, some still puzzling aspects of family therapy, whether family or marital therapy works and what do we mean by working, directions my own work has taken, some comments about the nature of family life, the satisfactions and frustrations and stresses of being a family therapist, some hidden agendas of family therapy practices, how one's own personal family relationships affect and are affected by this kind of work, the casualties among family and marital therapists, and, finally, whether family therapists should have family therapy for themselves and their own families.     

WHY FAMILY THERAPY SHOULD GO BEYOND HOMEOSTASIS: A KUHNIAN REPLY TO ARIEL,CAREL AND TYANO

The thesis of “Beyond Homeostasis” is (a) that the discourse of family therapists unquestionably shows that family therapists have tended to see homeostasis as a trait of families; and (b) that such a view of homeostasis is inconsistent with the systemic paradigm. Therefore, family therapy should go beyond such an understanding of homeostasis. Ariel et al. may have failed to grasp this argument; they have certainly chosen to ignore it. Ariel et al. have provided a logical empiricist explication of the nonsystemic version of homeostasis which is portrayed in the discourse of family therapists. I still argue that family therapy should go beyond such an understanding of homeostasis.     

FAMILY SYSTEMS THERAPY IN A PRIMARY CARE MEDICAL SETTING: THE ROCHESTER EXPERIENCE

Collaboration between family therapists and physicians has attracted increasing attention in the field of family therapy. Family therapists practicing in medical settings encounter many stimulating oppoutunities and challenges. This paper focuses on the experience of the authors providing family therapy in a primary care medical setting which is also a family medicine residency program. The authors discuss the role of physician and patient expectations in treatment as well as the influence of the medical context on the development of family therpists.     

Integrating a Trauma Lens into a Family Therapy Framework: Ten Principles for Family Therapists

This paper aims to show how a trauma lens can be incorporated into existing family therapy practices, changing how therapists perceive presenting problems and therefore the issues and sites of intervention. After reviewing the family therapy literature concerning trauma and defining different types of trauma, the paper discusses how traumatic memories differ from ordinary memories. Ten principles for practice are described to guide therapists in integrating the trauma lens into their family therapy practice. Three case studies are used to illustrate these principles.     

Integrating gender on multiple levels: a conceptual model for teaching gender issues in family therapy

As the field of family therapy has evolved, there has been growing recognition as to the importance of gender in family therapy. To prepare the next generation of family therapists adequately, it is important that they recognize the many and complex ways in which gender permeates their work. In this article we present an integrative model to help educators teach family therapists about gender issues. The model examines how gender influences clinical work on multiple levels, including contextual levels such as society and the marriage and family therapy field. The model also acknowledges how gender can influence individuals, including clients, therapists, and supervisors. Finally, the model attempts to capture the complexity of how gender can impact the relational dynamics between two or more individuals.     

“Being a Therapist Doesn't Exclude You From Real Life”: Family Therapists’ Beliefs and Barriers to Political Action

A crucial and overlooked facet of social justice in family therapy is political and policy advocacy. Family therapists have unique insight into how social policies and political discourse shapes clients’ lives and the life of our profession. Such knowledge can inform policymakers and political debate, yet few family therapists are trained to engage in political action. In this randomized, national survey of licensed family therapists’ (N = 174), we explore beliefs about and barriers to engagement in political and policy processes. The findings suggest that there are significant barriers and uncertainties surrounding family therapists’ engagement, including time, feelings of efficacy, and interest. Given these barriers we discuss practical suggestions for clinicians and family therapy training programs.     

The Bouverie Information and Assessment Schema (B.I.A.S.)

The Bouverie information and Assessment Schema (B.I.A.S) has been designed to assist family therapists in the organization of case material. It is intended for use in the review of individual sessions, or of a whole therapy (in Assessment and Termination Summaries), and is thus suitable for case recording. It is specifically designed for use by family therapists taking a Systemic/Strategic approach to therapy. It is not a guide for interviewing in family therapy. A case example illustrates its use.     

TRAINEES' CONJUGAL FAMILY EXPERIENCE, CURRENT INTERGENERATIONAL FAMILY RELATIONSHIPS, AND THE THERAPEUTIC ALLIANCE

This study examines the relaionship between trainees' conjugal family experience, current intergenerational family relationships, and the client's perception of the therapeutic alliance. Participants were 74 first practicum family therapy trainees, representing two family therapy programs and 90 clients. Results indicated a moderately significant relationship between conjugal family experience and trainees' reported intergenerational intimacy with parents. Additionally, Clients whose therapists had conjugal family experience reported a slightly more favorable therapeutic alliance than clients whose therapists did not have conjugal family experience. Additionally, trainees with conjugal family experience reported more current intimacy and individuation than nonconjugal trainees and felt less intimidated by their parents.     

BATTERING AND COUPLES THERAPY: UNIVERSAL SCREENING AND SELECTION OF TREATMENT MODALITY

As family therapists begin to experiment with couples treatment models for batterers and their partners, a basic question is: Which couples can be safely treated with conjoint therapy? Following a definition of battering and a review of rationales for considering couples therapy in cases of domestic violence, a framework for assessment of domestic violence is outlined, including sample questions, criteria for excluding couples from conjoint therapy, how to conduct a lethality assessment, and how to conceptualize postassessment treatment recommendations. This article also introduces family and couples therapists to domestic violence literature that is often not well integrated in family therapy theory and practice.     

THE MARGINALIZATION OF FAMILY THERAPY: A HISTORICAL AND CONTINUING PROBLEM

Family therapy, and marital and family problems, are mariginalized in the larger fields of mental and physical health care, which is a misfortune both for family therapy and for other mental health professions. The early family therapists, who had multidisciplinary backgrounds, attempted toestablish a new, nondisciplinary paradigm and also tried to expand the perspectives of the more traditional mental health disciplines. More recently, family therapists have exerted greater effortsto establish marriage and family therapy as a differentiated, autonomous profession. These alternatives each involve dilemmas for the family therapy field. The positive side of becoming a distinctive profession is greater internal strength and clear professional identy; the downside is the threat of increased marginalization in rlation to the other professions, a tendency toward intellectual isolation, and hence restricted opportunities for invigorating new challenges. Family therapy now needs to develop new modes of interchange, collaboration, and selective integration with otherhealth care professions. Such interchange will be beneficial both to family therapy and to other professions.     

Depression,the Family,and Family Therapy

The potential contribution of family therapists to the treatment of depression remains underdeveloped. Family therapists need to articulate how changes in family functioning might benefit depressed persons, as well as how other problems in the families of depressed persons tend to go unrecognised. Furthermore, family therapists need to be alert to how undetected depression in adults and children may interfere with their ability to meet their goals with families who seek therapy for other persons. This article provides family therapists with (1) an overview of the nature and experience of depression; (2) an introduction to antidepressant medication; (3) a summary of research findings relating depression to its family context and (4) a brief overview of developments in the marital and family treatment of depression.     

Integrating Reflective Practice in Family Therapy Supervision

This paper discusses how to integrate reflective practice in the family therapy supervisory relationship. This enables family therapists to think creatively, be insightful, and develop a range of perspectives regarding systemic formulation and practice. It encourages review of the past and promotes understanding in the present with the aim to improve therapists work with families in the future. Reflective practice encourages independent thinking and learning and helps therapists to develop a systemic process of critical enquiry to investigate and critique their own practice. It encourages therapists to be self‐reflective and develop confidence to think hypothetically regarding change. This allows them to pose questions for exploration, construct a new lens to conceptualise therapy and the therapeutic relationship and develop awareness of the personal as well as the professional self.