The way we were in 1983; Le Tour de Moonee Ponds Family Health Centre (by Appointment to the Queen)

In this paper, originally presented at the Sydney Family Therapy Conference in 1983, the author satirised the state of family therapy in Australia at the time, with its awe of overseas gurus, and in so doing mirrored some of our distinctive contributions to world culture. In her epilogue, the author briefly describes subsequent life events which have made her, twenty years later, a very different person, and a very different therapist as well.     

Gamblers Anonymous and Cognitive-Behavioral Therapies for Pathological Gamblers

Numerous types of treatments for pathological gambling have been described, but two of the most common are Gamblers Anonymous (GA) and cognitive-behavioral therapy. This paper describes some outcome data associated with the two approaches. It also reviews evidence suggesting that a combined intervention may enhance therapy engagement and reduce relapse rates.     

Fundamentals of Theory and Practice Revisited; The Mutiny and the Bounty: The Place of Milan Ideas Today

The author traces the development of the Milan approach from the beginning, through the split into two teams in 1980, and subsequent developments in theory and application. He identifies possible unrecognised or undeclared influences of Milan in other family therapy approaches.     

Anti-War Initiatives and the Un-Making of Civic Identities in the Former Yugoslav Republics

This paper describes the emergence of anti-war initiatives in the former Yugoslavia against the background of the official nationalism of Communist elites and their post-1990 successors. The author argues that anti-war activism in the disintegrating state was a mobilization of the most articulate segment of a widespread, all-Yugoslav, urban, cosmopolitan and genuinely non-ethnonationalistic cultural identity. One of the reasons behind its easy suppression by the official rhetoric of ethnic homogeneity is its purely cultural stance and lack of experience in alternative forms of political organization. Dominant approaches to ethno-nationalism in former Yugoslavia are criticised for essentializing ethnic identities, and contrasted with some interpretive approaches that analyze the structural preconditions of ethno-nationalism as top-to-bottom projects of the ex-Communist middle-to-high ranking functionaries in search of legitimacy and forced to create a 'democratic electorate.'     

Relationship Education and Therapy for Same‐Sex Couples

The gay and lesbian community suffers higher rates of discrimination, mental health problems, and relationship break‐up than their heterosexual counterparts. In this paper we analyse the challenges confronting same‐sex couples, and the implications for couple education and therapy with same‐sex couples. We describe some similarities in the challenges confronting heterosexual and same‐sex couples (e.g., negotiation of shared realistic relationship expectations, effective communication). These similarities suggest existing evidence‐based approaches to couple therapy and relationship education are likely to assist same sex couple relationships. We also describe distinctive challenges for same‐sex couples (e.g., homophobic discrimination, internalised homophobia, and low support from many families for same sex relationships). These distinctive challenges suggest some adaptation of existing approaches to couple education and therapy could enhance their relevance and effectiveness to same sex couples.     

Empathy — Still at the Heart of Therapy; The Interplay of Context and Empathy

Developing skilled and delicate approaches and interventions aimed at assisting families (or systems) to solve entrenched problems has been an exciting and stimulating aspect of family therapy over its relatively short existence. Recently, more and more authors have re-emphasised the need for respect and mutuality in dealing with clients, the need for the therapist to be aware of the clients' frames of reference and idiosyncratic solutions, some arguing that it is preferable to take less of the expert, interventionist stance. The necessity for empathy underlined in many earlier approaches to therapy is mentioned, though generally ‘in the small print’, in the reports of the processes being investigated and developed. This article re-considers empathy, always known to be at the heart of the counselling/therapy¹ process, but perhaps too easily assumed at present. It contends that empathy remains essential, that it can be understood more fully, and thereby used more effectively. Some of the traditional understandings of empathy, mostly from writings on individual therapy, are considered. Working with families and systems demands a broader understanding and different applications. The therapist must be capable of empathy with the context and the relationships as well as with individuals. While asserting that human beings are generally capable of empathy, the article examines some particular aspects of its use in therapy, particularly with families; it contends further that a fuller understanding of empathy can enrich the whole process of therapy. The article argues that empathy remains an indispensable guide to intervention with the family, the system or the person, whatever form the intervention (or non-intervention) may take.     

Who Should Be a Family Therapist? A Personal View of Selection for Training

The author presents a view of the selection of applicants for training programs in family therapy, drawing on his own experience. A case is made for the importance of selection, based in the notion that the profession is responsible for attempting to protect the therapy consumer from practitioners who are potentially unhelpful or even damaging. The qualities that are desirable in a trainee family therapist are itemised and discussed. The article then describes how particular selection processes can be used to identify appropriate and inappropriate applicants. The author stresses that a good selection process should be isomorphic with the program of which it forms the first stage.     

Managed behavioral health care premises, accountable systems of care, and AMBHA'S perms. American Managed Behavioral Healthcare Association

This article discusses the concepts and approaches underlying managed behavioral health care and the need to assess quality of care. The author describes the Performance Measures for Managed Behavioral Healthcare Programs (PERMS) developed by the American Managed Behavioral Healthcare Association (AMBHA), which is offered as a first step toward enhanced quality of care assessment in managed behavioral health care.     

Career Adaptability in Adults: A Construct Whose Time Has Come

This article describes Donald Super's construct of adaptability and reviews research on the construct. The review is followed by a discussion of related counseling research that uses the construct, and research in the area of organizational psychology that addresses the concept but does not use the term. The author summarizes other approaches to the need for adaptability in adult career development, and finally, presents suggestions for practitioners.     

The Divide Between “Evidenced‐Based” Approaches and Practitioners of Traditional Theories of Family Therapy

Evidenced‐based approaches continue to grow in the field of family therapy. However, practicing family therapists do not always embrace these approaches. In this article, we explore factors contributing to practitioners' concerns with evidence‐based treatments and suggest a broader, more clinically palatable view of evidenced‐based treatment. We also suggest how family therapy researchers, practitioners, and educators might begin to close the researcher–clinician divide in the best interest of all concerned.     

Maternal Sexual Abuse of Males

This article presents one aspect of the findings of a qualitative research study which explored the impact of childhood sexual abuse on the lives of a non-clinical sample of 25 adult males who responded to advertisements for adult male survivors of childhood sexual abuse. The author conducted in-depth interviews with the men to discover how their experiences of childhood sexual abuse had influenced their psychosocial development. Thirteen of the 25 men were abused by females. This article focuses on seven men who were abused by their mothers and describes how definition, prevalence and outcomes of maternal sexual abuse are affected by male socialization, creating additional difficulties for these men. The author describes some of the psychological defence mechanisms used by this sample of men, explores some of the reasons for maternal abuse and issues to be considered by practitioners. © 1997 John Wiley & Sons, Ltd.     

Depth‐Oriented Values Extraction

The author examines the role of values in the career decision‐making process and describes Depth‐Oriented Values Extraction (DOVE) as a process that translates various types of psychological data (e.g., Holland‐type themes) into values‐based terms and language that facilitate career decision making. The author presents a case study to demonstrate the implications of DOVE for career counseling and makes suggestions for counselors.     

‘Somebody Else's Roadmap’: Lived Experience of Maudsley and Family‐based Therapy for Adolescent Anorexia Nervosa

The Maudsley and more recent family‐based therapy manualised approaches are positioned by some as the gold standard, evidence‐based therapy for adolescent anorexia nervosa (AN). However, a significant proportion of adolescents and their families either discontinue this therapy and/or find that it simply does not work for them. These adolescents and families are under‐represented in the literature on therapeutic interventions for adolescent AN. This paper begins to address this gap with an in‐depth qualitative case study that explores the lived experience of Maudsley family therapy (MFT)/family‐based therapy (FBT) for one female adolescent (age 14 years) and her family over the period of 3 years (ages 11–14). Although initially handing over the responsibility for her eating was comforting and reinstated a sense of control in the family system, these experiences were not maintained. When she did not progress past the first phase of FBT, she and her family experienced the approach as blaming. She felt silenced and family alliances were weakened. This paper analyses how the family members negotiated and preserved their identities within this disabling context.     

Treatment of psychotic children and adolescents: A psychoanalytic social work approach from the Federal Republic of Germany

This paper offers data from the inpatient treatment of four psychotic adolescents in a clinic in Tubingen, in the Federal Republic of Germany. The author describes crucial episodes in therapy of each, and includes his own physical sensations and reactions, his dreams, and the thinking and feeling that determined his responses to these young patients. This way of working is a non-medical form of psychoanalysis.     

THERAPEUTIC INTERVENTIONS IN LIFE-THREATENING SITUATIONS*

Therapists who encounter life-threatening behavior in their clinical practice are at risk in providing interventions which do not take into account the systemic effects of their interventions. Specifically, therapists are likely to engage in “more of the same” behavior with clients who present with suicidal or homicidal threats. This paper presents two case studies that employed therapeutic methods derived from the systemic therapy of the Palo Alto group. In these case studies, the author illustrates the importance of the therapist's ability to speak the client's language in formulating an intervention that has the potential for reducing the likelihood of actual violence. The first case illustrates the use of the client's world view about her situation to assist her in dealing with domestic violence. The second case presented describes the use of systemic interventions in the case of a young woman known to have made homicidal threats. The author discusses the appropriateness, as well as the ethical issues, of the techniques described. Also offered, is a discussion clarifying the theoretical underpinnings of the clinical work presented and an amplification of some of the ideas originally presented by the Palo Alto group.     

Towards a Multicultural Society: Family Therapy with Greek Families†

Language and cultural differences can pose barriers to effective intervention in migrant families in conflict. Family therapy approaches can provide some useful strategies for overcoming these obstacles. A family therapy approach can (1) emphasise the value of utilizing natural network support systems; (2) provide a model which helps clarify communication problems arising in the relay of information through a third person acting as an interpreter; (3) underline the importance of non-verbal and process aspects of family communication; (4) suggest techniques for negotiating, joining, and finding commonalities of family experience between a therapist and family of different ethnic background. The therapist needs to develop sensitivity to both the universal and specific ethno-cultural structures, norms and problems of families; when this sensitivity is achieved powerful and culturally syntonic healing forces can be released. Examples of successful family therapy interventions in some Greek families in conflict are given.     

An Insight Approach to Marital Therapy

The trend in marital therapy has traditionally been away from insight approaches and toward action-oriented methods, such as manipulating the couple system or teaching partners to negotiate. This paper presents a form of insight therapy based upon systems theory and suggests that this orientation has much to offer. The first part describes general categories of relationship problems with which a couples therapist must deal. The second part takes each of these problem types and suggests how a therapist with the present systems-interpretive approach might proceed. The goal is a shared understanding by partners of their marital system.     

‘The Family’ In The Undergraduate Social Work Curriculum.**,***

The growing popularity of family therapy raises the question as to whether material on family therapy should be included in basic professional courses, or left as a more specialised area of study at the post-professional level. This paper describes how concepts and techniques of intervention from family therapy have been used in a unit on ‘Social Work with Couples and Families’ in an undergraduate degree course in Social Work.     

Attachment theory and clinical social work

Recent additions have rendered attachment theory potentially viable for clinical social work practice. The author examines its formulations and possible use, seeing it as an important alternative to other psychosocial approaches that attempt to explain how early childhood experiences may affect later mental health. The emphasis of this theory on the cognitive makes it congenial to those who favor cognitive approaches to individual therapy, and its emphasis on patterns of attachment makes it of appeal to family therapists.