FAMILY THERAPY AND QUALITATIVE RESEARCH*

Qualitative research is becoming accepted by the scientific community as a viable way to explore and understand socialscience phenomena. The purpose of this paper is to describe the essential features of the qualitative research paradigm and to encourage further development of that paradigm in the field of family therapy. First, typical characteristics of qualitative research designs are delineated; these characteristics are illustrated with two extended examples from the qualitative research literature in the field of education. Next, possible applications of the qualitative paradigm to research issues in the field of family therapy are discussed. Finally, potential pitfalls that could inhibit the development of qualitative family therapy research are examined. It is hoped that this paper will serve as a stimulus for the development of qualititative research in the field of family therapy.     

CLINICAL PROCESS RECORDING IN FOCAL FAMILY THERAPY*

A method for systematically recording the process of family therapy (the Focal Therapy Record Sheet) is described, based on the focal approach developed in earlier papers by the authors. It demands a conceptual distinction between assessment of families and treatment techniques and embodies continuous evaluation of family improvement according to specific criteria. A detailed case illustration showing the Sheets completed for each of 14 sessions after two diagnostic interviews is provided, together with an anecdotal-style account. The value of the instrument for teaching purposes, in routine clinical work and for research is discussed.     

FOUR USEFUL INTERVENTIONS IN BRIEF FAMILY THERAPY*

At the Brief Family Therapy Center we have developed some interventions that have repeatedly been found useful. Once a generalizable intervention is designed for a particular case and found effective, the team attempts to replicate by using it in other appropriate situations. When a pattern of usefulness emerges, it is time to think about and study what is going on that makes the intervention useful. The purpose of this paper is to describe four such interventions, the situations in which to use them or not use them, and our thinking about what is going on in each example.     

FAMILY THERAPY OUTCOME RESEARCH: POTENTIAL PITFALLS AND PROSPECTS*

This paper raises and attempts to resolve some significant and controversial issues in the design of family therapy outcome studies. First, the issue of clinical relevance is addressed. Much of psychotherapy research has little relevance for practicing clinicians; this paper discusses some partial explanations and proposes some changes in the way data are reported that would have a salutary effect. Second, inter-model comparative outcome studies are critiqued. Third, the necessary preconditions for internally valid outcome studies are delineated, along with conditions in which randomization and the use of control groups can be abandoned. Fourth, there is a discussion of a research strategy which examines the generalizability of treatment effects found in research settings to conditions which come closer to resembling clinical practice. Fifth, questions regarding the selection of therapists for family therapy outcome research are addressed, including the issue of optimal level of therapist experience, and the question of whether or not “therapists” should be treated as a randomized factor in the overall design. Finally, there is a brief discussion of outcome criteria, with a fairly clear-cut and straightforward recommendation for determining whether or not a family therapy has had a desirable effect.     

THE EFFECTIVENESS OF PSYCHOEDUCATIONAL FAMILY THERAPY IN THE TREATMENT OF SCHIZOPHRENIC DISORDERS

A review of the literature on family psychoeducational interventions in schizophrenic disorders revealed two generations of studies. The first generation compared the clinical efficacy of psychoeducational family treatments and medication to medication only or routine care. A second generation of studies used more complex experimental designs that often narrowed the differences between the experimental treatment and comparison conditions. The results of the first generation of studies are unequivocal in demonstrating the superiority of family intervention plus medication over medication alone in delaying psychotic relapses. The second-generation studies had more equivocal results; they suggest that the efficacy of family intervention as an adjunct to medication in schizophrenia is in part a function of the type and format of the intervention being delivered, the treatment setting, and other variables.     

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.     

RESEARCH IN FAMILY THERAPY: A GRADUATE LEVEL COURSE

Training in family therapy research must move beyond traditional methods courses. This paper describes a five-unit course which (a) reviews the fundamentals of research methodology and grounds the student in the history of psychotherapy research in general; (b) gives an overview of family research through detailed analysis of major review articles; (c) covers instrumentation tools and techniques; (d) critically evaluates key investigations in the field; and (e) examines the challenges of the "new epistemologies" for family therapy research. Learning activities are described for each unit that engage the student in such a way that the learning of research might be enjoyable as well as interesting. The paper may also be employed as a guide for self-study in family therapy research.     

SUPERVISION IN FAMILY THERAPY: A DECADE RESTUDY*1

This paper reports on a 10-year replication of Everett's (1980) survey of Approved Supervisors of the American Association for Marriage and Family Therapy (AAMFT). Significant differences were found between today's supervisors and supervision, including an increase in female supervisors, a shift toward a systemic theoretical orientation, greater concentration of supervisors in formal training settings, a great increase in the use of video recordings, a decline in the popularity of personal psychotherapy as part of training, a greater inclination of supervisors to identify themselves as Marital and Family Therapists (MFTs) regardless of original education, and others. The Approved Supervisor system appears to be fulfilling AAMFT organizational goals; other results will be reported elsewhere.     

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.     

FAMILY RESEARCH AND FAMILY THERAPY: A REUNION?*

This decade is witnessing the re-establishment of research in family therapy as an intrinsic component of the field. It is instructive to recall that family therapy actually had its most significant beginnings in the context of family research in the 1950s and that, three decades ago, family therapy and family research were fundamentally fused. In this paper, several of the most important forms of recent and current family research and family therapy research that are important to clinicians are identified, and it is suggested that this reunion of clinical and research interests signifies a new phase in the growth of the family therapy field.     

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.     

SNARES IN FAMILY THERAPY

Telephone calls after therapy sessions, concurrent individual treatment of family members, the offer of secret revelations, and the use of psychoactive drugs all involve issues and events that can be insidious to effective family therapy. Various tactics are presented which not only succeed in controlling these incidents, but which also use them as important occasions for therapeutic intervention within the model of family therapy developed by Selvini Palazzoli and her colleagues in Milan.     

WORKING WITH MEN IN FAMILY THERAPY: AN EXPLORATORY STUDY*

The results of this exploratory research provide a beginning formulation of a gender-sensitive approach to working with men in family therapy. A panel of 36 family therapists endorsed 131 interventions as appropriate and effective ways to work with men. The results suggest the importance of therapist awareness of gender issues and socialization in working with male clients. Interventions were highly endorsed in the areas of developing therapist perceptual and conceptual skills regarding gender, promoting mutual responsibility, and challenging stereo-typical behaviors and attitudes. Surprisingly few interventions pertaining to structuring treatment and encouraging affective expression in men had sufficient consensus to be included in the final results.     

NURTURANCE: A NEGLECTED DIMENSION IN FAMILY THERAPY WITH ADOLESCENTS*

This paper offers a model for integrating a nurturance framework into family therapy approaches with adolescents. This approach is seen as adding an important but neglected dimension to commonly used approaches, thus increasing both flexibility in treatment and the likelihood of a positive outcome. Steps to an effective treatment approach are outlined and guidelines offered for both in-session work and out-of-session tasks.     

PROLIFIC WRITERS IN MARITAL AND FAMILY THERAPY: A RESEARCH NOTE

Success and promotion within an academic setting depends heavily upon one's ability to publishscholarly work. The "publish or perish" syndrome, and how it relates to marital and family therapy, is of importance to current and aspiring academicians' futures as well as those who wish to impact the field. Research was conducted to identify the most prolific journal writers in the field, and 18 persons were surveyed in order to ascertain how they organized themselves personally and professionally, in order to write productively. The results are analyzed, and recommendations are made regarding the organization of oneself for publishing success.     

USING REPEATED MEASURES DESIGNS IN PROGRAM EVALUATION OF FAMILY THERAPY*

Data from 14 simulated families were analyzed with both a repeated measures and an ordinary analysis of variance design in order to illustrate the differences between the two approaches. The advantages of repeated measures designs for the analysis of family data in the program evaluation of family therapy are highlighted.