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.     

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.     

OBJECT RELATIONS AND THE FAMILY SYSTEM IN BULIMIA: A THEORETICAL INTEGRATION

This paper presents an integration of object relations theory and family systems theory in the conceptualization of bulimia. It is based primarily on Winnicott's construct of the maternal "holding environment," and Klein's formulation of ego deficits at the level of part-object relations, as they apply to the family as a whole. We propose that in bulimic families there are transgenerational developmental deficits and adaptations which determine the level and quality of intrapsychic experience within individuals, as well as the interpersonal relationships and dynamic functioning of the larger family system.     

THE ROLE OF THE MENTAL HEALTH PROFESSIONAL IN CONTESTED CUSTODY:

Two different roles for mental health professionals in contested custody cases are presented. The first, the evaluator of competence model, is the more traditional one; its underpinnings are individually-oriented concepts: the clinician is a diagnostician and evaluator, making a recommendation to the court, and the family's input in the decision-making is minimal. The second role, a facilitator of change, comes out of family therapy theory; its focus is on helping the family to change and resolve their issues so that custody can be decided fairly: it is evaluative only secondarily, that is, if the family is unable to resolve the dilemma themselves. When working with contested custody cases, which are really unresolved family problems, the second approach is more promising.     

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.     

CRITIQUING THE NEW EPISTEMOLOGIES: TOWARDMINIMUM REQUIREMENTS FOR A SCIENTIFIC THEORY OF FAMILY THERAPY*

The purpose of this paper is to critically analyze the structures of the new epistemologies. Epistemology is a technical term within the field of scientific philosophy. When it is used looselyby family therapists, confusion results. The central argument of the present author is that the new epistemologies are, in fact, weak theories. It is suggested that the practice of using the term “epistemology” to denote theory or paradigm, be discontinued. A more limited and narrowly defined use for the term “epistemology” is proposed. Specifically, this paper presents: (a) a discussion ofthree areas of philosophy that serve as foundations for the construction of scientific theory, (b)a critical analysis of the new epistemologies, (c) a logical structure for scientific family therapy theory, and (d) minimum requirements for a scientific theory of family therapy.     

EXAMINING THE MULTIFACETED NOTION OF ISOMORPHISM IN MARRIAGE AND FAMILY THERAPY SUPERVISION: A QUEST FOR CONCEPTUAL CLARITY

The notion of isomorphism has been recommended as a comceptual framework to guide the practice of marrige and family therapy (MFT) supervision. The term is frequently cited in the MFT training literature but is often used in different ways. A panel of MFT supervirors rated the impotance and relevance to both therapy and supervision of a large pool of variables. The majority of variables were found to be a equally relevant or isomorphic to the domains of MFT and MFT supervisoin. A qualitative interview with a small subset of the panelists suggested that the concept, to varying degrees, has influenced their work as supervisors. The implications of the results for theory development, research, and supervisory practices are discussed.     

TAKING IT PERSONALLY: ISSUES OF PERSONAL AUTHORITY AND COMPETENCE FOR THE FEMALE IN FAMILY THERAPY TRAINING*

The supervision and training of women requires thinking and planning about how to address issues women bring to the training process as a result of sex-role typing. Dependent behavior and attitudes are interactional problems that need to be overcome in a training process that leads to competency and creativity for therapists. Strategic supervision can benefit women by increasing their self-reliance, sense of personal authority, and competence.     

THE DEVELOPMENT OF A RELATIONAL ETHICS SCALE*

In order for empirical testing to be performed systematically on family therapy theories, appropriate testing instruments must be developed and validated. The purpose of this study was to develep a reliable and valid scale for measuring the related constructs of relational ethics as described in contextual family therapy (Boszormenyi-Nagy & Krasner, 1986). Presented here is the five-stage procedure used in development in Relational Ethics Scale, data supporting the validity and reliability of the scale, and the final version of the instrument.     

USE OF FAMILY IN THE TREATMENT OF SCHIZOPHRENIC AND PSYCHOPATHIC PATIENTS*

Editor's Note. Occasionally, the Journal of Marital and Family Therapy will publish papers of major historical significance to the field of family therapy which, though written long before their appearance in the Journal, have remained unpublished and received little public circulation or attention. Such papers are those which, in the view of the Editor, would have been certain “classics” in the literature of family therapy had they been published when they were written, and which, despite their overdue appearance, are of significant enduring value. The first of these papers, by Dr. C. F Midelfort, appears here. Though essentially isolated from the family therapy movement that was soon to follow, Dr. Midelfort, in fact, published the first book on family therapy. The present article grows out of what was probably the first paper on family therapy ever presented at a psychiatric convention in the United States. In this paper, originally written almost exactly thirty years ago, Dr. Midelfort articulately presents a creative interweaving of an appreciation of the psychodynamics of family relationships with an ego-oriented family approach to severe psychiatric disturbance in one family member. It is an innovative presage of the flexible use of the principles of family dynamics, social psychiatry and biological psychiatry that has been “discovered” only very recently in family therapy with schizophrenics. The paper is introduced by Dr. John E. Bell, to whom the Journal is grateful for bringing it to light.     

ARE TRUSTWORTHINESS AND FAIRNESS ENOUGH? CONTEXTUAL FAMILY THERAPY AND THE GOOD FAMILY

The moral dimension of family therapy theory and practice has received increasing attention in recent years. Boszormenyi-Nagy was among the first to see that family therapy and moral questions are inseparable. His focus on relational ethics has helped us to reappropriate individual responsibility and accountability within a systemic context. Although contextual therapy has clearly enriched the field, we argue that its emphasis on trustworthiness and fairness provides a limited view of the good in family life and leads to three related problems. First, Boszormenyi-Nagy offers a compelling ethical vision of the family and then denies that he has done so, which undermines some of his key moral claims. Second, because fairness is defined subjectively, contextual therapy may not have the resources to deal with legitimate differences in family ideals. Third, the reliance on self-interest as the primary motive for trustworthy relating appears to be self-defeating. We offer a hermeneutic perspective that takes a broader approach to the good. It places greater emphasis on the social and historical context, deals squarely with different understandings of the good in family life, and recommends an approach to resolving these differences.     

PERSONAL AUTHORITY VIA TERMINATION OF THE INTERGENERATIONAL HIERARCHICAL BOUNDARY: PART II—THE CONSULTATION PROCESS AND THE THERAPEUTIC METHOD

This paper is by way of a continuation of the definition of the theoretical position on the termination of the intergenerational hierarchical boundary, presented earlier (Williamson, 1981). That paper argued that this termination requires "a radical renegotiation of the power structures in the relationships between the two generations, and in the interactional political patterns which ensue from these." This paper reports on and describes a therapeutic methodology for securing and completing such a "radical renegotiation." It is implied that this therapeutic procedure has widespread applicability to the resolution of behavioral problems.     

THE LEGACY OF AIDS: CHALLENGE FOR THE NEXT CENTURY

AIDS presents an unprecedented challenge for family therapists. A method of response is suggested involving three stages of therapy: (a) dealing with the crisis of disclosure; (b) interacting with larger systems; (c) working on family relationships and the grieving process. Countertransference issues which threaten to disrupt this three-stage therapeutic process are discussed.     

PERCEPTIONS OF MARRIAGE AND RATIONALITY BY LEVELS OF PERCEIVED HEALTH IN THE FAMILY OF ORIGIN*

The family therapy field has witnessed a beneficial dedication to the study of the transmission of pathology (Mueller & Pope, 1977). Of late however, there is a concern that pathology has been overly stressed (Stachowiak, 1975). It is perhaps with this overemphasis in mind, and that the absence of pathology does not necessarily equal health (Kleiman, 1981), that researchers have recently pursued the study of family health (Olson, Russell & Sprenkle, 1983; Walsh, 1982). The concept of family health has particular significance when considering the family of origin. Bowen (1978) and Framo (1981), in particular, have described the transmission of pathology from one generation to the next. It is less clear, however, whether health follows a similar transmission process, although the notion seems appealingly logical. Anderson (1981) pointed to the dearth of investigations studying the consequences of health in the family of origin and offspring characteristics. This study addresses these concerns by investigating the extent to which subjects' rational thinking and perceptions of marriage are associated with their level of perceived health in their families of origin.     

STAGES OF FAMILY INVOLVEMENT IN THE RESIDENTIAL TREATMENT OF ADOLESCENTS

A strong case has been made in the literature that the effective treatment of adolescents in long-term psychiatric hospitals or residential treatment centers must include treatment of the family. This highlights the need for a family treatment model that integrates a long-term psychodynamically oriented residential treatment approach with family systems theory. Such a model must take into account the stages of inpatient treatment and must address therapeutic management of the physical, emotional and psychological aspects of separation between the adolescent and the family. A bridge between family systems theory and psychoanalytic theory can be found in object relations theory. A four-stage model for working with families having a hospitalized adolescent member is described in which each stage builds upon the previous one. Progress through the stages depends upon the establishment of a relationship in which the family perceives the hospital as supportive, nonjudgmental, helpful and trustworthy.     

THE EFFECTIVENESS OF FAMILY THERAPY IN THE TREATMENT OF ADOLESCENTS WITH CONDUCT DISORDERS AND DELINQUENCY

A literature review was conducted on recent studies using family therapy approaches to the treatment of conduct disorders in adolescents. Results from studies conducted since the Shadish et al. (1993) meta-analysis on the effects of family and marital therapies are included. Barriers to effective treatment are identified, costs of care are discussed, and a variety of systems of care in which family interventions are embedded are reviewed.     

THE FEMINIST CRITIQUE IN EPISTEMOLOGICAL PERSPECTIVE: QUESTIONS OF CONTEXT IN FAMILY THERAPY

Family therapy's neglect of social context as a factor in its continuing distortion of women's issues has led feminist critics to wonder if systems-based psychotherapy truly serves women. Rather than heralding the demise of family therapy, however, the feminist critique is here taken to open up concerns central to the epistemological discussion underway in the field. At first, these have to do with the functions of "punctuation,""boundary" and "closure" in systemic epistemology. Later, the central question becomes that of the place given to context in systems epistemology generally, as well as family therapy in particular. Several implications of a more lively interest in context for family therapy's work are explored. These are discussed with respect to women's issues, clinical epistemology, and the challenge to raise novel questions in family therapy.     

INDIVIDUATION FROM THE FAMILY OF ORIGIN AND PERSONAL ADJUSTMENT IN LATE ADOLESCENCE

The present study explored the relationships between late adolescents' self-reported personal adjustment and individuation from their families of origin. Individuation was defined as adolescents' subjective perceptions of how psychologically enmeshed they were in the transactional processes of fusion and triangulation within their families of origin. The results indicated a significantrelationship between adolescents' perceived involvement in their family's patterns of fusion and self-esteem, mastery, college maladjustment and the number of reported health problems. Perceived involvement in the family triangulation process was significantly related to adolescents' perceptions of self-esteem and mastery. The implications of the study's findings and directions for future research are discussed.