THE FAMILY FIRO MODEL: A MODEST PROPOSAL FOR ORGANIZING FAMILY TREATMENT

This paper presents a model for organizing family issues and family treatment. Schutz's FIRO model is offered as a framework for organizing family issues into inclusion, control and affection categories. Following Schutz's theory of group development, we propose that inclusion, control and affection constitute a logical hierarchy of core issues to be dealt with in treating multiproblem families-inclusion first, then control, and then affection (intimacy). Furthermore, we propose that the FIRO model can be used to organize theories of family therapy. We attempt to demonstrate that different family therapies are best suited for one of the three core issues of family interaction. We advocate an "intelligent eclecticism" based on the premise that when an issue is appropriately matched with a therapy, therapeutic effectiveness should be enhanced. We also discuss implications of our Family FIRO model for clinical practice.     

OBESITY AND FAMILY SYSTEMS: A FAMILY FIRO APPROACH TO ASSESSMENT AND TREATMENT PLANNING1

This paper offers a model for conceptualizing interactional patterns in families presenting for treatment of obesity, and suggests a method for organizing assessment and for prioritizing treatment strategies. We use the Family FIRO Model as a framework to organize complex assessment issues, to assign priorities for which issues should be treated first, and to select appropriate treatment techniques that cut across different models of family therapy.     

CORRESPONDENCE OF FAMILY THERAPISTS' PERCEPTIONS WITH FRCCCS CODING RULES FOR TRIADIC INTERACTIONS

Family therapy theory, practice, and research across many orientations are concerned with multiperson interactional phenomena such as intercepts, disconfirmations, and indirect communications. This study reports a successful criterion validity test of the rules for coding these triadic features in the Family Relational Communication Control Coding System (FRCCCS) (Friedlander & Heatherington, 1989). Thirty-five experienced family therapists observed two videotaped family therapy interactions and reported their perceptions of each of 25 communications. These perceptions-the criterion-significantly corresponded with the FRCCCS coding rules about the relational control aspects of triadic communications. Discussion focuses on the future use of the FRCCCS in research on family therapy.     

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.     

A BLUEPRINT FOR INCREASING THE RELEVANCE OF FAMILY THERAPY RESEARCH

Family therapy research and psychotherapy research in general have been criticized for their lack of relevance to clinical practice. This paper presents a fivestage model that family therapy researchers can follow to increase the relevance of their work for clinicians and other consumers of family therapy research. Using lessons derived from private industry, the research model is based on a marketing and developmental perspective.     

FAMILY THERAPY AND IDEOLOGY*

Contemporary family therapy is examined in terms of its ideological content. The adoption of cybernetics and biological systems theory to the family has led to the erroneous belief that familytherapy is exclusively concerned with natural systems, is process oriented, content relative, and above ideology. This article argues that the family and the enterprise of family therapy are social systems and under the influence of the ideology particular to a given society. The strategic family therapy treatment of a family with a drug-addicted member serves as an example to clarify the ideological themes of contemporary family therapy. These themes are: (a) family reductionism and blaming; (b) the relabeling of personal injustice into communicational terminology; (c) the assumption that the nuclear family is optimal; (d) the conceptualization of therapy as a commodity; and (e) the model of human relatedness and intimacy supported by family therapy.     

BASIC FAMILY THERAPY SKILLS, IV: TRANSGENERATIONAL THEORIES OF FAMILY THERAPY

This pape focuses on the basic skills and compentencies of transgenerational approaches to family therapy, the fourth report of a program of research surveys by the Basic Family Therapy Skills Project. In the first survey, a panel of family therapy educators listed the most critical or basic skills or compentencies of beginning family therapist with a transgenerational orientation. In the third survey, self-selected respondents rated these items according to degree of importance for beginning family therapists. Rankings of the items according to mean scores of the Likert responses indicate that transgenerational family therapy skills are founded in theory and can be identified behaviorally. The most important skills are those that use the self of the therapist to understand and utilize transgenerational family therapy skills for both therapist and client. Also listed are skills that many raters deemed "generic" rather than specifically related to transgenerational family therapy. Other findings and their implications for the future training of family therapists are discusses. Although the paper is intended for family therapy educators interested in their colleagues' ideas about critical skills in trans-generational family therapy, theorists and clinicians may also find it useful.     

A FAMILY THERAPY INTERNSHIP IN A MULTIDISCIPLINARY HEALTHCARE SETTING: TRAINEES' AND SUPERVISOR'S REFLECTIONS

Family therapy doctoral students from American Association for Marriage and Family Therapy-accredited programs are required to complete a full-time clinical internship. The literature provides little information about these internship experiences. Two doctoral-level marriage and family therapists summarize their professional and personal experiences in their internships located within a multidisciplinary healthcare setting. In addition, their supervisor reports on her experiences working with marriage and family therapy doctoral interns. We hope that this case report will stimulate all interns and their supervisors to provide feedback to their internship sites and graduate programs about their clinical training and the extent to which the programs prepared them for their marriage and family therapy careers in the larger health and mental health community.     

PERSONAL AUTHORITY IN THE FAMILY SYSTEM: DEVELOPMENT OF A QUESTIONNAIRE TO MEASURE PERSONAL AUTHORITY IN INTERGENERATIONAL FAMILY PROCESSES*

This paper reports a series of studies on the development of the Personal Authority in the Family System (PAFS) questionnaire. The PAFS questionnaire is designed to measure family processes based on aspects of current intergenerational family theory (Williamson, 1981, 1982b). Eight scales which measure concepts such as differentiation/fusion, intimacy/isolation, and personal authority/intimidation in the three-generational context comprise the questionnaire. Study 1 indicates that the scales have good internal consistency and good test-retest reliability. Correlations with other measures of family processes provide validity for some of the PAFS scales. Study 2 confirms the underlying factor structure of the PAFS questionnaire and supports the construct validity of the scales. Implications for intergenerational family theory and applications in research and clinical practice are discussed.     

THE AGE ONSET OF PERSONAL AUTHORITY IN THE FAMILY SYSTEM

The present research explored Williamson's position that relational patterns indicative of Personal Authority in the Family System (PAFS) occur during the fourth and early fifth decades of life. Participants were 232 university student volunteers. Individuals age 30 and above reported less triangulation with their nuclear families and less intimidation and less intimacy with their parents than the under age 30 group. These results provide some support for the view that differentiation is more clearly discernible in the fourth and fifth decades of life than in earlier years. Canonical correlations revealed that as age increases, the amount of variance accounted for by nuclear family triangulation, intergenerational intimidation, and integenerational intimacy increases, supporting Williamson's position that age is a significant factor in achieving several relational patterns indicative of PAFS.     

The effects of family therapies for adolescent delinquency and substance abuse: a meta-analysis

This meta-analysis summarizes results from k = 24 studies comparing either Brief Strategic Family Therapy, Functional Family Therapy, Multidimensional Family Therapy, or Multisystemic Therapy to either treatment-as-usual, an alternative therapy, or a control group in the treatment of adolescent substance abuse and delinquency. Additionally, the authors reviewed and applied three advanced meta-analysis methods including influence analysis, multivariate meta-analysis, and publication bias analyses. The results suggested that as a group the four family therapies had statistically significant, but modest effects as compared to treatment-as-usual (d = 0.21; k = 11) and as compared to alternative therapies (d = 0.26; k = 11). The effect of family therapy compared to control was larger (d = 0.70; k = 4) but was not statistically significant probably because of low power. There was insufficient evidence to determine whether the various models differed in their effectiveness relative to each other. Influence analyses suggested that three studies had a large effect on aggregate effect sizes and heterogeneity statistics. Moderator and multivariate analyses were largely underpowered but will be useful as this literature grows.     

AGING AND FAMILY THERAPY: PREVALENCE OF AGING ISSUES AND LATER FAMILY LIFE CONCERNS IN MARITAL AND FAMILY THERAPY LITERATURE (1986-1993)

To what extent are gerontological issues addressed in the marital and family literature? In answering this question, the authors conducted a content analysis of 873 articles published in the Journal of Marital Family Therapy, Family Process, Family Systems Medicine, and the Journal of Family Psychology during an 8-year period beginning in 1986. Only 3.2% (n = 28) of these articles contained explicit emphasis on aging issues and later life family concerns. Furthermore, there was no significant trend in the number of gerontologically focused articles published during this period. The paper describes the content of the 28 aging-focused articles, including the types of presenting problems mentioned, the relational contexts of these problems, and the types of family therapy theories represented. Included in the content analysis were the proceedings of the annual national conferences of the American Association of Marital and Family Therapy from 1986 to 1993. Only 2.3% (n = 37) of the regular conference sessions had an explicit aging focus, as did 1 of the 29 plenary sessions and 1 of the 40 Master Series® sessions. Used as a gauge of gerontological interest and awareness of late life issues, the implication of these findings is that the family therapy community is still engaged in “comming of age.”     

SELF ISSUES FOR FAMILY THERAPY EDUCATORS

Family therapy educators frequently encourage self-reflection in their students and clients. However, little attention has been paid to the challanges and processes of the eudcators themselves. In this piece, four faculty members reflect individually and collectively on their lives and roles as educators. the describe family-of-origin influences, the intersections of their personal and academic lives, systemic factors in the professional setting, balancing work and family, hierarchy, gender, and coping strategies ot increase support and reduce competition. They recommend a deliberate process of self-reflection to other family therapy educators and offer suggestions for improving the organizational dynamic of family therapy training programs.     

THE EFFECTIVENESS OF FAMILY INTERVENTIONS IN THE TREATMENT OF PHYSICAL ILLNESS

Although a large body of research demonstrates that the family has a powerful influence on physical health, the evidence for the effectiveness of family interventions in physical illness is less conclusive. Family therapy and other family interventions appear to be most effective in chronic childhood illnesses such as asthma and diabetes. Family interventions have also been shown to be effective in the management of some cardiovascular and neurologic disorders and for the treatment of obesity. Family therapy appears to be more effective than individual therapy for some groups of patients with anorexia nervosa. This research supports the increasingly important role of medical family therapy in the new health care system. Recommendations for future research are discussed.     

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.     

FAMILY GOAL RECORDING: AN ADAPTATION OF GOAL ATTAINMENT SCALING FOR ENHANCING FAMILY THERAPY AND ASSESSMENT*

Family Goal Recording is proposed as a systemic approach for measuring change in the presenting concerns of couples and families. This paper describes the procedures for using Family Goal Recording as an outcome measure for family therapy and a device to enhance goal attainment. In addition, the results of an initial study on the reliability and validity of this method are presented.     

PREVALENCE OF FAMILY THERAPY MODELS: A RESEARCH NOTE

A survey was undertaken to assess the prevalence of family therapy models utilized by a sample of members in the American Association for Marital and Family Therapy. Frequencies and rankings of widely recognized therapeutic frameworks are reported. Brief discussion centers on the highest ranking choice, the notion of eclecticism, and cautious interpretation of the data.     

A FEMINIST FAMILY THERAPY SCALE*

This paper reports on the development and psychometric properties of a 17-item instrument intended to reflect the degree to which family therapists conceptualize the process of family therapy from a feminist-informed perspective. Items were adapted from those generated by 37 feminist-informed family therapists in a previous study. Factor analysis results on 383 subjects reflect a unidimensional scale. The Feminist Family Therapy Scale had a Cronbach Alpha of 83 and was found to discriminate between (a) self indentified feminists and nonfeminists, (b) women and men, and (c) subjects scoring higher on Scanzoni's (1975) Sex Role Modernity Scale and those scoring lower. Additional psychometric data are reported, and possible uses of this scale are discussed.     

THE STRUCTURE OF FAMILY PARADIGMS: AN ANALYTICAL MODEL OF FAMILY VARIATION

The theory of family paradigms provides an integrative framework for under-standing and systematizing the diverse ways that families organize and make sense of family life. Using formal methods of analysis based on logical and geometrical arguments, the priecise implications of models of family types can be investigated and compared. The paradigmatic framework can thus be refined and extended to form a more rigorous theoretical grounding for family typologies is explored and a miltidimensional model is derived the geometry of which is equivalent to, but more succinctly captures, the underlying structure of uariation in family para-digms. In Part II, the resulting model is interpredtd and explored in terms of implications for family theory, theory construction, and family therapy. Clarifying the basic dimensions of the paradigmatic framework also permits more precise exploration of interrelationships among related models of family types, which can be understood as reduced models derivable from the complete geometry of the paradigmatic framework.     

A MODEL FOR TRAINING PRACTICING PROFESSIONALS IN FAMILY THERAPY*

This paper offers a model for high quality training in family therapy. The unique aspects of the Family Consortium's model are that it: (a) is aimed at practicing professionals; (b) emphasizes structural family therapy principles with strategic and experiential elements; (c) is geared secondarily toward training members as effective peer consultants and trainers; and (d) uses an awareness of the isomorphic nature of training, therapy and family transactions. Part I describes the practical organization structure of the Consortium. Part II discusses the current theoretical philosophy and training approach of this evolving group. Examples are given of how the Consortium has dealt with specific training issues.