Family Therapy Process in a Family Therapy Seminar

The interaction between leaders and members in a year-long family therapy seminar is systematically compared to the process that unfolds between therapist and family during the course of family therapy. A five stage developmental process common to both is postulated and described: (1) Battle for Structure, (2) Naive Enthusiasm, (3) Conflictual Frustration, (4) Task Orientation, and (5) Mutuality. The dynamic elements of each stage are analyzed and factors affecting their development are identified. It is concluded that this five stage process occurs in all similar groups, but that the content of each stage may vary widely from group to group.     

Beyond the Cringe: Family Therapy in an Australian Context

The practice of family therapy has become widespread in Australia during the past fifteen years. Beliefs here about family therapy mirror wider social trends and dilemmas. Several difficulties persist, which are anchored in the geography and colonial history of the society.     

Is Family Therapy Including Children?

This paper presents a review of recent child therapy and family therapy texts and training courses in Australia. The aim was to determine the extent to which knowledge and information about child development and emotional and psychological problems in children and adolescents is included in the education and training of family therapists. The paper argues this is crucial to prevent the difficulties of young person's being ignored or exacerbated and discusses relevant ethical issues.     

Family Therapy for the Trainee in Family Therapy*

The growth and self understanding of the therapist as a person are considered by most training centres to be a significant part of the training process. This article reports on a pilot project which provided marital and family therapy for trainees in a two-year program. Therapy was established on a contract basis and included individual, conjoint, family intergenerational and small group. Interns and family members responded favorably to the program. Supervisors found the experience enabled trainees to maintain an experiential consistency with a general systems model utilized as the core theory of the training program.     

Family Social Work/Family Therapy

The author responds to Witkin's (1993) comparison of family social work and family therapy. The author argues that family social work and family therapy share important commonalities. He challenges Witkin's characterization of family therapy as outdated. Instead, family therapy is characterized as having contributed important writings about gender and culture to its practitioners. The paper ends with reflections on the implications of social justice for clinicians.     

Child-Focused Family Therapy: Behavioural Family Therapy Versus Brief Family Therapy

We examined the effectiveness of behavioural family therapy (following the treatment agenda outlined in Fleischman, Horne and Arthur, 1983) and brief family therapy (following the procedures outlined in Fisch, Weakland and Segal, 1985), in the treatment of child psychological disorders. The parents of the 49 children referred to the outpatient unit of a children's hospital completed the Child Behavior Checklist (CBCL) (Achenbach and Edelbrock, 1983). Three scales of the CBCL were examined to assess the effectiveness of the two therapeutic approaches pre- to post-treatment. Significant pre- and post-treatment differences were found for behavioural family therapy on the Internalizing, Externalizing, and Sum T scales and for brief family therapy on the Internalizing and Sum T scales. Sum T scales represent the sum of scores across all sub-scales of the CBCL. Neither treatment was found to be more effective than the other.     

Fathers in Family Therapy: A Survey of Family Therapists

Sixty family therapists were surveyed in an investigation of resistance by family members to family therapy. Consistent with other investigations, the father was viewed as the most resistant along a number of dimensions. Therapist behaviors that related to difficulties with the father, specifically, and to family therapy generally, were identified. The implication of these results and possible strategies to reduce the resistance of the father are discussed.     

Family Therapy with the Elderly

This article outlines health and lifestyle challenges to elderly persons and associated changes in their family systems. Flexibility, related to attachment patterns, is considered central to healthy adaptation. Family therapy approaches and relevant systemic and cultural factors influencing psychotherapy with the elderly are discussed. Key family therapy concepts and strategies (genograms, transmission of family histories and circular patterns of interaction), are reviewed and exemplified. Four types of family therapy presentations are elucidated by composite case examples. Firstly, the elderly person can be the identified patient. Secondly, another family member can seek help for him/herself in relation to the elderly person. Thirdly, another family member can be the identified patient without direct reference to the elderly person. Finally, the wider health care system involved with the elderly person and family can be the focus of therapy. Family therapy offers important conceptual and strategic advantages in working with the elderly and their systems.     

Family Therapy with the Learning Disabled Child and His/Her Family

No therapist can come in contact with and treat children with minimal brain damage or specific learning disabilities without being struck by the fact that there are numerous intertwined factors that have contributed to and continue to perpetuate the problems. In addition to the helping approaches which have been utilized in recent years, such as tutoring, special education, and child therapy, this article elaborates the importance of utilizing family therapy as the treatment of choice sometime during the course of treating the child and helping the parents to understand and deal with their handicapped youngster.     

Brief Family Therapies

A modified version of Guerin's (1976) classification was used to categorise the principal models of brief family therapy according to theoretical and technical dimensions. While all models stemmed from common origins, either psychodynamic or systems theory, they differed in three particular areas: the premises regarding the origin of symptoms, the aims of therapy, and the major strategies employed. Nevertheless, all models were in agreement on several aspects, including the principles underlying brief family therapy techniques, the focus on the family's current level of functioning, the importance of clearly defining the problem (but not necessarily in terms of traditional psychiatric diagnoses), and other family variables. A survey of the literature indicated that there was a paucity of scientifically acceptable investigations of brief family therapy, and thus, a lack of valid evidence that any model provided an effective approach to therapy.     

Family Therapy: A Client-Centered Perspective

>This article first critiques therapist-directed approaches to family therapy in the light of research findings on therapist variables (empathy, warmth, genuineness) associated with positive outcomes in psychotherapy. Second, two polar opposite positions in family therapy — psychodynamic and family systems — are examined and found to have much in common. The two approaches are based on a pessimistic view of the family, which is seen as an intractable unit, resistant to its own growth. Third, an alternative, phenomenological view of the family is developed, which more optimistically assumes the family to be motivated for enhancement and growth. Finally, a client-centered approach to family therapy is described.     

An Empirical Assessment of the Goals of Family Therapy*

This study is an empirical assessment of the goals of family therapists. A list of goals was developed based on a theoretical clustering of the family therapy literature into the dimensions of communication, cohesion, and adaptability. Three hundred ten clinical members of the American Association for Marriage and Family Therapy (AAMFT) responded to a questionnaire about their use of these goals in family therapy. The findings indicate that the goals employed by this sample seem to reflect ideas from the literature which are not the property of any one “school” of family therapy. The goals that were rated and ranked highest included encouraging family members to relate caringly, responsibly, and creatively in negotiating their differences. Goals that were rated and ranked lowest included the more advanced or technical communication skills and some cohesion goals that may be interpreted as related to institutional aspects of family life.     

Family Therapy and the Family Doctor − 1

The author shows that the family doctor's burden of responsibility in the area of psychological dysfunction in the community is immense. Traditionally he has little training, limited knowledge, and a paucity of skills, in the areas of counselling and psychotherapy. The author argues that structural and strategic family therapy skills may be applicable to family practice and of benefit to the family doctor. A brief introductory course and subsequent feedback are described.     

Mixed Methods Research in Marriage and Family Therapy: A Content Analysis

Considering mixed methods research is gaining reputability in the marriage and family therapy field (Research methods in family therapy, Guilford, 2005), we conducted a mixed methods content analysis to examine the prevalence and quality of published mixed and multimethod research during the past 10 years in eight prominent MFT journals (N = 32). Our purpose was to determine the characteristics of studies that utilized both qualitative and quantitative methods, the themes of the rationales for combining methods, and their respective topics of study. We found 16 mixed methods articles, many of which used surveys and interviews, focused on the process of therapy, and did not discuss their methodology as mixed. We encourage authors of mixed methods studies to explicitly define design types, to establish a clear rationale for the combination of methods, to state how qualitative and quantitative methods and data were mixed, and to use theory effectively.     

Climbing the Family Tree: Working with Genograms

The genogram is a practical and widely adopted tool for mapping families in therapy. Its use can be easily learnt and is recommended for beginners in family therapy. The genogram promotes thinking In system and transactional terms, and shifts emphasis away from individual problems to relational issues. A family system can be given a visual focus, and this often reveals patterns and connections previously unnoticed. A set of conventions for constructing genograms is suggested, with ways of elaborating on this basic frame. The applications of the genogram in joining families, in planning interventions, as a clinical communication medium, and in learning family therapy are discussed. Other types of network diagrams are briefly listed, and a clinical example of a genogram is given. Finally, limits and cautions on the use of genograms are discussed.     

Family Therapy: Inner,Outer and the Issue of Pathology

This paper sets out to examine the relationship between ‘the inner’, ‘the outer’, and ‘the issue of pathology’ in the family therapy field. It begins with the observations that ‘pathology’ has become a rarely mentioned issue in family therapy, and ‘what is wrong’ is increasingly located in ‘the outer’: the family ‘game’, ‘linguistic activity’ or ‘the cultural discourse’. At the same time, family therapy often hosts forums in which presenters are ‘attacked’ for not seeming to hold the ‘correct view’. The paper considers these phenomena in tandem, looks at the matter of ‘method’, and applies James Hillman's critique of psychoanalysis to family therapy. The suggestion is that family therapy has been blinded by its own metaphor of ‘seeing’, symbolised and literalised in the one way screen. Alternative metaphors privileging intuition, feeling and aesthetics are put forward, before discussion points are raised, and before this paper on therapy concludes poetically, or this paper concludes that therapy may be poetry.     

Costs of Treating Depression With Individual Versus Family Therapy

Depression is one of the most common concerns that bring clients to treatment. Although marriage and family therapy has been shown to be an effective treatment, little research exists regarding the cost‐effectiveness of related services. In this study, we examined claims data for 164,667 individuals diagnosed with depression to determine (a) differences in the cost of treating depression according to type of therapy and license type, (b) differences in recidivism rates by age, gender, type of therapy, and type of mental health professional, and (c) differences in cost‐effectiveness by therapy modality and type of professional. The results showed that services provided by marriage and family therapists resulted in the lowest recidivism rate, and family therapy services were the least expensive.     

Religious Cults, the Individual and the Family

Relatively little attention has been paid in the professional literature to the cult phenomenon: what it is, how it attracts converts, what differentiates the vulnerable youth from the non-vulnerable; the effects of cult membership on the convert's family, and, particularly, in what ways the family can be aided during and after involvement with the cult. The authors have drawn on clinical observations, interviews, and extant literature from a variety of disciplines in constructing a portrait of the vulnerable youth; the techniques used by cults to attract, recruit, and convert members; the dynamics of the recruits family; and the most effective modes of therapy for intervening. The intent of the article is to stimulate: 1) professional awareness of and knowledge about the cults, and 2) further research into related family dynamics and therapeutic techniques.     

An Open-Systems Approach to Teaching Family Therapy*

Through systems concepts are increasingly employed in family and marital therapy, they are usually employed in a limited way, excluding some aspects of the total system. Systems ideas are applied most fully to the nuclear and extended family of the referred patient, and increasingly to the therapist's family of origin. The interface between the influence of the family of origin of the professional and difficulties in his practice is also scrutinized, though more often in a teaching and supervisory context than during therapy. The relationships among the therapist's family of origin, his marriage and family of procreation, and his professional work are more often neglected, and the influence of all three on the dynamics of institutions, training programs and staff groups is least often explored. The authors, a married couple who work together professionally, occupied fin-several years a crucial leadership role in developing the first multi-disciplinary teaching programs in the London area, bringing together key teachers from all the main institutions, with widely differing theoretical orientations, in a group which now forms the Institute of Family Therapy (London). This paper describes their attempt to facilitate a more consistently open-systems approach which appeared to stimulate unusually rapid growth, learning, and group cohe-siveness.     

Family Context Therapy: A Model for Family Change*

Starting where family group therapy fails, this article breaks new territory in family context therapy. Consolidating the past 14 years of his work, Dr. Bell sets forth a conceptual program and methods to meet problems that earlier forms of family therapy could not reach. Here he provides a model drawn from studies, theories, and personal experience of organizational patterns, interrelations, and change among community institutions that provide settings for family functioning. His new methods are designed to modify the family environment so as to solve family problems and promote beneficial family growth—a framework that may bring together a broad variety of existing family development approaches.