Exploring changes in family functioning when a child participates in a School-Based Filial Therapy program

Child focus is a central construct within Bowen family systems theory (Bowen theory). A clinical implication is that mental health treatment focusing on a child may unwittingly reinforce the operation of child-focused processes, which undermine rather than enhance child well-being. The concept of child focus in Bowen theory presents significant implications for professionals working in school settings and in fields such as children's mental health, which are inherently child-focused. Bowen theory is the guiding theoretical framework for School-Based Filial Therapy (SBFT). SBFT is a play therapy intervention that was initially established in remote and outer-regional New South Wales, Australia in response to the low availability of children's mental health services and the significant barriers associated with caregiver engagement in children's mental health treatment. It involves trained school personnel facilitating therapeutic play sessions with children experiencing emotional–behavioural problems. The intervention occurs on school grounds, during school hours, and children's family members do not participate in the intervention. This mixed-methods study examines the impact of children's participation in SBFT upon family functioning. Interviews with caregivers (n = 10) of children who participated in 10 SBFT sessions were analysed using content analysis. Quantitative data were collected using the Differentiation of Self Inventory – Short Form and Visual Analogue Scale – Family Functioning. A Wilcoxon signed rank test was used to analyse the pre- and post-data. Qualitative outcomes indicated changes in the categories of child functioning, caregiver functioning, and extended family functioning, whilst child-focused processes remained dominant but changed in intensity and valence following SBFT.     

Separations: A Personal Account of Bowen Family Systems Theory

This paper is a personal account of my own family of origin research. It explores the impact of separations from parents, nuclear family, and extended family through a Bowen family systems theory perspective using concepts pertaining to Bowen theory such as chronic anxiety, differentiation of self, multigenerational family process, and the emotional system. An outline of the process of doing research in ‘vivo’ with my mother as well as conversations with my supervisor are included. Theoretical differences between individual and system models are discussed. A Bowen theoretical approach to the anxiety of separations is investigated. The efficacy of engaging in family of origin work and the effects of thinking systems is examined in light of how it assisted me to view family members, family system disturbances, and clients’ emotional systems more objectively.     

Sometimes Words Just Ain't Enough – Enhancing the Contribution of Children in Therapy through Creative Expression

The meaningful inclusion of children in family therapy is an ideal that therapists readily align with and yet struggle to implement effectively. Within a practice that relies heavily on verbal expression, young children provide a unique challenge for therapists, who require developmentally appropriate opportunities for the child to express, document, and share his or her experience in all its richness and colour. In this paper the author utilises art therapy to support greater inclusion of children in family therapy by capitalising on their creative talents and facilitating the child's visual story within the family dialogue. This can assist in the formulation and treatment of systemic issues.     

Making sense of the parenting ‘soft/hard split’

This paper explores the common parenting style tension around nurture versus limit-setting often evident when working with families with a symptomatic child. Firstly it will delve into the parenting ‘soft/hard split’ with an overview of the literature on parenting styles. Next, it summarises the appearance of this phenomenon in the family therapy literature during its formative days, noting how Bowen, Minuchin, Haley, MRI (Bateson), and the Milan associates respond to this parent presentation in their approaches. Next, the paper outlines recent iterations of these family therapy interventions. An expanded discussion follows on Bowen theory's understanding of the parenting tension triangle. The article then outlines elements of the author's qualitative research study of parents' experience of adolescents' mental health treatment where the ‘soft/hard split’ emerged as a repeating theme. Finally, a clinical intervention based on Bowen theory, the Parent Hope Project, is outlined for how it addresses the parenting ‘soft/hard split.’ The goal is to contribute to understanding this phenomenon and its implications for clinical practice.     

Interview With Michael Kerr

The following article was written by Dr Michael Kerr in response to questions put to him by Barbara Fraser; Linda Mackay and Lu Pease when he visited Australia two years ago. These three family therapists took it upon themselves to prepare this interview in recognition of Dr Kerr's unique vantage point on Bowen Theory and family therapy. Michael Kerr was trained by Murray Bowen in the 1970s and subsequently went on to work as faculty at the Georgetown Family centre. He succeeded Bowen as director of the centre where he has devoted his professional life to the understanding, application and extension of theory. He is the co‐author with Dr Bowen of Family Evaluation: An Approach Based on Bowen Theory (Kerr & Bowen, 1988), which remains the most esteemed text on this theory. He is also the editor of Family Systems: A Journal of Natural Systems Thinking in Psychiatry and The Sciences. Bowen's Family Systems Theory grew out of years of research from the 1950s‐1970s, which included observations of inpatient families with a schizophrenic member and using data from Bowen's own interactions with his family of origin (Bowen, 1978). The theory continues to be influential in family therapy with its most well‐known contributions being the process of triangling, the intergenerational transmission of family patterns and the concept of differentiation of self. (Brown, 1999). The following discussion from Dr Kerr brings a fresh perspective on the current applications and developments of this systems theory     

Family-based approach to the child welfare system: an integration of Bowen family theory concepts

The purpose of this article is to apply Bowen family systems theory to work with families involved in the child welfare system. An overview of family systems theory is provided, and then specific tenets of Bowen family systems theory are presented. The authors highlight incidents within the child welfare setting that can be conceptualized through Bowen family therapy terms and concepts. A case study is used to highlight how this theory could be applied in practice. Furthermore, recommendations for child welfare practice and policy implications are discussed, utilizing the lens of a Bowenian family systems approach.     

Assisting the Two‐person System: An Approach Based on the Bowen Theory

The Bowen theory, developed by Murray Bowen, views the family as a natural system of relationships. This paper reviews basic concepts of the Bowen theory and describes their role in guiding the clinical approach to the disturbed two‐person relationship.     

Collaborative Approaches to Family Systems Supervision: Differentiation of Self

Many systems approaches speak to the importance of respectful mutual curiosity in supervision rather than linear teacher–learner didacticism. This paper provides an overview of collaborative approaches to supervision in family therapy. It then focuses on Bowen family systems and encouraging differentiation in the relationship process between supervisor and supervisee as a useful approach towards equal collaboration. The authors use case examples to illustrate what impedes and fosters mutuality in the supervision process where both supervisor and supervisee learn from each other.     

Family Therapy for a Korean Son with Schizophrenia

In recent decades the treatment of schizophrenia has focused primarily on pharmacotherapy with an emphasis on respite for family caregivers, support groups, and compliance regimens to sustain and maintain the affected client and family members. The use of family therapy models to intervene effectively with families affected by a diagnosis of schizophrenia is less common in the professional literature. This case study draws on the Mental Research Institute's communication theory and Bowen Family Systems Theory in therapeutic work with a Korean family.     

La metafora: the power of metaphors and creative resources in working systemically with families and children with autism—a conversation with Carmine Saccu

Metaphors are valuable tools of expression, which give meaning to situations and allow the spontaneous processing of feelings and emotions. As therapists, we can support clients to develop and create their individual metaphor to explain their own meaning of experiences or communicate their perception of problems. Creativity provides us with a rich landscape to explore, expand, and enrich ourselves as therapists and consequently our clients. As systemic therapists, we are responsible for the co-creation of a human process, which has at its core safety in allowing expression, connection, and movement. Through a respectful and curious approach, we can develop pathways to tap organically into our ‘creative selves’ while reaching into our clients' creativity and selves as catalysts for connection and positive change. Creative resources and therapies have been successfully used in psychotherapy to enhance the mental and emotional well-being of children, particularly children with autism who have limited verbal capacity or who are non-verbal. These children also wish to be understood in expressing their thoughts and feelings; however, they use other methods of communication – sometimes obvious, sometimes not. Therefore, it is important that a therapist can access diverse ways to support the child through this process. The creative use of animals in therapy neutralises spaces, eliciting calm, safety, and healing. This is particularly the case when working with this group of children. This paper is derived from my conversation with an elder statesman of the family therapy profession, Professor Carmine Saccu. He is a jovial master storyteller who craftfully communicates via metaphors. Through creative means, play, and humour, he has developed a remarkably unique way of working with children, especially non-verbal children with autism. He uses his canine, co-therapist Mafalda, as a powerful resource and intervention strategy to safely elicit engagement and connection in the therapeutic space.     

Integrating Art Therapy Methodology in Brief Inpatient Substance Abuse Treatment for Adults

ABSTRACT

Decades of drug addiction research and clinical work have underscored the need for multifaceted and comprehensive treatment responses in order to sufficiently address the varied needs of individuals struggling with addiction. One valuable treatment component that can be incorporated into traditional treatment protocols to expand the comprehensive nature of treatment response is art therapy. A conceptual framework is presented, detailing the integrative opportunities and benefits of including an art therapy component to short-term hospital-based inpatient substance abuse treatment programs. A creative arts component can be particularly beneficial for brief inpatient programs, where the client population is diverse, in crisis, and at high-risk for relapse; and where clinicians need to obtain comprehensive client information from multiple sources in a short amount of time. Art therapy methodology can provide a mechanism for collecting such collateral information for assessment purposes, can be employed to facilitate therapeutic change, and is used to track and document client progress and clinical change over time. Practice guidelines and specific treatment techniques are presented through short case examples.     

Differentiation of Self and the Process of Forgiveness: A Clinical Perspective for Couple and Family Therapy

In this article we explore the role of differentiation of self in facilitating forgiveness in the context of couple and family relationships. Differentiation is defined from the Bowen perspective as the ability to connect with others without being excessively emotionally reactive to the ebb and flow inherent in all significant relationships (being able to connect to others yet also being able to self‐regulate). Forgiveness is described as the releasing of an emotional injury via a complex psychological and relational process that is less an act of will than a discovery or possibility through understanding and empathy. Differentiation of self is related to emotional intelligence and empathy. The developmental and relational benefits of such are illustrated and discussed. A rationale for viewing differentiation and forgiveness in a contextual, historical, and relational attachment paradigm is suggested. Relevant clinical cases illustrate the dynamics of differentiation and forgiveness as discovery in the context of an understanding and empathic relational environment.     

The Family Movement,Bowen Theory,and Theoretical Medicine: A View from the 21st Century

Important changes have occurred in the family movement in the United States since it emerged in the mid‐1950s. Psychiatry supported the movement in its early years, but that changed as psychiatry abandoned the biopsychosocial model and adopted the biological paradigm through the 1970s. This development pushed family and other therapies to the periphery of the discipline. Medicine is dominated by the biological paradigm and cause‐and‐effect thinking. The roots of the medical model go back to Pasteur. In contrast, psychiatry in the United States had been dominated through the 20^th century by psychoanalytic thinking, which rendered the discipline a step‐child to medicine. This and other factors pushed psychiatry to get biological. The change generated a ‘failure of nerve’ in the family movement, abandoning the role of the family in schizophrenia in the face of psychiatry's assertion that all serious mental illnesses had nothing to do with the family. Other important changes separating the family movement from psychiatry occurred as well. Bowen theory is anchored in biology and evolution, but it is not a biological paradigm. Maintaining solid connections to the scientific disciplines are important for keeping the theory an open system. The recent emergence of systems biology and systems medicine could challenge psychiatry's allegiance to the biological paradigm and bring family systems theory centre stage in the discipline. These new disciplines may also arrive at a systems theory of the individual that can be integrated with family theory, powering a paradigm shift in medicine as a whole.     

Specific Cases,Techniques and Approaches: Talking Pictures in Family Therapy

This article presents a case study on the use of arts‐based resources in family therapy to help children and their post‐separation families describe their experience, communicate and collaborate with each other, witness and learn about each other, and develop their individual and family well‐being.     

Self‐Soothing — A Recursive Intrapsychic and Relational Process: The Contribution of the Bowen Theory to the Process of Self‐Soothing

The concept of self‐soothing originating in the psychodynamic tradition has attracted interest from therapists as a key skill in the managing and regulating of strong affect and emotional discomfort. While a capacity for self‐soothing is implicit in, and a vital prerequisite to, the process of differentiation, Murray Bowen also predicted that the outcome of increased differentiation is improved emotional equilibrium and a capacity for self‐soothing, clearly a recursive process. The attention of Bowen family systems theory to both the relational and intrapsychic aspects of human functioning provides a useful framework through which to explore these aspects of the dynamics of self‐soothing. This article describes some of the key processes involved in developing a self‐soothing capacity within an effort to define a more autonomous self in significant relationships. The author contrasts Family Systems thinking with other theoretical perspectives that speak to the importance of self‐soothing. Finally, the role of the therapist as a facilitator of an environment in which the self‐soothing resources of clients can emerge is considered alongside suggestions and strategies for how a therapist may contribute to a client's own efforts.     

International Women's Day: Art project for young women

Abstract

The primary aim of the project was to provide the opportunity for a marginalised group of young women to participate in International Women's Day with other women and members of the community and to have the opportunity to express themselves and aspects of their lives in art work on ceramic platters. The target group were ‘homeless, transient and at risk young women from 18 to 25 years of age, including Koori women’, engaged mainly through local homeless youth agencies in the Port Phillip area in Victoria. It was thought that many of this target group had been left out of formal support service provision. The project was evidently a success, both in terms of its modest aims and, most importantly, as evaluated by the participants themselves. Those interviewed expressed greater feelings of social connectedness - particularly with other women, raised self esteem and optimism and a new found enjoyment in the creative process.     

Nothing is as Practical as a Good Theory: Bowen Theory and the Workplace — a Personal Application

Bowen Family Systems Theory is most commonly used to understand and predict family process. It is also applied to other potentially intense relationship systems, especially the workplace. It has been used by workplace consultants and by individuals to understand, and to manage, their own workplace functioning. This paper will draw from several key Bowen concepts to analyse common workplace dilemmas and to suggest responses that may assist the functioning of the individual and the system. The author's own experience as a manager in a child and adolescent mental health programme will be used as the case study to illustrate the theory's application.     

Developing Family Therapy Skills on a Shoe String Budget: A Peer Supervision and Training Approach

Family therapy skills are an essential tool when working with young children and their families, yet accessing family therapy training and supervision in workplace settings has become more difficult. Skills enhancement may be obtained through formal training in accredited courses, a costly undertaking, in which clinicians most often carry the entire cost for the training. In this paper, we propose that specific family therapy skills relevant to working with families of young children can be developed within a peer group format. The peer training described in this paper is extremely cost effective, easy to set up, specifically tailored to our unique training needs and the characteristics of the population of families we are working with. Further, the training allows us to develop fresh and creative ways of skills acquisition, our own ‘curriculum’, with flexible use of training techniques, depending on our particular needs at a given time. We conclude with some of the disadvantages of the model and propose ideas for future development.     

Interactive Family Music Therapy: Untangling the System

Interactive Family Music Therapy can have a unique role to play when working as part of a multidisciplinary team by demonstrating a capacity to ‘surprise’ a client/patient when they least expect it. It provides a positive shared experience that can add to multidisciplinary assessment and treatment planning. This article will illustrate the role Interactive Family Music Therapy has at Redbank House and includes case material.     

All in the family: a belated response to Knudson-Martin's feminist revision of Bowen theory

The first formal attempt at revising Bowen theory within the marriage and family therapy literature is represented in the work of Knudson-Martin (1994). Claiming that several of the theory's concepts are defined at odds with female development, Knudson-Martin (1994) reconceptualizes and expands Bowen theory to rectify these perceived shortcomings. In turn, we address several fundamental concerns with Knudson-Martin's critique and revision of Bowen theory. An alternative representation of Bowen Theory, as well as its relationship to feminist thought, is put forth. Suggestions for the field's future relationship to Bowen theory are also discussed.