What's the Use of Family Therapy?

This paper, a plenary address to the Australian Family Therapy Conference, is concerned with the role of family therapy in society and the abuse of professional power. It is argued that family therapy is part of the medicalisation of marriage and the family, through which problems are defined — often inappropriately — as relationship problems and experts (therapists) are created. Aspects of professional power are identified; its pursuit is not in the interests of families, especially those with greatest needs. Proposals to tackle these obstacles are made regarding practice and training in therapy, and the management of professional power.     

Transcultural Therapy with Aboriginal Families: Working with the Belief System*

A framework for conducting transcultural therapy with families is considered. This emphasises the importance of developing cultural sensitivity, competence, and the role of cultural consultants. The paper then applies this framework to Aboriginal families. The author explores the indigenous belief system about health and healing, demonstrating the importance of body, land and spirit to the Aboriginal people. Continuity and change in belief and health practices are then traced from the traditional setting to the mission or reserve and urban setting. A case study demonstrates how to work with this belief system and provides practical recommendations for family therapists. On a broader level the paper demonstrates the compatibility of systemic thinking to the Aboriginal world view and draws from the literature of transcultural psychiatry, geography, medical anthropology and family therapy.     

User Involvement in Therapy: Couples' and Family Therapists’ Lived Experiences with the Inclusion of a Feedback Procedure in Clinical Practice

User involvement in therapy includes some form of feedback from the clients. The feedback guides the therapist and the clients toward a best possible result through a best possible therapy process. In recent years many different procedures for collecting feedback have been developed. In a previous study presented in this journal we explored the expectations therapists had before including the comprehensive clinical feedback procedure, Systemic Therapy Inventory of Change (STIC), in their clinical practices. Our aim with this present study is to explore couples' and family therapists’ experiences with STIC from the perspective of user involvement. We found that the term ‘using STIC’ represented many different variations both between therapists and between the families each therapist worked with. Likewise user involvement, combined with a feedback procedure like STIC, was also a many faceted area. We discuss how therapists’ experiences may relate to the different aspects of user involvement in therapy.     

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.     

Clients’ perceptions of marriage and family therapists’ way‐of‐being: a phenomenological analysis

Previous research highlights the influence of therapist factors on treatment outcomes. One therapist factor proposed as fundamental to the process of therapy is the therapist's way‐of‐being, a relational concept that refers to how the therapist regards a client—either as a person or object (Fife et al., [2014] Journal of Marital and Family Therapy, 40, 20–33). Although this case has been made conceptually, there is little empirical research on therapists’ way‐of‐being with clients. The primary purpose of this research is to investigate clients’ perceptions of their therapists’ way‐of‐being. Utilizing a common factors perspective, the study seeks to explore: (a) how clients experience their therapists’ way‐of‐being and (b) the influence therapists’ way‐of‐being has on clients’ engagement. Phenomenological methods were used to gain a nuanced understanding of the phenomenon. Qualitative data were collected through semi‐structured face‐to‐face interviews with clients (N = 10) who received individual therapy from a marriage and family therapist. Results were organized into two main themes: core tenets (attunement, congruency, and aligning with clients) and operational tenets (providing affirmation and validation, balancing flexibility and structure, and accomplishing goals). Findings are used to make a case for adding the concept of way‐of‐being as an overarching construct for several well‐established therapist factors. Clinical and training implications are discussed.     

Expanding Systems Thinking: Incorporating Tools from Medical Sociology into MFT Education and Research

The field of marriage and family therapy has historically focused on dynamics within family systems, and at times the role of social and cultural factors external to the family. To date, however, little scholarship has examined how therapists themselves are embedded within a mental healthcare system. The purpose of this article is to demonstrate how structural components of the mental healthcare system shape the practice of therapy. We draw from the field of medical sociology to illustrate how three dominant structures—managed care, diagnosis, and evidence‐based models—are intertwining and mutually reinforcing systems that have significant and long‐term implications for systemic therapists and researchers. We recommend incorporating a sociological understanding of such structures into MFT education and research.     

A Thematic Guide To Bulimia Nervosa

This article offers a thematic guide to bulimia nervosa for both therapists and clients. It explores the relationship of common themes — developmental, interactional, sociocultural and behavioural — to the central issue of control. It uses examples from therapy sessions to highlight the themes as they emerge in therapy and to illustrate the ways in which the problem may be addressed.     

Public Participation: Moving Beyond the Four Walls of Therapy

Family therapists have an ethical responsibility for public participation, to work toward creating a better society. Serving the public interest and developing laws to promote the profession and the public good can be achieved through policy advocacy and political participation. Political and policy work are important but overlooked aspects of family therapy, which is significant given the consequences differing policies have for clients and the profession. This paper reports on results from a random, national survey of licensed family therapists’ (N = 174) advocacy actions. Findings indicate family therapists have overarching policy concerns yet lack proactive legislative and activist engagement. The exploration of therapists’ actions and beliefs presented in this paper, serves as a springboard for therapists’ movement into the public arena. Video abstract accessible by clicking here .     

Degradation of the Word or the Adventures of an Intelligent in Viktor Pelevin’s Generation II

This paper addresses the concept of the intelligentsia and its transformation in the post-Soviet period. I present a brief overview of the multiple and problematic ways of defining the intelligentsia, and then turn to a novel that I see as a chronicle of the post-perestroika intelligentsia, Viktor Pelevin’s Generation П. I suggest that the intelligentsia, the milieu in which major Russian cultural myths originated and developed, is itself best understood in terms of cultural myth—a cultural construct reflecting the group’s self-image. A major component of this image is the intelligentsia’s reliance on culture, and especially literature, as both a source and justification for its view of the world and its role in it. In Pelevin’s novel, the career of a poet turned advertising writer—copywriter— parallels the post-perestroika cultural crisis in Russia and the degradation of the Word, which, in turn, symbolizes the demise of the intelligentsia.     

Making Difference Matter: An Exploration of Culture and Identity in the Therapeutic Domain

This paper examines a number of dimensions which the author believes are pivotal to a feminist perspective in working with clients from linguistically and culturally diverse communities. Definitions of culture and identity are examined in the context of power, followed by a discussion of the therapist's relationship with her/his frameworks of knowledge. Finally, the place of ethics is considered, drawing on a recent analysis of democracy. Through this discussion and analysis, therapists may reflect more fully on their own culture and identity, without which it is not possible to do therapy which can bridge cultural difference.     

“Being a Therapist Doesn't Exclude You From Real Life”: Family Therapists’ Beliefs and Barriers to Political Action

A crucial and overlooked facet of social justice in family therapy is political and policy advocacy. Family therapists have unique insight into how social policies and political discourse shapes clients’ lives and the life of our profession. Such knowledge can inform policymakers and political debate, yet few family therapists are trained to engage in political action. In this randomized, national survey of licensed family therapists’ (N = 174), we explore beliefs about and barriers to engagement in political and policy processes. The findings suggest that there are significant barriers and uncertainties surrounding family therapists’ engagement, including time, feelings of efficacy, and interest. Given these barriers we discuss practical suggestions for clinicians and family therapy training programs.     

Speaking for herself: Andrea Dunbar and Bradford on film

In October 2010, the radio broadcaster Philip Dodd interviewed Clio Barnard about her new documentary, The Arbor (2010), based on the life of the late playwright Andrea Dunbar. As part of the film-making process, Barnard recorded audio interviews with Dunbar’s family then hired professional actors to lip-synch the responses in the film. Dodd had a major problem with this method: The Arbor is rooted in the lives of working-class Northern women, yet for Dodd, ‘they’re not good enough to be seen’. In a passionate defence, Barnard argued ‘I wanted people to speak for themselves’. This article examines Barnard’s film in conjunction with Rita, Sue and Bob Too!, for which Dunbar wrote the screenplay. A paradox is considered, where the ‘real’ and ‘authentic’ female voices of Dunbar, her family and neighbours are then mediated by cinematic form; this is placed within a wider argument about how issues around realism and representation in documentary and fiction film contribute to our understanding of the North in popular culture. The analysis then situates this thinking in terms of the representation of Northern writers and spaces, considering how the site-specific locations of writers affect the kind of cultural texts that they are able to produce.     

DOES RELATIVE THINKING EXIST IN REAL‐WORLD SITUATIONS? A FIELD EXPERIMENT WITH BAGELS AND CREAM CHEESE

Many experiments show that consumers consider relative price differences even when only absolute price differences are relevant from an economic perspective, a phenomenon that was denoted “relative thinking.” These experiments, however, were conducted using hypothetical questions. To test whether the relative thinking bias also exists in real‐world situations, a field experiment where subjects could purchase either a bagel or a bagel with cream cheese was conducted. The monetary addition for the cream cheese was kept constant ($0.20) in both treatments, but the bagel's price varied ($0.05 in one treatment and $0.30 in the other). Relative thinking then implies that more people should add the cream cheese when the bagel's price is higher, because the relative price increase for the cream cheese is then smaller. However, the results did not document any relative thinking—more people (in percentage of those who purchase) added the cream cheese when the bagel's price was lower (the difference between the treatments, however, was not statistically significant). A replication of the experiment as a hypothetical‐scenario experiment did document relative thinking, suggesting that introduction of financial incentives might alleviate relative thinking. (JEL C93, D01, D10, L00, M31)     

Para-Modern Family Therapy: Deconstructing Post-Modernism

As in the arts and humanities and other social sciences, post-modernism is quickly gaining orthodoxy in family therapy. This paper presents a social-realist and deconstructive critique of recent post-modern thought in family therapy. From the perspective of the French philosopher Jacques Derrida, it suggests that family therapy is neither modern nor post-modern, but both/and these alternatives, that is, para-modern. In deconstructive thought, philosophical dualities like realism/social constructionism, cybernetic/post-cybernetic, systemic/narrative co-exist in an absurd double logic. Like writers of literature, the para-modern family therapy ‘puts forward’ a theory or method not as an ideology of truth, but as a play of irony. She/he works simultaneously inside and outside family therapy discourse, open to a wide range of images and metaphors.     

Moving Up the Continuum of Hope: Developing a Theory of Hope and Understanding its Influence in Couples Therapy

For years therapists have suggested that hope is an important catalyst in the process of change. This study takes a grounded theory approach to address the need for a clearer conceptualization of hope, and to place interventions that increase hope within a therapeutic context so that therapists know how and when to use those interventions. Fifteen active and experienced marriage and family therapists from across the United States participated in hour-long phone interviews about hope in couples therapy. Moving Up the Continuum of Hope emerged as the core category from the grounded theory analysis of the data. This category represents a process, with general and specific conditions and consequences that increase a couple’s level of hope. This study serves as a foundation for future process research on couples therapy, as well as research on hope in other contexts (e.g., individual and family therapy) and with other perspectives (e.g., clients).     

‘Working fathers' in Japan: Leading a change in gender relations?

Does the emergent phenomenon of ‘working fathers' herald a process of change in gender relations in Japan? Against the background of the current discourse in Japan about new modes of fathers' participation in the family, the article focuses on the small group of working fathers — men who explicitly organize their working lives around family responsibilities — to examine the potentiality of change. This supposed change in the roles of men (and women), at home and in the workplace, is considered in terms of latency, as a ‘slow‐dripping' process. The qualitative research focuses on Fathering Japan, Japan's leading fathering movement, its ideology, its members and their families. The article offers a critical perspective, juxtaposing gender ideology with practice. Exploring the real‐life experiences of working fathers caught between family and work, especially against Japan's gendered corporate culture, the article also addresses the persistence of gender inequality in Japan.     

Gender, home and family in cultural capital theory

The paper argues that Bourdieu's stress on early familiarization for the highest value of cultural capital is closely linked to his idea, strongly emphasized in Distinction, about the role of family and domestic life for individual development and social positions. The role of women, as mothers and homemakers, is crucial in this process. Yet, Bourdieu defines social origin as deriving from the father. The centrality to Bourdieu's thinking of a resilient traditional pattern of masculine domination and feminine submission constitutive of the Western gender habitus explains both his stress on ‘normalcy’ for the production of legitimate dispositions, and his resistance to incorporating into his thinking the implications of recent transformations in home family living, which have destabilized the gender order. It is thus important to consider contemporary feminist analyses of the family and home life and their significance for a renewed theory of cultural capital. The paper considers two sets of literature. Firstly, it addresses the manners in which home and family are conceptualized in Bourdieu's key texts where these issues were prominent in the development of his thinking on cultural capital. The second set of literature includes texts by feminist academics in the fields of family, gender and the body, which analyse the destabilizing of the gender order and everyday family living in contemporary society. Two questions are addressed on the basis of these reflections: (1) Is cultural capital an individual or a household resource? (2) How does cultural capital relate to personal interdependencies at the level of family and households?     

A careful balance: multinational perspectives on culture, gender, and power in marriage and family therapy practice

In this study, we examined how marriage and family therapists from various countries and diverse cultural backgrounds address the intersection of gender, power, and culture in therapy. Twenty participants from 15 countries responded to an Internet survey that included several hypothetical, clinical vignettes not associated with any one particular culture or nationality. Participants selected a vignette based on its similarity to clinical situations they face in practice within their cultural contexts, and provided information about their conceptualizations of gender, culture, and power, along with treatment recommendations. We analyzed data using analytic induction and constant comparison methods. Results indicate the careful balance with which the participants work to engage clients in therapy, respect cultural values and practices, and promote equitable gender relationships.