COMPLEMENTARITY AS A FUNCTION OF STAGE IN THERAPY: AN ANALYSIS OF MINUCHIN'S STRUCTURAL FAMILY THERAPY

The level of family therapist complementarity in the early, middle and late stages of therapy was explored. A micro-analysis of Salvador Minuchin with one family in successful therapy was conducted using the Structural Analysis of Social Behavior (Benjamin, 1974). Interactions from videotapes representing the three stages were coded. An ANOVA was used to compare sequences that occurred at least 5 times within any given stage. Level of therapist complementarity was significantly greater in the early and late stages than in the middle stage. Furthermore, level of therapist complementarity was significantly correlated with client change. Further research is needed to explore whether these findings can be generalized to other therapists and families.     

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.     

THE "INCESTUOUS FAMILY" REVISITED: A CRITICAL ANALYSIS OF FAMILY THERAPY MYTHS

From a feminist perspective, the family therapy literature concerning incest fails to perceive the patriarchal context of abusive behavior and consequently blames the victim. This paper critiques the family therapy literature by drawing on the feminist discourse concerning incest. Several pervasive myths are identified: (a) that fathers and mothers are pathologically disturbed or inadequate; (b) incest is caused by separation and loss; (c) family isolation or a rigid external boundary explains incest; and (d) incest serves a function in maintaining family organization. By analyzing the contradictions arising from these polemical positions, we propose criteria for developing an adequate clinical account of incest.     

THE INVISIBLE MIRROR: IN-HOME FAMILY THERAPY AND SUPERVISION

Home-based family therapy intervention programs, designed as a preventive strategy for multi-problem, at-risk families, are a rapidly growing phenomenon in mental health agencies. However, a review of the literature reveals little information on clinical supervision, which is a major component of home-based family intervention. The purpose of this article is to provide an alternative supervisory approach, in-home supervision, for training therapists who do home-based intervention.     

THE POLITICS OF GENDER IN FAMILY THERAPY

This article provides an overview of the political implications of various approaches to gender within the clinical literature. It emphasizes the process of the rapy within the social context of gender relations and identifies the politcal consequences of various clinical responses. Issues surrounding the appropriate role and stance of therapists relative to gender are identified, ethical issues such as neutrality and client welfare are re-examined, and suggestions for practice are addressed.     

EMPHASES OF THE MAJOR FAMILY THERAPY MODELS: A FAMILY FIRO ANALYSIS

This paper analyzes 13 models of family therapy according to their special emphases on the Family FIRO model's dimensions of inclusion, control and intimacy. We first examined chapters on each model in Gurman and Kniskern's Handbook of Family Therapy; we then sent our preliminary ratings to the authors of the chapters for comment. The final conceptual analysis of the models indicated that 4 family therapy models emphasize inclusion as a primary focus, 4 emphasize control, and 5 emphasize intimacy. We also rated the secondary and tertiary emphases of the models. This analysis provides a possible guide for therapists who wish to be eclectic or integrative in their work, specifically, by suggesting a way to match therapy techniques from different family therapy models to the presenting family issues that each model emphasizes most strongly.     

BEYOND LAW AND ETHICS: AN INTERDISCIPLINARY COURSE IN FAMILY LAW AND FAMILY THERAPY

The professions of family therapy and law share many clients and areas of overlap. Law-related coursework in family therapy programs in typically limited to legal, ethical, and professional issues. However, students can also benefit from understanding other areas of overlap, such as divorce, child custody, and mediation. This article discusses the curriculum for an interdisciplinary course that educates both family therapy and law students. The course provides: (1) a substantive education about similarities and differences between the profession, how they operate as systems, and specific areas of overlap, (2) opportunities to learn clinical skills, and (3) opportunities for personal insight about skills, personality tyes, and negotiations, styles, and how these may differ between the professions.     

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.     

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.     

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.     

ETHICAL DILEMMAS IN FAMILY THERAPY

A review of the literature in the area of ethical dilemmas facing family therapists revealed that there were a number of issues facing family therapists which are not included in the Principles for Family Therapists (1984) of the American Association for Marriage and Family Therapy. Seventy-five family therapists from across the nation responded to a questionnaire which asked what ethical dilemmas they face and how helpful the ethical guidelines are with these dilemmas. Results indicate that family therapists are encountering dilemmas which are not included in the Principles, significantly more often than those that are included. The ethical principles were found to be helpful for those ethical dilemmas attended to by the Principles.     

POSITIVE PRACTICE IN FAMILY THERAPY

Positive practice, a brief integative approach to consultation with families, is described in this paper. A clear distinction is made between the stages of planning, assessment, therapy, and disengagement. Guideliness for progression from one stage to the next are provided. Frameworks for deciding who to invite to preliminary sessions and methods for planning and organizing lines of inquiry are incorporated into this approach to practice. A three-column model is used to construct formulations. The model allows therapists and clients to map information about the pattern of interaction around the presenting problem, beliefs that constrain family members from altering their roles in these problem-maintaining patterns, and factors that have predisposed family members to hold these beliefs. Positive practice offers methods for evolving new behavioral patterns and belief systems within sessions and for arranging homework tasks for clients between sessions. It also incorporates methods for dealing with resistnace, for managing therapeutic crises, for convening indivudial sessions and borader network meetings, for disengaging from the consultation process, and for recontracting for further episodes of therapy. This evolving approach to practice draws on ideas from many traditions within the family therapy field and takes account of recent research relevent to the practice of family therapy.     

INFLUENCE OF THERAPIST SKILLS ON CLIENT PERCEPTIONS OF MARRIAGE AND FAMILY THERAPY OUTCOME: IMPLICATIONS FOR SUPERVISION

Clients seen in two marriage and family therapy training clinics were surveyed regarding treatment outcome. They rated their therapist's skill level on several therapist variables including "experience,""confident,""concerned," how well the treatment used seemed to "fit" their view of the problem and if the therapist seemed to "know how to deal" with their concerns. The variable of "fit" of treatment accounted for 35% of the variance in the client's perception of treatment outcome. "Concerned,""fit," and "knew how to deal" accounted for 36% of the variance in overall rating of the therapist. Suggestions for using these results in supervision of beginning therapists are given.     

EVALUATION OF AN ACADEMIC FAMILY THERAPY TRAINING PROGRAM: CHANGES IN TRAINEES' RELATIONSHIP AND INTERVENTION SKILLS

Students in an academic training program were assessed for changes in their relationship and intervention skills following completion of the program. Positive improvements were found on some measures but not all. Additionally, trainee variables such as previous clinical experience. gender, age, marital stauts and scores on standardized admission tests were examined in relation to trainees' skills changes. Trainee characteristics were unrelated to changes in intervention skills. However, a number of relationships were found between trainee characteristics and changes in relationship skills.