BOOK REVIEWS

Book reviewed in this article:
Kirschner, Diana A. and Kirschner, Sam. Comprehensive family therapy: An integration of systemic and psychodynamic treatment models .
Anderson, C. M., Reiss, D. J. & Hogarty, G. E. Schizophrenia and the family .
Efron, Donald E. Journeys: Expansion of the strategic-systemic therapies .
Wynne, Lyman C., McDaniel, Susan H., Weber, Timothy T. Systems consultation: A new perspective for family therapy .
Ulrich, David N. & Dunne, Harry P., Jr. To love and work: A systemic interlocking of family, workplace, and career .
Root, Maria P. P., Fallon, Patricia, and Friedrich, William N. Bulimia: A systems approach to treatment .
Fossum, Merle and Mason, Marilyn. Facing shame: Families in recovery .
Ackerman, Norman J. A theory of family systems .     

PERSONAL CONSTRUCT THEORY AND SYSTEMIC THERAPIES: PARALLEL OR CONVERGENT TRENDS?

Since the constructivist position is progressively being adopted by most of systemic therapies, more attention is being paid to personal meanings. However, an integrative framework is needed to include both systemic and individual phenomena. Kell's Personal Construct Theory (PCT) can provide a significant contribution in this integration. Although PCT and the systemic therapies traditionally have had a different evolution and focus of attention (the individual and the family, respectively), they have profound similarities. First, they share a common epistemological stance-constructivism-in considering that reality is not revealed to us in only one true way but is constructed by the knower. Second, personal construct systems possess the properties described for open systems. Finally, PCT and the systemic therapies hold similar positions on relevant theoretical and clinical issues. From the exploration of these similarities, and from other confluent trends, arise patterns of convergence which can become central for an integrative approach to both individual and family (and larger) systems.     

Studying Circular Questioning “In Situ”: Discourse Analysis of A First Systemic Family Therapy Session

The present article focuses on the study of circular questioning “in situ,” that is, in the context of the discursive arena of an actual first systemic family therapy session. Two typical circular questions are selected, and discourse analysis heavily drawing from the discursive action model is deployed with the aim to highlight their function in the context of therapist and family members' problem talk. The analysis demonstrates the gradual building of two respective patterns, which both exhibit signs of shifts toward the instillment of a systemic epistemology in relation to problem talk: a shift from homogeneity to heterogeneity in family members' voices, which legitimizes the existence of different viewpoints within a system, and a shift from the construction of an accusation toward its deconstruction, which challenges the linear perception of causality underlying the accusation, thus introducing a more circular perspective. Implications are discussed in relation to contemporary, constructionist systemic family therapy practice, and reference is made to the methodological “promises” and challenges of the deployment of discourse analysis for the scrutiny of systemic family therapy therapeutic techniques and tools under a discursively informed light.     

AGAINST THE GRAIN: DECENTERING FAMILY THERAPY

This paper is an interpretive polemic. It has two aims: (a) to clarify the concept of "system" as it is employed in family therapy, and, by doing so, to undermine and call into question the practice that follows from, or is contained within, a systemic perspective,¹ (b) it will offer several suggestions towards the development of an alternative perspective which preserves the idea of system in a social network/diachronic framework. With respect to the first aim, an argument will be made that there are severe and insurmountable problems in attempting to maintain a systemic perspective, that the methodology of analysis is fatally flawed, and that the results of analysis imprisons the therapist in a framework, which though extremely powerful interpersonally, must be rejected as overly authoritarian and overly restrictive in the range of perceptions of social situations allowed. A position will be adopted advocating a move of decentering family therapy to a more peripheral space within a social network perspective. What immediately follows is a redefinition and repunctuation of what can only be considered as a highly problematic paradigm.     

THE INTEGRATIVE PSYCHOTHERAPY ALLIANCE: FAMILY,COUPLE AND INDIVIDUAL THERAPY SCALES*

The therapeutic alliance concept has been confined primarily to the literature on individual psychotherapy. This paper formally introduces the concept into the family and marital therapy domain and presents various clinical hypotheses about the nature of the alliance and its role in familyand marital therapy. A systemic perspective is brought to bear on the concept within individual psychotherapy. A new, integrative definition of the alliance is presented that conceptualizes individual, couple and family therapy as occurring within the same systemic framework. The implications of this integrative-alliance concept for family, couple and individual therapy research are examined. Three new system-ically oriented scales to measure the alliance in individual, couple and family therapy are presented along with some preliminary data on their methodological characteristics.     

Key Systemic Ideas as Seen Through the Eyes of First‐Year Trainees

This article offers an introduction to key systemic ideas as seen through the eyes of first‐year trainees in a postgraduate systemic therapy course. Our aim is to present these ideas in user‐friendly, accessible language, with examples to illustrate their use. The article is organised around three main themes: how a family system gets organised; how systemic work helps to effect change in families; and how a systemic therapist creates a context for change. Ideas covered include circular patterns, processes and questions, feedback loops, the importance of context, the interdependence of meaning and action, taking a meta‐perspective, systemic hypothesising, neutrality, curiosity, second‐order change, use of language and the position of the therapist. The article may be of particular interest to those who are new to systemic ideas, as well as for those involved in providing training in systemic practice.     

THE EVALUATION PHASE OF SYSTEMIC FAMILY THERAPY*

The initial, evaluation phase of family therapy is of decisive importance within the systemic perspective. Contacting a therapist is always a complex action for a family. The therapist's evaluation must include the possibility that continued contact may influence the family negatively and limit their potential for change. If there appears to be a logical context in which continued therapy can be justified, it will be necessary to use the first three or four sessions to collect essential data and to organize them meaningfully. It is essential to clarify the circular interaction that is maintaining the symptom, as well as the presence of specific family structures and traditions, and the kind of relationships the family attempts to establish with the therapist. On the basis of this information, the therapist can build models of the family's functioning. These models, according to general system theory, make possible logical intervention in complicated, living systems, without distorting them by artificially splitting them into their component parts. Two models that are important to our treatment perspective—the phenomenological and the mythical—are presented.     

The Ecological Perspective Revisited*

Family therapy inaugurated a radical change in the way many emotional and psychiatric problems are understood. ‘Systems thinking’ dictated that the individual needed to be seen within a larger systemic context if his/her behaviour was to be understood and effective intervention carried out. The logical extension of this way of thinking is to argue that the family itself must be viewed within a wider context. This perspective has appeared a number of times in the family therapy literature, particularly in the ‘ecological’ tradition. Utilising an ecological perspective can, however, lead to a new and less clearly defined role for the therapist, and there are thus good pragmatic reasons working against its adoption.     

Frameworks for Practice in the Systemic Field: Part 2 — Contemporary Frameworks in Family Therapy

This is the second of two articles to map the landscape of practice theory in systemic family therapy. The first article gave a particular chronology of the development of family therapy practice theory, beginning with the frameworks that emerged in the 1960s‐1970s and then tracing the transitional decade of the 1980s. The convergences of three sets of influences — ecosystemic epistemology, the feminist challenge and postmodernist ideas — led to the changed landscape of post‐1990 practice theory. This second article picks up at this point, mapping four contemporary influential approaches in Australian family therapy — the Milan‐systemic, narrative and solution‐focused frameworks, and the dialogical perspective. Social constructionist and narrative ideas together constitute the dominant common theory influence in the post‐1990 practice frameworks, although intersected and used in different ways in the different frameworks. Throughout the history of the development of practice theory, context and relationship remain the enduring parameters of the systemic family therapy field.     

Enhancing Family Therapy's Relationships With Research

The contention of this article is that systemic family therapy has much to gain from a realistic appraisal of its research base, which is as positive as possible. And that through such an appraisal we can find ways of developing the scope of family therapy to the benefit of the profession and thereby, of our clients. Family therapy will benefit if practitioners can present an informed view of research. As a preliminary approach to this objective, I review reasons why perceptions of family therapy underestimate its research base, and why therapists might resist involvement with research. The article then explores the reasons for regarding randomised controlled trials as a ‘gold standard’, and why they are not well fitted for the purpose of evaluating or developing a relational therapy. Next is a consideration of alternative approaches to research, including a consideration of what clients actually want from their therapy, then a brief review of the positive findings of outcome research. Greater emphasis on researching processes in therapy is proposed, and consideration of the ‘common factors’ debate is shown to support priorities that are specific to systemic therapies. The article concludes with suggestions for increasing the involvement of family therapists with research, both as consumers and as research practitioners.     

Transitions to Systemic Practice for a Clinical Psychology Trainee

This article provides an individual perspective on encounters with systemic and family therapy ideas during the transition from university training to professional practice as a Clinical Psychology Registrar. Clinical psychology training provides a solid grounding in individually focussed, cognitive and behavioural models of psychotherapy. What may be less developed on entry to practice are the knowledge, procedural skills and reflective competencies needed to understand and respond to challenges in family‐based therapy and in working within complex caregiving systems. Systemic ideas can provide important resources for facilitating these transitions. Trainees may need support not only in gaining knowledge of family therapy models, but also in making a challenging ‘epistemological shift’ (Cullin, 2014) from internalised models of psychopathology to systemic ways of thinking about problems and change. Systemic concepts and support in developing a position of ‘hospitality’ (Larner, 2003) towards competing therapeutic models can also help the trainee be more effective in complex caregiving environments. This article provides examples from my learning as well as reflections on what may help trainees make the transition to professional practice and make use of systemic ideas.     

FAMILY SYSTEMS THERAPY AFTER OPERATIONS DESERT STORM WITH EUROPEAN-THEATER VETERANS

We describe a quasi-experimental trial of time-limited family therapy with veterans and families of veterans who served in Europe, outside the war zone, during Operation Desert Storm (ODS). Family systems therapy was provided both to individuals and conjointly to couples or families during the acute postwar readjustment period. The intervention adapted strategies from structural, strategic, intergenerational, and behavioral family therapies in a brief-treatment protocol for systemic stressor resolution. Veterans given family system therapy were able to resume functional levels of psychosocial adjustment and reduce the risk of long-term (Chronic or delayed) psychosocial impairment. Based on these preliminary findings, controlled evaluation of family systems therapy appears warranted for indi-     

Frameworks for Practice in the Systemic Field: Part 1 — Continuities and Transitions in Family Therapy Knowledge

This is the first of two articles to map the landscape of practice theory in systemic family therapy. In this first article, the representation of knowledge for practice is explored, and an argument is made that while frameworks remain important, the relationship to them is now more conditional and pragmatic. A particular chronology is offered of the development of family therapy practice theory frameworks, beginning with the frameworks that emerged in the 1960s to the 1970s. An analysis is given of the important transitions in the 1980s and three sets of influences in this decade — ecosystemic epistemology, the feminist challenge and postmodernism — are identified. This reading emphasises hidden continuities in the transition, despite the seemingly discontinuous shifts in practice theory from the beginning of the 1980s to the beginning of the 1990s. Context and relationship are identified as the enduring parameters of systemic family therapy knowledge, though understandings of context and relationship have been recast in the contemporary (post‐1990s) practice theory. The second article will explore the four contemporary influential approaches in Australian family therapy — the Milan‐systemic, narrative and solution‐focused frameworks, and the dialogical perspective — and point to intersections in practice ideas and integrative movements.     

PSYCHOTHERAPY WITH LESBIAN COUPLES: INDIVIDUAL ISSUES,FEMALE SOCIALIZATION,AND THE SOCIAL CONTEXT*

Relationship patterns in lesbian couples vary systematically from relationship patterns in heterosexual couples in ways that are related to the exclusively female composition of these couples, their stigmatizable identity, and the lack of social recognition and acceptance for such family units. These patterned differences are addressed from a systemic perspective in five arenas: distance regulation and boundary maintenance, sexual expression, financial arrangements, breaking up, and stage differences in coming out and acceptance of lesbian identity.     

The Conversational Model and Child and Family Counselling: Treating Chronic Complex Trauma in a Systemic Framework

Child and Family Counselling Teams in NSW Community Health Services are expected to provide therapeutic services to children who have experienced complex trauma. However, parental trauma is often overlooked or referred elsewhere. A systemic perspective informed by attachment theory and trauma theory provides the basis for addressing parental trauma in Child and Family Counselling Teams, thereby improving parenting. The Conversational Model is an evidence‐based intervention for chronic complex trauma. The foundations of the Conversational Model and its brief component, Short Term Intensive Psychodynamic Psychotherapy, are outlined and a case study is given to illustrate the usefulness of the intervention in Child and Family Counselling. Highlighted is the importance of addressing systemic trauma through parenting to improve attachment quality, family relationships, and children's function.     

ECLECTIC STRATEGIC PRACTICE: A PROCESS CONSTRUCTIVE PERSPECTIVE

The development of an integrative individual and family therapy approach has been hampered by fundamental differences in philosophy and theoretical conceptualization among approaches. Given these largely irreconcilable differences systemic framework for a technical eclecticism may represent a logical step toward a more flexible consideration of both individual and family approaches. This article will describe an extension of the strategic therapy model that enables and encourages the selective application of content and techniques from individual and family approaches. Three case examples will illustrate a process-oriented, constructivist rationale for eclectic strategic practice as well as a more collaborative and relationship-oriented perspective of strategic therapy.     

Adolescent Violence: A Systemic and Feminist Perspective

In writing this paper I want to locate adolescent violence toward family members firmly within the spectrum of family violence, including spouse abuse, child abuse, and elder abuse. To call violence of this sort ‘challenging behaviour’, or to see it as ‘delinquency’ is to locate it outside this spectrum, where it is less subject to scrutiny from a systemic and feminist perspective. This paper looks at the relevant literature on adolescent violence, and attempts to develop family therapy theory in this difficult area. It is a companion piece to Marni Sheehan's more practice-focused paper in this issue.     

Feminism and Beyond: Interview with Carolyn Quadrio

In interview with Kasia Kozlowska, Melbourne‐born psychiatrist Carolyn Quadrio describes the impact of growing up in a Greek migrant family, the significant influences on her choice of profession, and the ways in which she gradually developed a feminist position simultaneously with embracing a systemic perspective on ‘depression’ and other diagnostic categories. Quadrio talks frankly about her challenges to the male‐dominated psychiatric establishment, her struggles to get her critique of it published, her excitement about the family therapy field, and her later disillusionment with it. Her current work is in the area of forensic psychiatry.